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Sample records for affect infant mortality

  1. Individual and Center-Level Factors Affecting Mortality Among Extremely Low Birth Weight Infants

    PubMed Central

    Alleman, Brandon W.; Li, Lei; Dagle, John M.; Smith, P. Brian; Ambalavanan, Namasivayam; Laughon, Matthew M.; Stoll, Barbara J.; Goldberg, Ronald N.; Carlo, Waldemar A.; Murray, Jeffrey C.; Cotten, C. Michael; Shankaran, Seetha; Walsh, Michele C.; Laptook, Abbot R.; Ellsbury, Dan L.; Hale, Ellen C.; Newman, Nancy S.; Wallace, Dennis D.; Das, Abhik; Higgins, Rosemary D.

    2013-01-01

    OBJECTIVE: To examine factors affecting center differences in mortality for extremely low birth weight (ELBW) infants. METHODS: We analyzed data for 5418 ELBW infants born at 16 Neonatal Research Network centers during 2006–2009. The primary outcomes of early mortality (≤12 hours after birth) and in-hospital mortality were assessed by using multilevel hierarchical models. Models were developed to investigate associations of center rates of selected interventions with mortality while adjusting for patient-level risk factors. These analyses were performed for all gestational ages (GAs) and separately for GAs <25 weeks and ≥25 weeks. RESULTS: Early and in-hospital mortality rates among centers were 5% to 36% and 11% to 53% for all GAs, 13% to 73% and 28% to 90% for GAs <25 weeks, and 1% to 11% and 7% to 26% for GAs ≥25 weeks, respectively. Center intervention rates significantly predicted both early and in-hospital mortality for infants <25 weeks. For infants ≥25 weeks, intervention rates did not predict mortality. The variance in mortality among centers was significant for all GAs and outcomes. Center use of interventions and patient risk factors explained some but not all of the center variation in mortality rates. CONCLUSIONS: Center intervention rates explain a portion of the center variation in mortality, especially for infants born at <25 weeks’ GA. This finding suggests that deaths may be prevented by standardizing care for very early GA infants. However, differences in patient characteristics and center intervention rates do not account for all of the observed variability in mortality; and for infants with GA ≥25 weeks these differences account for only a small part of the variation in mortality. PMID:23753096

  2. Infant Mortality

    MedlinePlus

    ... Control and Prevention. (2013). CDC health disparities and inequalities report—United States, 2013. Morbidity and Mortality Weekly ... M. (2008). The fall and rise of U.S. inequalities in premature mortality: 1960–2002. PLOS Medicine, 5 ( ...

  3. Factors Affecting Infant Mortality in Rural Bangladesh: Results from a Retrospective Sample Survey.

    ERIC Educational Resources Information Center

    Paul, Bimal Kanti

    1990-01-01

    Data from interviews with 1,787 women in rural Bangladesh revealed that infant mortality was highly correlated with smaller birth interval and absence of contraceptive use, followed by younger age of mother, prior pregnancy loss, smaller family landholdings, and birth of less preferred sex. Contains 49 references. (Author/SV)

  4. Deciphering infant mortality

    NASA Astrophysics Data System (ADS)

    Berrut, Sylvie; Pouillard, Violette; Richmond, Peter; Roehner, Bertrand M.

    2016-12-01

    This paper is about infant mortality. In line with reliability theory, "infant" refers to the time interval following birth during which the mortality (or failure) rate decreases. This definition provides a systems science perspective in which birth constitutes a sudden transition falling within the field of application of the Transient Shock (TS) conjecture put forward in Richmond and Roehner (2016c). This conjecture provides predictions about the timing and shape of the death rate peak. It says that there will be a death rate spike whenever external conditions change abruptly and drastically and also predicts that after a steep rise there will be a much longer hyperbolic relaxation process. These predictions can be tested by considering living organisms for which the transient shock occurs several days after birth. Thus, for fish there are three stages: egg, yolk-sac and young adult phases. The TS conjecture predicts a mortality spike at the end of the yolk-sac phase and this timing is indeed confirmed by observation. Secondly, the hyperbolic nature of the relaxation process can be tested using very accurate Swiss statistics for postnatal death rates spanning the period from one hour immediately after birth through to age 10 years. It turns out that since the 19th century despite a significant and large reduction in infant mortality, the shape of the age-specific death rate has remained basically unchanged. Moreover the hyperbolic pattern observed for humans is also found for small primates as recorded in the archives of zoological gardens. Our overall objective is to identify a series of cases which start from simple systems and move step by step to more complex organisms. The cases discussed here we believe represent initial landmarks in this quest.

  5. Indonesia lowers infant mortality.

    PubMed

    Bain, S

    1991-11-01

    Indonesia's success in reaching World Health Organization (WHO) universal immunization coverage standards is described as the result of a strong national program with timely, targeted donor support. USAID/Indonesia's Expanded Program for Immunization (EPI) and other USAID bilateral cooperation helped the government of Indonesia in its goal to immunize children against diphtheria, pertussis, tetanus, polio, tuberculosis, and measles by age 1. The initial project was to identify target areas and deliver vaccines against the diseases, strengthen the national immunization organization and infrastructure, and develop the Ministry of Health's capacity to conduct studies and development activities. This EPI project spanned the period 1979-90, and set the stage for continued expansion of Indonesia's immunization program to comply with the full international schedule and range of immunizations of 3 DPT, 3 polio, 1 BCG, and 1 measles inoculation. The number of immunization sites has increased from 55 to include over 5,000 health centers in all provinces, with additional services provided by visiting vaccinators and nurses in most of the 215,000 community-supported integrated health posts. While other contributory factors were at play, program success is at least partially responsible for the 1990 infant mortality rate of 58/1,000 live births compared to 72/1,000 in 1985. Strong national leadership, dedicated health workers and volunteers, and cooperation and funding from UNICEF, the World Bank, Rotary International, and WHO also played crucially positive roles in improving immunization practice in Indonesia.

  6. Breast feeding and infant mortality.

    PubMed

    Golding, J; Emmett, P M; Rogers, I S

    1997-10-29

    The evidence linking bottle feeding to infant and early childhood mortality has been reviewed. Ecological studies of national time trends in infant mortality do not parallel breast feeding trends in those countries, and indicate that falling death rates are more likely to be related to better health care facilities and social conditions. Direct studies of deaths provide some contradictory findings; meta-analyses are not informative because of the many differences in statistical and sample methodology. The methodology exhibited in most studies is more likely to have over- rather than under-estimated a relationship between bottle feeding and infant mortality. Retrospective analyses must take account of changes in feeding pattern due to early signs of illness. Prospective population studies able to account for large numbers of potential confounders provide the best estimates, especially if proportional hazards models are used. Two such studies have been carried out--both showed protective effects of breast feeding.

  7. America's Infant-Mortality Puzzle.

    ERIC Educational Resources Information Center

    Eberstadt, Nicholas

    1991-01-01

    Conventional explanations attributing the high infant mortality rate in United States to the prevalence of poverty and lack of adequate health care do not tell the whole story. Contributions of parental behavior, lifestyles, and public health care availability versus utilization must be examined in determining public policies to address the…

  8. Infant Mortality: The Shared Concern.

    ERIC Educational Resources Information Center

    Heagarty, Margaret C.

    1990-01-01

    Addresses the causes for and implications of infant mortality. Besides the more immediate causes such as disease, nutrition, and lifestyle, there are the additional hurdles of government bureaucracy, lack of funds, and institutional attitudes that block access to prenatal care. Suggests structural solutions, including a consistent, individual,…

  9. Infant Mortality: 1989 Research Accomplishments.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    Collected in this document are reports of the National Institutes of Health's 1989 accomplishments in research on the problem of infant mortality. Reports are provided by the: (1) National Institute of Child Health and Human Development; (2) National Cancer Institute; (3) National Heart, Lung, and Blood Institute; (4) National Institute of…

  10. Infant mortality and child health in Brazil.

    PubMed

    Alves, Denisard; Belluzzo, Walter

    2004-12-01

    Child health is a central issue in the public policy agenda of developing countries. Several policies aimed at improving child health have been implemented over the years, with varying degrees of success. In Brazil, such policies have triggered a significant decline in infant mortality rates over the last 30 years. Despite this improvement, however, mortality rates are still high compared to international standards. Moreover, there is considerable imbalance across Brazilian municipalities suggesting that various policies should be adopted. We investigate the determinants of infant mortality at the municipal level and provide an analysis of the factors affecting child health at the individual level. To analyze the mortality rate, we estimate static and dynamic panel data models using four censuses covering the period from 1970 to 2000. The demand for child health, on the other hand, is addressed through a household decision model, estimated using anthropometric data from the 1996 Standard of Living Survey. The results obtained indicate that a rise in sanitation, education and per capita income contributed to the decline of infant mortality in Brazil, with stronger impacts in the long run than in the short run. The fixed effects associated with county characteristics explain the observed dispersion in child mortality rates. The results from the decision model are confirmed by the findings of the mortality model: education, sanitation and poverty are the most important causes of poor child health in Brazil.

  11. Reducing Infant Mortality. KIDS COUNT Indicator Brief

    ERIC Educational Resources Information Center

    Shore, Rima; Shore, Barbara

    2009-01-01

    Despite the wide range of expertise that has been brought to bear on reducing infant mortality across the nation, the first year of life remains a time of considerable risk for many babies. Although the U.S. spends more on health care than any other country, its infant mortality rate remains higher than that of most other industrialized nations.…

  12. CPV Cell Infant Mortality Study: Preprint

    SciTech Connect

    Bosco, N.; Sweet, C.; Silverman, T.; Kurtz, S.

    2011-05-01

    Six hundred and fifty CPV cells were characterized before packaging and then after a four-hour concentrated on-sun exposure. An observed fielded infant mortality failure rate was reproduced and attributed to epoxy die-attach voiding at the corners of the cells. These voids increase the local thermal resistance allowing thermal runaway to occur under normal operation conditions in otherwise defect-free cells. FEM simulations and experiments support this hypothesis. X-ray transmission imaging of the affected assemblies was not found capable of detecting all suspect voids and therefore cannot be considered a reliable screening technique in the case of epoxy die-attach.

  13. Social Welfare Expenditures and Infant Mortality.

    PubMed

    Shim, Joyce

    2015-01-01

    This study examines the effects of social welfare expenditures on infant mortality (deaths younger than age 1 per 1,000 live births) across 19 Organisation for Economic Co-operation and Development (OECD) countries from 1980 to 2010. Data are obtained from various sources including the OECD, World Health Organization, and World Bank. The findings indicate that among three social welfare expenditure measures for families, the expenditures on family cash allowances are predicted to reduce infant mortality. However, the other two measures-the expenditures on parental and maternity leave and expenditures on family services-have no significant effects on infant mortality.

  14. Topographical Differences of Infant Mortality in Nepal.

    PubMed

    Dev, R; Williams, M F; Fitzpatrick, A L; Connell, F A

    2016-01-01

    Background Infant mortality is a major problem in Nepal, particularly in the mountainous region of the country. Objective To identify factors that contributes to the high rate of infant mortality in the mountain zone in Nepal. Method Data were derived from the 2011 Nepal Demographic and Health Survey (NDHS). Infant mortality was analyzed across three ecological zones in a sample of 5,306 live births in the five years preceding the survey. The contribution of risk factors to the excess infant mortality was assessed using multiple logistic regression. Result Infant mortality rate (deaths per 1000 live births) in the ecological zones were 59 (95% CI: 36, 81), 44 (35, 53), and 40 (33, 47) for the mountain, hill and terai zones, respectively. Women living in the mountain zone were more likely to report that distance to care was a "big problem" and had a greater risk of infant mortality compared to the terai zone (OR=1.42, 95% CI: 1.01, 2.02, p=0.04). This increased risk was observed only among births to mothers who perceived distance to the nearest health facility as a "big problem" (aOR=1.57, 95% CI: 1.01, 2.40, p=0.04) controlling for other risk factors. Conclusion These findings suggest that the higher Infant mortality rate (IMR) in the mountain zone was among the women who perceived distance to health facilities as a big problem. Improved accessibility to health services, particularly in this zone, is an essential strategy for reducing infant mortality in Nepal.

  15. Relationship of infant mortality and community development.

    PubMed

    Abejo, S D

    1987-01-01

    A researcher applied indirect estimation techniques to data from 352 rural villages from the 1978 Republic of the Philippines Fertility Survey to determine if community factors affect mortality of children 5 years old. Children with the highest mortality risks included those of the poor and least educated parents. For example, infant and child mortality stood at 203 among mothers with no education compared to 42 among those with at least a college education. In addition, infant and child mortality among husbands who were farmers was 111 whereas it was 28 among husbands who worked in professional and clerical jobs. Low cost health services and midwives were the health factors that had the greatest effect ion the probability of survival for children 5 years old, especially among the poor and least educated. For example, the probability of dying fell from 123-80 among the poor and 152-79 among the least educated if a dispensary was accessible and from 131-88 among the poor and 154-96 among the least educated if a midwife was accessible. Furthermore, adequate nutrition, better housing conditions, safe water, and sanitation also played a key role in reducing the probability of death. In terms of community development, only accessibility to a newspaper outlet the families were. On the other hand, the presence of electricity was significant only when education of the mother, occupation of the father, and region of residence were used as control variables. Thus the government should expand health care services to the rural population. Further, it should integrate health components in social and economic development programs

  16. Evolution of infant and child mortality in Chile: a model.

    PubMed

    Hojman, D E

    1992-10-01

    The author contends that birth rate and infant and child mortality rates are jointly determined by demographic, economic, health care, and other influences. Working under this structural assumption, a multiequation model is developed, estimated, and simulated, in which real earnings, unemployment, midwife visits, access to cheap energy, public health expenditures, and degree of urbanization are determinant factors of declining infant and child mortality in Chile. Most notably, mortality declined during a period of increasing unemployment and falling living standards for at least part of the population. The study found all 3 rates to be jointly determined, but by different variables. Specifically, unemployment affected birth rate and child mortality rate, while declining infant mortality was based upon midwife visits, health expenditure, and access to cheap energy. At the policy level, trade-offs often result between infant and child mortality, especially where high birth rates prevail. Where movement along the Phillips curve is possible, higher earnings should be preferred over lower unemployment for the benefit of infant and child mortality. Preferred policy would week to provide a carefully balanced combination of better earnings and more midwife visits.

  17. Air pollution and infant mortality from pneumonia

    SciTech Connect

    Penna, M.L.; Duchiade, M.P. )

    1991-03-01

    This study examines the relationship between air pollution, measured as concentration of suspended particulates in the atmosphere, and infant mortality due to pneumonia in the metropolitan area of Rio de Janeiro. Multiple linear regression (progressive or stepwise method) was used to analyze infant mortality due to pneumonia, diarrhea, and all causes in 1980, by geographic area, income level, and degree of contamination. While the variable proportion of families with income equivalent to more than two minimum wages was included in the regressions corresponding to the three types of infant mortality, the average contamination index had a statistically significant coefficient (b = 0.2208; t = 2.670; P = 0.0137) only in the case of mortality due to pneumonia. This would suggest a biological association, but, as in any ecological study, such conclusions should be viewed with caution. The authors believe that air quality indicators are essential to consider in studies of acute respiratory infections in developing countries.

  18. Infant mortality and family welfare: policy implications for Indonesia

    PubMed Central

    Poerwanto, S; Stevenson, M; de Klerk, N

    2003-01-01

    Design: A population based multistage stratified clustered survey. Setting: Women of reproductive age in Indonesia between 1983–1997. Data sources: The 1997 Indonesian Demographic and Health Survey. Main results: Infant mortality was associated with FWI and maternal education. Relative to families of high FWI, the risk of infant death was almost twice among families of low FWI (aOR=1.7, 95%CI=0.9 to 3.3), and three times for families of medium FWI (aOR=3.3 ,95%CI=1.7 to 6.5). Also, the risk of infant death was threefold higher (aOR=3.4, 95% CI=1.6 to 7.1) among mothers who had fewer than seven years of formal education compared with mothers with more than seven years of education. Fertility related indicators such as young maternal age, absence from contraception, birth intervals, and prenatal care, seem to exert significant effect on the increased probability of infant death. Conclusions: The increased probability of infant mortality attributable to family income inequality and low maternal education seems to work through pathways of material deprivation and chronic psychological stress that affect a person's health damaging behaviours. The policies that are likely to significantly reduce the family's socioeconomic inequality in infant mortality are implicated. PMID:12821691

  19. Infant and child mortality: the implications for fertility behaviour.

    PubMed

    Ruzicka, L T; Kane, P

    1988-01-01

    In developing countries, infant and child mortality affect fertility through biological or involuntary mechanisms operating through shortened breastfeeding, and more rapid return of ovulation following upon an infant death. Fertility is also affected through volitional responses of couples to perceived mortality levels in the community (insurance effect) or experience of earlier child loss (replacement effect) as well as through societal responses to high probability of child loss. In return, fertility affects infant and child mortality through birth to very young mothers, due to physiological immaturity of teenaged mothers and low birth-weight, as well as through birth to old mothers in high birth orders, due to maternal depletion syndrome. Trussel and Pebley estimated that the elimination of 4th and higher order births, along with the limitation of reproduction within the age of 20 to 34 years old, would reduce infant mortality by about 12%. A large number of studies show strong evidence that the timing and spacing of birth have a significant impact on both maternal and child health. According to Maine and McNamara (1985), who analysed data from 25 developing countries, if all children were born 2 years apart, 1/5 of infant deaths could be avoided. Mother's ill-health, maternal mortality, mother's malnutrition and its consequences in low quality breast milk and short breastfeeding, reduce sharply the new child's chances of survival. Many of these adverse biological and physiological conditions for childbearing can be compensated for by the provision of health care of high quality, including family planning, as well as education and good nutritional status of the mother and her children. Unfortunately, in many societies and for large segments of the population, such conditions are still a dream.

  20. Urban poverty and infant mortality rate disparities.

    PubMed Central

    Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

    2007-01-01

    This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity. PMID:17444423

  1. Urban poverty and infant mortality rate disparities.

    PubMed

    Sims, Mario; Sims, Tammy L; Bruce, Marino A

    2007-04-01

    This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.

  2. Infant Mortality and the Health of Societies. Worldwatch Paper 47.

    ERIC Educational Resources Information Center

    Newland, Kathleen

    Demographic data are used in this report to present information about infant mortality in more- and less-developed countries. One chapter is devoted to rising infant mortality rates in developed countries, which defy the typical post-World War II pattern. Severe economic conditions are linked to this increase. Direct causes of infant deaths are…

  3. A community-wide infant mortality review: findings and implications.

    PubMed Central

    McCloskey, L; Plough, A L; Power, K L; Higgins, C A; Cruz, A N; Brown, E R

    1999-01-01

    The authors present the results of a community-wide infant mortality review, describe implications for the delivery of maternal and child health services, and discuss the value of such reviews in addressing local public health concerns. The review included an analysis of birth and death certificates and medical record data; maternal interviews; review of cases and development of recommendations by provider panels; and convening of community groups to develop strategies to improve the health and health care of women and infants. The review focused on 287 infant deaths during 1990-1993. More than half of all neonatal deaths were attributable to "previable" or "borderline viable" births. Sexually transmitted infections were the most frequently identified underlying risk, and smoking was the most frequently identified prenatal risk. Homelessness, physical and sexual abuse, and alcohol use were at least twice as likely among women whose babies died than among a high risk comparison group. Panelists identified fragmented health care over the course of women's reproductive lives as a predominant theme. The authors conclude that: (a) The focus of maternal and child health care should shift to a model of women's health care that addresses the chronicity of social and clinical risks. (b) Infant mortality reviews are a valuable tool for community education, systems review, and policy development and can be applied to other public health issues with local significance. (c) Expectations about the review process's ability to produce conclusions about causality or recommendations narrowly geared to reducing infant mortality rates need to be reframed. (d) The model will be strengthened by greater participation of families affected by infant death. PMID:10199719

  4. Community-level determinants of infant mortality in Mexico.

    PubMed

    Holian, J

    1988-01-01

    Data from pregnancy histories collected by the 1976-77 Mexican Fertility Survey show wide variations in infant mortality among a sample of 125 communities. For example, in regard to community population, localities of 2500 or less averaged 104/1000 live births which was almost 2 times the rate of 56/1000 experienced by cities with 100,000 or more people. While the rates for Mexico's 3 largest cities (Guadalajara, Monterrey, and Mexico City) were slightly higher, this trend was due to the large slum populations. Overall, there were large and statistically significant infant mortality differentials by community population, proportion of the labor force in agriculture, mean wage, access to the nearest urban center, communication means, proportion of households with electricity, piped water and sewers, and distance to the closest 2ndary and preparatory school and university. Considering health care variables, there was an expected relationship between distance to the nearest health care facility and mortality levels. These community-level factors, which have been litte used in previous studies, are highly correlated and do not appear to affect infant survival independently of population size. Community size serves as a summary measure of a locality's overall level of development and comparative risk of early death for its children.

  5. Air Pollution and Infant Mortality in Mexico City

    EPA Science Inventory

    Historic air pollution episodes of the 1950s led to acute increases in infant mortality, and some recent epidemiologic studies suggest that infant or child mortality may still result from air pollution at current levels. To investigate the evidence for such an association, we con...

  6. [Infant mortality in the indigenous population: backwardness and contrasts].

    PubMed

    Fernandez Ham, P

    1993-01-01

    Some 6.4 million speakers of indigenous languages were enumerated in the 1990 Mexican census. The same census provided the basis for an indirect estimate of infant mortality using data on the numbers of live born and surviving children. Municipios with 40% or more of the population speaking an indigenous language were studied. The overall estimated infant mortality rate for indigenous municipios was 55.1/1000 live births, the equivalent of the Mexican infant mortality rate around 1982. Mexico's national infant mortality rate in 1990 was 34.8/1000. Great contrasts were found in indigenous infant mortality rates. Campeche, Quintana Roo, and Yucatan, the states of the Mayan region, had a low rate of 35.09/1000, very close to the national average. Infant mortality levels were relatively low in the indigenous populations of Hidalgo, the state of Mexico, and Michoacan, with rates of 44 to 48. Chiapas, Oaxaca, Puebla, Durango, Guerrero, and San Luis Potosi had rates of 55 to 65. The highest rates were in states with few indigenous municipios, including Chihuahua, Jalisco, and Nayarit. The Huichol of Jalisco had the highest rate at 100.01/1000. Infant mortality levels were found to be correlated in different degrees with socioeconomic indicators. The highest infant mortality rates were in the indigenous regions with the poorest socioeconomic conditions.

  7. Adolescent Pregnancy and Infant Mortality: Isolating the Effects of Race.

    ERIC Educational Resources Information Center

    Davis, Richard A.

    1988-01-01

    Examined data from state of North Carolina to test assumption that inordinately high Black teenage pregnancy rate accounts for difference between Black and White infant mortality rates. Results suggest that poverty, not race, plays crucial role in infant mortality. (Author/NB)

  8. Class, Race, and Infant Mortality in the United States.

    ERIC Educational Resources Information Center

    Hogue, Carol J. Rowland; Hargraves, Martha A.

    1993-01-01

    Examines the Swedish experience for lessons to help reduce infant mortality in the United States. Because of Sweden's efforts to eliminate poverty and provide comprehensive health care, there are only small social class differences in infant mortality. Class and race issues play much larger roles in the United States. (SLD)

  9. Go Naked: Diapers Affect Infant Walking

    ERIC Educational Resources Information Center

    Cole, Whitney G.; Lingeman, Jesse M.; Adolph, Karen E.

    2012-01-01

    In light of cross-cultural and experimental research highlighting effects of childrearing practices on infant motor skill, we asked whether wearing diapers, a seemingly innocuous childrearing practice, affects infant walking. Diapers introduce bulk between the legs, potentially exacerbating infants' poor balance and wide stance. We show that…

  10. The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh

    PubMed Central

    Huda, Tanvir M.; Tahsina, Tazeen; El Arifeen, Shams; Dibley, Michael J.

    2016-01-01

    Introduction Health is multidimensional and affected by a wide range of factors, many of which are outside the health sector. To improve population health and reduce health inequality, it is important that we take into account the complex interactions among social, environmental, behavioural, and biological factors and design our health interventions accordingly. Objectives This study examines mortality differentials in children of different age groups by key social determinants of health (SDH) including parental education and employment, mother's level of autonomy, age, asset index, living arrangements (utilities), and other geographical contextual factors (area of residence, road conditions). Design We used data from the two rounds of Bangladesh Health and Demographic Survey, a nationally representative sample survey of the population residing in Bangladesh. Multilevel logistic models were used to study the impact of SDH on child mortality. Results The study found that the mother's age, the education of both parents, the mother's autonomy to take decisions about matters linked to the health of her child, the household socio-economic conditions, the geographical region of residence, and the condition of the roads were significantly associated with higher risks of neonatal, infant, and under-five mortality in Bangladesh. Conclusion The study findings suggest there are complex relationships among different SDH. Thus larger intersectoral actions will be needed to reduce disparities in child health and mortality and achieve meaningful progress towards equity-oriented universal health coverage. PMID:26880153

  11. The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh.

    PubMed

    Huda, Tanvir M; Tahsina, Tazeen; Arifeen, Shams El; Dibley, Michael J

    2016-01-01

    Introduction Health is multidimensional and affected by a wide range of factors, many of which are outside the health sector. To improve population health and reduce health inequality, it is important that we take into account the complex interactions among social, environmental, behavioural, and biological factors and design our health interventions accordingly. Objectives This study examines mortality differentials in children of different age groups by key social determinants of health (SDH) including parental education and employment, mother's level of autonomy, age, asset index, living arrangements (utilities), and other geographical contextual factors (area of residence, road conditions). Design We used data from the two rounds of Bangladesh Health and Demographic Survey, a nationally representative sample survey of the population residing in Bangladesh. Multilevel logistic models were used to study the impact of SDH on child mortality. Results The study found that the mother's age, the education of both parents, the mother's autonomy to take decisions about matters linked to the health of her child, the household socio-economic conditions, the geographical region of residence, and the condition of the roads were significantly associated with higher risks of neonatal, infant, and under-five mortality in Bangladesh. Conclusion The study findings suggest there are complex relationships among different SDH. Thus larger intersectoral actions will be needed to reduce disparities in child health and mortality and achieve meaningful progress towards equity-oriented universal health coverage.

  12. Short-Term Outcomes and Mortality of Late Preterm Infants

    PubMed Central

    Bulut, Cahide; Gürsoy, Tuğba; Ovalı, Fahri

    2016-01-01

    Background: Late preterm infants have increased rates of morbidity and mortality compared to term infants. Determining the risk factors in these infants leads to more comprehensive preventive and treatment strategies. Aims: Our aim was to analyse the morbidity rates such as respiratory system diseases, infections, congenital anomalies, hypoglycemia and hematologic abnormalities and mortality rates in a large group of patients at a referral center. Study Design: Retrospective cross-sectional study. Methods: Medical records of late preterm and term infants who were managed at the referral center were analysed. Results: 41752 births were analysed in 3 years. 71.9% of all births were between 37–42 gestational weeks (i.e. term) and 16.1% were between 34–37 weeks (i.e. late preterm). Compared to term infants, late preterm infants had increased rates of short-term problems. The rate of mortality increased with decreased gestational age. The duration of hospitalization was significantly higher in the smallest late preterm infants. Conclusion: This study demonstrated the need that late preterm infants who have higher risk for morbidity and mortality, compared to term infants require close monitoring. The rate of mortality and hospitalization increased with decreased gestational age. PMID:27403390

  13. Risk factors for early infant mortality in Sarlahi district, Nepal.

    PubMed Central

    Katz, Joanne; West, Keith P.; Khatry, Subarna K.; Christian, Parul; LeClerq, Steven C.; Pradhan, Elizabeth Kimbrough; Shrestha, Sharada Ram

    2003-01-01

    OBJECTIVES: Early infant mortality has not declined as rapidly as child mortality in many countries. Identification of risk factors for early infant mortality may help inform the design of intervention strategies. METHODS: Over the period 1994-97, 15,469 live-born, singleton infants in rural Nepal were followed to 24 weeks of age to identify risk factors for mortality within 0-7 days, 8-28 days, and 4-24 weeks after the birth. FINDINGS: In multivariate models, maternal and paternal education reduced mortality between 4 and 24 weeks only: odds ratios (OR) 0.28 (95% confidence interval (CI) = 0.12-0.66) and 0.63 (95% CI = 0.44-0.88), respectively. Miscarriage in the previous pregnancy predicted mortality in the first week of life (OR = 1.98, 95% CI = 1.37-2.87), whereas prior child deaths increased the risk of post-neonatal death (OR = 1.85, 95% CI 1.24-2.75). A larger maternal mid-upper arm circumference reduced the risk of infant death during the first week of life (OR = 0.88, 95% CI = 0.81-0.95). Infants of women who did not receive any tetanus vaccinations during pregnancy or who had severe illness during the third trimester were more likely to die in the neonatal period. Maternal mortality was strongly associated with infant mortality (OR = 6.43, 95% CI = 2.35-17.56 at 0-7 days; OR = 11.73, 95% CI = 3.82-36.00 at 8-28 days; and OR = 51.68, 95% CI = 20.26-131.80 at 4-24 weeks). CONCLUSION: Risk factors for early infant mortality varied with the age of the infant. Factors amenable to intervention included efforts aimed at maternal morbidity and mortality and increased arm circumference during pregnancy. PMID:14758431

  14. Go naked: diapers affect infant walking.

    PubMed

    Cole, Whitney G; Lingeman, Jesse M; Adolph, Karen E

    2012-11-01

    In light of cross-cultural and experimental research highlighting effects of childrearing practices on infant motor skill, we asked whether wearing diapers, a seemingly innocuous childrearing practice, affects infant walking. Diapers introduce bulk between the legs, potentially exacerbating infants' poor balance and wide stance. We show that walking is adversely affected by old-fashioned cloth diapers, and that even modern disposable diapers - habitually worn by most infants in the sample - incur a cost relative to walking naked. Infants displayed less mature gait patterns and more missteps and falls while wearing diapers. Thus, infants' own diapers constitute an ongoing biomechanical perturbation while learning to walk. Furthermore, shifts in diapering practices may have contributed to historical and cross-cultural differences in infant walking.

  15. US infant mortality and the President’s party

    PubMed Central

    Rodriguez, Javier M; Bound, John; Geronimus, Arline T

    2014-01-01

    Background Infant mortality rates in the US exceed those in all other developed countries and in many less developed countries, suggesting political factors may contribute. Methods Annual time series on overall, White and Black infant mortality rates in the US were analysed over the 1965–2010 time period to ascertain whether infant mortality rates varied across presidential administrations. Data were de-trended using cubic splines and analysed using both graphical and time series regression methods. Results Across all nine presidential administrations, infant mortality rates were below trend when the President was a Democrat and above trend when the President was a Republican. This was true for overall, neonatal and postneonatal mortality. Regression estimates show that, relative to trend, Republican administrations were characterized by infant mortality rates that were, on average, 3% higher than Democratic administrations. In proportional terms, effect size is similar for US Whites and Blacks. US Black rates are more than twice as high as White, implying substantially larger absolute effects for Blacks. Conclusions We found a robust, quantitatively important association between net of trend US infant mortality rates and the party affiliation of the president. There may be overlooked ways by which macro-dynamics of policy impact microdynamics of physiology, suggesting the political system is a component of the underlying mechanism generating health inequality in the USA. PMID:24381011

  16. Infant mortality in central Asia: sad statistics come to life.

    PubMed

    Meyers, Melisa R

    2014-01-01

    The 2010 Afghanistan Mortality Survey estimates that for every 1000 births, 73 infants and 3 to 5 women die. In this articles a nurse relays the very personal story of a young mother losing her infant in childbirth in Afghanistan and makes suffestions for how nurses can get involved in improving women's health in developing countries.

  17. A Study of Risks, Medical Care, and Infant Mortality

    ERIC Educational Resources Information Center

    Chase, Helen C., Ed.

    1973-01-01

    Using vital records for live births which occurred in New York City in 1968, and infant deaths among them, this study of Risks, Medical Care, and Infant Mortality examined the characteristics of prenatal care among pregnant women from a wide range of racial, social, and economic backgrounds. (Author/SB)

  18. Infant Mortality in Novo Hamburgo: Associated Factors and Cardiovascular Causes

    PubMed Central

    Brum, Camila de Andrade; Stein, Airton Tetelbom; Pellanda, Lucia Campos

    2015-01-01

    Background Infant mortality has decreased in Brazil, but remains high as compared to that of other developing countries. In 2010, the Rio Grande do Sul state had the lowest infant mortality rate in Brazil. However, the municipality of Novo Hamburgo had the highest infant mortality rate in the Porto Alegre metropolitan region. Objective To describe the causes of infant mortality in the municipality of Novo Hamburgo from 2007 to 2010, identifying which causes were related to heart diseases and if they were diagnosed in the prenatal period, and to assess the access to healthcare services. Methods This study assessed infants of the municipality of Novo Hamburgo, who died, and whose data were collected from the infant death investigation records. Results Of the 157 deaths in that period, 35.3% were reducible through diagnosis and early treatment, 25% were reducible through partnership with other sectors, 19.2% were non-preventable, 11.5% were reducible by means of appropriate pregnancy monitoring, 5.1% were reducible through appropriate delivery care, and 3.8% were ill defined. The major cause of death related to heart disease (13.4%), which was significantly associated with the variables ‘age at death’, ‘gestational age’ and ‘birth weight’. Regarding access to healthcare services, 60.9% of the pregnant women had a maximum of six prenatal visits. Conclusion It is mandatory to enhance prenatal care and newborn care at hospitals and basic healthcare units to prevent infant mortality. PMID:25993588

  19. Air pollution and infant mortality in Mexico City.

    PubMed

    Loomis, D; Castillejos, M; Gold, D R; McDonnell, W; Borja-Aburto, V H

    1999-03-01

    Historic air pollution episodes of the 1950s led to acute increases in infant mortality, and some recent epidemiologic studies suggest that infant or child mortality may still result from air pollution at current levels. To investigate the evidence for such an association, we conducted a time-series study of infant mortality in the southwestern part of Mexico City in the years 1993 to 1995 using mortality data from death registrations and air pollution measurements from a monitoring station we operated. Excess infant mortality was associated with the level of fine particles in the days before death, with the strongest association observed for the average concentration of fine particles during the period 3 to 5 days previously: a 10-microg m(-3) increase in the mean level of fine particles during these 3 days was associated with a 6.9% excess of infant deaths (95% confidence interval 2.5-11.3%). Infant mortality was also associated with the levels of nitrogen dioxide and ozone 3 to 5 days before death, but not as consistently as with particles.

  20. Infant and fetal mortality among a high fertility and mortality population in the Bolivian Amazon

    PubMed Central

    Gurven, Michael

    2012-01-01

    Indigenous populations experience higher rates of poverty, disease and mortality than non-indigenous populations. To gauge current and future risks among Tsimane Amerindians of Bolivia, I assess mortality rates and growth early in life, and changes in risks due to modernization, based on demographic interviews conducted Sept. 2002–July 2005. Tsimane have high fertility (Total Fertility Rate = 9) and infant mortality (13%). Infections are the leading cause of infant death (55%). Infant mortality is greatest among women who are young, monolingual, space births close together, and live far from town. Infant mortality declined during the period 1990–2002, and a higher rate of reported miscarriages occurred during the 1950–1989 period. Infant deaths are more frequent among those born in the wet season. Infant stunting, underweight and wasting are common (34%, 15% and 12%, respectively) and greatest for low-weight mothers and high parity infants. Regression analysis of infant growth shows minimal regional differences in anthropometrics but greater stunting and underweight during the first two years of life. Males are more likely to be underweight, wasted, and spontaneously aborted. Whereas morbidity and stunting are prevalent in infancy, greater food availability later in life has not yet resulted in chronic diseases (e.g. hypertension, atherosclerosis and diabetes) in adulthood due to the relatively traditional Tsimane lifestyle. PMID:23092724

  1. Community variations in infant and child mortality in Peru.

    PubMed Central

    Edmonston, B; Andes, N

    1983-01-01

    Data from the national Peru Fertility Survey are used to estimate infant and childhood mortality ratios, 1968--77, for 124 Peruvian communities, ranging from small Indian hamlets in the Andes to larger cities on the Pacific coast. Significant mortality variations are found: mortality is inversely related to community population size and is higher in the mountains than in the jungle or coast. Multivariate analysis is then used to assess the influence of community population size, average female education, medical facilities, and altitude on community mortality. Finally, this study concludes that large-scale sample surveys, which include maternal birth history, add useful data for epidemiological studies of childhood mortality. PMID:6886581

  2. Patterns of infant mortality in Kuwait from 2003 to 2006.

    PubMed

    Al-Waheeb, Salah; Al-Kandary, Nadia

    2013-11-01

    Infant death is often tragic, particularly in the Arab World, where infants, especially males, are supposed to carry their family's names due to ancient cultural traditions. The conditions and events that may be associated with infant death are extremely varied. Infants may die from either congenital disorders or natural diseases, or may pass away as a consequence of a complicated delivery. Infants are also victims of accidents and violence such as homicides. The main aim of this study was to investigate the reported medico legal cases of infant mortality in Kuwait due to natural and un-natural causes between 2003 and 2006. The average IMR rate in Kuwait during the study period was better than the IMR average for developing countries and the IMR average for the world during the same study period. In general, these figures for Kuwait are even better than the average for Middle East and North Africa. More medico- legal cases were reported for deaths among Kuwaiti infants in 2004, 2005 and 2006 compared to non Kuwaiti infants. More Kuwaiti infants died due to RTA and domestic accidents. In contrast, only non Kuwaiti infant died from infanticide.

  3. Infant mortality: world estimates and projections, 1950-2025.

    PubMed

    1982-01-01

    Although the infant mortality rate is considered 1 of the preferred indicators for describing both demographic conditions and the overall and social economic well-being of a country, comparable and consistent estimates and projections of infant mortality for all countries of the world have been lacking. In an attempt to improve this situation, the UN Population Division, with the support and encouragement of the UN Children's Fund and the assistance of the World Health Organization and the UN regional commissions, has recently completed a comprehensive project which provides estimates and projections of infant mortality for all world countries for the period 1950-2025. This article reviews the estimates and projections produced by this project. The various sources and the quality of the data, as well as the methods employed to estimate current and past levels of infant mortality and to project future trends, are reviewed and evaluated. The article concludes with a discussion of the results vis-a-vis the goals set for infant mortality by the World Population Plan of Action and the International Development Strategy for the 3rd UN Development Decade.

  4. Dependency, democracy, and infant mortality: a quantitative, cross-national analysis of less developed countries.

    PubMed

    Shandra, John M; Nobles, Jenna; London, Bruce; Williamson, John B

    2004-07-01

    This study presents quantitative, sociological models designed to account for cross-national variation in infant mortality rates. We consider variables linked to four different theoretical perspectives: the economic modernization, social modernization, political modernization, and dependency perspectives. The study is based on a panel regression analysis of a sample of 59 developing countries. Our preliminary analysis based on additive models replicates prior studies to the extent that we find that indicators linked to economic and social modernization have beneficial effects on infant mortality. We also find support for hypotheses derived from the dependency perspective suggesting that multinational corporate penetration fosters higher levels of infant mortality. Subsequent analysis incorporating interaction effects suggest that the level of political democracy conditions the effects of dependency relationships based upon exports, investments from multinational corporations, and international lending institutions. Transnational economic linkages associated with exports, multinational corporations, and international lending institutions adversely affect infant mortality more strongly at lower levels of democracy than at higher levels of democracy: intranational, political factors interact with the international, economic forces to affect infant mortality. We conclude with some brief policy recommendations and suggestions for the direction of future research.

  5. Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

    PubMed Central

    Kim, Elizabeth W.; Teague-Ross, Terri J.; Greenfield, William W.; Williams, D. Keith; Kuo, Dennis; Hall, Richard W.

    2014-01-01

    OBJECTIVES We assessed a telemedicine (TM) network's effects on decreasing deliveries of very low birth-weight (VLBW, <1500 grams) neonates in hospitals without Neonatal Intensive Care Units (NICUs) and statewide infant mortality. STUDY DESIGN This prospective study used obstetrical and neonatal interventions through TM consults, education, and census rounds with 9 hospitals from July 1, 2009 – March 31, 2010. Using a generalized linear model, Medicaid data compared VLBW birth sites, mortality, and morbidity before and after TM use. Arkansas Health Department data and chi square analysis were used to compare infant mortality. RESULTS Deliveries of VLBW neonates in targeted hospitals decreased from 13.1% to 7.0% (p=0.0099); deliveries of VLBW neonates in remaining hospitals was unchanged. Mortality decreased in targeted hospitals (13.0% before TM and 6.7% after TM). Statewide infant mortality decreased from 8.5 to 7.0 per 1000 deliveries (p=0.043). CONCLUSIONS TM decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality.. PMID:23579490

  6. Correcting vital information: estimating infant mortality, Brazil, 2000-2009

    PubMed Central

    de Frias, Paulo Germano; Szwarcwald, Célia Landmann; de Souza, Paulo Roberto Borges; de Almeida, Wanessa da Silva; Lira, Pedro Israel Cabral

    2013-01-01

    OBJECTIVE To propose a simplified method of correcting vital information and estimating the coefficient of infant mortality in Brazil. METHODS Vital data in the information systems on mortality and live births were corrected using correction factors, estimated based on events not reported to the Brazilian Ministry of Health and obtained by active search. This simplified method for correcting vital information for the period 2000-2009 for Brazil and its federal units establishes the level of adequacy of information on deaths and live births by calculating the overall coefficient of mortality standardized by age and the ratio between reported and expected live births, respectively, in each Brazilian municipality. By applying correction factors to the number of deaths and live births reported in each county, the vital statistics were corrected, making it possible to estimate the coefficient of infant mortality. RESULTS The highest correction factors were related to infant deaths, reaching values higher than 7 for municipalities with very precarious mortality information. For deaths and live births, the correction factors exhibit a decreasing gradient as indicators of adequacy of the vital information improve. For the year 2008, the vital information corrected by the simplified method per state were similar to those obtained in the research of active search. Both the birth rate and the infant mortality rate decreased in the period in all Brazilian regions. In the Northeast, the annual rate of decline was 6.0%, the highest in Brazil (4.7%). CONCLUSIONS The active search of deaths and births allowed correction factors to be calculated by level of adequacy of mortality information and live births. The simplified method proposed here allowed vital information to be corrected per state for the period 2000-2009 and the progress of the coefficient of infant mortality in Brazil, its regions and states to be assessed. PMID:24626543

  7. The effects of kin propinquity on infant mortality.

    PubMed

    Heath, Kathleen Marie

    2003-01-01

    This study tests the grandmother hypothesis and analyzes the effect of kin propinquity on infant mortality in a 19th century American frontier communal, polygynous population. The study shows that the presence of maternal grandmothers, aunts, uncles, and paternal aunts were significantly associated with increased infant survivorship while grandfathers, paternal grandmothers, and paternal uncles showed little effect. This study has implications for understanding the evolution of a long postreproductive life span, postmarital residential strategies, and behavioral strategies that enhance inclusive fitness.

  8. Family planning issues relating to maternal and infant mortality in the United States.

    PubMed

    Puffer, R R

    1993-01-01

    Both maternal and infant death rates in the United States are much higher than in many developed countries. The interrelationships between abortions and maternal and infant mortality have been analyzed on the basis of data from the 1970s and 1980s. The legalization of abortions in 1973 resulted in a marked increase in legal abortions and marked reductions in maternal and infant mortality over the course of the 1970s. However, a wide variation in abortion rates and in the number of abortion facilities indicates that such facilities were not readily available to all segments of the population in some areas. This probably accounts in part for higher maternal and infant death rates in such areas. Smoking, small weight gain, use of alcohol and drugs in pregnancy, and excessive maternal youth or age affected the outcome of pregnancy and contributed to high rates of infant death. Infant death rates were especially high among newborns of teenagers and young adult mothers; relatively high proportions of these newborns had low birthweights; a large share of the pregnancies involved were unintended; and slightly over half of the unintended pregnancies in teenagers and young women resulted in abortion. Comparisons with findings in Sweden reveal that the rates of unplanned pregnancy, abortion, and infant mortality were all much higher in the United States than in Sweden. The differences are attributed to better contraceptive services, which were made available free or very inexpensively in Sweden. Also, the frequency of low weight births was much lower in Sweden.

  9. Why do foreign-born blacks have lower infant mortality than native-born blacks? New directions in African-American infant mortality research.

    PubMed Central

    Rosenberg, Kenneth D.; Desai, Rani A.; Kan, Jianli

    2002-01-01

    OBJECTIVE: This study focuses attention on maternal nutrition and stress as possible reasons for excess black infant mortality after exploring lower infant mortality for the infants of foreign-born black mothers compared to native-born black mothers. METHODS: All births to non-Hispanic black women in New York City from 1988-1992 were examined and infant mortality for the infants of native-born women was compared to infant mortality for the infants of foreign-born women. RESULTS: Before controlling for potential confounders on the birth certificate, the infants of native-born black women had a greater risk of infant mortality than the infants of foreign-born black women: OR = 1.48 (95% confidence interval [CI] = 1.38, 1.58). After controlling for potential confounders, the infants of native-born black women still had a greater risk of infant mortality than the infants of foreign-born black women: OR(a) = 1.32 (95% Cl = 1.21, 1.43). CONCLUSIONS: Maternal nutrition and stress are possible causes of excess black infant mortality. They should be topics for research and program development. PMID:12392040

  10. Use of biomass fuel is associated with infant mortality and child health in trend analysis.

    PubMed

    Rinne, Seppo T; Rodas, Edgar J; Rinne, Mikael L; Simpson, Joshua M; Glickman, Larry T

    2007-03-01

    Biomass fuel used for cooking results in widespread exposure to indoor air pollution (IAP), affecting nearly 3 billion people throughout the world. Few studies, however, have tested for an exposure-response relationship between biomass fuel and health outcomes. The aim of this study was to explore the relationship between biomass fuel, infant mortality, and children's respiratory symptoms. Eighty households in a rural community in Ecuador were selected based on their use of biomass fuel and questioned regarding a history of infant mortality and children's respiratory symptoms. Carbon monoxide (CO) and particulate matter (PM) were measured in a subset of these homes to confirm the relationship between biomass fuel use and IAP. Results showed a significant trend for higher infant mortality among households that cooked with a greater proportion of biomass fuel (P=0.008). Similar trends were noted for history of cough (P=0.02) and earache (P<0.001) among children living in these households.

  11. Fiscal decentralisation and infant mortality rate: the Colombian case.

    PubMed

    Soto, Victoria Eugenia; Farfan, Maria Isabel; Lorant, Vincent

    2012-05-01

    There is a paucity of research analysing the influence of fiscal decentralisation on health outcomes. Colombia is an interesting case study, as health expenditure there has been decentralising since 1993, leading to an improvement in health care insurance. However, it is unclear whether fiscal decentralisation has improved population health. We assess the effect of fiscal decentralisation of health expenditure on infant mortality rates in Colombia. Infant mortality rates for 1080 municipalities over a 10-year period (1998-2007) were related to fiscal decentralisation by using an unbalanced fixed-effect regression model with robust errors. Fiscal decentralisation was measured as the locally controlled health expenditure as a proportion of total health expenditure. We also evaluated the effect of transfers from central government and municipal institutional capacity. In addition, we compared the effect of fiscal decentralisation at different levels of municipal poverty. Fiscal decentralisation decreased infant mortality rates (the elasticity was equal to -0.06). However, this effect was stronger in non-poor municipalities (-0.12) than poor ones (-0.081). We conclude that decentralising the fiscal allocation of responsibilities to municipalities decreased infant mortality rates. However, this improved health outcome effect depended greatly on the socio-economic conditions of the localities. The policy instrument used by the Health Minister to evaluate municipal institutional capacity in the health sector needs to be revised.

  12. The Global Distribution of Infant Mortality: A subnational spatial view

    PubMed Central

    Storeygard, Adam; Balk, Deborah; Levy, Marc; Deane, Glenn

    2012-01-01

    We describe the compilation of a spatially explicit dataset detailing infant mortality rates in over 10,000 national and subnational units worldwide, benchmarked to the year 2000. Although their resolution is highly variable, subnational data are available for countries representing over 90% of non-OECD population. Concentration of global infant deaths is higher than implied by national data alone. Assigning both national and subnational data to map grid cells so that they may be easily integrated with other geographic data, we generate infant mortality rates for environmental regions, including biomes and coastal zones, by continent. Rates for these regions also show striking refinements from the use of the higher resolution data. Possibilities and limitations for related work are discussed. PMID:22962545

  13. Beriberi (Thiamine Deficiency) and High Infant Mortality in Northern Laos

    PubMed Central

    Barennes, Hubert; Sengkhamyong, Khouanheuan; René, Jean Pascal; Phimmasane, Maniphet

    2015-01-01

    Background Infantile beriberi (thiamine deficiency) occurs mainly in infants breastfed by mothers with inadequate intake of thiamine, typically among vulnerable populations. We describe possible and probable cases of infantile thiamine deficiency in northern Laos. Methodology/Principal Findings Three surveys were conducted in Luang Namtha Province. First, we performed a retrospective survey of all infants with a diagnosis of thiamine deficiency admitted to the 5 hospitals in the province (2007–2009). Second, we prospectively recorded all infants with cardiac failure at Luang Namtha Hospital. Third, we further investigated all mothers with infants (1–6 months) living in 22 villages of the thiamine deficiency patients’ origin. We performed a cross-sectional survey of all mothers and infants using a pre-tested questionnaire, physical examination and squat test. Infant mortality was estimated by verbal autopsy. From March to June 2010, four suspected infants with thiamine deficiency were admitted to Luang Namtha Provincial hospital. All recovered after parenteral thiamine injection. Between 2007 and 2009, 54 infants with possible/probable thiamine deficiency were diagnosed with acute severe cardiac failure, 49 (90.2%) were cured after parenteral thiamine; three died (5.6%). In the 22 villages, of 468 live born infants, 50 (10.6%, 95% CI: 8.0–13.8) died during the first year. A peak of mortality (36 deaths) was reported between 1 and 3 months. Verbal autopsy suggested that 17 deaths (3.6%) were due to suspected infantile thiamine deficiency. Of 127 mothers, 60 (47.2%) reported edema and paresthesia as well as a positive squat test during pregnancy; 125 (98.4%) respected post-partum food avoidance and all ate polished rice. Of 127 infants, 2 (1.6%) had probable thiamine deficiency, and 8 (6.8%) possible thiamine deficiency. Conclusion Thiamine deficiency may be a major cause of infant mortality among ethnic groups in northern Laos. Mothers’ and children

  14. Regional Infant and Child Mortality Review Committee 2014 Final Report.

    PubMed

    Wilson, Ann L; Sideras, Jim

    2015-10-01

    The Regional Infant and Child Mortality Review Committee serves 10 counties in southeastern South Dakota with the aim of using its reviews to prevent future loss of life during childhood. In 2014, the committee reviewed 25 deaths. Consistent with observations made in previous years, in 2014 all infants who died during sleep did so with risks present in the sleep environment. Concern persists about progress in decreasing these infant deaths during sleep in the region. The two teen suicides in 2014 marked a decrease in the number observed in 2013, but represent an ongoing concern. Four deaths involved auto crashes with three of these involving a teen driver. A child homicide did not occur in the region in 2014. The report provides the committee's recommendations for community action that could prevent future deaths of infants and children.

  15. Population-based study on infant mortality.

    PubMed

    Lima, Jaqueline Costa; Mingarelli, Alexandre Marchezoni; Segri, Neuber José; Zavala, Arturo Alejandro Zavala; Takano, Olga Akiko

    2017-03-01

    Although Brazil has reduced social, economic and health indicators disparities in the last decade, intra- and inter-regional differences in child mortality rates (CMR) persist in regions such as the state capital of Mato Grosso. This population-based study aimed to investigate factors associated with child mortality in five cohorts of live births (LB) of mothers living in Cuiabá (MT), Brazil, 2006-2010, through probabilistic linkage in 47,018 LB. We used hierarchical logistic regression analysis. Of the 617 child deaths, 48% occurred in the early neonatal period. CMR ranged from 14.6 to 12.0 deaths per thousand LB. The following remained independently associated with death: mothers without companion (OR = 1.32); low number of prenatal consultations (OR = 1.65); low birthweight (OR = 4.83); prematurity (OR = 3.05); Apgar ≤ 7 at the first minute (OR = 3.19); Apgar ≤ 7 at the fifth minute (OR = 4.95); congenital malformations (OR = 14.91) and male gender (OR = 1.26). CMR has declined in Cuiabá, however, there is need to guide public healthcare policies in the prenatal and perinatal period to reduce early neonatal mortality and further studies to identify the causes of preventable deaths.

  16. The business of preventing African-American infant mortality.

    PubMed Central

    Gates-Williams, J; Jackson, M N; Jenkins-Monroe, V; Williams, L R

    1992-01-01

    African-American women are twice as likely as women from other ethnic groups to have babies with low birth weights and to experience the loss of infant death. The problem is so endemic in black communities in Alameda County, California, that numerous programs have been developed over the past decade to reduce maternal risk factors and eliminate barriers to prenatal care. Despite these efforts, African-American ethnicity continues to be a major risk factor for infant mortality for reasons that are poorly understood. We take a critical look at 3 types of studies characteristic of infant mortality research: epidemiologic, studies that advocate prenatal care, and ethnomedical (cultural). We argue that the assumptions informing this research restrict the thinking about infant mortality and the political issues involved in how prevention programs are developed and structured. The persistent focus on maternal behavioral characteristics limits more in-depth analysis of the micropolitics of perinatal bureaucracies established in response to this ongoing crisis. PMID:1413783

  17. Disparities in perinatal medicine: preterm birth, stillbirth, and infant mortality.

    PubMed

    Spong, Catherine Y; Iams, Jay; Goldenberg, Robert; Hauck, Fern R; Willinger, Marian

    2011-04-01

    Infant mortality, stillbirths, and preterm births are major public health priorities with significant disparities based on race and ethnicity. Interestingly, when evaluating the rates over the past 30 to 50 years, the disparity persists in all three and is remarkably consistent. In the United States, the infant mortality rate is 6.7 deaths per 1,000 live births, the stillbirth rate is 6.2 per 1,000 deliveries, and the preterm birth rate is 12.8% of live births. The rates among non-Hispanic African Americans are dramatically higher, nearly double the infant mortality at 13.4 infant deaths per 1,000 live births, nearly double the stillbirth rate at 11.1 stillbirths per 1,000 deliveries, and one third higher with preterm births at 18.4% of live births. Despite numerous conferences, workshops, articles, and investigators focusing on this line of work, the disparities persist and, in some cases, are growing. In this article, we summarize a Eunice Kennedy Shriver National Institute of Child Health and Human Development workshop that focused on these disparities to identify the associated factors to determine their relative contributions, identify gaps in knowledge, and develop specific strategies to address the disparities in the short-term and long-term.

  18. Factors associated with trends in infant and child mortality in developing countries during the 1990s.

    PubMed Central

    Rutstein, S. O.

    2000-01-01

    The 1990s have seen a remarkable decrease in mortality among infants and children in most developing countries. In some countries, particularly in sub-Saharan Africa, these declines in mortality among children have slowed and are now increasing again. Internationally comparable data derived from survey programmes, such as the Demographic and Health Survey (DHS) programme, are available both to document the changes that have occurred in mortality and to provide insight into some of the factors that may explain these trends in mortality. The factors found in repeated DHS programmes that explain these trends fall into five categories: fertility behaviour; nutritional status, breastfeeding, and infant feeding; the use of health services by mothers and for children; environmental health conditions; and socioeconomic status. Both simple analyses and multivariate analyses of changes in these factors between surveys indicate that all factors affected the mortality trends. However, to explain trends in mortality, the variables themselves had to have changed over time. During the 1990s fertility behaviour, breastfeeding, and infant feeding have changed less than other factors and so would seem to have played a smaller role in mortality trends. This study confirms that trends in mortality during the 1990s were related to more than just a handful of variables. It would, therefore, be a mistake to concentrate policy actions on one or a few of these while forsaking others. Countries with the largest decreases in mortality have had substantial improvements in most of the factors that might be used to explain these changes. In some countries mortality has risen. In part these increases can be explained by the factors included in this study, such as deterioration in seeking medical care for children with fever. Other factors that were not measured, such as the increasing resistance of malaria to drug treatment and the increased prevalence of parental HIV/AIDS, may be contributing

  19. Birth Outcomes and Infant Mortality by the Degree of Rural Isolation among First Nations and Non-First Nations in Manitoba, Canada

    ERIC Educational Resources Information Center

    Luo, Zhong-Cheng; Wilkins, Russell; Heaman, Maureen; Martens, Patricia; Smylie, Janet; Hart, Lyna; Simonet, Fabienne; Wassimi, Spogmai; Wu, Yuquan; Fraser, William D.

    2010-01-01

    Context: It is unknown whether rural isolation may affect birth outcomes and infant mortality differentially for Indigenous versus non-Indigenous populations. We assessed birth outcomes and infant mortality by the degree of rural isolation among First Nations (North American Indians) and non-First Nations populations in Manitoba, Canada, a setting…

  20. Social inequality in infant mortality: what explains variation across low and middle income countries?

    PubMed

    Hajizadeh, Mohammad; Nandi, Arijit; Heymann, Jody

    2014-01-01

    Growing work demonstrates social gradients in infant mortality within countries. However, few studies have compared the magnitude of these inequalities cross-nationally. Even fewer have assessed the determinants of social inequalities in infant mortality across countries. This study provides a comprehensive and comparative analysis of social inequalities in infant mortality in 53 low-and-middle-income countries (LMICs). We used the most recent nationally representative household samples (n = 874,207) collected through the Demographic Health Surveys (DHS) to calculate rates of infant mortality. The relative and absolute concentration indices were used to quantify social inequalities in infant mortality. Additionally, we used meta-regression analyses to examine whether levels of inequality in proximate determinants of infant mortality were associated with social inequalities in infant mortality across countries. Estimates of both the relative and the absolute concentration indices showed a substantial variation in social inequalities in infant mortality among LMICs. Meta-regression analyses showed that, across countries, the relative concentration of teenage pregnancy among poorer households was positively associated with the relative concentration of infant mortality among these groups (beta = 0.333, 95% CI = 0.115 0.551). Our results demonstrate that the concentration of infant deaths among socioeconomically disadvantaged households in the majority of LMICs remains an important health and social policy concern. The findings suggest that policies designed to reduce the concentration of teenage pregnancy among mothers in lower socioeconomic groups may mitigate social inequalities in infant mortality.

  1. Seeking explanations for high levels of infant mortality in Pakistan.

    PubMed

    Sathar, Z A

    1987-01-01

    Data from the Fertility Module of the 1979 Population, Labour Force and Migration (PLM) Survey of Pakistan were analyzed to determine which of 4 factors were primarily responsible for the high infant mortality rate. The factors examined were poverty, childbearing and childrearing practices, distribution of health care and lack of individual attention given to children due to ignorance. These items were presented in a discussion format. Infant mortality in Pakistan is high at about 125-140/1000, for a country with mid-level per capita income. Income was not a good indicator of child mortality, primarily because it was difficult to determine, particularly in rural areas where non-cash income predominates. Wealth and status were good indicators of child survival. Child-rearing practices were somewhat important, as judged by birth order, breastfeeding duration and gender. Childbearing practices as shown by spacing were important determinants of survival. Health care facilities were somewhat important, indicated by higher mortality in rural areas. Rural neonates die from tetanus due to lack of immunization, or later from diarrheal disease due to lack of potable water or poor weaning practices. Maternal education was a strong indicator of survival, much more so than paternal education. Similarly, female heads of households increased survival, probably because they control financial allocations. The study suggested that rather than attempting to eliminate poverty overall, improvements in maternal education, nutrition, health care facilities and their use, and childbearing and child-rearing methods would do more to improve child survival in Pakistan.

  2. Bacillus Calmette-Guérin vaccination and infant mortality.

    PubMed

    Roth, Adam; Garly, M L; Jensen, H; Nielsen, J; Aaby, P

    2006-04-01

    When the bacillus Calmette-Guérin (BCG) vaccine was introduced in the 1920s, it was suggested that BCG occasionally had nonspecific beneficial effects on mortality beyond the specific protection against tuberculosis. Considering that BCG has since then become the most used vaccine in the world, surprisingly few studies have been undertaken into the effect of BCG on general mortality and morbidity. Recent studies suggest that BCG has beneficial nontargeted effects on general infant morbidity and mortality in low-income countries, often with the most pronounced effect among girls. These observational findings are supported by early trials in which children were randomized or alternated to BCG vaccination. Furthermore, a BCG scar and a positive tuberculin reaction are related to better survival among BCG-vaccinated children in low-income countries, especially for girls. The findings are not explained by frailty bias, in other words, that healthy children are more likely to receive BCG vaccination. A nonspecific, gender-differential effect of BCG on general infant mortality may have large implications for tuberculosis vaccine research and routine vaccination policy.

  3. Behind international rankings of infant mortality: how the United States compares with Europe.

    PubMed

    MacDorman, Marian F; Mathews, T J

    2009-11-01

    Infant mortality is an important indicator of the health of a nation, and the recent stagnation (since 2000) in the U.S. infant mortality rate has generated concern among researchers and policy makers. The percentage of preterm births in the United States has risen 36% since 1984 (1). In this report we compare infant mortality rates between the United States and Europe. We also compare two factors that determine the infant mortality rate-gestational age-specific infant mortality rates and the percentage of preterm births. U.S. data are from the Linked Birth/Infant Death Data Set (2,3), and European data for 2004 are from the recently published European Perinatal Health Report (4). We also examine requirements for reporting a live birth among countries to assess the possible effect of reporting differences on infant mortality data.

  4. Geographical disparities of infant mortality in rural China

    PubMed Central

    Wang, Yanping; Zhu, Jun; He, Chunhua; Li, Xiaohong; Miao, Lei; Liang, Juan

    2012-01-01

    Objective The purpose of the study was to investigate the trends and causes of regional disparities of infant mortality rate (IMR) in rural China from 1996 to 2008. Design A population-based, longitudinal study. Setting The national child mortality surveillance network. Population Population of the 79 surveillance counties. Main outcome measure IMR, leading causes of infant death and the RR of IMR. Results The IMR in coastal, inland and remote regions declined by 72.4%, 62.9% and 58.2%, respectively, from 1996 to 2008. Compared with the coastal region, the RR of IMR were 1.7 (95% CI 1.6 to 1.9), 1.9 (95% CI 1.7 to 2.0) and 1.8 (95% CI 1.6 to 2.0) for inland region and 2.6 (95% CI 2.4 to 2.7), 3.2 (95% CI 3.0 to 3.5) and 3.1 (95% CI 2.7 to 3.4) for the remote region during 1996–2000, 2001–2005 and 2006–2008, respectively. The regional disparities existed for both male and female IMRs. The postneonatal mortality showed the highest regional disparities. Pneumonia, birth asphyxia, prematurity/low birth weight, injuries and diarrhoea were the main contributors to the regional disparities. There were significantly more infants who did not seek healthcare services before death in the remote region relative to the inland and coastal regions. Conclusion The results indicated persistent existence of regional disparities in IMR in rural China. It is worth noting that regional disparities in IMR increased in the remote and coastal regions during 2001–2005 in rural China. These disparities remained unchanged during 2006–2008. The results indicate that strategies to reduce mortality caused by pneumonia, birth asphyxia and diarrhoea are keys to reducing IMR. PMID:22247413

  5. Regional Infant and Child Mortality Review Committee 2010 final report.

    PubMed

    Randall, Brad; Wilson, Ann

    2011-12-01

    The 2010 annual report of the Regional Infant and Child Mortality Review Committee (RICMRC) is presented. Since 1997, RICMRC has sought to achieve its mission to "review infant and child deaths so that information can be transformed into action to protect young lives." For the year 2010, the Committee reviewed 15 deaths from Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hanson, Miner and Brookings counties that met the following criteria: Children under age 18 dying subsequent to hospital discharge following delivery. Children who either died in these counties from causes sustained in them, or residents who died elsewhere from causes sustained in the 10-county region. The acronym SUID (Sudden Unexpected Infant Death) is being increasingly used by investigators of infant deaths. SUID is an intentionally broad category used for any sudden infant death when the cause of death is unapparent or multifactorial. Sudden Infant Death Syndrome (SIDS) is a subset of SUID, which in addition to SIDS includes sudden unexpected infant deaths of any cause. One death categorized as SIDS occurred in 2010. The committee has observed a stable decline in the number of deaths due to SIDS for the last several years with the exception of two SIDS deaths that occurred in 2008. The national SIDS rate of 0.57 per 1000 live births' would suggest that our region should have one SIDS death per year. It would appear that on average, our region's SIDS incidence is close to that number. Many investigators believe that a "diagnostic drift" is occurring in the SIDS determination. These investigators believe that some deaths certified as SIDS in earlier years may now be classified as "undetermined," or in the new terminology, SUID. Overall the number of SUID deaths has remained relatively stable over the last decade. In those years when there were spikes of infant deaths, the increases were largely due to an increase in the number of "undetermined" deaths. The majority of our "undetermined

  6. [Infant Mortality in Argentina: reducibility criteria, 3rd review].

    PubMed

    Finkelstein, Juliana Zoe; Duhau, Mariana; Abeyá Gilardon, Enrique; Ferrario, Claudia; Speranza, Ana; Asciutto, Carolina; Marconi, Élida; Guevel, Carlos; Fernández, María de las Mercedes; Martínez, María Laura; Santoro, Adrián; Loiacono, Karina; Lomuto, Celia

    2015-08-01

    The infant mortality rate is an indicator of quality of life, development, and quality and accessibility of health care. Improvements in science, technology and better access to health care have contributed to a major decrease in the infant mortality rate in Argentina. Since the 1980s, infant deaths have been classified based on the opportunities for reducibility yielded by scientific knowledge and available technologies, in order to obtain a basis for the monitoring and implementation of health policies. The last review of this classification was in 2011. In 2012, a total of 5,541 neonatal deaths (less than 28 days of life) were registered and, under this new classification, over 61% were reducible mainly by the improvement of perinatal health care and adequate and timely treatment of the at-risk newborn. In 2012, a total of 2,686 post-neonatal deaths (from 28 days of life to a year) were registered and, under this new classification, over 66.8% were reducible by improving prevention strategies and providing adequate and timely treatment. This new analysis demonstrates the need to improve the opportunity, accessibility and quality of perinatal care starting at pregnancy, guaranteeing quality care at delivery and reinforcing prevention and timely treatment of common diseases in childhood over the first year of life.

  7. [Association between types of need, human development index, and infant mortality in Mexico, 2008].

    PubMed

    Medina-Gómez, Oswaldo Sinoe; López-Arellano, Oliva

    2011-08-01

    The aim of this study was to assess the association between different types of economic and social deprivation and infant mortality rates reported in 2008 in Mexico. We conducted an ecological study analyzing the correlation and relative risk between the human development index and levels of social and economic differences in State and national infant mortality rates. There was a strong correlation between higher human development and lower infant mortality. Low schooling and poor housing and crowding were associated with higher infant mortality. Although infant mortality has declined dramatically in Mexico over the last 28 years, the decrease has not been homogeneous, and there are persistent inequalities that determine mortality rates in relation to different poverty levels. Programs with a multidisciplinary approach are needed to decrease infant mortality rates through comprehensive individual and family development.

  8. Saving babies: the impact of public education programs on infant mortality.

    PubMed

    Moehling, Carolyn M; Thomasson, Melissa A

    2014-04-01

    We take advantage of unique data on specific activities conducted under the Sheppard-Towner Act from 1924 through 1929 to focus on how public health interventions affected infant mortality. Interventions that provided one-on-one contact and opportunities for follow-up care, such as home visits by nurses and the establishment of health clinics, reduced infant deaths more than did classes and conferences. These interventions were particularly effective for nonwhites, a population with limited access to physicians and medical care. Although limited data on costs prevent us from making systematic cost-benefit calculations, we estimate that one infant death could be avoided for every $1,600 (about $20,400 in 2010 dollars) spent on home nurse visits.

  9. The effect of systematic pediatric care on neonatal mortality and hospitalizations of infants born with oral clefts

    PubMed Central

    2011-01-01

    Background Cleft lip and/or palate (CL/P) increase mortality and morbidity risks for affected infants especially in less developed countries. This study aimed at assessing the effects of systematic pediatric care on neonatal mortality and hospitalizations of infants with cleft lip and/or palate (CL/P) in South America. Methods The intervention group included live-born infants with isolated or associated CL/P in 47 hospitals between 2003 and 2005. The control group included live-born infants with CL/P between 2001 and 2002 in the same hospitals. The intervention group received systematic pediatric care between the 7th and 28th day of life. The primary outcomes were mortality between the 7th and 28th day of life and hospitalization days in this period among survivors adjusted for relevant baseline covariates. Results There were no significant mortality differences between the intervention and control groups. However, surviving infants with associated CL/P in the intervention group had fewer hospitalization days by about six days compared to the associated control group. Conclusions Early systematic pediatric care may significantly reduce neonatal hospitalizations of infants with CL/P and additional birth defects in South America. Given the large healthcare and financial burden of CL/P on affected families and the relatively low cost of systematic pediatric care, improving access to such care may be a cost-effective public policy intervention. Trial Registration ClinicalTrials.gov: NCT00097149 PMID:22204448

  10. Disparities in mortality rates among US infants born late preterm or early term, 2003-2005.

    PubMed

    King, Jennifer P; Gazmararian, Julie A; Shapiro-Mendoza, Carrie K

    2014-01-01

    The purpose of this study was to identify disparities in neonatal, post-neonatal, and overall infant mortality rates among infants born late preterm (34-36 weeks gestation) and early term (37-38 weeks gestation) by race/ethnicity, maternal age, and plurality. In analyses of 2003-2005 data from US period linked birth/infant death datasets, we compared infant mortality rates by race/ethnicity, maternal age, and plurality among infants born late preterm or early term and also determined the leading causes of death among these infants. Among infants born late preterm, infants born to American Indian/Alaskan Native, non-Hispanic black, or teenage mothers had the highest infant mortality rates per 1,000 live births (14.85, 9.90, and 11.88 respectively). Among infants born early term, corresponding mortality rates were 5.69, 4.49, and 4.82, respectively. Among infants born late preterm, singletons had a higher infant mortality rate than twins (8.59 vs. 5.62), whereas among infants born early term, the rate was higher among twins (3.67 vs. 3.15). Congenital malformations and sudden infant death syndrome were the leading causes of death among both late preterm and early term infants. Infant mortality rates among infants born late preterm or early term varied substantially by maternal race/ethnicity, maternal age, and plurality. Information about these disparities may help in the development of clinical practice and prevention strategies targeting infants at highest risk.

  11. [Political crises in Africa and infant and child mortality].

    PubMed

    Garenne, M

    1997-01-01

    Many African countries experienced severe political crises after independence, and in a number of cases the crises had significant demographic consequences, especially for child mortality. Data based on maternity histories allowed the reconstruction of child mortality trends over the past 20-30 years in Uganda, Ghana, Rwanda, Madagascar, and Mozambique. The indicator used was the child mortality quotient (number of deaths of under-5 children per 1000 births). Uganda's child mortality declined from 227/1000 in 1960 to 154/1000 in 1970, but the trend was reversed in 1971, when Idi Amin Dada came to power, and the rate reached 204/1000 in 1982 before beginning to decline again. The level of mortality remained high, however, and was still 160/1000 in 1988. Ghana suffered a political and economic crisis during 1979-84. Child mortality rose from 130/1000 in 1978 to 175/1000 in 1983. Mortality rates began a rapid decline after structural adjustment programs were begun, possibly due to improved management of health services. The child mortality rate in Rwanda increased from around 220/1000 in 1960 to 240/1000 in 1975, before beginning a decline in the late 1970s that reached 140/1000 by 1990. The period of political stability and relative prosperity during the 15-year reign of Juvenal Habyarimana was associated with the decline. Political crises marked by student and peasant uprisings were associated with Madagascar's child mortality rate increase from about 145/1000 in 1960 to 185/1000 in 1985. Mozambique was beset by civil war after independence, in which destruction of the health infrastructure was a strategy. The child mortality rate increased from 270/1000 to 470/1000 between 1975 and 1986, a peak war year. The factors by which political crises affect mortality so profoundly remain to be explained, but particular attention should be given to studying the health sector.

  12. Age-Specific Preferences for Infant-Directed Affective Intent

    ERIC Educational Resources Information Center

    Kitamura, Christine; Lam, Christa

    2009-01-01

    This study examined the developmental course of infants' attentional preferences for 3 types of infant-directed affective intent, which have been shown to be commonly used at particular ages in the first year of life. Specifically, Kitamura and Burnham (2003) found mothers' tone of voice in infant-directed speech is most comforting between birth…

  13. Infant mortality in South Africa - distribution, associations and policy implications, 2007: an ecological spatial analysis

    PubMed Central

    2011-01-01

    Background Many sub-Saharan countries are confronted with persistently high levels of infant mortality because of the impact of a range of biological and social determinants. In particular, infant mortality has increased in sub-Saharan Africa in recent decades due to the HIV/AIDS epidemic. The geographic distribution of health problems and their relationship to potential risk factors can be invaluable for cost effective intervention planning. The objective of this paper is to determine and map the spatial nature of infant mortality in South Africa at a sub district level in order to inform policy intervention. In particular, the paper identifies and maps high risk clusters of infant mortality, as well as examines the impact of a range of determinants on infant mortality. A Bayesian approach is used to quantify the spatial risk of infant mortality, as well as significant associations (given spatial correlation between neighbouring areas) between infant mortality and a range of determinants. The most attributable determinants in each sub-district are calculated based on a combination of prevalence and model risk factor coefficient estimates. This integrated small area approach can be adapted and applied in other high burden settings to assist intervention planning and targeting. Results Infant mortality remains high in South Africa with seemingly little reduction since previous estimates in the early 2000's. Results showed marked geographical differences in infant mortality risk between provinces as well as within provinces as well as significantly higher risk in specific sub-districts and provinces. A number of determinants were found to have a significant adverse influence on infant mortality at the sub-district level. Following multivariable adjustment increasing maternal mortality, antenatal HIV prevalence, previous sibling mortality and male infant gender remained significantly associated with increased infant mortality risk. Of these antenatal HIV sero

  14. Can better infrastructure and quality reduce hospital infant mortality rates in Mexico?

    PubMed

    Aguilera, Nelly; Marrufo, Grecia M

    2007-02-01

    Preliminary evidence from hospital discharges hints enormous disparities in infant hospital mortality rates. At the same time, public health agencies acknowledge severe deficiencies and variations in the quality of medical services across public hospitals. Despite these concerns, there is limited evidence of the contribution of hospital infrastructure and quality in explaining variations in outcomes among those who have access to medical services provided at public hospitals. This paper provides evidence to address this question. We use probabilistic econometric methods to estimate the impact of material and human resources and hospital quality on the probability that an infant dies controlling for socioeconomic, maternal and reproductive risk factors. As a measure of quality, we calculate for the first time for Mexico patient safety indicators developed by the AHRQ. We find that the probability to die is affected by hospital infrastructure and by quality. In this last regard, having been treated in a hospital with the worse quality incidence doubles the probability to die. This paper also presents evidence on the contribution of other risk factors on perinatal mortality rates. The conclusions of this paper suggest that lower infant mortality rates can be reached by implementing a set of coherent public policy actions including an increase and reorganization of hospital infrastructure, quality improvement, and increasing demand for health by poor families.

  15. The health of nations in a global context: trade, global stratification, and infant mortality rates.

    PubMed

    Moore, Spencer; Teixeira, Ana C; Shiell, Alan

    2006-07-01

    Despite the call for a better understanding of macro-level factors that affect population health, social epidemiological research has tended to focus almost exclusively on national-level factors, such as Gross Domestic Product per capita (GDP/c) or levels of social cohesion. Using a world-systems framework to examine cross-national variations in infant mortality, this paper seeks to emphasize the effects of global trade on national-level population health. Rather than viewing national-level health indicators as autonomous from broader global contexts, the study uses network analysis methods to examine the effects of international trade on infant mortality rates. Network data for countries were derived from international data on the trade of capital-intensive commodities in 2000. Using automorphic equivalence to measure the degree to which actors in a network perform similar roles, countries were assigned into one of six world-system blocks, each with its own pattern of trade. These blocks were dummy-coded and tested using ordinary least squares (OLS) regression. A key finding from this analysis is that after controlling for national-level factors, the two blocks with the lowest density in capital-intensive exchange, i.e., the periphery, are significantly and positively associated with national-level infant mortality rates. Results show the effects of peripherality and stratification on population health, and highlight the influence of broader macro-level factors such as trade and globalization on national health.

  16. Regionalization and Local Hospital Closure in Norwegian Maternity Care—The Effect on Neonatal and Infant Mortality

    PubMed Central

    Grytten, Jostein; Monkerud, Lars; Skau, Irene; Sørensen, Rune

    2014-01-01

    Objective To study whether neonatal and infant mortality, after adjustments for differences in case mix, were independent of the type of hospital in which the delivery was carried out. Data The Medical Birth Registry of Norway provided detailed medical information for all births in Norway. Study Design Hospitals were classified into two groups: local hospitals/maternity clinics versus central/regional hospitals. Outcomes were neonatal and infant mortality. The data were analyzed using propensity score weighting to make adjustments for differences in case mix between the two groups of hospitals. This analysis was supplemented with analyses of 13 local hospitals that were closed. Using a difference-in-difference approach, the effects that these closures had on neonatal and infant mortality were estimated. Principal Finding Neonatal and infant mortality were not affected by the type of hospital where the delivery took place. Conclusion A regionalized maternity service does not lead to increased neonatal and infant mortality. This is mainly because high-risk deliveries were identified well in advance of the birth, and referred to a larger hospital with sufficient perinatal resources to deal with these deliveries. PMID:24476021

  17. Ecological study of effect of breast feeding on infant mortality in Latin America

    PubMed Central

    Betrán, Ana P; de Onís, Mercedes; Lauer, Jeremy A; Villar, José

    2001-01-01

    Objective To estimate the effect of exclusive breast feeding and partial breast feeding on infant mortality from diarrhoeal disease and acute respiratory infections in Latin America. Design Attributable fraction analysis of national data on infant mortality and breast feeding. Setting Latin America and the Caribbean. Main outcome measures Mortality from diarrhoeal disease and acute respiratory infections and nationally representative breastfeeding rates. Results 55% of infant deaths from diarrhoeal disease and acute respiratory infections in Latin America are preventable by exclusive breast feeding among infants aged 0-3 months and partial breast feeding throughout the remainder of infancy. Among infants aged 0-3 months, 66% of deaths from these causes are preventable by exclusive breast feeding; among infants aged 4-11 months, 32% of such deaths are preventable by partial breast feeding. 13.9% of infant deaths from all causes are preventable by these breastfeeding patterns. The annual number of preventable deaths is about 52 000 for the region. Conclusions Exclusive breast feeding of infants aged 0-3 months and partial breast feeding throughout the remainder of infancy could substantially reduce infant mortality in Latin America. Interventions to promote breast feeding should target younger infants. What is already known on this topicInfant mortality is lower among breast fed than non-breast fed infantsThe reductions are greatest for deaths from diarrhoeal disease and acute respiratory infectionsWhat this study addsExclusive breast feeding of infants aged 0-3 months and partial breast feeding for the remainder of the first year would prevent about 52 000 infant deaths a year in Latin AmericaThis corresponds to 13.9% of infant deaths from all causesPromotion of breast feeding has an important role in increasing survival of infants PMID:11498485

  18. The Aberdeen Indian Health Service Infant Mortality Study: Design, Methodology, and Implementation

    ERIC Educational Resources Information Center

    Randall, Leslie L.; Krogh, Christopher; Welty, Thomas K.; Willinger, Marian; Iyasu, Solomon

    2001-01-01

    Of all Indian Health Service areas, the Aberdeen Area has consistently had the highest infant mortality rate. Among some tribes in this area the rate has exceeded 30/1000 live birth and half the infant deaths have been attributed to Sudden Infant Death Syndrome, a rate four to five times higher than the national average. The Indian Health Service,…

  19. The Prevention of Prematurity: A Strategy to Reduce Infant Mortality in the District of Columbia.

    ERIC Educational Resources Information Center

    Maxwell, Joan

    The infant mortality rate in the District of Columbia is higher than that for any other state. This high rate stems from the great number of infants born seriously underweight and reflects the area's high percentage of births to impoverished black women. Efforts to reduce the mortality rate have centered around the medical treatment approach,…

  20. Race/Ethnicity, Nativity, and Infant Mortality in the United States.

    ERIC Educational Resources Information Center

    Hummer, Robert A.; Biegler, Monique; De Turk, Peter B.; Forbes, Douglas; Frisbie, W. Parker; Hong, Ying; Pullum, Starling G.

    1999-01-01

    Health statistics show wide variations in risk and determinants of infant death across racial and ethnic subpopulations, a within-group advantage to being an immigrant, and the same direction of effects for mortality risk factors across groups. Efforts to lower infant mortality should benefit all groups. Contains 83 references. (TD)

  1. Poverty, Race, and Infant Mortality in the United States. Discussion Papers 404-77.

    ERIC Educational Resources Information Center

    Gortmaker, Steven L.

    This paper examines the theoretical and empirical roles of income poverty and race in the determination of infant mortality differentials in the United States. A basic model of the process of infant mortality is conceptualized. It outlines a theory of the influence of a variety of biological, social, and economic factors upon the risk of infant…

  2. Interpregnancy intervals and the risk for infant mortality: a case control study of Arizona infants 2003-2007.

    PubMed

    Hussaini, Khaleel S; Ritenour, Douglas; Coonrod, Dean V

    2013-05-01

    There is well-documented evidence on how interpregnancy interval (IPI) is associated with adverse perinatal outcomes and how short and long IPIs are associated with increased risk for preterm birth, low birth weight, and intra-uterine growth restriction. However, the extremes of IPI on infant mortality are less well documented. The current study builds on the existing evidence on IPI to examine if extremes of IPI are associated with infant mortality, and also examines if IPI is associated with both neonatal and post-neonatal mortality after adjusting for several known confounders. Matched birth and death certificate data for Arizona resident infants was drawn for 2003-2007 cohorts. The analysis was restricted to singleton births among resident mothers with a previous live birth (n = 1,466) and a randomly selected cohort of surviving infants during the same time-frame was used as a comparison group (n = 2,000). Logistic regression models were utilized to assess the odds for infant mortality at monthly interpregnancy intervals (<6, 6-11, 12-17, 18-23, 24-59, ≥60), while adjusting for established predictors of infant mortality (i.e., preterm birth, low birth weight, and small for gestational age), and other potential confounders. Unadjusted analysis showed greater clustering at extreme IPIs of <6 months and ≥60 months for infants that died (32%) compared to infants that survived (24.7%). Shorter IPI (i.e., <6 months, 6-11 months, and 12-17 months) compared to 'ideal' IPI (i.e., 18-23 months), were associated with infant mortality even after adjusting for confounders. Short intervals were significantly associated with neonatal, but not post-neonatal deaths. IPI above 23 months were not associated with infant mortality in our analyses. Shorter IPIs (18 months or less) significantly increases the risk for neonatal infant mortality even after controlling for known confounders, and our study adds to the existing evidence on adverse perinatal outcomes. Counseling women

  3. Effects of the health service and environmental factors on infant mortality: the case of Sri Lanka.

    PubMed Central

    Patel, M

    1980-01-01

    One of the findings of this study is that regional variations in the infant mortality rates of Sri Lanka are large, ranging from 26 per 1000 live births in Jaffna to 91 per 1000 in Nuwara Eliya, a tea estate district. These differences are more strongly associated with regional variations in environmental determinants of mortality than with regional variations in public health expenditure. The most significant environmental factor associated with interregional infant mortality rates was to be the nature of the water supply (r = -0.82, significant at the 99% level). Regional government expenditure on health had only a weak association with infant mortality rates (r = 0.08). PMID:6772730

  4. Trends in preterm-related infant mortality by race and ethnicity, United States, 1999-2004.

    PubMed

    MacDorman, Marian F; Callaghan, William M; Mathews, T J; Hoyert, Donna L; Kochanek, Kenneth D

    2007-01-01

    Trends in preterm-related causes of death were examined by maternal race and ethnicity. A grouping of preterm-related causes of infant death was created by identifying causes that were a direct cause or consequence of preterm birth. Cause-of-death categories were considered to be preterm-related when 75 percent or more of total infant deaths attributed to that cause were deaths of infants born preterm, and the cause was considered to be a direct consequence of preterm birth based on a clinical evaluation and review of the literature. In 2004, 36.5 percent of all infant deaths in the United States were preterm-related, up from 35.4 percent in 1999. The preterm-related infant mortality rate for non-Hispanic black mothers was 3.5 times higher and the rate for Puerto Rican mothers was 75 percent higher than for non-Hispanic white mothers. The preterm-related infant mortality rate for non-Hispanic black mothers was higher than the total infant mortality rate for non-Hispanic white, Mexican, and Asian or Pacific Islander mothers. The leveling off of the U.S. infant mortality decline since 2000 has been attributed in part to an increase in preterm and low-birthweight births. Continued tracking of preterm-related causes of infant death will improve our understanding of trends in infant mortality in the United States.

  5. Inequalities in health: living conditions and infant mortality in Northeastern Brazil

    PubMed Central

    Carvalho, Renata Alves da Silva; Santos, Victor Santana; de Melo, Cláudia Moura; Gurgel, Ricardo Queiroz; Oliveira, Cristiane Costa da Cunha

    2015-01-01

    OBJECTIVE To analyze the variation of infant mortality as per condition of life in the urban setting. METHODS Ecological study performed with data regarding registered deaths of children under the age of one who resided in Aracaju, SE, Northeastern Brazil, from 2001 to 2010. Infant mortality inequalities were assessed based on the spatial distribution of the Living Conditions Index for each neighborhood, classified into four strata. The average mortality rates of 2001-2005 and 2006-2010 were compared using the Student’s t-test. RESULTS Average infant mortality rates decreased from 25.3 during 2001-2005 to 17.7 deaths per 1,000 live births in 2006-2010. Despite the decrease in the rates in all the strata during that decade, inequality of infant mortality risks increased in neighborhoods with worse living conditions compared with that in areas with better living conditions. CONCLUSIONS Infant mortality rates in Aracaju showed a decline, but with important differences among neighborhoods. The assessment based on a living condition perspective can explain the differences in the risks of infant mortality rates in urban areas, highlighting health inequalities in infant mortality as a multidimensional issue. PMID:25741650

  6. GIS as a community engagement tool: developing a plan to reduce infant mortality risk factors.

    PubMed

    Detres, Maridelys; Lucio, Robert; Vitucci, Judi

    2014-07-01

    This article describes how a community coalition focusing on maternal and child health engages community participation through the use of geographic information systems (GIS) mapping, developing strategies that culminate in the implementation of a service delivery plan to improve birth outcomes. Vital statistics data from 2007 to 2009 was analyzed by zip code in Pinellas County Florida to produce choropleth thematic maps using ArcGIS for 3 year rolling average infant deaths and single year percentages for prematurity. The maps were presented at the organization's annual coalition meeting to discuss risk areas, changes over time in the selected indicators and solicit community feedback on how to best target issues addressing infant mortality and prematurity. The maps identified new zip codes of concern for prematurity in addition to known high risk zip codes for both infant mortality and prematurity. The community identified changes in demographic composition and changes in housing patterns, such as new mobile home areas, in the high risk areas. In response, the community assisted the Coalition in developing a holistic plan addressing risk factors affecting birth outcomes by expanding current services, hiring a nutritionist, and contracting a health navigator. When compared to tables and charts, a visual depiction of a neighborhood by recognizable zip codes is a useful tool to help community decision makers better visualize public health concerns and interpret trends based on local knowledge. Public health professionals should use this community knowledge to interpret research results and implement strategies to improve birth outcomes.

  7. Understanding racial and ethnic disparities in U.S. infant mortality rates.

    PubMed

    MacDorman, Marian F; Mathews, T J

    2011-09-01

    In the United States, different racial and ethnic groups have very different infant mortality patterns. When assessing the relative contribution of the percentage of preterm births and gestational age-specific infant mortality rates to racial and ethnic infant mortality differences, we found that for non-Hispanic black women, 78 percent of their elevated infant mortality rate compared with non-Hispanic white women was due to their higher percentage of preterm births, while 22 percent was due to higher gestational age-specific infant mortality rates (primarily at 34 weeks of gestation or more). For Puerto Rican women, their elevated infant mortality rate compared with non-Hispanic white women was entirely due to their higher percentage of preterm births. However, AIAN women had a very different infant mortality pattern: 76 percent of their higher infant mortality rate compared with non-Hispanic white women was due to their higher gestational age-specific infant mortality rates (primarily at 34 weeks or more), and only 24 percent was due to their higher percentage of preterm births.These findings are consistent with the cause-of-death analysis, which found that for bothnon-Hispanic black and Puerto Rican women, most of their higher infant mortality rate compared with non-Hispanic white women was due to preterm-related causes. In contrast, for AIAN women, the infant mortality rate from SIDS was 2.4 times, and the rate from unintentional injuries was 2.3 times, the non-Hispanic white rate. Infant mortality rates for non-Hispanic black women would be reduced by 71 percent, those for AIAN women by 64 percent, and those for Puerto Rican women by 67 percent if rates from preterm-related causes, congenital malformations, SIDS, and unintentional injuries could be reduced to non-Hispanic white levels.The different infant mortality patterns for non-Hispanic black, Puerto Rican, and AIAN women suggest different prevention strategies (6,7). In addition, because the percentage of

  8. White Infant Mortality in Appalachian States, 1976-1980 and 1996-2000: Changing Patterns and Persistent Disparities

    ERIC Educational Resources Information Center

    Yao, Nengliang; Matthews, Stephen A.; Hillemeier, Marianne M.

    2012-01-01

    Purpose: Appalachian counties have historically had elevated infant mortality rates. Changes in infant mortality disparities over time in Appalachia are not well-understood. This study explores spatial inequalities in white infant mortality rates over time in the 13 Appalachian states, comparing counties in Appalachia with non-Appalachian…

  9. Why Is Infant Mortality Higher in the United States Than in Europe?

    PubMed Central

    Chen, Alice; Oster, Emily; Williams, Heidi

    2015-01-01

    The US has higher infant mortality than peer countries. In this paper, we combine micro-data from the US with similar data from four European countries to investigate this US infant mortality disadvantage. The US disadvantage persists after adjusting for potential di erential reporting of births near the threshold of viability. While the importance of birth weight varies across comparison countries, relative to all comparison countries the US has similar neonatal (<1 month) mortality but higher postneonatal (1-12 months) mortality. We document similar patterns across Census divisions within the US. The postneonatal mortality disadvantage is driven by poor birth outcomes among lower socioeconomic status individuals. PMID:27158418

  10. Factors associated to infant mortality in Sub-Saharan Africa

    PubMed Central

    Ester, Pablo Viguera; Torres, Alberto; Freire, José M.; Hernández, Valentín; Gil, Ángel

    2011-01-01

    Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA). The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR) in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variables. Information and data sources were WHO, World Bank, UNICEF and UNDP (1997–2007). IMR mean value is 92.2 (per 1000 live births) and a relationship with several of the factors could be observed. In the bi-variate analysis direct relationship was observed with maternal mortality rate and an inverse relationship was observed with prenatal care coverage, births assisted by skilled health personnel, gross national income per capita, per capita government expenditure on health, social security expenditure, adult literacy rate, net primary school enrolment rate, population with access to safe drinking water (in urban and rural areas) and with population with access to basic sanitation in rural areas. In the multi-variate analysis IMR had an inverse relationship with children under 5 years with diarrhoea who receive oral re-hydration, with social security expenditure as percentage of general government expenditure on health and with per capita government expenditure on health. The situation in SSA would change if their inhabitants received education and information to demand more equitable polices and better investments from their governments. PMID:28299068

  11. Environmental regulations on air pollution in China and their impact on infant mortality.

    PubMed

    Tanaka, Shinsuke

    2015-07-01

    This study explores the impact of environmental regulations in China on infant mortality. In 1998, the Chinese government imposed stringent air pollution regulations, in one of the first large-scale regulatory attempts in a developing country. We find that the infant mortality rate fell by 20 percent in the treatment cities designated as "Two Control Zones." The greatest reduction in mortality occurred during the neonatal period, highlighting an important pathophysiologic mechanism, and was largest among infants born to mothers with low levels of education. The finding is robust to various alternative hypotheses and specifications. Further, a falsification test using deaths from causes unrelated to air pollution supports these findings.

  12. Infant mortality in SMSAs before Medicaid: test of a causal model.

    PubMed Central

    Brooks, C H

    1978-01-01

    Path analysis is applied to data on infant mortality, supplies of physicians and hospital beds, and population percentages of blacks and low-income families in 201 standard metropolitan statistical areas (SMSAs) to test the hypothesis that medical resources mediate the effects of racial composition and low income on infant mortality rates. The hypothesis is not supported for the SMSA data: direct effects of racial composition and low income on infant mortality are stronger than indirect effects. The use of SMSA data for analysis is contrasted with the use of county data in a discussion of study by Anderson, from which the hypothesis was drawn. PMID:632103

  13. Contingency, Imitation, and Affect Sharing: Foundations of Infants' Social Awareness

    ERIC Educational Resources Information Center

    Markova, Gabriela; Legerstee, Maria

    2006-01-01

    Predictions about the role of contingency, imitation, and affect sharing in the development of social awareness were tested in infants during natural, imitative, and yoked conditions with their mothers at 5 and 13 weeks of age. Results showed that at both ages, infants of highly attuned mothers gazed, smiled, and vocalized positively more during…

  14. Apparent disappearance of the black-white infant mortality gap - Dane County, Wisconsin, 1990-2007.

    PubMed

    2009-05-29

    Despite substantial reductions in U.S. infant mortality during the past several decades, black-white disparities in infant mortality persist. Among 40 states with sufficient numbers of black infant deaths to generate reliable rates for the years 2002-2004, Wisconsin had the highest black infant mortality rate (IMR) at 17.6 deaths per 1,000 live births, approximately three times the state rate for whites. However, in contrast to trends in Wisconsin and the other 39 states, the black IMR in Dane County, Wisconsin, has declined substantially, achieving parity with whites and meeting Healthy People 2010 objective 16-1 for reducing fetal and infant deaths. The county rate declined 67%, from 19.4 per 1,000 live births for the period 1990-2001 to 6.4 for the period 2002-2007. To gain understanding of this development, Public Health Madison Dane County (PHMDC) analyzed approximately 100,000 birth and death records from 1990 through 2007 for birthweight, gestational age, prenatal care, and other infant mortality risk factors. The main contributors to the decrease in black infant mortality were a large decrease in the extremely premature (mortality rate for newborns weighing <1,500 g. Because the observed trend in black infant mortality is based on small reductions in the absolute number of deaths (approximately three infants per year), conclusions based on these results should be considered preliminary, and additional studies are needed to confirm the reduction in rates over time. PHMDC is planning continued surveillance and other studies to determine whether the reduction in mortality is stable.

  15. Human Cytomegalovirus Infant Infection Adversely Affects Growth and Development in Maternally HIV-Exposed and Unexposed Infants in Zambia

    PubMed Central

    Larke, N.; Sanz-Ramos, M.; Bates, M.; Musonda, K.; Manno, D.; Siame, J.; Monze, M.; Filteau, S.

    2012-01-01

    Background. Human immunodeficiency virus (HIV) and human cytomegalovirus (HCMV) coinfections have been shown to increase infant morbidity, mortality, and AIDS progression. In HIV-endemic regions, maternal HIV-exposed but HIV-uninfected infants, which is the majority of children affected by HIV, also show poor growth and increased morbidity. Although nutrition has been examined, the effects of HCMV infection have not been evaluated. We studied the effects of HCMV infection on the growth, development, and health of maternally HIV-exposed and unexposed infants in Zambia. Methods. Infants were examined in a cohort recruited to a trial of micronutrient-fortified complementary foods. HIV-infected mothers and infants had received perinatal antiretroviral therapy to prevent mother-to-child HIV transmission. Growth, development, and morbidity were analyzed by linear regression analyses in relation to maternal HIV exposure and HCMV infection, as screened by sera DNA for viremia at 6 months of age and by antibody for infection at 18 months. Results. All HCMV-seropositive infants had decreased length-for-age by 18 months compared with seronegative infants (standard deviation [z]-score difference: −0.44 [95% confidence interval {CI}, −.72 to −.17]; P = .002). In HIV-exposed infants, those who were HCMV positive compared with those who were negative, also had reduced head size (mean z-score difference: −0.72 [95% CI, −1.23 to −.22]; P = .01) and lower psychomotor development (Bayley test score difference: −4.1 [95% CI, −7.8 to −.5]; P = .03). HIV-exposed, HCMV-viremic infants were more commonly referred for hospital treatment than HCMV-negative infants. The effects of HCMV were unaffected by micronutrient fortification. Conclusion. HCMV affects child growth, development, and morbidity of African infants, particularly in those maternally exposed to HIV. HCMV is therefore a risk factor for child health in this region. PMID:22247303

  16. Lead Water Pipes and Infant Mortality at the Turn of the Twentieth Century

    ERIC Educational Resources Information Center

    Troesken, Werner

    2008-01-01

    In 1897, about half of all American municipalities used lead pipes to distribute water. Employing data from Massachusetts, this paper compares infant death rates in cities that used lead water pipes to rates in cities that used nonlead pipes. In the average town in 1900, the use of lead pipes increased infant mortality by 25 to 50 percent.…

  17. Determining the Amount, Timing and Causes of Mortality among Infants with Down Syndrome

    ERIC Educational Resources Information Center

    Goldman, S. E.; Urbano, R. C.; Hodapp, R. M.

    2011-01-01

    Objective: To examine the amount, timing and causes/correlates of infant mortality among newborns with Down syndrome. Methods: Using the Tennessee Department of Health Birth, Hospital Discharge and Death records, infants were identified who were born with Down syndrome from 1990 to 2006. Those who died during the first year were separated into…

  18. Infant Mortality Rates: Socioeconomic Factors. United States. National Vital Statistics System, Series 22, Number 14.

    ERIC Educational Resources Information Center

    National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

    Statistics are presented on infant mortality rates according to race, sex, family income, education of mother, and education of father. The statistics are based on data collected by a questionnaire mailed to mothers of legitimate births and to medical care facilities and mothers of legitimate infant deaths. Samples were selected from records of…

  19. Infant Mortality in Washington, D.C.: A Study of Risk Factors among Black Residents.

    ERIC Educational Resources Information Center

    Ahmed, Feroz

    This report examines the determinants of the high level of infant mortality in Washington, D.C. Data were analyzed for 36,872 black resident single-delivery births occurring in the years 1980 through 1984, and 762 infant deaths occurring to these birth cohorts from 1980 to 1985. Findings were the following: (1) poor birthweight distribution among…

  20. Factors which affect mortality in neonatal sepsis

    PubMed Central

    Turhan, Esma Ebru; Gürsoy, Tuğba; Ovalı, Fahri

    2015-01-01

    Aim: Neonatal sepsis is an important cause of mortality and morbidity in newborns. The causative agents may be different in different units and may change in time. It was aimed to examine the microbiological agents leading to sepsis, clinical features and antibiotic resistances in babies with sepsis hospitalized in our unit in a two-year period. Material and Methods: The clinical features, microbiological and laboratory results, antibiotic resistance patterns and mortality rates of the newborns with sepsis followed up in our unit between 2010 and 2011 were examined in the patient record system. Results: 351 babies diagnosed with sepsis among 3219 patients hospitalized in the neonatal intensive care unit were included in the study. The mean gestational age was found to be 30.1±4.1 weeks, the mean birth weight was found to be 1417.4±759.1 g and the mean hospitalization time was found to be 43.6±34.4 days. Blood cultures were found to be positive in 167 (47.6%) patients, urine cultures were found to be positive in 6 (7.1%) patients and cerebrospinal fluid cultures were found to be positive in 34 (9.6%) cases. Candida grew in 5 patients (2 patients with early-onset sepsis and 3 patients with late-onset sepsis). The most common cause of sepsis was found to be staphylococci (coagulase negative staphylococcus was found in 65 patients (51%) and Staphylococcus aureus was found in 38 patients (39%). 49.6% (n=63) of the gram positive bacteriae and 60% (n=21) of the gram negative bacteriae were resistant to antibiotics. Six (7.1%) of the patients who were infected with these bacteriae were lost. In total 24 babies were lost because of sepsis. The bacteriae which caused to mortality with the highest rate included E. coli, coagulase negative staphylocicci, S. aureus and Klebsiella. Low birth weight, mechanical ventilation and parenteral nutrition were found to be significant risk factors in terms of mortality. Conclusions: Staphylococci were found to be the most common agents

  1. Ecological context of infant mortality in high-focus states of India

    PubMed Central

    2016-01-01

    OBJECTIVES: This goal of this study was to shed light on the ecological context as a potential determinant of the infant mortality rate in nine high-focus states in India. METHODS: Data from the Annual Health Survey (2010-2011), the Census of India (2011), and the District Level Household and Facility Survey 3 (2007-08) were used in this study. In multiple regression analysis explanatory variable such as underdevelopment is measured by the non-working population, and income inequality, quantified as the proportion of households in the bottom wealth quintile. While, the trickle-down effect of education is measured by female literacy, and investment in health, as reflected by neonatal care facilities in primary health centres. RESULTS: A high spatial autocorrelation of district infant mortality rates was observed, and ecological factors were found to have a significant impact on district infant mortality rates. The result also revealed that non-working population and income inequality were found to have a negative effect on the district infant mortality rate. Additionally, female literacy and new-born care facilities were found to have an inverse association with the infant mortality rate. CONCLUSIONS: Interventions at the community level can reduce district infant mortality rates. PMID:26971696

  2. Is economic inequality in infant mortality higher in urban than in rural India?

    PubMed

    Kumar, Abhishek; Singh, Abhishek

    2014-11-01

    This paper examines the trends in economic inequality in infant mortality across urban-rural residence in India over last 14 years. We analysed data from the three successive rounds of the National Family Health Survey conducted in India during 1992-1993, 1998-1999, and 2005-2006. Asset-based household wealth index was used as the economic indicator for the study. Concentration index and pooled logistic regression analysis were applied to measure the extent of economic inequality in infant mortality in urban and rural India. Infant mortality rate differs considerably by urban-rural residence: infant mortality in rural India being substantially higher than that in urban India. The findings suggest that economic inequalities are higher in urban than in rural India in each of the three survey rounds. Pooled logistic regression results suggest that, in urban areas, infant mortality has declined by 22 % in poorest and 43 % in richest. In comparison, the decline is 29 and 32 % respectively in rural India. Economic inequality in infant mortality has widened more in urban than in rural India in the last two decades.

  3. Impact of the Family Health Program on Infant Mortality in Brazilian Municipalities

    PubMed Central

    de Oliveira, Nelson F.; Barreto, Mauricio L.

    2009-01-01

    Objectives. We evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. Methods. We collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. We performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. Results. We observed a statistically significant negative association between FHP coverage and infant mortality rate. After we controlled for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. Conclusions. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities. PMID:19008516

  4. The extraordinary decline of infant and childhood mortality among Palestinian refugees.

    PubMed

    Khawaja, Marwan

    2004-02-01

    This article documents the levels and patterns of infant and child mortality among Palestinian refugees in Jordan, Lebanon and the Palestinian areas based on comparable data from household sample surveys conducted since 1995. The findings show that Palestinian refugees have clear advantage in mortality levels as compared to their non-refugee counterparts in every setting, and refugees living in the camps have similar or lower levels of mortality than their non-camp counterparts, other things being equal. The recent decline of infant and child mortality among this vulnerable segment of the Palestinian population demonstrates the importance of political will in halting the truncation of infant lives. An examination of the mortality patterns by sex and education sheds light on the nature of the decline currently underway.

  5. [The regularities and tendencies of infant and children mortality in the Russian Federation].

    PubMed

    Baranov, A A; Namazova-Baranova, L S; Albitskii, V Yu; Terletskaia, R N

    2015-01-01

    The article presents dynamics and causes of infant and children mortality in the Russian Federation during post-soviet period (1990-2012) in conditions of implementation of demographic policy and reforming of health care system. The data of official statistics of Rosstat (1990-2012) is analyzed. The comparative analysis with similar indicators in countries of European Union was made. The significant decreasing of infant mortality more than twice at the expense of all its components (early neonatal, neonatal, post-neonatal mortality) and because ofalmost all causes (conditions of perinatal period, infectious diseases, respiratory organs diseases, malformations, accidents) is established In the Russian. Federation, the characteristic of this indicator is decreasing of neonatal mortality and mortality and increasing of post-neonatal mortality in contrast with countries of European Union where its decreasing occurs just at the expense of late losses. It is demonstrated that this particularity is conditioned by under-registration of infants died in early neonatal period. The higher level of infant mortality in rural territories is established. However, the gap between urban and rural indicators shortens. In the Russian Federation infant mortality has regional characteristics and the Siberian and Far-East region are the most unfavorable ones. The mortality of children aged before 5 decreases. However, its level is still higher than in countries of European Union. Among causes of death of children in this age group the first places are for external factors and significance of malignant neoplasms increases. Therefore, development of system of mother and child health care in the Russian Federation made it possible to significantly decrease infant and children mortality.

  6. Infant Mortality on the Yakama Indian Reservation, 1914-1964.

    ERIC Educational Resources Information Center

    Trafzer, Clifford E.

    1999-01-01

    Infants under age 1 constituted the most deaths recorded for any age group among Native people on the Yakama Indian Reservation (Washington), between 1914 and 1964. Poverty conditions, including poor diet and unsanitary housing; social anomie; and lack of adequate health care contributed to infant deaths. Data tables and figures detail infant…

  7. Infant mortality after takeovers in wild Ethiopian hamadryas baboons.

    PubMed

    Swedell, Larissa; Tesfaye, Teklu

    2003-07-01

    In this work we report the first observational evidence of infanticide in wild hamadryas baboons. The study group inhabits the lowlands of the northern Rift Valley in Ethiopia and has been under observation for over 1,200 hr, on and off, since October 1996. Here we report observations from August and September 2002 of the consequences of two takeovers of known females with black infants. After the first takeover, the respective infant disappeared and was presumed dead within 11 days of the takeover. After the second takeover, the infant incurred repeated severe aggression from its mother's new leader male and eventually died 4 days after the takeover. We interpret these findings as support for the sexual selection hypothesis regarding male infanticide. We suggest that hamadryas leader males usually protect infants born into their units, but may withhold this protection-or even directly attack and kill infants-after takeovers.

  8. Socioeconomic status and infant mortality among Hispanics in a southwestern city.

    PubMed

    Levin, J S; Markides, K S

    1985-01-01

    Recent investigations of infant mortality in the Southwest part of the US have shown that Spanish surname infant death rates are lower than might be expected from the relatively low socioeconomic standing of the Spanish surname population, a phenomenon that appears to be confined to the neonatal componont of the infant mortality rate. The relationship between socioeconomic status (ses) and infant mortality is examined overall and separately within the Anglo and Spanish surname populations of Corpus Christ, Texas. The investigation utilizes data from the 36 Nueces County census tracts. Most recent data on infant, neonatal, and postneonatal mortality was provided by the local health department. Subjects were limited to Anglos and those whites with at least 1 Spanish surname parent. The 1979-1983 cohort is analyzed. Information from the 1980 US census was utilized to divide the 36 census tracts into 3 SES groups: high, medium and low. The most immediately striking aspect of the findings is the significant inverse gradient in Anglos between SES and both the total infant mortality rate (IMR) and the neonatal mortality (NMR), a gradient which is nonexistent in the Spanish surname population as well as overall. In addition, Anglos and Spanish persons differ significantly with respect to all IMRs and NMRs. In the high and medium SES groups and overall, all Anglo rates are lower, while in the low SES group, Spanish surname rates are lower. These findings suggest that, among Anglos, SES is a crucial factor in infant deaths, whereas, among the Spanish surname population, having a medium or high SES does not offer any additional protection against mortality. Alternatively, lower SES does not translate into significantly lower infant mortality among Spanish persons. These findings provide support for the study's hypotheses that the SES-infant mortality association is weaker among Spanish persons than among Anglos. The analysis also shows the importance of analyzing the SES-infant

  9. Polygynous Contexts, Family Structure, and Infant Mortality in sub-Saharan Africa

    PubMed Central

    Smith-Greenaway, Emily; Trinitapoli, Jenny

    2014-01-01

    Contextual characteristics influence infant mortality above and beyond family-level factors. The widespread practice of polygyny is one feature of many sub-Saharan African contexts that may be relevant to understanding patterns of infant mortality. Building on evidence that the prevalence of polygyny reflects broader economic, social, and cultural features, and has implications for how families engage in the practice, we investigate whether and how the prevalence of polygyny (1) spills over to elevate infant mortality for all families, and (2) conditions the survival disadvantage for children living in polygynous families (i.e., compared to monogamous families). We use data from Demographic and Health Surveys to estimate multilevel hazard models that identify associations between infant mortality and region-level prevalence of polygyny among 236,336 children in 260 subnational regions across 29 sub-Saharan African countries. We find little evidence that the prevalence of polygyny influences mortality for infants in non-polygynous households net of region-level socioeconomic factors and gender inequality. However, the prevalence of polygyny significantly amplifies the survival disadvantage for infants in polygynous families. Our findings demonstrate that considering the broader marital context reveals important insights into the relationship between family structure and child wellbeing. PMID:24402794

  10. Developing a statewide public health initiative to reduce infant mortality in Oklahoma.

    PubMed

    Dooley, Suzanna; Patrick, Paul; Lincoln, Alicia; Cline, Janette

    2014-01-01

    The Preparing for a Lifetime, It's Everyone's Responsibility initiative was developed to improve the health and well- being of Oklahoma's mothers and infants. The development phase included systematic data collection, extensive data analysis, and multi-disciplinary partnership development. In total, seven issues (preconception/interconception health, tobacco use, postpartum depression, breastfeeding, infant safe sleep, preterm birth, and infant injury prevention) were identified as crucial to addressing infant mortality in Oklahoma. Workgroups were created to focus on each issue. Data and media communications workgroups were added to further partner commitment and support for policy and programmatic changes across multiple agencies and programs. Leadership support, partnership, evaluation, and celebrating small successes were important factors that lead to large scale adoption and support for the state-wide initiative to reduce infant mortality.

  11. Do Fertility Transitions Influence Infant Mortality Declines? Evidence from Early Modern Germany

    PubMed Central

    Fernihough, Alan; McGovern, Mark E.

    2014-01-01

    The timing and sequencing of fertility transitions and early-life mortality declines in historical Western societies indicates that reductions in sibship (number of siblings) may have contributed to improvements in infant health. Surprisingly however, this demographic relationship has received little attention in empirical research. We outline the difficulties associated with establishing the causal effect of sibship on infant mortality, and discuss the inherent bias associated with conventional empirical approaches. We offer a solution that permits an empirical test of this relationship whilst accounting for reverse causality. Our approach is illustrated by evaluating the causal impact of family size on infant mortality using genealogical data from 13 German parishes spanning the 16th, 17th, 18th and 19th centuries. Overall, our findings do not support the hypothesis that declining fertility led to increased infant survival probabilities in historical populations. PMID:25404789

  12. Improvement in Infant and Perinatal Mortality in the United States, 1965-1973.

    ERIC Educational Resources Information Center

    Information Sciences Research Inst., Washington, DC.

    Changes in United States infant and perinatal mortality during the period 1965-1973 are examined by race, age at death or length of gestation, and degree of urbanization. Several improvements in mortality rates are identified and discussed in relation to changes in the United States which have occurred in economic conditions and standards of…

  13. Paradox found (again): infant mortality among the Mexican-origin population in the United States.

    PubMed

    Hummer, Robert A; Powers, Daniel A; Pullum, Starling G; Gossman, Ginger L; Frisbie, W Parker

    2007-08-01

    Recent research suggests that the favorable mortality outcomes for the Mexican immigrant population in the United States may largely be attributable to selective out-migration among Mexican immigrants, resulting in artificially low recorded death rates for the Mexican-origin population. In this paper we calculate detailed age-specific infant mortality rates by maternal race/ethnicity and nativity for two important reasons: (1) it is extremely unlikely that women of Mexican origin would migrate to Mexico with newborn babies, especially if the infants were only afew hours or afew days old; and (2) more than 50% of all infant deaths in the United States occur during the first week of life, when the chances of out-migration are very small. We use concatenated data from the U.S. linked birth and infant death cohort files from 1995 to 2000, which provides us with over 20 million births and more than 150,000 infant deaths to analyze. Our results clearly show that first-hour, first-day, and first-week mortality rates among infants born in the United States to Mexican immigrant women are about 10% lower than those experienced by infants of non-Hispanic, white U.S.-born women. It is extremely unlikely that such favorable rates are artificially caused by the out-migration of Mexican-origin women and infants, as we demonstrate with a simulation exercise. Further, infants born to U.S.-born Mexican American women exhibit rates of mortality that are statistically equal to those of non-Hispanic white women during the first weeks of life and fare considerably better than infants born to non-Hispanic black women, with whom they share similar socioeconomic profiles. These patterns are all consistent with the definition of the epidemiologic paradox as originally proposed by Markides and Coreil (1986).

  14. Infant mortality in Kyrgyzstan before and after the break-up of the Soviet Union.

    PubMed

    Guillot, Michel; Lim, So-Jung; Torgasheva, Liudmila; Denisenko, Mikhail

    2013-01-01

    There is a great deal of uncertainty over the levels of, and trends in, infant mortality in the former Soviet republics of Central Asia. As a result, the impact of the break-up of the Soviet Union on infant mortality in the region is not known, and proper monitoring of mortality levels is impaired. In this paper, a variety of data sources and methods are used to assess levels of infant mortality and their trend over time in one Central Asian republic, Kyrgyzstan, between 1980 and 2010. An abrupt halt to an already established decline in infant mortality was observed to occur during the decade following the break-up of the Soviet Union, contradicting the official statistics based on vital registration. Infants of Central Asian ethnicity and those born in rural areas were also considerably more at risk of mortality than suggested by the official sources. We discuss the implications of these findings, both for health policy in this seldom studied part of the former Soviet Union and for our understanding of the health crisis which it currently faces.

  15. Comparing relative effects of education and economic resources on infant mortality in developing countries.

    PubMed

    Pamuk, Elsie R; Fuchs, Regina; Lutz, Wolfgang

    2011-01-01

    Research on the social determinants of health has often considered education and economic resources as separate indicators of socioeconomic status. From a policy perspective, however, it is important to understand the relative strength of the effect of these social factors on health outcomes, particularly in developing countries. It is also important to examine not only the impact of education and economic resources of individuals, but also whether community and country levels of these factors affect health outcomes. This analysis uses multilevel regression models to assess the relative effects of education and economic resources on infant mortality at the family, community, and country level using data from demographic and Health Surveys in 43 low-and lower-middle-income countries. We find strong effects for both per capita gross national income and completed secondary education at the country level, but a greater impact of education within families and communities.

  16. Trends in infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight.

    PubMed

    Barría-Pailaquilén, René Mauricio; Mendoza-Maldonado, Yessy; Urrutia-Toro, Yohana; Castro-Mora, Cristian; Santander-Manríquez, Gema

    2011-01-01

    The aim of the study was to assess the trend of the infant mortality rate between 1990-2004 and the neonatal mortality between 2000-2005 in infants born at less than 32 weeks of gestational age or with very low birth-weight. Based on secondary data, infant mortality rate and by its component for Valdivia city were compared with national indicators. Mortality at <32 weeks and <1500g was calculated, establishing causes of death and evaluating its relation with specific interventions, such as the use of surfactant and antenatal corticoids. Since the year 2000, infant mortality rates have stopped their decrease in comparison to the preceding decade and the gap between national and local rates before 2000 was drastically reduced. Mortality at <32 weeks and <1500g varied between 88% and 200% of liveborns, emphasizing respiratory distress as the main cause of death. The use of corticoids and surfactant was in line with reductions in mortality rates.

  17. Maternal factors, birthweight, and racial differences in infant mortality: a Georgia population-based study.

    PubMed Central

    Sung, J. F.; Taylor, B. D.; Blumenthal, D. S.; Sikes, K.; Davis-Floyd, V.; McGrady, G.; Lofton, T. C.; Wade, T. E.

    1994-01-01

    Black infant mortality rates (IMRs) are approximately twice those of whites in Georgia and nationwide. This study evaluates maternal factors, 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) PMID:8078081

  18. The social bases of declining infant mortality: lessons from a nineteenth-century Italian town.

    PubMed

    Hogan, D P; Kertzer, D I

    1987-05-01

    A detailed study of the factors associated with the decline of infant mortality in the town of Casalecchio di Reno, near Bologna, Italy, from 1865-1921 was generated from household tax records, birth and death registers, census data, and a variety of scholarly sources. Infant mortality had been 400/1000 in 17th century, fell to about 250 in the mid 18th, to 186 from 1865-1880, to 100 in 1900, and 75 in 1910. Infant mortality was lower among merchant and sharecropper families who had decent housing, food and water, higher among daily wage workers who lived in filthy crowded apartments on marginal incomes, and much higher among women who worked in emerging textile factories who could not breastfeed and used animal milk (682/1000 in 1903). Results are expressed in terms of probability of an infant death for specific demographic or maternal characteristics. Infant deaths among wage working women began to fall after 1902 when the government regulated child and female labor, requiring post-partum leave and time to breastfeed. The fact that factory workers were literate and urbanized did not help their children survive until they received better water, sewage systems, free medical care, and better housing. Thus, infant mortality varied in subgroups, was not necessarily lower in "modern" urban classes, and its fall depended on direct government intervention.

  19. Geographic analysis of low birthweight and infant mortality in Michigan using automated zoning methodology

    PubMed Central

    Grady, Sue C; Enander, Helen

    2009-01-01

    Background Infant mortality is a major public health problem in the State of Michigan and the United States. The primary adverse reproductive outcome underlying infant mortality is low birthweight. Visualizing and exploring the spatial patterns of low birthweight and infant mortality rates and standardized incidence and mortality ratios is important for generating mechanistic hypotheses, targeting high-risk neighborhoods for monitoring and implementing maternal and child health intervention and prevention programs and evaluating the need for health care services. This study investigates the spatial patterns of low birthweight and infant mortality in the State of Michigan using automated zone matching (AZM) methodology and minimum case and population threshold recommendations provided by the National Center for Health Statistics and the US Census Bureau to calculate stable rates and standardized incidence and mortality ratios at the Zip Code (n = 896) level. The results from this analysis are validated using SaTScan. Vital statistics birth (n = 370,587) and linked infant death (n = 2,972) records obtained from the Michigan Department of Community Health and aggregated for the years 2004 to 2006 are utilized. Results For a majority of Zip Codes the relative standard errors (RSEs) of rates calculated prior to AZM were greater than 20%. Spurious results were the result of too few case and birth counts. Applying AZM with a target population of 25 cases and minimum threshold of 20 cases resulted in the reconstruction of zones with at least 50 births and RSEs of rates 20–22% and below respectively, demonstrating the stability reliability of these new estimates. Other AZM parameters included homogeneity constraints on maternal race and maximum shape compactness of zones to minimize potential confounding. AZM identified areas with elevated low birthweight and infant mortality rates and standardized incidence and mortality ratios. Most but not all of these areas were also

  20. Infant mortality trends in a region of Belarus, 1980–2000

    PubMed Central

    Zichittella, Lauren J; Mahoney, Martin C; Lawvere, Silvana; Michalek, Arthur M; Chunikhovskiy, Sergey P; Khotianov, Natan

    2004-01-01

    Background The Chernobyl disaster in 1986 and the breakup of the former Soviet Union (FSU) in 1991 challenged the public health infrastructure in the former Soviet republic of Belarus. Because infant mortality is regarded as a sensitive measure of the overall health of a population, patterns of neonatal and postneonatal deaths were examined within the Mogilev region of Belarus between 1980 and 2000. Methods Employing administrative death files, this study utilized a regional cohort design that included all infant deaths occurring among persons residing within the Mogilev oblast of Belarus between 1980 and 2000. Patterns of death and death rates were examined across 3 intervals: 1980–1985 (pre-Chernobyl), 1986–1991 (post-Chernobyl & pre-FSU breakup), and 1992–2000 (post-Chernobyl & post-FSU breakup). Results Annual infant mortality rates declined during the 1980s, increased during the early 1990s, and have remained stable thereafter. While infant mortality rates in Mogilev have decreased since the period 1980–1985 among both males and females, this decrement appears due to decreases in postneonatal mortality. Rates of postneonatal mortality in Mogilev have decreased since the period 1980–1985 among both males and females. Analyses of trends for infant mortality and neonatal mortality demonstrated continuous decreases between 1990, followed by a bell-shaped excess in the 1990's. Compared to rates of infant mortality for other countries, rates in the Mogilev region are generally higher than rates for the United States, but lower than rates in Russia. During the 1990s, rates for both neonatal and postneonatal mortality in Mogilev were two times the comparable rates for East and West Germany. Conclusions While neonatal mortality rates in Mogilev have remained stable, rates for postneonatal mortality have decreased among both males and females during the period examined. Infant mortality rates in the Mogilev region of Belarus remain elevated compared to rates

  1. Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010

    PubMed Central

    Xiao, Lin; Zhang, Dan-Li; Torrie, Jill; Auger, Nathalie; McHugh, Nancy Gros-Louis; Luo, Zhong-Cheng

    2016-01-01

    Background Cree births in Quebec are characterized by the highest reported prevalence of macrosomia (~35%) in the world. It is unclear whether Cree births are at greater elevated risk of perinatal and infant mortality than other First Nations relative to non-Aboriginal births in Quebec, and if macrosomia may be related. Methods This was a population-based retrospective birth cohort study using the linked birth-infant death database for singleton births to mothers from Cree (n = 5,340), other First Nations (n = 10,810) and non-Aboriginal (n = 229,960) communities in Quebec, 1996–2010. Community type was ascertained by residential postal code and municipality name. The primary outcomes were perinatal and infant mortality. Results Macrosomia (birth weight for gestational age >90th percentile) was substantially more frequent in Cree (38.0%) and other First Nations (21.9%) vs non-Aboriginal (9.4%) communities. Comparing Cree and other First Nations vs non-Aboriginal communities, perinatal mortality rates were 1.52 (95% confidence intervals 1.17, 1.98) and 1.34 (1.10, 1.64) times higher, and infant mortality rates 2.27 (1.71, 3.02) and 1.49 (1.16, 1.91) times higher, respectively. The risk elevations in perinatal and infant death in Cree communities attenuated after adjusting for maternal characteristics (age, education, marital status, parity), but became greater after further adjustment for birth weight (small, appropriate, or large for gestational age). Conclusions Cree communities had greater risk elevations in perinatal and infant mortality than other First Nations relative to non-Aboriginal communities in Quebec. High prevalence of macrosomia did not explain the elevated risk of perinatal and infant mortality in Cree communities. PMID:27517613

  2. The evolution of fetal and infant mortality review as a public health strategy.

    PubMed

    Koontz, Ann M; Buckley, Kathleen A; Ruderman, Marjory

    2004-12-01

    Infant mortality review (IMR), the forerunner of fetal and infant mortality review (FIMR), emerged at the national level in the mid-1980s as a promising method to improve understanding of local factors contributing to infant mortality and to motivate community response. Building on federal efforts to enhance data capacity and early state and local infant mortality case review studies, the federal Maternal and Child Health Bureau (MCHB) initiated its IMR Program in 1988. Key actions taken to refine and diffuse the IMR/FIMR method include forging a public-private partnership between MCHB and the American College of Obstetricians and Gynecologists in 1990 to develop the National Fetal and Infant Mortality Review Program, recruiting prominent leaders to advocate for FIMR, seeding community projects in geographically dispersed states and localities, and routinely reporting best practices information to the field. In concert with the articulation of core public health functions and a growing emphasis on accountability, attention at the national level has turned to promoting and institutionalizing FIMR in state systems. Efforts are underway in states to build on the FIMR model and coordinate multiple maternal and child health-related review programs. Increasingly, FIMR is recognized as a strategy for contributing to implementation of the core public health functions of assessment, policy development, and quality assurance. The recent national evaluation of FIMR sheds new light on the role of FIMR in community and state maternal and child health systems and marks a new phase in the evolution of FIMR.

  3. Maternal education, birth weight, and infant mortality in the United States.

    PubMed

    Gage, Timothy B; Fang, Fu; O'Neill, Erin; Dirienzo, Greg

    2013-04-01

    This research determines whether the observed decline in infant mortality with socioeconomic level, operationalized as maternal education (dichotomized as college or more, versus high school or less), is due to its "indirect" effect (operating through birth weight) and/or to its "direct" effect (independent of birth weight). The data used are the 2001 U.S. national African American, Mexican American, and European American birth cohorts by sex. The analysis explores the birth outcomes of infants undergoing normal and compromised fetal development separately by using covariate density defined mixture of logistic regressions (CDDmlr). Among normal births, mean birth weight increases significantly (by 27-108 g) with higher maternal education. Mortality declines significantly (by a factor of 0.40-0.96) through the direct effect of education. The indirect effect of education among normal births is small but significant in three cohorts. Furthermore, the indirect effect of maternal education tends to increase mortality despite improved birth weight. Among compromised births, education has small and inconsistent effects on birth weight and infant mortality. Overall, our results are consistent with the view that the decrease in infant death by socioeconomic level is not mediated by improved birth weight. Interventions targeting birth weight may not result in lower infant mortality.

  4. Laughing matters: Infant humor in the context of parental affect.

    PubMed

    Mireault, Gina C; Crockenberg, Susan C; Sparrow, John E; Cousineau, Kassandra; Pettinato, Christine; Woodard, Kelly

    2015-08-01

    Smiling and laughing appear very early during the first year of life, but little is known about how infants come to appraise a stimulus as humorous. This short-term longitudinal study explored infant humor perception from 5 to 7 months of age as a function of parental affect during an absurd event. Using a within-participants design, parents alternated smiling/laughing with emotional neutrality while acting absurdly toward their infants. Group comparisons showed that infants (N = 37) at all ages smiled at the event regardless of parental affect but did so significantly longer at 5 and 6 months, and more often and sooner at 7 months, when parents provided humor cues. Similarly, sequential analyses revealed that after gazing at the event, 7-month-olds were more likely to smile at it only when parents provided humor cues and were comparatively more likely to look away when parents were neutral. Thus, starting at 5 months of age, parental affect influenced infants' affect toward an absurd event, an effect that was magnified at 7 months. These results are discussed in the context of emotional contagion, regulation, and the emergence of social referencing.

  5. The Aberdeen Indian Health Service infant mortality study: design, methodology, and implementation.

    PubMed

    Randall, L L; Krogh, C; Welty, T K; Willinger, M; Iyasu, S

    2001-01-01

    Of all Indian Health Service areas, the Aberdeen Area has consistently had the highest infant mortality rate. Among some tribes in this area the rate has exceeded 30/ 1000 live birth and half the infant deaths have been attributed to Sudden Infant Death Syndrome,a rate four to five times higher than the national average. The Indian Health Service, Centers for Disease Control and Prevention, National Institute of Child Health and Human Development, and the Aberdeen Area Tribal Chairmen's Health Board collaborated to investigate these high rates with the goals of refining the ascertainment of the causes of death, improving cause-specific infant mortality rates and identifying factors contributing to the high rates. Ten of the 19 tribes or tribal communities, representing 66%of the area population, participated in a 4-year prospective case-control study of infants who died after discharge from the hospital. Infant care practices and socio-demographic, economic, medical, health care, and environmental factors were examined. The study included parental interviews, death scene investigations, autopsies, neuropathology studies, medical chart abstractions, blood cotinine assays, and a surveillance system for infant deaths. Controls were the previous and subsequent infants born on the case mother's reservation. From December 1,1992 until November 30,1996,72 infant deaths were investigated. This report describes the study methods and the model employed for involving the community and multiple agencies to study the problem of infant mortality among Northern Plains Indians. Data gathered during the investigations are being analyzed and will be published at a later date.

  6. Analysis of geographic differentials in infant mortality rates. The Or Yehuda community.

    PubMed

    Barell, V; Wax, Y; Ruder, A

    1988-07-01

    Comprehensive evaluation of matched infant death certificate data and livebirth certificate data for 1977-1980 was performed for two areas in Israel: Or Yehuda, a small, low socioeconomic status community which had an infant mortality rate of 19.1 per 1,000, and the rest of Ramat Gan district, which had an infant mortality rate of 10.3 per 1,000. A method is presented which illuminates the role of statistical models in analyzing small area data, in evaluating twofold observed differences in crude and factor-specific mortality rates in two areas, in assessing heterogeneity in population stratum-specific mortality rate ratios, and in identifying causes for inter-area differences in infant mortality rate. Identical logistic models were fitted to each of the areas independently, and these were used to investigate effects due to birth weight, sex, parity, maternal age and education, and parental occupation. The differences in the distribution of risk level (number of risk factors) present in each population (or the proportion of multi-problem families) were identified as a single factor that can explain most of the disparity between the areas. The direction and magnitude of the relation between risk level and infant mortality rate were similar in both communities: the greater the number of risk factors, the higher the rate. Identification of a target population for intervention through only one or two specific risk factors would be unprofitable in reducing the overall community infant mortality rate since too many families with multiple risk would be excluded, and too many with single risk factors would be included.

  7. Poor Infants, Poor Chances: A Longitudinal Study of Progress toward Reducing Low Birth Weight and Infant Mortality in the United States and Its Largest Cities, 1979-1984.

    ERIC Educational Resources Information Center

    Ducey, Sara Bachman; And Others

    This study examined low birth weight and infant mortality in the 50 states and the 54 largest American cities between 1979 and 1984. Its findings confirm that progress in reducing low birth weight and infant mortality has slowed, and in some cases the progress has actually reversed. Some states and many cities had higher rates of low birth weight…

  8. Infant mortality and prenatal care: contributions of the clinic in the light of Canguilhem and Foucault.

    PubMed

    Figueiredo, Paula Pereira de; Lunardi Filho, Wilson Danilo; Lunardi, Valéria Lerch; Pimpão, Fernanda Demutti

    2012-01-01

    This review study aimed to verify how studies conducted in Brazil have related infant mortality to prenatal care and to present contributions of the clinic in the light of Canguilhem and Foucault for qualification of the care. An integrative literature review was conducted from searches in the databases SciELO, LILACS, MEDLINE and BDENF for the period 2000 to 2009. The relationship between infant mortality and prenatal care is related to the insufficient number of consultations or to the quality of the care provided. Even when the number of and routine consultations in the prenatal care were adequate, avoidable deaths were present. For the qualification of prenatal care, it is suggested that the clinical knowledge and other elements that comprise the process of human living are considered, in order that the clinical view is enlarged and articulated to the technologies available in the health system and, together, they are able to contribute to the reduction of infant mortality in Brazil.

  9. Air pollution and infant mortality from pneumonia in the Rio de Janeiro metropolitan area

    SciTech Connect

    Penna, M.L.; Duchiade, M.P. )

    1991-01-01

    The authors report the results of an investigation into the possible association between air pollution and infant mortality from pneumonia in the Rio de Janeiro Metropolitan Area. This investigation employed multiple linear regression analysis (stepwise method) for infant mortality from pneumonia in 1980, including the study population's areas of residence, incomes, and pollution exposure as independent variables. With the income variable included in the regression, a statistically significant association was observed between the average annual level of particulates and infant mortality from pneumonia. While this finding should be accepted with caution, it does suggest a biological association between these variables. The authors' conclusion is that air quality indicators should be included in studies of acute respiratory infections in developing countries.

  10. Levels, trends & predictors of infant & child mortality among Scheduled Tribes in rural India

    PubMed Central

    Sahu, Damodar; Nair, Saritha; Singh, Lucky; Gulati, B.K.; Pandey, Arvind

    2015-01-01

    Background & objectives: The level of infant and child mortality is high among Scheduled Tribes particularly those living in rural areas. This study examines levels, trends and socio-demographic factors associated with infant and child mortality among Scheduled Tribes in rural areas. Methods: Data from the three rounds of the National Family Health Survey (NFHS) of India from 1992 to 2006 were analysed to assess the levels and trends of infant and child mortality. Univariate and multivariate Cox proportional hazard model were used to understand the socio-economic and demographic factors associated with mortality during 1992–2006. Results: Significant change was observed in infant and child mortality over the time period from 1992-2006 among Scheduled Tribes in rural areas. After controlling for other factors, birth interval, household wealth, and region were found to be significantly associated with infant and child mortality. Hazard of infant mortality was highest among births to mothers aged 30 yr or more (HR=1.3, 95% CI=1.1-1.7) as compared with births to the mother's aged 20-29 yr. Hazard of under-five mortality was 42 per cent (95% CI=1.3-1.6) higher among four or more birth order compared with the first birth order. The risk of infant dying was higher among male children (HR = 1.2, 95% CI=1.1-1.4) than among female children while male children were at 30 per cent (HR=0.7, 95% CI=0.6-0.7) less hazard of child mortality than female children. Literate women were at 40 per cent (HR=0.6, 95% CI=0.50-0.76) less hazard of child death than illiterate women. Interpretation & conclusions: Mortality differentials by socio-demographic and economic factors were observed over the time period (1992-2006) among Scheduled Tribes (STs) in rural India. Findings support the need to focus on age at first birth and spacing between two births. PMID:26139791

  11. Infant mortality and ethnicity in an indigenous European population: Novel evidence from the Finnish population register

    PubMed Central

    Saarela, Jan

    2014-01-01

    We provide the first analyses of infant mortality rates by indigenous ethnic group in Finland, a country that has one of the lowest relative numbers of infant deaths in the world. Using files from the Finnish population register, we identified both of the parents of children born in the period from 1975–2003 according to ethnic affiliation, socioeconomic profile, and demographic position. The infant mortality rate in homogamous Finnish unions is similar to that in homogamous Swedish unions, which reflects a lack of social disparities between the two groups. Surprisingly, infants from ethnically mixed unions have markedly lower mortality rates, with an adjusted rate ratio of 0.81 relative to homogamous Swedish unions (95% CI: 0.67–0.98). Although not empirically verified, we argue that the lower infant mortality rate in ethnically mixed unions may be due to lower levels of inbreeding, and hence related to historically low intermarriage rates between the two ethnic groups, remote consanguinities, and restricted inter-community gene flow. PMID:24572973

  12. Training affects the development of postural adjustments in sitting infants.

    PubMed Central

    Hadders-Algra, M; Brogren, E; Forssberg, H

    1996-01-01

    1. The present study addressed the question of whether daily balance training can affect the development of postural adjustments in sitting infants. 2. Postural responses during sitting on a moveable platform were assessed in twenty healthy infants at 5-6, 7-8 and 9-10 months of age. Multiple surface EMGs and kinematics were recorded while the infants were exposed to slow and fast horizontal forward (Fw) and backward (Bw) displacements of the platform. After the first session the parents of nine infants trained their child's sitting balance daily. 3. At the youngest age, when none of the infants could sit independently, the muscle activation patterns were direction specific and showed a large variation. This variation decreased with increasing age, resulting in selection of the most complete responses. Training facilitated response selection both during Fw and Bw translations. This suggests a training effect on the first level of the central pattern generator (CPG) model of postural control. 4. Training also affected the development of response modulation during Fw translations. It accelerated the development of: (1) the ability to modulate EMG amplitude with respect to platform velocity and initial sitting position, (2) antagonist activity and (3) a distal onset of the response. These findings point to a training effect on the second level of the CPG model of postural adjustments. Images Figure 1 Figure 4 PMID:8735713

  13. [Social inequalities and health. Socioeconomic level and infant mortality in Chile in 1985-1995].

    PubMed

    Hollstein, R D; Vega, J; Carvajal, Y

    1998-03-01

    Birth and death statistics from Chile¿s National Institute of Statistics were used to determine the influence of socioeconomic status as measured through maternal educational level on infant mortality from 1990-95 and to assess trends since 1985. The rates of infant, neonatal, and postneonatal mortality were calculated for 6 educational groups for the mother and father: 0, 1-3, 4-6,7-9, 10-12, and 13 or more years. The deaths were classified by cause according to the International Classification of Diseases and to Taucher¿s classification into avoidable, difficult to avoid, poorly defined, and other causes. A clear association was observed in levels of infant mortality according to maternal education. Infant mortality rates ranged from 38.2/1000 live births for children of illiterate mothers to 7.8/1000 for children of mothers with higher education. A child of an illiterate mother had a risk of death in the first year 4.9 times higher than the child of a mother with higher education. The same trend was observed for neonatal mortality and for paternal education. The mortality gradient by maternal education was maintained for all causes of death and both classifications studied. Diseases of the respiratory system had a relative risk (RR) of 14.3 and a population attributable risk (PAR) of 73%, trauma had an RR of 11.3 and PAR of 69%, and infectious diseases had an RR of 10.8 and PAR of 62%. Infant mortality rates declined between 1985-95 in all maternal educational groups, but the inequalities remained.

  14. REGIONAL VARIATIONS IN INFANT AND CHILD MORTALITY IN NIGERIA: A MULTILEVEL ANALYSIS.

    PubMed

    Adedini, Sunday A; Odimegwu, Clifford; Imasiku, Eunice N S; Ononokpono, Dorothy N; Ibisomi, Latifat

    2015-03-01

    There are substantial regional disparities in under-five mortality in Nigeria, and evidence suggests that both individual- and community-level characteristics have an influence on health outcomes. Using 2008 Nigeria Demographic and Health Survey data, this study (1) examines the effects of individual- and community-level characteristics on infant/child mortality in Nigeria and (2) determines the extent to which characteristics at these levels influence regional variations in infant/child mortality in the country. Multilevel Cox proportional hazard analysis was performed on a nationally representative sample of 28,647 children nested within 18,028 mothers of reproductive age, who were also nested within 886 communities. The results indicate that community-level variables (such as region, place of residence, community infrastructure, community hospital delivery and community poverty level) and individual-level factors (including child's sex, birth order, birth interval, maternal education, maternal age and wealth index) are important determinants of infant/child mortality in Nigeria. For instance, the results show a lower risk of death in infancy for children of mothers residing in communities with a high proportion of hospital delivery (HR: 0.70, p < 0.05) and for children whose mothers had secondary or higher education (HR: 0.84, p < 0.05). Although community factors appear to influence the association between individual-level factors and death during infancy and childhood, the findings consistently indicate that community-level characteristics are more important in explaining regional variations in child mortality, while individual-level factors are more important for regional variations in infant mortality. The results of this study underscore the need to look beyond the influence of individual-level factors in addressing regional variations in infant and child mortality in Nigeria.

  15. Perinatal and infant mortality and low birth weight among residents near cokeworks in Great Britain

    SciTech Connect

    Dolk, H.; Pattenden, S.; Vrijheid, M.; Thakrar, B.; Armstrong, B.

    2000-02-01

    With growing evidence of the adverse health effects of air pollution--especially fine particulates--investigators must concentrate on the fetus, neonate, and infant as potentially vulnerable groups. Cokeworks are a major source of smoke and sulfur dioxide. In the current study, the authors investigated whether populations residing near cokeworks had a higher risk of adverse perinatal and infant outcomes. Zones of 7.5-km radius around 22 cokeworks in Great Britain were studied, within which the authors assumed that exposure declined from highest levels within 2 km to background levels. Routinely recorded birth and death data for Great Britain during the period 1981--1992 were analyzed. Each individual record had a postcode that referred to a small geographical area of typically 15--17 addresses. The authors calculated expected numbers on the basis of regional rates, stratified by year, sex, and a small-area socio-economic deprivation score. For all cokeworks combined, the observed/expected ratio within 2 km of cokeworks was 1.00 for low-birth-weight infants; 0.94 for still births; 0.95 for infant mortality; 0.86 for neonatal mortality; 1.10 for postneonatal mortality; 0.79 for respiratory postneonatal mortality; and 1.07 for postneonatal Sudden Infant Death Syndrome. Respiratory postneonatal mortality was low throughout the entire 0--7.5-km study area. There was no statistically significant decline in risk with distance from cokeworks for any of the outcomes studied. The authors concluded that there was no evidence of an increased risk of low birth weight, stillbirths, and/or neonatal mortality near cokeworks, and there was no strong evidence for any association between residence near cokeworks and postneonatal mortality. One must remember, however, the limited statistical power of the study to detect small risks.

  16. Laughing Matters: Infant Humor in the Context of Parental Affect

    PubMed Central

    Mireault, Gina C.; Crockenberg, Susan C.; Sparrow, John E.; Cousineau, Kassandra; Pettinato, Christine; Woodard, Kelly

    2015-01-01

    Smiling and laughing appear very early in the first year, but little is known about how infants come to appraise a stimulus as humorous. This short-term longitudinal study explored infant humor perception from 5- to 7-months as a function of parental affect during an absurd event. Using a within-subjects design, parents alternated smiling/laughing with emotional neutrality while acting absurdly toward their infants. Group comparisons showed that infants (N = 37) at all ages smiled at the event regardless of parental affect, but significantly longer at 5 and 6 months , and more often and sooner at 7 months when parents provided humor cues. Similarly, sequential analyses revealed that after gazing at the event, 7-month-olds were only more likely to smile at it when parents provided humor cues, and were comparatively more likely to look away when parents were neutral. Thus, starting at 5 months, parental affect influenced infants’ affect toward an absurd event, an effect that was magnified at 7 months. These results are discussed in the context of emotional contagion, regulation, and the emergence of social referencing. PMID:25897958

  17. Affective Properties of Mothers' Speech to Infants with Hearing Impairment and Cochlear Implants

    ERIC Educational Resources Information Center

    Kondaurova, Maria V.; Bergeson, Tonya R.; Xu, Huiping; Kitamura, Christine

    2015-01-01

    Purpose: The affective properties of infant-directed speech influence the attention of infants with normal hearing to speech sounds. This study explored the affective quality of maternal speech to infants with hearing impairment (HI) during the 1st year after cochlear implantation as compared to speech to infants with normal hearing. Method:…

  18. Chronic arsenic exposure and risk of infant mortality in two areas of Chile.

    PubMed Central

    Hopenhayn-Rich, C; Browning, S R; Hertz-Picciotto, I; Ferreccio, C; Peralta, C; Gibb, H

    2000-01-01

    Chronic arsenic exposure has been associated with a range of neurologic, vascular, dermatologic, and carcinogenic effects. However, limited research has been directed at the association of arsenic exposure and human reproductive health outcomes. The principal aim of this study was to investigate the trends in infant mortality between two geographic locations in Chile: Antofagasta, which has a well-documented history of arsenic exposure from naturally contaminated water, and Valparaíso, a comparable low-exposure city. The arsenic concentration in Antofagasta's public drinking water supply rose substantially in 1958 with the introduction of a new water source, and remained elevated until 1970. We used a retrospective study design to examine time and location patterns in infant mortality between 1950 and 1996, using univariate statistics, graphical techniques, and Poisson regression analysis. Results of the study document the general declines in late fetal and infant mortality over the study period in both locations. The data also indicate an elevation of the late fetal, neonatal, and postneonatal mortality rates for Antofagasta, relative to Valparaíso, for specific time periods, which generally coincide with the period of highest arsenic concentration in the drinking water of Antofagasta. Poisson regression analysis yielded an elevated and significant association between arsenic exposure and late fetal mortality [rate ratio (RR) = 1.7; 95% confidence interval (CI), 1.5-1.9], neonatal mortality (RR = 1.53; CI, 1.4-1.7), and postneonatal mortality (RR = 1.26; CI, 1.2-1.3) after adjustment for location and calendar time. The findings from this investigation may support a role for arsenic exposure in increasing the risk of late fetal and infant mortality. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:10903622

  19. Diverse Morbidity and Mortality Among Infants Treated with Venoarterial Extracorporeal Membrane Oxygenation

    PubMed Central

    Betit, Peter; Craig, Nancy; Gauvreau, Kimberlee; Rycus, Peter; Wilson, Jay M; Thiagarajan, Ravi

    2015-01-01

    Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is utilized for cardiopulmonary failure. We aimed to qualify and quantify the predictors of morbidity and mortality in infants requiring VA-ECMO. Methods: Data was collected from 170 centers participating in the extracorporeal life support organization (ELSO) registry. Relationships between in-hospital mortality and risk factors were assessed using logistic regression. Survival was defined as being discharged from the hospital. Results: Six hundred and sixty-two eligible records were reviewed. Mortality occurred in 303 (46%) infants. Congenital diaphragmatic hernia patients (OR=3.83, 95% CI 1.96-7.49, p<0.001), cardiac failure with associated shock (OR= 2.90, 95% CI 1.46-5.77, p=0.002), and pulmonary failure including respiratory distress syndrome (OR=4.06, 95% CI 1.72-9.58, p=0.001) had the highest odds of mortality in this cohort. Birth weight (BW) < 3 kg (OR=1.83, 95% CI 1.21-2.78, p=0.004), E-CPR (OR=3.35, 95% CI 1.57-7.15, p=0.002), hemofiltration (OR=2.04, 95% CI 1.32-3.16, p=0.001), and dialysis (OR=6.13, 95% CI 1.70-22.1, p<0.001) were all independent predictors of mortality. Conclusion: Infants requiring VA-ECMO experience diverse sequelae and their mortality are high. PMID:26180687

  20. Iron deficiency anemia and affective response in rhesus monkey infants.

    PubMed

    Golub, Mari S; Hogrefe, Casey E; Widaman, Keith F; Capitanio, John P

    2009-01-01

    Infant iron deficiency anemia (IDA) occurs spontaneously in monkey populations as it does in humans, providing a model for understanding effects on brain and behavior. A set of 34 monkey infants identified as IDA (hemoglobin <11 g/dl) over a 5-year period at the California National Primate Research Center (CNPRC) was compared to a set of 57 controls (hemoglobin >12 g/dl) matched for age and caging location. The infants had participated in a Biobehavioral Assessment conducted at 3-4 months of age at CNPRC that included measures of behavioral and adrenocortical response to a novel environment. IDA males differed from control males in two factors ("activity," "emotionality") derived from observational data taken on the first and second day of the exposure to the novel environment. In the male infants, IDA was associated with less restriction of activity in the novel environment on both days and less emotionality on the second day (p < .05). IDA males also displayed less response to approach by a human (human intruder test) than did control males. IDA females did not differ from controls. Adrenocortical response was not significantly affected. These findings may be relevant to functional deficits in human infants with IDA that influence later behavior.

  1. Tackling Health Inequities in Chile: Maternal, Newborn, Infant, and Child Mortality Between 1990 and 2004

    PubMed Central

    Requejo, Jennifer Harris; Nien, Jyh Kae; Merialdi, Mario; Bustreo, Flavia; Betran, Ana Pilar

    2009-01-01

    Objectives. We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions. Methods. Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4 000 000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles. Results. During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100 000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile. Conclusions. During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions. PMID:19443831

  2. Wage inequality, the health system, and infant mortality in wealthy industrialized countries, 1970-1996.

    PubMed

    Macinko, James A; Shi, Leiyu; Starfield, Barbara

    2004-01-01

    This pooled, cross-sectional, time-series study assesses the impact of health system variables on the relationship between wage inequality and infant mortality in 19 OECD countries over the period 1970-1996. Data are derived from the OECD, World Value Surveys, Luxembourg Income Study, and political economy databases. Analyses include Pearson correlation and fixed-effects multivariate regression. In year-specific and time-series analyses, the Theil measure of wage inequality (based on industrial sector wages) is positively and statistically significantly associated with infant mortality rates--even while controlling for GDP per capita. Health system variables--in particular the method of healthcare financing and the supply of physicians--significantly attenuated the effect of wage inequality on infant mortality. In fixed effects multivariate regression models controlling for GDP per capita and wage inequality, variables generally associated with better health include income per capita, the method of healthcare financing, and physicians per 1000 population. Alcohol consumption, the proportion of the population in unions, and government expenditures on health were associated with poorer health outcomes. Ambiguous effects were seen for the consumer price index, unemployment rates, the openness of the economy, and voting rates. This study provides international evidence for the impact of wage inequalities on infant mortality. Results suggest that improving aspects of the healthcare system may be one way to partially compensate for the negative effects of social inequalities on population health.

  3. State downsizing as a determinant of infant mortality and achievement of Millennium Development Goal 4.

    PubMed

    Palma-Solís, Marco Antonio; Alvarez-Dardet Díaz, Carlos; Franco-Giraldo, Alvaro; Hernández-Aguado, Ildefonso; Pérez-Hoyos, Santiago

    2009-01-01

    The aim of this study was to evaluate the worldwide effect of state downsizing policies on achievement of U.N. Millennium Development Goal 4 (MDG4) on infant mortality rates. In an ecological retrospective cohort study of 161 countries, from 1978 to 2002, the authors analyzed changes in government consumption (GC) as determining exposure to achievement of MDG4. Descriptive methods and a multiple logistic regression were applied to adjust for changes in gross domestic product, level of democracy, and income inequality. Excess infant mortality in the exposed countries, attributable to reductions in GC, was estimated. Fifty countries were found to have reduced GC, and 111 had increased GC. The gap in infant mortality rate between these groups of countries doubled in the study period. Non-achievement of MDG4 was associated with reductions in GC and increases in income inequality. The excess infant mortality attributable to GC reductions in the exposed countries from 1990 to 2002 was 4,473,348 deaths. The probability of achieving MDG4 seems to be seriously compromised for many countries because of reduced public sector expenditure during the last 25 years of the 20th century, in response to World Bank/International Monetary Fund Washington Consensus policies. This seeming contradiction between the goals of different U.N. branches may be undermining achievement of MDG4 and should be taken into account when developing future global governance policy.

  4. Dynamics of Inequality: Mother's Education and Infant Mortality in China, 1970-2001

    ERIC Educational Resources Information Center

    Song, Shige; Burgard, Sarah A.

    2011-01-01

    In this study, the authors analyze the dynamic relationship between Chinese women's education, their utilization of newly available medical pregnancy care, and their infants' mortality risk. China has undergone enormous social, economic, and political changes over recent decades and is a novel context in which to examine the potential influence of…

  5. Sex Ratio at Birth and Infant Mortality Rate in China: An Empirical Study

    ERIC Educational Resources Information Center

    Lai, Denjian

    2005-01-01

    In this article, we used the data from the last three population censuses of China in 1982, 1990 and 2000, to study the dynamics of the sex ratio at birth and the infant mortality rate in China. In the late 1970s, China started its economic reform and implemented many family planning programs. Since then there has been great economic development…

  6. Analysis of neonatal and infant mortality data for the white population of the Witwatersrand.

    PubMed

    Rothberg, A D; Bibby, B D; Herman, A A; Cooper, P A

    Statistics of population size, number of births, and neonatal and infant mortality for the White populations of 10 Witwatersrand municipalities were studied. Sources of data were: (i) national statistics from the Central Statistical Services; and (ii) annual reports from the local authorities. The two sources correlated well for population size and number of births (r = 0,99), less so for infant deaths (r = 0,71), and not at all for neonatal deaths (r = 0,43). Causes of infant mortality were also studied, using national and local reports. Comparison of hospital records with those of the local Department of Health revealed significant coding errors in the recording of causes of death. The mechanisms for reporting births and deaths are discussed and suggestions for improvements in the system are made.

  7. Increased Duration of Paid Maternity Leave Lowers Infant Mortality in Low- and Middle-Income Countries: A Quasi-Experimental Study

    PubMed Central

    Nandi, Arijit; Hajizadeh, Mohammad; Harper, Sam; Koski, Alissa; Strumpf, Erin C.; Heymann, Jody

    2016-01-01

    Background Maternity leave reduces neonatal and infant mortality rates in high-income countries. However, the impact of maternity leave on infant health has not been rigorously evaluated in low- and middle-income countries (LMICs). In this study, we utilized a difference-in-differences approach to evaluate whether paid maternity leave policies affect infant mortality in LMICs. Methods and Findings We used birth history data collected via the Demographic and Health Surveys to assemble a panel of approximately 300,000 live births in 20 countries from 2000 to 2008; these observational data were merged with longitudinal information on the duration of paid maternity leave provided by each country. We estimated the effect of an increase in maternity leave in the prior year on the probability of infant (<1 y), neonatal (<28 d), and post-neonatal (between 28 d and 1 y after birth) mortality. Fixed effects for country and year were included to control for, respectively, unobserved time-invariant confounders that varied across countries and temporal trends in mortality that were shared across countries. Average rates of infant, neonatal, and post-neonatal mortality over the study period were 55.2, 30.7, and 23.0 per 1,000 live births, respectively. Each additional month of paid maternity was associated with 7.9 fewer infant deaths per 1,000 live births (95% CI 3.7, 12.0), reflecting a 13% relative reduction. Reductions in infant mortality associated with increases in the duration of paid maternity leave were concentrated in the post-neonatal period. Estimates were robust to adjustment for individual, household, and country-level characteristics, although there may be residual confounding by unmeasured time-varying confounders, such as coincident policy changes. Conclusions More generous paid maternity leave policies represent a potential instrument for facilitating early-life interventions and reducing infant mortality in LMICs and warrant further discussion in the post-2015

  8. Infant mortality in India: use of maternal and child health services in relation to literacy status.

    PubMed

    Gokhale, Medha K; Rao, Shobha S; Garole, Varsha R

    2002-06-01

    Slow reduction in infant mortality rate in the last couple of decades is a major concern in India. State-level aggregate data from the National Family Health Survey 1992 and micro-level data on rural mothers (n=317) were used for examining the influence of female literacy on reduction of infant mortality through increased use of maternal and child health (MCH) services. Illiteracy of females was strongly associated with all variables relating to maternal care and also with infant mortality rate. States were grouped into best, medium, and worst on the basis of female illiteracy (about 11%, 48.5%, and 75% respectively). Infant mortality rate (per 1,000 livebirths) was significantly (p<0.01) higher among the worst group (90.99) than that among the medium (64.2) and the best (24.0) groups. Use of maternal health services increased in the worst to become the best groups for tetanus toxoid (from 48.0% to 84.4%), iron and folic acid tablets (36.6% to 76.2%), hospitalized deliveries (14.2% to 69.7%), and childcare services, such as vaccination (23.8% to 64.9%). Illiteracy of females had a more detrimental impact on rural than on urban areas. In the event of high female illiteracy, male literacy was beneficial for improving the use of services for reducing infant mortality rate. The micro-level study supported all major findings obtained for the national-level aggregate data. Programmes, like providing free education to girls, will yield long-term health benefits.

  9. Zinc supplementation affects the activity patterns of rural Guatemalan infants.

    PubMed

    Bentley, M E; Caulfield, L E; Ram, M; Santizo, M C; Hurtado, E; Rivera, J A; Ruel, M T; Brown, K H

    1997-07-01

    Zinc deficiency has been associated with growth deficits, reduced dietary intake and appetite, and has been hypothesized to result in reduced activity. This randomized, double-blind, placebo-controlled study examined whether 10 mg of oral zinc as zinc sulfate, given daily for up to 7 mo, affected activity patterns of 85 Guatemalan infants recruited at 6-9 mo of age. Infant activity was assessed by time sampling-observation method at 10-min intervals during a 12-h data collection period, at base line, 3 and 7 mo follow-up. Motor development and the percentage of time infants were observed in various positions (being carried, lying down, sitting, crawling, standing or walking) and engaged in various activities (eating, sleeping, resting, crying/whining or playing) were compared by treatment group. No differences in motor development were observed by treatment group. However, at follow-up 2 (after 7 mo of supplementation), zinc-supplemented infants were significantly more frequently observed sitting up compared with lying down, and were playing during 4.18 +/- 1.95% (P < 0.05) more observations than unsupplemented infants. They were also somewhat less likely to be observed crying or whining (P < 0.10) compared with those receiving the placebo. These effects are independent of other factors including infant age, motor development, sex, maternal education, family socioeconomic status and nutritional status at base line. Further research must be conducted to determine the long-term developmental importance of these differences in activity patterns associated with zinc supplementation in this setting.

  10. An ecological study to identify census blocks supporting a higher burden of disease: infant mortality in the lille metropolitan area, france.

    PubMed

    Padilla, Cindy; Lalloué, Benoit; Pies, Cheri; Lucas, Emminarie; Zmirou-Navier, Denis; Séverine, Deguen

    2014-01-01

    In France, reducing social health inequalities has become an explicit goal of health policies over the past few years, one of its objectives is specifically the reduction of the perinatal mortality rate. This study investigates the association between infant mortality and social deprivation categories at a small area level in the Lille metropolitan area, in the north of France, to identify census blocks where public authorities should prioritize appropriate preventive actions. We used census data to establish a neighbourhood deprivation index whose multiple dimensions encompass socioeconomic characteristics. Infant mortality data were obtained from the Lille metropolitan area municipalities to estimate a death rate at the census tract level. We used Bayesian hierarchical models in order to reduce the extra variability when computing relative risks (RR) and to assess the associations between infant mortality and deprivation. Between 2000 and 2009, 668 cases of infant death occurred in the Lille metropolitan area (4.2 per 1,000 live births). The socioeconomic status is associated with infant mortality, with a clear gradient of risk from the most privileged census blocks to the most deprived ones (RR = 2.62, 95 % confidence interval [1.87; 3.70]). The latter have 24.6 % of families who were single parents and 29.9 % of unemployed people in the labor force versus 8.5 % and 7.7 % in the former. Our study reveals socio-spatial disparities in infant mortality in the Lille metropolitan area and highlights the census blocks most affected by the inequalities. Fine spatial analysis may help inform the design of preventive policies tailored to the characteristics of the local communities.

  11. Object use affects motor planning in infant prehension.

    PubMed

    Contaldo, Annarita; Cola, Elisabetta; Minichilli, Fabrizio; Crecchi, Alessandra; Carboncini, Maria Chiara; Rossi, Bruno; Bonfiglio, Luca

    2013-06-01

    The purpose of this study was to investigate the factors underlying the ability to plan object-oriented grasping movements in the first two years of life. In particular, we were interested in evaluating the relationship between manual motor planning, object use and infant-parent interaction. In order to achieve this aim, grasping behaviors of nineteen healthy infants, aged nine to 25 months, were examined during naturalistic play sessions with a standard set of toys. Our main finding was that, regardless of age, infants perform a better manual planning when they use an object in a functional rather than non-functional way, suggesting that the planning of an action also depends on knowing the functional properties of an object. In addition, we found that the ability to use objects in a functional way was strongly affected by infant-parent interaction. Thus, level of object use and environmental role must be taken into account in order to understand the development of manual motor planning.

  12. Depressed Mothers' Touching Increases Infants' Positive Affect and Attention in Still-Face Interactions.

    ERIC Educational Resources Information Center

    Pelaez-Nogueras, Martha; And Others

    1996-01-01

    Investigated effects of depressed mothers' touching on their infants' behavior during still-face situation. Subjects were 48 mothers and their 3-month-old infants. Findings suggested that by providing touch stimulation for their infants, depressed mothers can increase infants' positive affect and compensate for negative effects often resulting…

  13. The price of play: self-organized infant mortality cycles in chimpanzees.

    PubMed

    Kuehl, Hjalmar S; Elzner, Caroline; Moebius, Yasmin; Boesch, Christophe; Walsh, Peter D

    2008-06-18

    Chimpanzees have been used extensively as a model system for laboratory research on infectious diseases. Ironically, we know next to nothing about disease dynamics in wild chimpanzee populations. Here, we analyze long-term demographic and behavioral data from two habituated chimpanzee communities in Taï National Park, Côte d'Ivoire, where previous work has shown respiratory pathogens to be an important source of infant mortality. In this paper we trace the effect of social connectivity on infant mortality dynamics. We focus on social play which, as the primary context of contact between young chimpanzees, may serve as a key venue for pathogen transmission. Infant abundance and mortality rates at Taï cycled regularly and in a way that was not well explained in terms of environmental forcing. Rather, infant mortality cycles appeared to self-organize in response to the ontogeny of social play. Each cycle started when the death of multiple infants in an outbreak synchronized the reproductive cycles of their mothers. A pulse of births predictably arrived about twelve months later, with social connectivity increasing over the following two years as the large birth cohort approached the peak of social play. The high social connectivity at this play peak then appeared to facilitate further outbreaks. Our results provide the first evidence that social play has a strong role in determining chimpanzee disease transmission risk and the first record of chimpanzee disease cycles similar to those seen in human children. They also lend more support to the view that infectious diseases are a major threat to the survival of remaining chimpanzee populations.

  14. Public health care funding modifies the effect of out-of-pocket spending on maternal, infant, and child mortality.

    PubMed

    Noel, Jonathan K

    2017-03-01

    Increased out-of-pocket (OOP) health care spending has been associated with increased maternal, infant, and child mortality, but the effect of public health care spending on mortality has not been studied. I identified a statistically significant interaction between public health care expenditure and OOP health care spending for maternal, infant, and child mortality. Generally, increases in public expenditure coincide with decreased rates of mortality, regardless of OOP spending levels. Specifically, higher levels of public expenditure with moderate levels of OOP spending may result in the lowest mortality rates. Increased public health care spending may improve health outcomes better than efforts to reduce OOP expenditure alone.

  15. When bad mothers lose good babies: understanding fetal and infant mortality case reviews.

    PubMed

    Fordyce, Lauren

    2014-01-01

    This article examines how the practices of the Fetal and Infant Mortality Review-Case Review Team (FIMR CRT) in "Florida City" constructs particular types of maternal and fetal subjects and how these narratives about fetal and infant death reflect particular discourses about "bad mothers" and "good babies." I argue that the very methods of the Florida City FIMR committee structure the types of conversations and, in effect, judgments that can be made about women who experience a fetal or neonatal death. In addition, I examine how many of these ideas resonate with the discourses around fetal rights that pervade contemporary abortion politics in the United States.

  16. The role of medicine in the decline of post-War infant mortality in Japan.

    PubMed

    Yorifuji, Takashi; Tanihara, Shinichi; Inoue, Sachiko; Takao, Soshi; Kawachi, Ichiro

    2011-11-01

    The infant mortality rate (IMR) in Japan declined dramatically in the immediate post-War period (1947-60) in Japan. We compared the time trends in Growth Domestic Product (GDP) in Japan against declines in IMR. We then conducted a prefecture-level ecological analysis of the rate of decline in IMR and post-neonatal mortality from 1947 to 1960, focusing on variations in medical resources and public health strategies. IMR in Japan started to decline after World War II, even before the era of rapid economic growth and the introduction of a universal health insurance system in the 1960s. The mortality rates per 1000 infants in 2009 were 2.38 for IMR, 1.17 for neonatal mortality and 1.21 for post-neonatal mortality. The rate of decline in IMR and preventable IMR (PIMR) during the post-War period was strongly correlated with prefectural variations in medical resources (per capita physicians, nurses, and proportion of in-hospital births). The correlation coefficients comparing the number of physicians in 1955 with the declines in IMR and PIMR from 1947 to 1960 were 0.46 [95% confidence interval (CI) 0.19, 0.66] and 0.39 [95% CI 0.11, 0.61], respectively. By contrast, indicators of public health strategies were not associated with IMR decline. The IMR in Japan has been decreasing and seems to be entering a new era characterised by lower neonatal compared with post-neonatal mortality. Furthermore, the post-War history of Japan illustrates that improvement in infant mortality is attributable to the influence of medical care, even in the absence of rapid economic development.

  17. Small area estimation for estimating the number of infant mortality in West Java, Indonesia

    NASA Astrophysics Data System (ADS)

    Anggreyani, Arie; Indahwati, Kurnia, Anang

    2016-02-01

    Demographic and Health Survey Indonesia (DHSI) is a national designed survey to provide information regarding birth rate, mortality rate, family planning and health. DHSI was conducted by BPS in cooperation with National Population and Family Planning Institution (BKKBN), Indonesia Ministry of Health (KEMENKES) and USAID. Based on the publication of DHSI 2012, the infant mortality rate for a period of five years before survey conducted is 32 for 1000 birth lives. In this paper, Small Area Estimation (SAE) is used to estimate the number of infant mortality in districts of West Java. SAE is a special model of Generalized Linear Mixed Models (GLMM). In this case, the incidence of infant mortality is a Poisson distribution which has equdispersion assumption. The methods to handle overdispersion are binomial negative and quasi-likelihood model. Based on the results of analysis, quasi-likelihood model is the best model to overcome overdispersion problem. The basic model of the small area estimation used basic area level model. Mean square error (MSE) which based on resampling method is used to measure the accuracy of small area estimates.

  18. Infant mortality and childhood nutritional status among Afghan refugees in Pakistan.

    PubMed

    Boss, L P; Brink, E W; Dondero, T J

    1987-12-01

    In 1984 and again in 1985, systematic surveys were undertaken to evaluate infant mortality and childhood nutritional status among the Afghan refugee population in Pakistan. The entire Afghan refugee population under the administration of the United Nations High Commissioner for Refugees was sampled. Infant mortality rates were estimated to be 156 per 1000 for 1984 and 119 per 1000 for 1985. A decline was also suggested in neonatal mortality rates from 61 per 1000 for 1984 to 46 per 1000 for 1985. For neither infant nor neonatal mortality was the difference statistically significant. Improvements were seen in the percentage of children who died before their fifth birthday (22.5% in 1984 and 18.8% in 1985), in the percentage of children who were malnourished (3.5% in 1984 and 2.3% in 1985), and an increase in the percentage of children above the WHO/NCHS/CDC weight-for-height reference median (26% in 1984 and 35% in 1985). Diarrhoea was the most frequently reported cause of death for both years and was a particularly important cause of death among one-year-old children. In 1985, measles was related to 24% of the deaths and neonatal tetanus to 9% of the deaths, an increase from 8% for measles and 6% for tetanus in 1984.

  19. Differential Neonatal and Postneonatal Infant Mortality Rates across US Counties: The Role of Socioeconomic Conditions and Rurality

    ERIC Educational Resources Information Center

    Sparks, P. Johnelle; McLaughlin, Diane K.; Stokes, C. Shannon

    2009-01-01

    Purpose: To examine differences in correlates of neonatal and postneonatal infant mortality rates, across counties, by degree of rurality. Methods: Neonatal and postneonatal mortality rates were calculated from the 1998 to 2002 Compressed Mortality Files from the National Center for Health Statistics. Bivariate analyses assessed the relationship…

  20. Feeding babies in the battle to combat infant mortality a century ago.

    PubMed

    Weaver, L

    2009-08-01

    At the end of the nineteenth century Glasgow, like many large industrial European cities, had an infant mortality rate (IMR) of well over 100 deaths per 1000 live births. Recognition that 'improper feeding' was a significant factor in accounting for this prompted public health authorities to establish infant milk depots, to support breast-feeding mothers and to provide artificial milk feeds for their babies if necessary. The initiative was led by the medical officer of health of Glasgow, Archibald Chalmers, who promoted welfare services for mothers and infants during the first decade of the 20th century. However these initiatives were questioned by an up-and-coming paediatrician, Leonard Findlay, who was to go on to be Glasgow's first professor of medical paediatrics in 1924. Nevertheless IMRs started to go down from 1900 and have continued steadily ever since; and while artificial infant milks clearly posed a risk to the health of babies, attention to infant nutrition, growth and feeding may have played a part in initiating and perpetuating this decline in IMR and improving infant survival and welfare during the last century.

  1. Affective Properties of Mothers' Speech to Infants With Hearing Impairment and Cochlear Implants

    PubMed Central

    Bergeson, Tonya R.; Xu, Huiping; Kitamura, Christine

    2015-01-01

    Purpose The affective properties of infant-directed speech influence the attention of infants with normal hearing to speech sounds. This study explored the affective quality of maternal speech to infants with hearing impairment (HI) during the 1st year after cochlear implantation as compared to speech to infants with normal hearing. Method Mothers of infants with HI and mothers of infants with normal hearing matched by age (NH-AM) or hearing experience (NH-EM) were recorded playing with their infants during 3 sessions over a 12-month period. Speech samples of 25 s were low-pass filtered, leaving intonation but not speech information intact. Sixty adults rated the stimuli along 5 scales: positive/negative affect and intention to express affection, to encourage attention, to comfort/soothe, and to direct behavior. Results Low-pass filtered speech to HI and NH-EM groups was rated as more positive, affective, and comforting compared with the such speech to the NH-AM group. Speech to infants with HI and with NH-AM was rated as more directive than speech to the NH-EM group. Mothers decreased affective qualities in speech to all infants but increased directive qualities in speech to infants with NH-EM over time. Conclusions Mothers fine-tune communicative intent in speech to their infant's developmental stage. They adjust affective qualities to infants' hearing experience rather than to chronological age but adjust directive qualities of speech to the chronological age of their infants. PMID:25679195

  2. Individual, Household, and Community U.S. Migration Experience and Infant Mortality in Rural and Urban Mexico

    PubMed Central

    Hamilton, Erin R.; Villarreal, Andrés; Hummer, Robert A.

    2009-01-01

    This study explores rural and urban differences in the relationship between U.S. migration experience measured at the individual, household, and community levels and individual-level infant mortality outcomes in a national sample of recent births in Mexico. Using 2000 Mexican Census data and multi-level regression models, we find that women’s own U.S. migration experience is associated with lower odds of infant mortality in both rural and urban Mexico, possibly reflecting a process of healthy migrant selectivity. Household migration has mixed blessings for infant health in rural places: remittances are beneficial for infant survival, but recent out-migration is disruptive. Recent community-level migration experience is not significantly associated with infant mortality overall, although in rural places, there is some evidence that higher levels of community migration are associated with lower infant mortality. Household- and community-level migration have no relationship with infant mortality in urban places. Thus, international migration is associated with infant outcomes in Mexico in fairly complex ways, and the relationships are expressed most profoundly in rural areas of Mexico. PMID:20047012

  3. The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993.

    PubMed Central

    Peña, R; Wall, S; Persson, L A

    2000-01-01

    OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality. PMID:10630139

  4. Does reducing infant mortality depend on preventing low birthweight? An analysis of temporal trends in the Americas.

    PubMed

    Kramer, Michael S; Barros, Fernando C; Demissie, Kitaw; Liu, Shiliang; Kiely, John; Joseph, K S

    2005-11-01

    Low birthweight (LBW) is highly associated with death during infancy, and countries with the highest LBW rates also have the highest infant mortality rates. We compared temporal trends in LBW with both overall and birthweight-specific infant mortality in United States, Canada, Argentina, Chile, and Uruguay over two time periods, using cohort and cross-sectional analysis of national population-based vital statistics for 1985-89 and 1995-98. Infant mortality diminished substantially (RR = 0.60-0.80 for the later vs. earlier periods) and to a similar degree in all birthweight categories in all five study countries, despite an increase in LBW in the US and Uruguay, minimal changes in Canada and Argentina, and a decrease in Chile. The strength of the (positive) association between LBW and overall infant mortality diminished over the two time periods (from r(s) = +0.80 to +0.25 and RR per SD increase in LBW rate from 2.13 [2.09, 2.17] to 1.76 [1.74, 1.79]). The proportion of infant deaths occurring among LBW infants was negatively correlated with overall infant mortality in both time periods (r(s) = -0.30 and -0.60, RR = 0.68 [0.67, 0.68] and 0.47 [0.46, 0.47]). Developed and less developed countries in the Americas have succeeded in reducing infant mortality in all birthweight groups despite inconsistent changes in LBW rates, and none has achieved this success primarily by reducing LBW. Although our results are not necessarily generalisable to the least developed countries in South Asia and sub-Saharan Africa, it is likely that all countries can substantially reduce their infant mortality rates by improving the care of infants at normal and low birthweights.

  5. Disaster, Deprivation and Death: Large but delayed infant mortality in the wake of Filipino tropical cyclones

    NASA Astrophysics Data System (ADS)

    Anttila-Hughes, J. K.; Hsiang, S. M.

    2011-12-01

    Tropical cyclones are some of the most disastrous and damaging of climate events, and estimates of their destructive potential abound in the natural and social sciences. Nonetheless, there have been few systematic estimates of cyclones' impact on children's health. This is concerning because cyclones leave in their wake a swath of asset losses and economic deprivation, both known to be strong drivers of poor health outcomes among children. In this paper we provide a household-level estimate of the effect of tropical cyclones on infant mortality in the Philippines, a country with one of the most active cyclone climatologies in the world. We reconstruct historical cyclones with detailed spatial and temporal resolution, allowing us to estimate the multi-year effects of cyclones on individuals living in specific locations. We combine the cyclone reconstruction with woman-level fertility and mortality data from four waves of the Filipino Demographic and Health Survey, providing birth histories for over 55,000 women. In multiple regressions that control for year and region fixed effects as well as intra-annual climate variation, we find that there is a pronounced and robust increase in female infant mortality among poor families in the 12-24 months after storms hit. The estimated mortality rate among this demographic subgroup is much larger than official mortality rates reported by the Filipino government immediately after storms, implying that much of a cyclone's human cost arrives well after the storm has passed. We find that high infant mortality rates are associated with declines in poor families' income and expenditures, including consumption of food and medical services, suggesting that the mechanism by which these deaths are effected may be economic deprivation. These results indicate that a major health and welfare impact of storms has been thus far overlooked, but may be easily prevented through appropriately targeted income support policies.

  6. A partnership to reduce African American infant mortality in Genesee County, Michigan.

    PubMed Central

    Pestronk, Robert M.; Franks, Marcia L.

    2003-01-01

    A partnership in Genesee County, Michigan, has been working to reduce African American infant mortality. A plan was developed utilizing "bench" science and community residents' "trench" knowledge. Its theoretical foundation is ecological, grounded in a philosophy of public health as social justice, and based on the understanding that cultural beliefs and practices can be both protective and harmful. Partners agree that no single intervention will eliminate racial disparities and that interventions must precede, include, and follow the period of pregnancy. Core themes for the work include: reducing racism, enhancing the medical care and social services systems, and fostering community mobilization. Strategies include community dialogue and raising awareness, education and training, outreach and advocacy, and mentoring and support. The evaluation has several components: scrutinizing the effect of partnership activities on direct measures of infant health; analyzing changes in knowledge, attitudes, behaviors and other mediating variables thought to influence maternal and infant health; and effecting changes in personal and organizational policy and practice. PMID:12815079

  7. Maternal Smoking during Pregnancy and Necrotizing Enterocolitis-associated Infant Mortality in Preterm Babies

    PubMed Central

    Ding, Guodong; Yu, Jing; Chen, Yan; Vinturache, Angela; Pang, Yu; Zhang, Jun

    2017-01-01

    Few studies have examined the possible pregnancy-related risk factors for necrotizing enterocolitis (NEC)-associated deaths during infancy. Infant death due to NEC in preterm babies was identified from the US Linked Livebirth and Infant Death records between 2000 and 2004. The average number of cigarettes per day reported by the mothers who were smoking during pregnancy was classified in three categories: non-smoking, light smoking (<10 cigarettes/day) and heavy smoking (≥10 cigarettes/day). Logistic regression analyses examined the association between prenatal smoking and NEC-associated infant mortality rates with adjustment for potential confounders. Compared with non-smoking mothers, light and heavy smoking mothers have a higher risk of NEC-associated infant mortality [light smoking: adjusted odds ratio (aOR) = 1.21, 95% confidence interval (CI), 1.03–1.43; heavy smoking: aOR = 1.30, 95% CI, 1.12–1.52], respectively. Moreover, the association was stronger among white race (light smoking: aOR = 1.69, 95% CI, 1.34–2.13; heavy smoking: aOR = 1.44, 95% CI, 1.18–1.75) and female babies (light smoking: aOR = 1.31, 95% CI, 1.02–1.69; heavy smoking: aOR = 1.62, 95% CI, 1.29–2.02). Maternal smoking during pregnancy is associated with increased risks of infant mortality due to NEC in preterm babies, especially in white race and female babies. PMID:28361963

  8. The impact of fiscal decentralization on infant mortality rates: evidence from OECD countries.

    PubMed

    Jiménez-Rubio, Dolores

    2011-11-01

    This study re-examines the hypothesis that shifts towards more decentralization would be accompanied by improvements in population health on a panel of 20 OECD countries over a thirty year period (1970-2001). Decentralization is proxied using a conventional indicator of revenue decentralization and a new measure of fiscal decentralization that reflects better than previous measures the existence of autonomy in the decision-making authority of lower tiers of government, a crucial issue in the decentralization process. The results show a considerable and positive effect of fiscal decentralization on infant mortality only if a substantial degree of autonomy in the sources of revenue is devolved to local governments. The proportion of health care expenditure on GDP and, in particular, education, were found to have a larger contribution to the reduction of infant mortality in the sample of OECD countries analysed over the period of study.

  9. The decline in infant mortality in Costa Rica, 1950-1973: modernization or technological diffusion?

    PubMed

    Klijzing Fkh; Taylor, H W

    1982-06-01

    Spatial patterns of infant mortality in Costa Rica are examined for the period 1950-1973, with special attention paid to contagious diffusion effects. In more general terms, the study is considered as an example of the spatial structures that arise during the process of demographic transition and modernization. The data are from official sources. The authors conclude that the census year 1950 probably marks the transition from a stage where technological diffusion had the primary effect on mortality to a stage where socioeconomic modernization played the major role.

  10. Sepsis-Related Mortality of Very Low Birth Weight Brazilian Infants: The Role of Pseudomonas aeruginosa

    PubMed Central

    Pereira, Sylvia Maria Porto; de Almeida Cardoso, Maria Helena Cabral; Figuexeds, Ana Lucia; Mattos, Haroldo; Rozembaum, Ronaldo; Ferreira, Vanessa Isidoro; Portinho, Maria Antonieta; Gonçalves, Ana Cristina; da Costa, Elaine Sobral

    2009-01-01

    The aim of this study is to identify risk factors for sepsis-related mortality in low birth weight (<1500 g) infants. We performed retrospective cohort study to investigate risk factors for sepsis-related mortality in all neonates birth weight <1500 g admitted to Level III neonatal intensive care unit, Brazil, April 2001/September 2004. Of the 203 cases, 71 (35%) had sepsis. Of those, gram-positive was identified in 52/87 blood cultures (59.8%), the most common Coagulase-negative Staphylococcus (31/87; 35.5%). Gram-negative was present in 29 of the 87 positive blood cultures (33.3%), with Pseudomonas aeruginosa (8/87; 9.1%), the most frequent agent. Overall 21 of 71 infants with sepsis (29.6%) died. Risk factors for sepsis-related mortality were gestational age ≤28 weeks, birth weight ≤1000 g (9.6 times more often than birth weight >1000 g), five-minute Apgar ≤7, gram-negative sepsis, mechanical ventilation (6.7 times higher than no use), and intravascular catheter. Sepsis-related mortality was due, mainly, to Pseudomonas aeruginosa; birth weight ≤1000 g and mechanical ventilation were strong sepsis-related mortality predictors. PMID:20182631

  11. Reproductive parameters of wild Trachypithecus leucocephalus: seasonality, infant mortality and interbirth interval.

    PubMed

    Jin, Tong; Wang, De-Zhi; Zhao, Qing; Yin, Li-Jie; Qin, Da-Gong; Ran, Wen-Zhong; Pan, Wen-Shi

    2009-07-01

    Understanding the reproductive parameters of endangered primate species is vital for evaluating the status of populations and developing adequate conservation measures. This study provides the first detailed analysis of the reproductive parameters of wild white-headed langurs (Trachypithecus leucocephalus), based on demographic data collected over an 8-year period in the Nongguan Karst Hills in Chongzuo County, Guangxi, China. From 1998 to 2002, a total of 133 live births were recorded in the population based on systematic censuses. Births occurred throughout the year, but the temporal pattern was highly correlated with seasonal variation in temperature and rainfall, with the birth peak coinciding with the dry and cold months of November-March. The average birthrate was 0.47+/-0.13 births per female per year and mortality for infants younger than 20 months was 15.8%. From 1998 to 2006, 14 females gave birth to 41 infants in four focal groups. The average age at first birth for female langurs was 5-6 years (n = 5) and the interbirth interval (IBI) was 23.2+/-5.2 months (median = 24.5 months, n = 27). Infants are weaned at 19-21 months of age. The IBI for females with infant loss before weaning was significantly shorter than those for females whose infants survived. It appears that birth seasonality in the white-headed langurs is influenced by seasonal changes in food availability. The timing of conceptions was found to coincide with peak food availability. The reproductive parameters for white-headed langurs reported here are quite similar to those reported for other colobine species. One major difference is our observation of lower infant mortality in Trachypithecus.

  12. Mothers' amygdala response to positive or negative infant affect is modulated by personal relevance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Understanding, prioritizing and responding to infant affective cues is a key component of motherhood, with long-term implications for infant socio-emotional development. This important task includes identifying unique characteristics of one's own infant, as they relate to differences in affect valen...

  13. The Induced Affect Response: 10-Week-Old Infants' Responses to Three Emotion Expressions.

    ERIC Educational Resources Information Center

    Haviland, Jeannette M.; Lelwica, Mary

    1987-01-01

    When mothers of 12 infants 10 weeks of age displayed noncontingent, practiced facial and vocal expressions of joy, anger, and sadness, infants responded differently to each expression. Infants' matching responses to maternal affects were only part of complex but predictable behavioral patterns that indicate meaningful affect states and possibly…

  14. Infant mortality in Brazil, 1980-2000: A spatial panel data analysis

    PubMed Central

    2012-01-01

    Background Infant mortality is an important measure of human development, related to the level of welfare of a society. In order to inform public policy, various studies have tried to identify the factors that influence, at an aggregated level, infant mortality. The objective of this paper is to analyze the regional pattern of infant mortality in Brazil, evaluating the effect of infrastructure, socio-economic, and demographic variables to understand its distribution across the country. Methods Regressions including socio-economic and living conditions variables are conducted in a structure of panel data. More specifically, a spatial panel data model with fixed effects and a spatial error autocorrelation structure is used to help to solve spatial dependence problems. The use of a spatial modeling approach takes into account the potential presence of spillovers between neighboring spatial units. The spatial units considered are Minimum Comparable Areas, defined to provide a consistent definition across Census years. Data are drawn from the 1980, 1991 and 2000 Census of Brazil, and from data collected by the Ministry of Health (DATASUS). In order to identify the influence of health care infrastructure, variables related to the number of public and private hospitals are included. Results The results indicate that the panel model with spatial effects provides the best fit to the data. The analysis confirms that the provision of health care infrastructure and social policy measures (e.g. improving education attainment) are linked to reduced rates of infant mortality. An original finding concerns the role of spatial effects in the analysis of IMR. Spillover effects associated with health infrastructure and water and sanitation facilities imply that there are regional benefits beyond the unit of analysis. Conclusions A spatial modeling approach is important to produce reliable estimates in the analysis of panel IMR data. Substantively, this paper contributes to our

  15. Los Años de la Crisis: an examination of change in differential infant mortality risk within Mexico.

    PubMed

    Frank, R; Finch, Brian Karl

    2004-08-01

    The main aim of the present analysis is to test the possibility that the period of economic hardship characterizing Mexico over the decade 1986-1996 has negatively influenced infant health outcomes. Data on births from two installments of the Encuesta Nacional de la Dinámica Demográfica, a nationally representative demographic survey, are used to determine whether a reduction in mortality differentials has paralleled the overall drop in the national infant mortality rate. The findings indicate that the decrease observed in the overall infant mortality rate has been matched by decreases in several disparities at the same time that it has been marred by increases in others. The data support the possibility that where you live has become an increasingly salient factor in determining the odds of infant mortality. High parity, low education and unemployment status have also become more salient factors in predicting post neonatal infant mortality risk in the more recent period as compared to the earlier period. As Mexico's infant mortality rate begins to stabilize in the near future, this research highlights the need to re-focus our research efforts on the causes and consequences of differential mortality trends.

  16. [Public health programs have greatly reduced infant mortality in Costa Rica].

    PubMed

    1987-01-01

    The spectacular decline of infant mortality in Costa Rica from 68/1000 live births in 1970 to 20/1000 in 1980 was largely due to the implementation of public health programs in the 1970s. The abrupt decline was even more notable because deaths of infants constituted the major health problem of the country during the 1960s, accounting for 40% of all registered deaths. Socioeconomic development and reduced fertility contributed to the reduction, but 3/4 of the improvement can be attributed to extension of primary health care to previously unserved rural populations and to better secondary health care, according to a study by the Costa Rican demographer Luis Rosero Bixby. The programs targeted at less privileged groups substantially reduced class and geographic differentials in infant mortality. Infant mortality began to decline at an accelerating rate in 1972, coinciding with the first national health plan and the law of universal social security in 1971, the transfer of public hospitals to the social security system and promulgation of a general health law in 1973, and application of the rural health program in 1973 and community health program in 1976. By 1980, home services reached 60% of the population and immunization programs were in place for measles and diphtheria, pertussis, and tetanus. There was a doubling of outpatient services and a tripling of hours contracted by doctors between 1970-80. Also in 1980, 78% of the Costa Rican population was fully covered by health insurance. After 1972, infant mortality declined from all causes except complications of pregnancy and congenital anomalies. The decline was most rapid for deaths due to prematurity, illnesses avoidable by vaccination, and illnesses such as septicemia and meningitis in which prompt diagnosis and treatment can be lifesaving. Although impressive gains were made in neonatal mortality, the main share of the decline between 1970-80 was in postneonatal mortality. Reductions in deaths due to diarrheal

  17. UNITED STATES BLACK:WHITE INFANT MORTALITY DISPARITIES ARE NOT INEVITABLE: IDENTIFICATION OF COMMUNITY RESILIENCE INDEPENDENT OF SOCIOECONOMIC STATUS

    PubMed Central

    Fry-Johnson, Yvonne W.; Levine, Robert; Rowley, Diane; Agboto, Vincent; Rust, George

    2010-01-01

    Introduction US disparities in Black:White infant mortality are persistent. National trends, however, may obscure local successes. Methods Zero-corrected, negative binomial multivariable modeling was used to predict Black infant mortality (1999–2003) in all US counties with reliable rates. Independent variables included county population size, racial composition, educational attainment, poverty, income and geographic origin. Resilient counties were defined as those whose Black infant mortality rate residual score was <2.0. Mortality data was accessed from the Compressed Mortality File compiled by the National Center for Health Statistics and found on the CDC WONDER website. Demographic information was obtained from the US Census. Results The final model included the percentage of Blacks, age 18 to 64 years, speaking little or no English (P<.008), a socioeconomic index comprising educational attainment, poverty, and per capita income (P<.001), and household income in 1990 (P<.001). After accounting for these factors, a stratum comprising Essex and Plymouth Counties, Mass.; Bronx, N.Y.; and Multnomah, Ore. was identified as unusually resilient. Percentage of Black poverty and educational attainment in Black women in the resilient stratum approximated the average for all 330 counties, In 1979, Black infant mortality in the resilient stratum (23.6 per 1,000 live births) exceeded Black US infant mortality (22.6). By 2001, Black infant mortality in the resilient stratum (5.6) was below the corresponding value for Whites (5.7). Resilient county neonatal mortality declined both early and late in the observation period, while post-neonatal declines were most marked after 1996. Conclusions Models for reduction/elimination of racial disparities in US infant mortality, independent from county-level contextual measures of socioeconomic status, may already exist. PMID:20521401

  18. Comparison of mortality risk: a score for very low birthweight infants

    PubMed Central

    Maier, R; Rey, M; Metze, B; Obladen;, M; TARNOW-MORDI, W.

    1997-01-01

    AIM—To develop and evaluate a score which quantifies mortality risk in very low birthweight (VLBW) infants (birthweight below 1500 g) at admission to the neonatal intensive care unit.
METHODS—Five hundred and seventy two VLBW infants admitted from 1978 to 1987 were randomly assigned to a cohort (n = 396) for score development and a cohort (n = 176) for score validation. Two hundred and ninety four VLBW infants admitted from 1988 to 1991 were used to compare risk adjusted mortality between the two eras.
RESULTS—Using multiple regression analysis, birthweight, Apgar score at 5 minutes, base excess at admission, severity of respiratory distress syndrome, and artificial ventilation were predictive of death in the development cohort. According to regression coefficients, a score ranging from 3 to 40 was developed. At a cutoff of 21, it predicted death in the validation cohort with a sensitivity of 0.85, a specificity of 0.73, and a correct classification rate of 0.76. The area under the receiver operating characteristic curve was 0.86. There was no significant difference in risk severity and in risk adjusted mortality between the eras 1978-87 and 1988-91.
CONCLUSION—The present score is robust, easily obtainable at admission, and permits early randomisation based on mortality risk.

 Keywords: mortality risk; scoring system; very low birthweight PMID:9175942

  19. Comparisons of infant mortality using a percentile-based method of standardization for birthweight or gestational age.

    PubMed

    Hertz-Picciotto, I; Din-Dzietham, R

    1998-01-01

    Comparisons of infant, perinatal, or neonatal mortality across populations with different birthweight or gestational age distributions are problematic. Summary measures with adjustment for birthweight or gestational age frequently are invalid or lack interpretability. We propose a percentile-based method of standardization for comparing infant, perinatal, or neonatal mortality across populations that have different distributions of birthweight and/or gestational age. The underlying concept is a simple one: comparable health for two population groups will be expressed as equal rates of disease or mortality at equal quantiles in the two distributions of birthweight or gestational age. We describe this method mathematically and present an example comparing mortality rates for African-American vs European-American infants in North Carolina. When gestational age is transformed to its rank, the well-known crossover in mortality rates, in which preterm African-American infants die at lower rates but term infants at higher rates, disappears: African-Americans show higher mortality rates at any percentile of gestational age. With homogeneous mortality rate ratios, a summary statistic becomes meaningful. We also demonstrate adjustment for percentile-transformed gestational age or birthweight in multiple logistic regression models. Percentile standardization is easily implemented, has advantages over other methods of internal standardization such as that of Wilcox and Russell, and communicates an intuitive public health-based concept of equality of mortality across populations.

  20. Hospitalizations, Costs, and Mortality among Infants with Critical Congenital Heart Disease: How Important Is Timely Detection?

    PubMed Central

    Peterson, Cora; Dawson, April; Grosse, Scott D.; Riehle-Colarusso, Tiffany; Olney, Richard S.; Tanner, Jean Paul; Kirby, Russell S.; Correia, Jane A.; Watkins, Sharon M.; Cassell, Cynthia H.

    2015-01-01

    BACKGROUND Critical congenital heart disease (CCHD) was recently added to the U.S. Recommended Uniform Screening Panel for newborns. States considering screening requirements may want more information about the potential impact of screening. This study examined potentially avoidable mortality among infants with late detected CCHD and assessed whether late detection was associated with increased hospital resource use during infancy. METHODS This was a state-wide, population-based, observational study of infants with CCHD (n =3603) born 1998 to 2007 identified by the Florida Birth Defects Registry. We examined 12 CCHD conditions that are targets of newborn screening. Late detection was defined as CCHD diagnosis after the birth hospitalization. Deaths potentially avoidable through screening were defined as those that occurred outside a hospital following birth hospitalization discharge and those that occurred within 3 days of an emergency readmission. RESULTS For 23% (n =825) of infants, CCHD was not detected during the birth hospitalization. Death occurred among 20% (n =568/2,778) of infants with timely detected CCHD and 8% (n =66/825) of infants with late detected CCHD, unadjusted for clinical characteristics. Potentially preventable deaths occurred in 1.8% (n =15/825) of infants with late detected CCHD (0.4% of all infants with CCHD). In multivariable models adjusted for selected characteristics, late CCHD detection was significantly associated with 52% more admissions, 18% more hospitalized days, and 35% higher inpatient costs during infancy. CONCLUSION Increased CCHD detection at birth hospitals through screening may lead to decreased hospital costs and avoid some deaths during infancy. Additional studies conducted after screening implementation are needed to confirm these findings. PMID:24000201

  1. Infant mortality evolution in Romania: perspectives from a country in transition

    NASA Astrophysics Data System (ADS)

    Burlea, A.-M.; Muntele, I.

    2012-04-01

    In the last two decades transition was a word used to describe the important mutations that have characterized social and economic structures in Romania. All the changes left their mark on every aspects of life including on population health status, and all modifications were reflected in the evolution of health indicators. Considered one of the most sensitive indicators of living conditions, population health literacy level and healthcare system efficiency infant mortality rate is a negative indicator which reflects the intensity of children deaths before their first anniversary. Based on the current statistical data collected at county level, this research aims to underline the existing spatial differences in Romania at county level, to identify spatial patterns, time trend and to point out the territories that need special attention and a more profound analysis for understanding the causes that are generating them. Using mathematical and statistical methods we have calculated infant mortality for a previous and available period of time (1990 - 2010) and identified a trend influenced by exogenous and endogenous factors. With the help of GIS techniques we have created cartographic material for allowing us an easier identification of spatial disparities. Following the global trend, Romania achieved significant progress in reduction infant mortality. From values that exceeded 26 ‰ at the beginning of the nineties this indicator has continued to diminish until 9.79 ‰ in 2010. But, with all the improvements, value is still double in compare with European Union average. Although characteristic for Romania is the general downward trend, at the county level there can be identified different types of evolution and different spatial pattern. Having the lowest economic development level in the country, Northeast and Southeast counties maintain high values for infant mortality rate. Positive examples are given by Bucharest and some central and western districts, all with

  2. Early Infant Temperament: The Saliency of Positive and Negative Affect.

    ERIC Educational Resources Information Center

    Coll, Cynthia Garcia; And Others

    Findings from three studies that used a laboratory procedure to assess individual differences in various dimensions of infant temperament in relation to later Brazelton scores are presented. Participants included 59 healthy, full-term and sick, preterm infants. The sick, preterm infants included infants who developed respiratory or neurological…

  3. Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants: A randomized clinical trial

    PubMed Central

    Benjamin, Daniel K.; Hudak, Mark L.; Duara, Shahnaz; Randolph, David A.; Bidegain, Margarita; Mundakel, Gratias T.; Natarajan, Girija; Burchfield, David J.; White, Robert D.; Shattuck, Karen E.; Neu, Natalie; Bendel, Catherine M.; Kim, M. Roger; Finer, Neil N.; Stewart, Dan L.; Arrieta, Antonio C.; Wade, Kelly C.; Kaufman, David A.; Manzoni, Paolo; Prather, Kristi O.; Testoni, Daniela; Berezny, Katherine Y.; Smith, P. Brian

    2014-01-01

    IMPORTANCE Invasive candidiasis in premature infants causes mortality and neurodevelopmental impairment. Fluconazole prophylaxis reduces candidiasis, but its effect on mortality and the safety of fluconazole is unknown. OBJECTIVE To evaluate the efficacy and safety of fluconazole in preventing death or invasive candidiasis in extremely low-birth-weight infants. DESIGN, SETTING, AND PATIENTS This study was a randomized, blinded, placebo-controlled trial of fluconazole in premature infants. Infants weighing less than 750 g at birth (N = 361) from 32 neonatal intensive care units (NICUs) in the United States were randomly assigned to receive either fluconazole or placebo twice weekly for 42 days. Surviving infants were evaluated at 18 to 22 months corrected age for neurodevelopmental outcomes. The study was conducted between November 2008 and February 2013. INTERVENTIONS Fluconazole (6 mg/kg of body weight) or placebo. MAIN OUTCOMES AND MEASURES The primary end point was a composite of death or definite or probable invasive candidiasis prior to study day 49 (1 week after completion of study drug). Secondary and safety outcomes included invasive candidiasis, liver function, bacterial infection, length of stay, intracranial hemorrhage, periventricular leukomalacia, chronic lung disease, patent ductus arteriosus requiring surgery, retinopathy of prematurity requiring surgery, necrotizing enterocolitis, spontaneous intestinal perforation, and neurodevelopmental outcomes—defined as a Bayley-III cognition composite score of less than 70, blindness, deafness, or cerebral palsy at 18–22-months corrected age. RESULTS Among infants receiving fluconazole, the composite primary end point of death or invasive candidiasis was 16% (95% CI, 11%–22%) vs 21% in the placebo group (95% CI, 15%–28%; odds ratio 0.73 [95% CI 0.43–1.23]; P=.24; treatment difference −5% [95% CI, −13%–3%]). Invasive candidiasis occurred less frequently in the fluconazole group (3% [95% CI, 1%

  4. The Effect of Oral Polio Vaccine at Birth on Infant Mortality: A Randomized Trial

    PubMed Central

    Lund, Najaaraq; Andersen, Andreas; Hansen, Anna Sofie K.; Jepsen, Frida S.; Barbosa, Amarildo; Biering-Sørensen, Sofie; Rodrigues, Amabelia; Ravn, Henrik; Aaby, Peter; Benn, Christine Stabell

    2015-01-01

    Background. Routine vaccines may have nonspecific effects on mortality. An observational study found that OPV given at birth (OPV0) was associated with increased male infant mortality. We investigated the effect of OPV0 on infant mortality in a randomized trial in Guinea-Bissau. Methods. A total of 7012 healthy normal-birth-weight neonates were randomized to BCG only (intervention group) or OPV0 with BCG (usual practice). All children were to receive OPV with pentavalent vaccine (diphtheria, tetanus, pertussis, Haemophilus influenzae type b, and hepatitis B) at 6, 10, and 14 weeks of age. Seven national OPV campaigns were also conducted during the trial period. Children were followed to age 12 months. We used Cox regression to calculate hazard ratios (HRs) for mortality. Results. The trial contradicted the original hypothesis about OPV0 increasing male infant mortality. Within 12 months, 73 children in the BCG + OPV group and 87 children in the BCG-only group died, all from infectious diseases. Comparing BCG + OPV0 vs BCG only, the HR was 0.83 (95% confidence interval [CI], .61–1.13): 0.72 (95% CI, .47–1.10) in boys and 0.97 (95% CI, .61–1.54) in girls. For children enrolled within the first 2 days of life, the HR for BCG + OPV0 vs BCG only was 0.58 (95% CI, .38–.90). From enrollment until the time of OPV campaigns, the HR was 0.68 (95% CI, .45–1.00), the beneficial effect being separately significant for males (0.55 [95% CI, .32–.95]). Conclusions. This is the only randomized trial of the effect of OPV0 on mortality. OPV0 may be associated with nonspecific protection against infectious disease mortality, particularly when given early in life. There are reasons to monitor mortality when OPV is being phased out. Clinical Trials Registration. NCT00710983. PMID:26219694

  5. The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight

    PubMed Central

    Livingston, Melvin D.; Markowitz, Sara; Wagenaar, Alexander C.

    2016-01-01

    Objectives. To investigate the effects of state minimum wage laws on low birth weight and infant mortality in the United States. Methods. We estimated the effects of state-level minimum wage laws using a difference-in-differences approach on rates of low birth weight (< 2500 g) and postneonatal mortality (28–364 days) by state and month from 1980 through 2011. All models included state and year fixed effects as well as state-specific covariates. Results. Across all models, a dollar increase in the minimum wage above the federal level was associated with a 1% to 2% decrease in low birth weight births and a 4% decrease in postneonatal mortality. Conclusions. If all states in 2014 had increased their minimum wages by 1 dollar, there would likely have been 2790 fewer low birth weight births and 518 fewer postneonatal deaths for the year. PMID:27310355

  6. The 2007 annual report of the Regional Infant and Child Mortality Review Committee.

    PubMed

    Randall, Brad; Wilson, Ann L

    2008-08-01

    The mission of the Regional Infant and Child Mortality Review Committee (RICMRC) is to review infant and child deaths so that information can be transformed into action to protect young lives. The 2007 review area includes South Dakota's Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, Miner and Brookings counties. Although there were no deaths in 2007 that met the criteria of the Sudden Infant Death Syndrome (SIDS) in our region, there were three infant deaths associated with unsafe sleeping environments (including adult co-sleeping) that either caused or potentially may have caused these infants' deaths. We need to continue to promote the "Back to Sleep" campaign message of not only placing infants to sleep on their backs, but also making sure infants are put down to sleep on safe, firm sleeping surfaces and that they are appropriately dressed for the ambient temperature. Parents need to be aware of the potential hazards of co-sleeping with their infants. Compared to nine such deaths in 2006, only four deaths in 2007 involved motor-vehicle crashes, none of which were alcohol related. Two drowning deaths illustrated the rapidity in which even momentary caregiver distractions can lead to deaths in children in and around water. Since 1997 the Regional Infant and Child Mortality Review Committee (RICMRC) has sought to achieve its mission to "review infant and child deaths so that information can be transformed into action to protect young lives." For 2007, the committee reviewed 25 deaths from Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, Miner and Brookings counties that met the following criteria: Children under the age of 18 dying subsequent to hospital discharge following delivery. Children who either died in these counties from causes sustained in them, or residents who died elsewhere from causes sustained in the 10-county region. The report that follows reviews the committee's activities for 2007. No deaths meeting the criteria

  7. Post-neonatal infant mortality in Malawi: the importance of maternal health.

    PubMed

    Verhoeff, Francine H; Le Cessie, Saskia; Kalanda, Boniface F; Kazembe, Peter N; Broadhead, Robin L; Brabin, Bernard J

    2004-06-01

    In a cohort study of mothers and their infants, information was collected from women attending the antenatal services of two hospitals in a rural area of Malawi and 561 of their babies were enrolled in a follow-up study. There were 128 with a low birthweight (LBW, <2500 g), 138 with fetal anaemia (FA, cord haemoglobin <12.5 g/dl), 42 with both and 228 with a normal birthweight and no FA. Infants were seen monthly for 1 year. Risk factors for post-neonatal infant mortality (PNIM) were calculated using Cox regression analysis adjusting for LBW and FA. PNIM was 9.3%. Respiratory infections and diarrhoeal disease were the principal attributable causes of death. PNIM increased with LBW (RR 3.08, 95% CI 1.51-6.23) but not significantly so with FA (RR 1.60, 95% CI 0.78-3.27). An additional effect on PNIM was observed with maternal HIV (RR 3.44, 95% CI 1.63-7.26) and malaria at the first antenatal visit (RR 2.26, 95% CI 1.09-4.73). Illiteracy was not associated with mortality. Placental malaria in HIV-seronegative mothers was significantly associated with increased PNIM. Improving birthweight through effective antimalarial control in pregnancy will lead to a reduction in PNIM. Reduction of HIV prevalence and prevention of mother-to-child transmission of HIV must be a main target for government health policy.

  8. [Infant mortality due to avoidable causes in a city in Northeastern Brazil].

    PubMed

    do Nascimento, Suelayne Gonçalves; de Oliveira, Conceição Maria; Sposito, Verônica; Ferreira, Daniela Karina da Silva; do Bonfim, Cristine Vieira

    2014-01-01

    This is a cross-sectional study that aimed to describe the occurrence of infant mortality in Recife (PE) between 2000 and 2009, second to avoidable causes. The population composed of cases of deaths between 2000 and 2009 among the infants of mothers living in Recife. Deaths were classified as avoidable by using the List of avoidable causes of deaths resulting from interventions within the Brazilian National Health System (SUS). Descriptive statistics were used for data analysis. A decrease in the infant mortality coefficient from 20.4 to 12.1 per 1.000 live births was observed (reduction of 40.6%). From the total of 3.743 deaths registered, 2.861 (76.4%) were classified as avoidable. It was notable that 61.2% of the deaths could have been avoided through appropriate care for the woman during the pregnancy. An approach in which avoidability is analyzed may assist in discussions relating to organization, quality and access to healthcare service, and in identifying deaths that could have been avoided through appropriate mother-child healthcare.

  9. Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality

    PubMed Central

    Ogbo, Felix A.; Agho, Kingsley; Ogeleka, Pascal; Woolfenden, Sue; Page, Andrew; Eastwood, John

    2017-01-01

    Background The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children’s Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality. Method The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries. Results Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77–0.85, P<0.001 and OR = 0.50; 95%CI: 0.43–0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14–1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05–1.55) were significantly associated with a higher risk of diarrhoea. Conclusion Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each

  10. Infant Mortality

    MedlinePlus

    ... and Alaska Native Activities Building Tribal MCH Epidemiologic Capacity Improving Surveillance Systems and Collecting American Indian and ... Selected Recommendations for Contraceptive Use Providing Quality Family Planning Services Training for Providers Unintended Pregnancy Women’s Reproductive ...

  11. Infant Mortality: District Profiles for the Congressional Black Caucus, 102nd Congress. Report for the Congressional Black Caucus.

    ERIC Educational Resources Information Center

    National Commission To Prevent Infant Mortality, Washington, DC.

    This report provides an overview of infant mortality rates in congressional districts represented by members of the Congressional Black Caucus (CBC). The 1989 or 1990 mortality rates for Blacks and Whites for the 25 districts represented by CBC members are presented, as well as rates for the overall population. An appendix provides data on Black,…

  12. Breast-feeding, social variables, and infant mortality: a hazards model analysis of the case of Malaysia.

    PubMed

    Holland, B

    1987-01-01

    A hazards model was used to estimate the relative risks of infant mortality at various points during the 1st year of life among Malaysian infants who were breastfed for various durations. Data on infant mortality, breastfeeding, and social variables were derived from the retrospective Malaysian Family Life Survey. To provide adequate samples in subperiods of the 1st year of life, analysis intervals were constructed starting at ages 0, 2, 4, and 7 months, and including up to 13 months of exposure. The preferred models for the 1st 3 analysis intervals included breastfeeding as a predictor of infant mortality. It is a particularly significant determinant in the 1st and 3rd intervals. The relative risk of death among those who received food other than human milk was 6.26 compared to those who did not, and the infant who was never breastfed was 12 times more likely to die than the infant who was breastfed at some time. Infants breastfed for intermediate durations had intermediate effects estimates. In each analysis interval, the regression coefficient for unsupplemented breastfeeding was of larger magnitude than that for supplemented breastfeeding. Overall, this study shows that breastfeeding is an important determinant of infant mortality in Malaysia. Studies with larger samples are urged to confirm the preliminary finding of a monotonic relationship between breastfeeding duration and lower infant of mortality risks. However, this analysis demonstrates the utility of hazard model methodology as a powerful tool for calculating relative risk estimates when the sample size is relatively small and there are numerous covariates.

  13. What explains the rural-urban gap in infant mortality: household or community characteristics?

    PubMed

    Van de Poel, Ellen; O'Donnell, Owen; Van Doorslaer, Eddy

    2009-11-01

    The rural-urban gap in infant mortality rates is explained by using a new decomposition method that permits identification of the contribution of unobserved heterogeneity at the household and the community level. Using Demographic and Health Survey data for six Francophone countries in Central and West sub-Saharan Africa, we find that differences in the distributions of factors that determine mortality--not differences in their effects--explain almost the entire gap. Higher infant mortality rates in rural areas mainly derive from the rural disadvantage in household characteristics, both observed and unobserved, which explain two-thirds of the gap. Among the observed characteristics, environmental factors--a safe source of drinking water, electricity, and quality of housing materials--are the most important contributors. Community characteristics explain less than one-quarter of the gap, with about two-thirds of this coming from community unobserved heterogeneity and one-third from the existence of a health facility within the community. The effect of disadvantageous environmental conditions--such as limited electricity and water supply--derives both from a lack of community-level infrastructure and from the inability of some households to exploit it when available. Policy needs to operate at both the community and household levels to correct such deficiencies.

  14. "A sudden and terrible revelation": motherhood and infant mortality in France, 1858-1874.

    PubMed

    Cole, J

    1996-01-01

    In 1874, legislators in France passed a law regulating the wet-nursing industry. Citing recent medical research into the causes and social costs of high infant mortality, the law's supporters met little opposition, despite the fact that the law challenged the tradition of paternal authority and familial autonomy that had been inscribed in French law since the promulgation of the Civil Code of 1804. Extending state power into the familial realm required a concerted effort by reformers, who concentrated on two issues: maternal responsibility for newborn infants and the social costs of early death. Because working women in urban areas used wet-nurses to preserve their wage-earning capacity, reformers capitalized on widespread opposition to women's labor outside the home. The law met little opposition in part because the issues of paternal authority had already been thoroughly debated several months earlier in the child labor law of 1874.

  15. Influence of socioeconomic and health care development on infant and perinatal mortality in Spain 1975-86.

    PubMed Central

    Lardelli, P; Blanco, J I; Delgado-Rodríguez, M; Bueno, A; de Dios Luna, J; Gálvez, R

    1993-01-01

    STUDY OBJECTIVE--This study aimed to analyse the influence of social, economic, and health development on infant and perinatal mortality in Spain between 1975 and 1986, and to identify possible changes in these relationships over time. DESIGN--Study of the association between mortality and a range of variables. SETTING--50 Spanish provinces. MEASUREMENTS AND MAIN RESULTS--Mean infant and perinatal mortality were estimated for two periods--1975-8 and 1983-6. Social, economic, and health care indicators were collected as independent variables for these two periods. The rates of variation between periods were estimated for each variable. Multiple linear regression models were used to define the association between infant and perinatal mortality and their respective rate of variation with the former indicators. Mean familial income was the main predictive factor for infant and perinatal mortality in the first period but in the second period health care indicators were more relevant. CONCLUSIONS--The reduction in Spanish infant and perinatal mortality over the period can be attributed mainly to the improvement in prenatal and neonatal health care in Spain in recent years, while economic factors seem less important. PMID:8228758

  16. Maternal emotion dysregulation is related to heightened mother-infant synchrony of facial affect.

    PubMed

    Lotzin, Annett; Schiborr, Julia; Barkmann, Claus; Romer, Georg; Ramsauer, Brigitte

    2016-05-01

    A heightened synchrony between the mother's and infant's facial affect predicts adverse infant development. We know that maternal psychopathology is related to mother-infant facial affect synchrony, but it is unclear how maternal psychopathology is transmitted to mother-infant synchrony. One pathway might be maternal emotion dysregulation. We examined (a) whether maternal emotion dysregulation is positively related to facial affect synchrony and (b) whether maternal emotion dysregulation mediates the effect of maternal psychopathology on mother-infant facial affect synchrony. We observed 68 mothers with mood disorders and their 4- to 9-month-old infants in the Still-Face paradigm during two play interactions. The mother's and infant's facial affect were rated from high negative to high positive, and the degree of synchrony between the mother's and infant's facial affect was computed with a time-series analysis. Emotion dysregulation was measured with the Difficulties in Emotion Regulation Scale, and psychopathology was assessed with the Symptom Checklist-90-Revised. Higher maternal emotion dysregulation was significantly associated with higher facial affect synchrony; emotion dysregulation fully mediated the effect of maternal psychopathology on facial affect synchrony. Our findings demonstrate that maternal emotion dysregulation rather than maternal psychopathology per se places mothers and infants at risk for heightened facial affect synchrony.

  17. Trends and determinants of infant and under-five childhood mortality in Vietnam, 1986–2011

    PubMed Central

    Lee, Hwa-Young; Van Do, Dung; Choi, Sugy; Trinh, Oanh Thi Hoang; To, Kien Gia

    2016-01-01

    Background Although Vietnam has taken great efforts to reduce child mortality in recent years, a large number of children still die at early age. Only a few studies have been conducted to identify at-risk groups in order to provide baseline information for effective interventions. Objective The study estimated the overall trends in infant mortality rate (IMR) and under-five mortality rate (U5MR) during 1986–2011 and identified demographic and socioeconomic determinants of child mortality. Design Data from the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000 (MICS2), 2006 (MICS3) and 2011 (MICS4) were analysed. The IMR and U5MR were calculated using the indirect method developed by William Brass. Unadjusted and adjusted odds ratios were estimated to assess the association between child death and demographic and socioeconomic variables. Region-stratified stepwise logistic regression was conducted to test the sensitivity of the results. Results The IMR and U5MR significantly decreased for both male and female children between 1986 and 2010. Male children had higher IMR and U5MR compared with females in all 3 years. Women who were living in the Northern Midlands and Mountain areas were more likely to experience child deaths compared with women who were living in the Red River Delta. Women who were from minor ethnic groups, had low education, living in urban areas, and had multiple children were more likely to have experienced child deaths. Conclusion Baby boys require more healthcare attention during the first year of their life. Comprehensive strategies are necessary for tackling child mortality problems in Vietnam. This study shows that child mortality is not just a problem of poverty but involves many other factors. Further studies are needed to investigate pathways underlying associations between demographic and socioeconomic conditions and childhood mortality. PMID:26950560

  18. Infant affective reactions to the resumption of maternal interaction after the still-face.

    PubMed

    Weinberg, M K; Tronick, E Z

    1996-06-01

    To investigate infants' reactions to the Face-to-Face Still-Face Paradigm and in particular the reunion episode, 50 6-month-olds' affective, behavioral, and physiologic reactions were recorded and analyzed. Infants reacted to the still-face with negative affect, a drop in vagal tone, and an increase in heart rate. By contrast, they reacted to the reunion episode with a mixed pattern of positive and negative affect. There was a carryover of negative affect from the still-face, an increase in fussiness and crying, and a rebound of positive affect. During this episode, the infants' heart rate and vagal tone returned to initial levels. The data indicate that infant affective displays are specifically related to different interactive events, but that their physiologic reactions do not show the same level of specificity. The findings also highlight the complexity of the affective and reparatory processes that take place in mother-infant interactions.

  19. Prenatal predictors of mortality in very preterm infants cared for in the Australian and New Zealand Neonatal Network

    PubMed Central

    Evans, N; Hutchinson, J; Simpson, J M; Donoghue, D; Darlow, B; Henderson‐Smart, D

    2007-01-01

    Aim To identify antenatal and perinatal risk factors for in‐hospital mortality of babies born within the Australian and New Zealand Neonatal Network (ANZNN). Methods Data were collected prospectively as part of the ongoing audit of high‐risk infants (birth weight <1500 g or gestation <32 weeks) admitted to all level III neonatal units in Australia and New Zealand. Antenatal and intrapartum factors to 1 min of age were examined in 11 498 infants with gestational age >24 weeks. Risk and protective factors for mortality were derived from logistic regression models fitted to 1998–9 data and validated on 2000–1 data. Results For the whole cohort of infants born between 1998 and 2001, prematurity was the dominant risk factor, infants born at 25 weeks having 32 times greater odds of death than infants born at 31 weeks. Low birth weight for gestational age also had a dose–response effect: the more growth restricted the infant the greater the risk of mortality; infants below the 3rd centile had eight times greater odds of death than those between the 25th and 75th centiles. Male sex was also a significant risk factor (odds ratio (OR) 1.55, 95% confidence interval (CI) 1.31 to 1.82). Maternal hypertension in pregnancy was protective (OR 0.46, 95% CI 0.36 to 0.50). The predictive model for mortality had an area under the receiver operating characteristic curve of 0.82. Conclusions Risk of mortality can be predicted with good accuracy with factors up to the 1 min Apgar score. By using gestation rather than birth weight as the main indicator of maturity, these data confirm that weight for gestational age is an independent risk factor for mortality. PMID:16877475

  20. Morbidity and Mortality in Preterm Infants following Antacid Use: A Retrospective Audit

    PubMed Central

    Dhayade, Aparna

    2016-01-01

    Background and Objectives. Antacids are often prescribed to preterm infants due to misdiagnosis of gastro-oesophageal reflux. This suppresses gastric acidity, a major defence mechanism against infection. This study aims to determine if ranitidine and omeprazole use in very low birth weight (VLBW) neonates, <1500 grams, is associated with increased risk of late onset sepsis, necrotising enterocolitis (NEC), and mortality. Methods. Retrospective analysis was conducted on neonates, <1500 grams, born and admitted into the Neonatal Intensive Care Unit at The Canberra Hospital during the period from January 2008 to December 2012. Information regarding late onset sepsis, NEC, mortality, ranitidine/omeprazole use, and other neonatal/hospital factors was collected for each neonate. Results. 360 neonates were evaluated, 64 received ranitidine and/or omeprazole, and 296 had not. There were no statistically significant differences in incidence of late onset sepsis (OR = 0.52, CI = 0.24–1.1, and p = 0.117), NEC Stage 2 and above (OR = 0.4, CI = 0.05–3.2, and p = 0.7), or mortality (OR = 0.35, CI = 0.08–1.5, and p = 0.19) between the two groups. After adjusting significant differences in neonatal and hospital factors, risk of late onset sepsis was significantly lower in those that received ranitidine/omeprazole (OR = 0.28, CI = 0.13–0.65, and p = 0.003). Conclusions. Ranitidine and omeprazole use in VLBW preterm infants may not be associated with an increased risk of infection, NEC, and mortality. PMID:27990166

  1. Respiratory Syncytial Virus–Associated Mortality in Hospitalized Infants and Young Children

    PubMed Central

    Wilkes, Jacob; Korgenski, Kent; Sheng, Xiaoming

    2015-01-01

    BACKGROUND AND OBJECTIVE: Respiratory syncytial virus (RSV) is a common cause of pediatric hospitalization, but the mortality rate and estimated annual deaths are based on decades-old data. Our objective was to describe contemporary RSV-associated mortality in hospitalized infants and children aged <2 years. METHODS: We queried the Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID) for 2000, 2003, 2006, and 2009 and the Pediatric Health Information System (PHIS) administrative data from 2000 to 2011 for hospitalizations with International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for RSV infection and mortality. RESULTS: The KID data sets identified 607 937 RSV-associated admissions and 550 deaths (9.0 deaths/10 000 admissions). The PHIS data set identified 264 721 RSV-associated admissions and 671 deaths (25.4 deaths/10 000 admissions) (P < .001 compared with the KID data set). The 2009 KID data set estimated 42.0 annual deaths (3.0 deaths/10 000 admissions) for those with a primary diagnosis of RSV. The PHIS data set identified 259 deaths with a primary diagnosis of RSV, with mortality rates peaking at 14.0/10 000 admissions in 2002 and 2003 and decreasing to 4.0/10 000 patients by 2011 (odds ratio: 0.27 [95% confidence interval: 0.14–0.52]). The majority of deaths in both the KID and PHIS data sets occurred in infants with complex chronic conditions and in those with other acute conditions such as sepsis that could have contributed to their deaths. CONCLUSIONS: Deaths associated with RSV are uncommon in the 21st century. Children with complex chronic conditions account for the majority of deaths, and the relative contribution of RSV infection to their deaths is unclear. PMID:25489019

  2. City-Specific Spatiotemporal Infant and Neonatal Mortality Clusters: Links with Socioeconomic and Air Pollution Spatial Patterns in France

    PubMed Central

    Padilla, Cindy M.; Kihal-Talantikit, Wahida; Vieira, Verónica M.; Deguen, Séverine

    2016-01-01

    Infant and neonatal mortality indicators are known to vary geographically, possibly as a result of socioeconomic and environmental inequalities. To better understand how these factors contribute to spatial and temporal patterns, we conducted a French ecological study comparing two time periods between 2002 and 2009 for three (purposefully distinct) Metropolitan Areas (MAs) and the city of Paris, using the French census block of parental residence as the geographic unit of analysis. We identified areas of excess risk and assessed the role of neighborhood deprivation and average nitrogen dioxide concentrations using generalized additive models to generate maps smoothed on longitude and latitude. Comparison of the two time periods indicated that statistically significant areas of elevated infant and neonatal mortality shifted northwards for the city of Paris, are present only in the earlier time period for Lille MA, only in the later time period for Lyon MA, and decrease over time for Marseille MA. These city-specific geographic patterns in neonatal and infant mortality are largely explained by socioeconomic and environmental inequalities. Spatial analysis can be a useful tool for understanding how risk factors contribute to disparities in health outcomes ranging from infant mortality to infectious disease—a leading cause of infant mortality. PMID:27338439

  3. Environmental factors in the relationship between breastfeeding and infant mortality: the role of sanitation and water in Malaysia.

    PubMed

    Butz, W P; Habicht, J P; DaVanzo, J

    1984-04-01

    Mothers' recall data collected in Malaysia in 1976-1977 are analyzed to study correlates of mortality of 5471 infants. Respondent population is 1262 women living in 52 primary sampling units of Peninsular Malaysia. Lengths of unsupplemented and supplemented breastfeeding and presence of piped household water and toilet sanitation are related to infant mortality in regressions that also control other correlates. The analysis is disaggregated into three periods of infancy. Through six months of feeding, unsupplemented breastfeeding is more strongly associated with fewer infant deaths than is supplemented breastfeeding. Type of sanitation is generally more strongly associated with mortality than is type of water supply. The effects of breastfeeding and the environmental variables are shown to be strongly interactive and to change systematically during the course of infancy. Breastfeeding is more strongly associated with infant survival in homes without piped water or toilet sanitation. In homes with both modern facilities, supplemented breastfeeding has no significant effect, and unsupplemented breastfeeding is statistically significant only for mortality in days 8-28. Presence of modern water and sanitation systems appears unimportant for mortality of infants who are breastfed without supplementation for six months.

  4. Management of diarrhea in HIV-affected infants and children.

    PubMed

    Pavlinac, Patricia B; Tickell, Kirkby D; Walson, Judd L

    2015-01-01

    Globally, diarrhea is the second leading cause of death in children less than 5 years of age. HIV-infected and HIV-exposed uninfected (HEU) children are at high risk of dying from diarrhea and may be more susceptible to the highest risk enteric pathogens. This increased risk associated with HIV infection and HIV exposure is likely multifactorial. Factors such as immunosuppression, proximity to individuals more likely to be shedding pathogens, and exposure to antimicrobial prophylaxis may alter the risk profile in these children. Current international guidelines do not differentiate management strategies on the basis of whether children are infected or affected by HIV, despite likely differences in etiologies and consequences. Reducing diarrhea mortality in high HIV prevalence settings will require strengthening of HIV testing and treatment programs; improvements in water, sanitation and hygiene interventions targeted at HIV-affected households; and reconsideration of the use of empiric antimicrobial treatment of pathogens known to infect HIV-infected and HEU children disproportionately.

  5. Family poverty affects the rate of human infant brain growth.

    PubMed

    Hanson, Jamie L; Hair, Nicole; Shen, Dinggang G; Shi, Feng; Gilmore, John H; Wolfe, Barbara L; Pollak, Seth D

    2013-01-01

    Living in poverty places children at very high risk for problems across a variety of domains, including schooling, behavioral regulation, and health. Aspects of cognitive functioning, such as information processing, may underlie these kinds of problems. How might poverty affect the brain functions underlying these cognitive processes? Here, we address this question by observing and analyzing repeated measures of brain development of young children between five months and four years of age from economically diverse backgrounds (n = 77). In doing so, we have the opportunity to observe changes in brain growth as children begin to experience the effects of poverty. These children underwent MRI scanning, with subjects completing between 1 and 7 scans longitudinally. Two hundred and three MRI scans were divided into different tissue types using a novel image processing algorithm specifically designed to analyze brain data from young infants. Total gray, white, and cerebral (summation of total gray and white matter) volumes were examined along with volumes of the frontal, parietal, temporal, and occipital lobes. Infants from low-income families had lower volumes of gray matter, tissue critical for processing of information and execution of actions. These differences were found for both the frontal and parietal lobes. No differences were detected in white matter, temporal lobe volumes, or occipital lobe volumes. In addition, differences in brain growth were found to vary with socioeconomic status (SES), with children from lower-income households having slower trajectories of growth during infancy and early childhood. Volumetric differences were associated with the emergence of disruptive behavioral problems.

  6. Family Poverty Affects the Rate of Human Infant Brain Growth

    PubMed Central

    Hanson, Jamie L.; Hair, Nicole; Shen, Dinggang G.; Shi, Feng; Gilmore, John H.; Wolfe, Barbara L.; Pollak, Seth D.

    2013-01-01

    Living in poverty places children at very high risk for problems across a variety of domains, including schooling, behavioral regulation, and health. Aspects of cognitive functioning, such as information processing, may underlie these kinds of problems. How might poverty affect the brain functions underlying these cognitive processes? Here, we address this question by observing and analyzing repeated measures of brain development of young children between five months and four years of age from economically diverse backgrounds (n = 77). In doing so, we have the opportunity to observe changes in brain growth as children begin to experience the effects of poverty. These children underwent MRI scanning, with subjects completing between 1 and 7 scans longitudinally. Two hundred and three MRI scans were divided into different tissue types using a novel image processing algorithm specifically designed to analyze brain data from young infants. Total gray, white, and cerebral (summation of total gray and white matter) volumes were examined along with volumes of the frontal, parietal, temporal, and occipital lobes. Infants from low-income families had lower volumes of gray matter, tissue critical for processing of information and execution of actions. These differences were found for both the frontal and parietal lobes. No differences were detected in white matter, temporal lobe volumes, or occipital lobe volumes. In addition, differences in brain growth were found to vary with socioeconomic status (SES), with children from lower-income households having slower trajectories of growth during infancy and early childhood. Volumetric differences were associated with the emergence of disruptive behavioral problems. PMID:24349025

  7. Infant Mortality and Social Environment in Georgia: An application of hotspot detection and prioritization†

    PubMed Central

    Yang, Tse-Chuan; McManus, Brian

    2011-01-01

    Recent years have witnessed the growth of new information technologies and their applications to various disciplines. The goal of this paper is to demonstrate how the two innovative methods, upper level set scan (ULS) hotspot detection and the multicriterion prioritization scheme, facilitate population health and break new ground in public health surveillance. It is believed that the social environment (i.e. social conditions and social capital) is one of the determinants of human health. Using infant health data and 10 additional indicators of social environment in the 159 counties of Georgia, ULS identified 52 counties that are in double jeopardy (high infant mortality and a high rate of low infant birth weight). The multicriterion ranking scheme suggested that there was no conspicuous spatial cluster of ranking orders, which improved the traditional decision making by visual geographic cluster. Both hotspot detection and ranking methods provided an empirical basis for re-allocating limited resources and several policy implications could be drawn from these analytic results. PMID:22022207

  8. The Changing Character of the Black–White Infant Mortality Gap, 1983–2004

    PubMed Central

    Elder, Todd E.; Goddeeris, John H.; Paneth, Nigel

    2014-01-01

    Objectives. We examined how changes in demographic, geographic, and childbearing risk factors were related to changes in the Black–White infant mortality rate (IMR) gap over 2 decades. Methods. Using 1983–2004 Vital Statistics, we applied inverse probability weighting methods to examine the relationship between risk factors and 3 outcomes: the overall IMR gap, its birth weight component, and its conditional (on birth weight) IMR component. Results. The unexplained IMR gap (the part not related to observed risk factors) was stable, changing from 5.0 to 5.3 deaths per 1000 live births. By contrast, the explained gap declined from 4.6 to 1.9. The decline in the explained gap was driven by the changing relationship between risk factors and IMR. Further analysis revealed that most of the unexplained gap occurred among infants weighing less than 1000 grams at birth, whereas most of the explained gap occurred among infants weighing more than 1000 grams. Conclusions. The unexplained gap was stable over the last 2 decades, but the explained gap declined markedly. If the stability of the unexplained gap continues, even complete convergence of risk factors would reduce the Black–White IMR gap by only one quarter. PMID:24354831

  9. The Born-Alive Infant Protection Act: impact on fetal and live birth mortality.

    PubMed

    Malloy, Michael H

    2011-05-01

    The Born-Alive Infant Protection Act (BAIPA) of 2002 defined a live birth in the United States without regard to gestation. The objective of this analysis was to determine if a significant decline in the fetal death rate or an increase in the live born death rate at previable gestational ages of 17 to 22 weeks has occurred. U.S. public use fetal death files and linked birth and infant death files were obtained for the years 2000 to 2005 for gestations of 17 to 22 weeks. The fetal death rate declined from 53.8% in the 2000 to 2002 period to 52.6% for the period 2003 to 2005 and the live birth mortality rate increased from 46.2 to 47.4% ( P < 0.02). The average annual live birth death rate increased significantly only at 17 weeks gestation ( P < 0.02). Although there was a small but statistically significant change in the fetal and live birth death rates for infants considered to be previable for the period following the passage of the BAIPA, the change appears to be isolated to only the most immature at 17 weeks gestation.

  10. The Geographical and Biophysical Correlates of Hunger and Infant Mortality: Lessons from CIESIN's Poverty Mapping Activities

    NASA Astrophysics Data System (ADS)

    de Sherbinin, A. M.; Balk, D.; Chen, R. S.; Levy, M.; Storeygard, A.

    2004-12-01

    This paper reports on a collection of recent efforts to integrate global spatial datasets and survey microdata to investigate drivers of hunger and infant mortality. They were motivated by a desire on the part of the United Nations Millennium Project to understand the conditions under which the world's poor and hungry live, for the purpose of improving the diagnosing the causes of poverty and hunger, designing interventions, and understanding the interactions among different Millennium Development Goals (MDGs). First, at the global level, it reports on a number of explorations that were undertaken to characterize the large-scale distribution of the world's poor in terms of climatic, topographic, land cover, ecosystem, and hydrologic factors. Second, at the regional level, it reports on an analysis of the correlates of hunger in Africa. Third, it reports on work combining survey microdata with spatial data in a study of infant mortality in West Africa. Lastly, it discusses ongoing work to combine these two scales at the continental and global scale in the context of drivers of hunger.

  11. Does fiscal decentralization improve health outcomes? Evidence from infant mortality in Italy.

    PubMed

    Cavalieri, Marina; Ferrante, Livio

    2016-09-01

    Despite financial and decision-making responsibilities having been increasingly devolved to lower levels of government worldwide, the potential impact of these reforms remains largely controversial. This paper investigates the hypothesis that a shift towards a higher degree of fiscal autonomy of sub-national governments could improve health outcomes, as measured by infant mortality rates. Italy is used as a case study since responsibilities for healthcare have been decentralized to regions, though the central government still retains a key role in ensuring all citizens uniform access to health services throughout the country. A linear fixed-effects regression model with robust standard errors is employed for a panel of 20 regions over the period 1996-2012 (340 observations in the full sample). Decentralization is proxied by two different indicators, capturing the degree of decision-making autonomy in the allocation of tax revenues and the extent to which regions rely on fiscal transfers from the central government. The results show that a higher proportion of tax revenues raised and/or controlled locally as well as a lower transfer dependency from the central government are consistently associated with lower infant mortality rates, ceteris paribus. The marginal benefit from fiscal decentralization, however, is not constant but depends on the level of regional wealth, favouring poorest regions. In terms of policy implications, this study outlines how the effectiveness of decentralization in improving health outcomes is contingent on the characteristics of the context in which the process takes place.

  12. A key genetic factor for fucosyllactose utilization affects infant gut microbiota development

    PubMed Central

    Matsuki, Takahiro; Yahagi, Kana; Mori, Hiroshi; Matsumoto, Hoshitaka; Hara, Taeko; Tajima, Saya; Ogawa, Eishin; Kodama, Hiroko; Yamamoto, Kazuya; Yamada, Takuji; Matsumoto, Satoshi; Kurokawa, Ken

    2016-01-01

    Recent studies have demonstrated that gut microbiota development influences infants' health and subsequent host physiology. However, the factors shaping the development of the microbiota remain poorly understood, and the mechanisms through which these factors affect gut metabolite profiles have not been extensively investigated. Here we analyse gut microbiota development of 27 infants during the first month of life. We find three distinct clusters that transition towards Bifidobacteriaceae-dominant microbiota. We observe considerable differences in human milk oligosaccharide utilization among infant bifidobacteria. Colonization of fucosyllactose (FL)-utilizing bifidobacteria is associated with altered metabolite profiles and microbiota compositions, which have been previously shown to affect infant health. Genome analysis of infants' bifidobacteria reveals an ABC transporter as a key genetic factor for FL utilization. Thus, the ability of bifidobacteria to utilize FL and the presence of FL in breast milk may affect the development of the gut microbiota in infants, and might ultimately have therapeutic implications. PMID:27340092

  13. Infant Maltreatment-Related Mortality in Alaska: Correcting the Count and Using Birth Certificates to Predict Mortality

    ERIC Educational Resources Information Center

    Parrish, Jared W.; Gessner, Bradford D.

    2010-01-01

    Objectives: To accurately count the number of infant maltreatment-related fatalities and to use information from the birth certificates to predict infant maltreatment-related deaths. Methods: A population-based retrospective cohort study of infants born in Alaska for the years 1992 through 2005 was conducted. Risk factor variables were ascertained…

  14. A review: dietary restrictions on hunter-gatherer women and the implications for fertility and infant mortality.

    PubMed

    Spielmann, K A

    1989-09-01

    In many hunter gatherer societies, food taboos dictate the diets of females. These taboos often happen during their most critical reproductive times in their life, e.g., pregnancy. Among some subarctic Athapaskan societies, females at menarche cannot eat fresh meat. They, like other hunter gatherer societies, also restrict fresh meat consumption for menstruating women. Young women of the Aranda society in Australia cannot eat protein rich foods, e.g., lizards, until they have a child. Australian aboriginal societies restrict protein and fat foods for pregnant and lactating women. Even though the literature shows that the undernourished are inclined to reach menarche at a later age than those who eat a well balanced diet, it does not clearly establish whether differences in age at menarche significantly affect overall fertility. Research done on many different under or marginally nourished populations indicates that maternal nutritional health influences birth spacing significantly. Specifically, undernutrition causes longer postpartum amenorrhea. Therefore, lower fertility rates follow longer birth intervals. Research shows that poor maternal nutritional health does not prevent the fetus from surviving and growing. Yet mothers who do not consume many calories often have low birth weight infants. These infants are at high risk of dying because they have little to no fat reserves and they consume inadequate amounts of nutrition since the mothers cannot make insufficient amounts of milk. Since contemporary research shows that maternal nutritional health does effect fertility and infant mortality, food taboos do have the ability to influence population size. More research is needed to understand the factors that influenced the reproductive rates of past hunter-gatherer societies, so anthropologists can identify the demographically significant changes which sedentism and agriculture caused 10,000 years ago.

  15. Infant mortality gap in the Baltic region - Latvia, Estonia, and Lithuania - in relation to macroeconomic factors in 1996-2010.

    PubMed

    Ebela, Inguna; Zile, Irisa; Ebela, Danute Razuka; Rozenfelde, Ingrida Rumba

    2013-01-01

    BACKGROUND AND OBJECTIVE. A constant gap has appeared in infant mortality among the 3 Baltic States - Latvia, Estonia, and Lithuania - since the restoration of independence in 1991. The aim of the study was to compare infant mortality rates in all the 3 Baltic countries and examine some of the macro- and socioeconomic factors associated with infant mortality. MATERIAL AND METHODS. The data were obtained from international databases, such as World Health Organization and EUROSTAT, and the national statistical databases of the Baltic States. The time series data sets (1996-2010) were used in the regression and correlation analysis. RESULTS. In all the 3 Baltic States, a strong and significant correlation was found: Latvia (r=-0.81, P<0.01), Lithuania (r=-0.93, P<0.01), and Estonia (r=-0.91, P<0.01). There was also a correlation between infant mortality and healthcare expenditure in local currency per capita: Latvia (r=-0.81, P<0.01); Lithuania (r=-0.90, P<0.01) and Estonia (r=-0.88, P<0.01). In Latvia (r=0.87, P<0.01) and Estonia (r=0.70; P<0.01), a significant correlation between infant mortality and unemployment levels was observed from 1996 to 2008, whereas the statistical significance disappeared in the period from 1996 to 2010. In Lithuania, the relationship was not significant. CONCLUSIONS. Higher infant mortality rates and a less stable decreasing tendency in Latvia are apparently explained by less successful adaptation to a new political and economic situation and limited skills in adjusting the healthcare system to the reality of life.

  16. Trends in infant mortality inequalities in the Americas: 1955–1995

    PubMed Central

    Schneider, M; Castillo-Salgado, C; Loyola-Elizondo, E; Bacallao, J; Mujica, O; Vidaurre, M; Alleyne, G

    2002-01-01

    Design: Infant mortality rates (IMRs) were computed and their trends assessed by ordinary least squares. Overall trends in IMR inequalities among countries were analysed by comparing 10 year period IMRs, Gini coefficients, and Lorenz curves. Income related trends in IMR inequalities were assessed using 10 year period IMR ratios between the highest and the lowest quintiles of the per capita gross national product (GNP) distributions (adjusted for purchasing power). Setting: Aggregated country data were used for all countries with over 200 thousand inhabitants (33 geopolitical units). The 10 year period midpoint IMR estimates used for the 1955–1995 time series were those published by the United Nations in 1997. Main results: IMRs decreased from 90.34 to 31.31 per 1000 live births between 1955 and 1995 at an average of 15.3 every 10 years. In contrast, Lorenz curves and Gini coefficients were similar for the five 10 year periods. After grouping by adjusted GNP distribution, a similar decreasing trend of IMR was observed in all groups. The rate ratio between the group at the lowest quintile and that at the highest quintile ranged from 4 to 5. The analysis of variance for repeated observations showed that there is a significant reduction in the IMR (F=130.18; p<0.01), that trends did not differ significantly among groups (F=1.16; p=0.32), and that they were approximately linear (F=155.83; p<0.01). Conclusions: Despite a sizable reduction in the infant mortality, whether or not income related, levels of IMR inequality among countries have remained almost constant between 1955 and 1995 in the Region of the Americas. Further analysis and focused interventions are needed to tackle the challenges of reducing these persistent mortality inequalities. PMID:12080163

  17. Trends in Overall Mortality, and Timing and Cause of Death among Extremely Preterm Infants near the Limit of Viability

    PubMed Central

    Sung, Sein; Ahn, So Yoon; Park, Won Soon

    2017-01-01

    Objective To investigate the trends in mortality, as well as in the timing and cause of death, among extremely preterm infants at the limit of viability, and thus to identify the clinical factors that contribute to decreased mortality. Methods We retrospectively reviewed the medical records of 382 infants born at 23–26 weeks’ gestation; 124 of the infants were born between 2001 and 2005 (period I) and 258 were born between 2006 and 2011 (period II). We stratified the infants into two subgroups–“23–24 weeks” and “25–26 weeks”–and retrospectively analyzed the clinical characteristics and mortality in each group, as well as the timing and cause of death. Univariate and multivariate logistic regression analyses were done to identify the clinical factors associated with mortality. Results The overall mortality rate in period II was 16.7% (43/258), which was significantly lower than that in period I (30.6%; 38/124). For overall cause of death, there were significantly fewer deaths due to sepsis (2.4% [6/258] vs. 8.1% [10/124], respectively) and air-leak syndrome (0.8% [2/258] vs. 4.8% (6/124), respectively) during period II than during period I. Among the clinical factors of time period, 1-and 5-min Apgar score, antenatal steroid identified significant by univariate analyses. 5-min Apgar score and antenatal steroid use were significantly associated with mortality in multivariate analyses. Conclusion Improved mortality rate attributable to fewer deaths due to sepsis and air leak syndrome in the infants with 23–26 weeks’ gestation was associated with higher 5-minute Apgar score and more antenatal steroid use. PMID:28114330

  18. The effect of divorce on infant mortality in a remote area of Bangladesh.

    PubMed

    Alam, N; Saha, S K; Razzaque, A; van Ginneken, J K

    2001-04-01

    The process of divorce is usually lengthy and hazardous, and can start quarrels that can lead to the abuse of women and their children. This study examines the effects of divorce on neonatal and postneonatal mortality of babies born before and after divorce in Teknaf, a remote area of Bangladesh. The longitudinal demographic surveillance system (DSS) followed 1,762 Muslim marriages in 1982-83 for 5 years to record divorce, deaths of spouse, emigration and births. It recorded 2,696 live births during the follow-up period, and their survival status during infancy. Logistic regression models were used to estimate the effect of divorce on neonatal and postneonatal mortality, controlling for maternal age at birth, parity, sex of the child and household economic status. The odds of neonatal and postneonatal deaths among babies born after divorce or less than 12 months before mothers were divorced were more than double the odds of those born to mothers of intact marriages. The odds of postneonatal deaths were two times higher among babies born more than 12 months before divorce happens than their peers. The high mortality of infants born before and after mothers were divorced may reflect how abusive marriage and divorce increase the vulnerability of women and children in rural Bangladesh. Divorce and abuse of women are difficult and intractable social and health problems that must be addressed.

  19. Neighborhood Socioeconomic Characteristics, Birth Outcomes and Infant Mortality among First Nations and Non-First Nations in Manitoba, Canada.

    PubMed

    Luo, Zhong-Cheng; Wilkins, Russell; Heaman, Maureen; Martens, Patricia; Smylie, Janet; Hart, Lyna; Wassimi, Spogmai; Simonet, Fabienne; Wu, Yuquan; Fraser, William D

    2010-01-01

    OBJECTIVE: Little is known about the possible impacts of neighborhood socioeconomic status on birth outcomes and infant mortality among Aboriginal populations. We assessed birth outcomes and infant mortality by neighborhood socioeconomic status among First Nations and non-First Nations in Manitoba. STUDY DESIGN: We conducted a retrospective birth cohort study of all live births (26,176 First Nations, 129,623 non-First Nations) to Manitoba residents, 1991-2000. Maternal residential postal codes were used to assign four measures of neighborhood socioeconomic status (concerning income, education, unemployment, and lone parenthood) obtained from 1996 census data. RESULTS: First Nations women were much more likely to live in neighborhoods of low socioeconomic status. First Nations infants were much more likely to die during their first year of life [risk ratio (RR) =1.9] especially during the postneonatal period (RR=3.6). For both First Nations and non-First Nations, living in neighborhoods of low socioeconomic status was associated with an increased risk of infant death, especially postneonatal death. For non-First Nations, higher rates of pre-term and small-for-gestational-age birth were consistently observed in low socioeconomic status neighborhoods, but for First Nations the associations were less consistent across the four measures of socioeconomic status. Adjusting for neighborhood socioeconomic status, the disparities in infant and postneonatal mortality between First Nations and non-First Nations were attenuated. CONCLUSION: Low neighborhood socioeconomic status was associated with an elevated risk of infant death even among First Nations, and may partly account for their higher rates of infant mortality compared to non-First Nations in Manitoba.

  20. Infant Mortality, Morbidity, and Childhood Handicapping Conditions: Psychosocial Factors. Based on Proceedings of a Bi-Regional Conference (Atlanta, Georgia, June 2-5, 1985).

    ERIC Educational Resources Information Center

    Watkins, Elizabeth L., Ed.; Melnick, Leslie R., Ed.

    In Part I, "Extent of Knowledge and Implications for Social Work Intervention," the following conference papers are presented: (1) "Unintended Pregnancy and Infant Mortality, Strategies and Interventions" (Alfred W. Brann, Jr.); (2) "Implications for Social Work Intervention in Biopsychosocial Factors Associated with Infant Mortality and…

  1. Management of diarrhea in HIV-affected infants and children

    PubMed Central

    Pavlinac, Patricia B.; Tickell, Kirkby D; Walson, Judd L

    2015-01-01

    Globally, diarrhea is the second leading cause of death in children less than 5 years of age. HIV-infected and HIV-exposed uninfected (HEU) children are at high risk of dying from diarrhea and may be more susceptible to the highest risk enteric pathogens. This increased risk associated with HIV infection and HIV exposure is likely multifactorial. Factors such as immunosuppression, proximity to individuals more likely to be shedding pathogens, and exposure to antimicrobial prophylaxis may alter the risk profile in these children. Current international guidelines do not differentiate management strategies on the basis of whether children are infected or affected by HIV, despite likely differences in etiologies and consequences. Reducing diarrhea mortality in high HIV prevalence settings will require strengthening of HIV testing and treatment programs; improvements in water, sanitation and hygiene interventions targeted at HIV-affected households; and reconsideration of the use of empiric antimicrobial treatment of pathogens known to infect HIV-infected and HEU children disproportionately. PMID:25384353

  2. Changes in infants' affect related to the onset of independent locomotion.

    PubMed

    Whitney, Pamela G; Green, James A

    2011-06-01

    Previous research suggests that after gaining several weeks of independent locomotor experience, infants may show both more negative and more positive affect toward parents. However, this prior work has been based largely on parent report, and no studies have used longitudinal or naturalistic methods to chart changes in infants' affective expressions as they gain locomotor ability. Fifteen infants were observed at home before, during, and after learning to crawl in two naturalistic contexts, free play and dyadic play. Expressions of negative affect during free play decreased after the onset of crawling, but there was no change in expressions of positive affect. At the same time, however, mothers reported an increase in both negative and positive reactivity. These results are discussed in terms of the contexts typically assessed during observations and the different sensitivities of mothers to infants' expressions of affect. Several lines of evidence point to a potential role for independent locomotion in the reorganization of affective expressions.

  3. Associations Between Infant Negative Affect and Parent Anxiety Symptoms are Bidirectional: Evidence from Mothers and Fathers.

    PubMed

    Brooker, Rebecca J; Neiderhiser, Jenae M; Leve, Leslie D; Shaw, Daniel S; Scaramella, Laura V; Reiss, David

    2015-01-01

    Little is known about child-based effects on parents' anxiety symptoms early in life despite the possibility that child characteristics may contribute to the quality of the early environment and children's own long-term risk for psychological disorder. We examined bidirectional effects between parent anxiety symptoms and infant negative affect using a prospective adoption design. Infant negative affect and adoptive parent anxiety symptoms were assessed at child ages 9, 18, and 27 months. Birth parent negative affect was assessed at child age 18 months. More anxiety symptoms in adoptive parents at child age 9 months predicted more negative affect in infants 9 months later. More infant negative affect at child age 9 months predicted more anxiety symptoms in adoptive parents 18 months later. Patterns of results did not differ for adoptive mothers and adoptive fathers. Birth parent negative affect was unrelated to infant or adoptive parent measures. Consistent with expectations, associations between infant negative affect and rearing parents' anxiety symptoms appear to be bidirectional. In addition to traditional parent-to-child effects, our results suggest that infants' characteristics may contribute to parent qualities that are known to impact childhood outcomes.

  4. Fertility and infant mortality trends in Nicaragua 1964-1993. The role of women's education

    PubMed Central

    Pena, R.; Liljestrand, J.; Zelaya, E.; Persson, L. A.

    1999-01-01

    OBJECTIVES: To assess trends in fertility and infant mortality rates (IMR) in Leon, Nicaragua, and to examine the effect of women's education on these trends during 1964-1993, a period of rapid social change. DESIGN: Cross sectional survey, based on random cluster sampling. A retrospective questionnaire on reproductive events was used. SETTING: The municipality of Leon, which is the second largest city in Nicaragua, with a total population of 195,000 inhabitants. SUBJECTS: 10,867 women aged 15-49 years, corresponding to 176,281 person years of reproductive life. Their children contributed 22,899 person years under 12 months of age to the IMR analysis. MAIN OUTCOME MEASURES: Fertility rate (number of pregnancies per 1000 person years) for specific age groups and calendar periods, total fertility rate, and IMR. RESULTS: Fertility rates and IMR declined in parallel, especially during the 1980s. However, education specific fertility rates did not decline, but the proportion of educated young women increased from 20% to 46%. This had also an impact on the overall IMR decline, although IMR reduction mainly took place among infants of women without formal education, decreasing from 118 to 69 per 1000 during the observation period. CONCLUSIONS: In this demographic transition over three decades, fertility and IMR declined simultaneously. The decreasing trend in fertility was mainly explained by an increase in women's education, while the IMR decline seemed to be the result of health interventions, specially targeted to poorer groups of women and their infants. Thus, social differences in fertility rates remained unchanged, while equity in chances of child survival increased.   PMID:10396488

  5. Consequences of differential residence designations for rural health policy research: the case of infant mortality.

    PubMed

    Farmer, F L; Clarke, L L; Miller, M K

    1993-01-01

    In 1991, members of the rural caucus proposed numerous bills designed to attenuate the rural-urban differences in health care delivery and health status. Implicit in the legislative process is the assumption that "rural America" differs systematically from "urban America." However, research has consistently demonstrated that there is not a single rural America but rather, those areas outside of the major metropolitan areas represent a complex mosaic of varying social and environmental settings. Rural communities differ in meaningful ways along a number of socioenvironmental parameters, and accordingly, health status indicators also differ across rural communities. Thus, health outcome statistics averaged across rural communities will often mask important disparities experienced by certain population groups. Policies based on these aggregate indicators may overlook the needs of the most disadvantaged. While a number of measures of rurality have emerged in the last decade, much of the information presented to policy-makers is either too aggregated (i.e., metropolitan-nonmetropolitan) to identify important differences across the range of communities, or it is gathered in agency-specific categories that are not comparable. The central question under examination in the current context is the possibility of distorting the picture of infant health status by aggregating the diverse rural locales of the United States. Empirical results indicate that when considering infant mortality, any rural disadvantage is contingent upon how 'rural' and 'urban' have been defined. Further, the results indicate that conclusions must be conditioned on other important sociodemographic parameters such as region of the country and race.

  6. Respiratory syncytial virus infections in infants affected by primary immunodeficiency.

    PubMed

    Lanari, Marcello; Vandini, Silvia; Capretti, Maria Grazia; Lazzarotto, Tiziana; Faldella, Giacomo

    2014-01-01

    Primary immunodeficiencies are rare inherited disorders that may lead to frequent and often severe acute respiratory infections. Respiratory syncytial virus (RSV) is one of the most frequent pathogens during early infancy and the infection is more severe in immunocompromised infants than in healthy infants, as a result of impaired T- and B-cell immune response unable to efficaciously neutralize viral replication, with subsequent increased viral shedding and potentially lethal lower respiratory tract infection. Several authors have reported a severe clinical course after RSV infections in infants and children with primary and acquired immunodeficiencies. Environmental prophylaxis is essential in order to reduce the infection during the epidemic season in hospitalized immunocompromised infants. Prophylaxis with palivizumab, a humanized monoclonal antibody against the RSV F protein, is currently recommended in high-risk infants born prematurely, with chronic lung disease or congenital heart disease. Currently however the prophylaxis is not routinely recommended in infants with primary immunodeficiency, although some authors propose the extension of prophylaxis to this high risk population.

  7. Respiratory Syncytial Virus Infections in Infants Affected by Primary Immunodeficiency

    PubMed Central

    Capretti, Maria Grazia; Lazzarotto, Tiziana; Faldella, Giacomo

    2014-01-01

    Primary immunodeficiencies are rare inherited disorders that may lead to frequent and often severe acute respiratory infections. Respiratory syncytial virus (RSV) is one of the most frequent pathogens during early infancy and the infection is more severe in immunocompromised infants than in healthy infants, as a result of impaired T- and B-cell immune response unable to efficaciously neutralize viral replication, with subsequent increased viral shedding and potentially lethal lower respiratory tract infection. Several authors have reported a severe clinical course after RSV infections in infants and children with primary and acquired immunodeficiencies. Environmental prophylaxis is essential in order to reduce the infection during the epidemic season in hospitalized immunocompromised infants. Prophylaxis with palivizumab, a humanized monoclonal antibody against the RSV F protein, is currently recommended in high-risk infants born prematurely, with chronic lung disease or congenital heart disease. Currently however the prophylaxis is not routinely recommended in infants with primary immunodeficiency, although some authors propose the extension of prophylaxis to this high risk population. PMID:25089282

  8. The Healthy Start Initiative: A Community-Driven Approach to Infant Mortality Reduction. Volume II. Early Implementation: Lessons Learned.

    ERIC Educational Resources Information Center

    McCoy-Thompson, M.; And Others

    This volume describes the experiences of each of the 15 rural and urban Healthy Start initiatives. These projects were set up in areas that had infant mortality rates that were 1.5 to 2.5 times the national average. Project locations include major cities such as Chicago, Illinois; Boston, Massachusetts; and Oakland, California, and rural areas in…

  9. In Italy, North-South Differences in IQ Predict Differences in Income, Education, Infant Mortality, Stature, and Literacy

    ERIC Educational Resources Information Center

    Lynn, Richard

    2010-01-01

    Regional differences in IQ are presented for 12 regions of Italy showing that IQs are highest in the north and lowest in the south. Regional IQs obtained in 2006 are highly correlated with average incomes at r = 0.937, and with stature, infant mortality, literacy and education. The lower IQ in southern Italy may be attributable to genetic…

  10. The Healthy Start Initiative: A Community-Driven Approach to Infant Mortality Reduction--Vol. I. Consortia Development.

    ERIC Educational Resources Information Center

    McCoy-Thompson, Meri

    The purpose of the Healthy Start Initiative, a national demonstration program, is to reduce infant mortality by 50 percent in 15 communities. At the heart of the initiative is the belief that the community, guided by a consortium of individuals and organizations from many sectors, can best design and implement the services needed by the women and…

  11. An illustrative example of infant and child death review in South Dakota: "the 1998 annual report of the Regional Infant and Child Mortality Review Committee".

    PubMed

    Randall, B; Wilson, A

    1999-11-01

    Local, regional, or state infant and child death review teams provide an excellent mechanism for identifying risk factors for infant and childhood deaths along with establishing a conduit for effecting preventive measures to reduce the number of deaths in these particularly vulnerable age groups. In 1997, a predecessor of the current Regional Infant and Child Mortality Review Committee was established in Minnehaha County as South Dakota's first non-Indian review committee for infant and childhood deaths. The 1998 Review Committee's annual report to the public is presented in this paper as an illustration of what can be expected from such a committee along with the specific public health concerns identified and their potential remedies. Especially noted in the committee's 1998 report is an alarming increase in Sudden Infant Death Syndrome (SIDS) death in the region and the educational role the Back to Sleep Campaign can play in the prevention of SIDS. The annual report serves as an example to illustrate how local review mechanisms can identify community strategies that may promote the health and well being of infants and children in their review areas.

  12. Happy babies, chatty toddlers: infant positive affect facilitates early expressive, but not receptive language.

    PubMed

    Laake, Lauren M; Bridgett, David J

    2014-02-01

    Eighty-three mother-infant dyads participated in this study. Positive affect (PA) broadly, along with fine-grained aspects of PA, was measured at 10 months of age. Language was measured at 14 months. Infant PA predicted expressive, but not receptive, language. The implications of these findings are discussed.

  13. The impact of water supply and sanitation on infant mortality: Individual-level evidence from Tartu, Estonia, 1897-1900.

    PubMed

    Jaadla, Hannaliis; Puur, Allan

    2016-07-01

    Evidence from a number of historical studies has demonstrated a strong impact of the provision of clean water on mortality risks, while no clear effect has been reported in others. We investigated the relationship between water supply, sanitation, and infant survival in Tartu, a university town in Estonia, 1897-1900. Based on data from parish registers, which were linked to the first census of the Russian Empire, the analysis reveals a clear disadvantage for infants in households using surface water, compared with families that acquired water from groundwater or artesian wells. The impact is stronger in the later stages of infancy. Competing-risk analysis shows that the effect is more pronounced for deaths caused by diseases of the digestive system. Our findings suggest that it may have been possible to improve the water supply, and consequently reduce infant mortality, before the introduction of piped water and sewage systems.

  14. Does Body Mass Index Affect Mortality in Coronary Surgery?

    PubMed Central

    Protopapas, Aristotle D.

    2016-01-01

    Introduction: The Body Mass Index (BMI) quantifies nutritional status and classifies humans as underweight, of normal weight, overweight, mildly obese, moderately obese or morbidly obese. Obesity is the excessive accumulation of fat, defined as BMI higher than 30 kg/m2. Obesity is widely accepted to complicate anaesthesia and surgery, being a risk factor for mediastinitis after coronary artery bypass grafting (CABG). We sought the evidence on operative mortality of CABG between standard BMI groups. Materials and Methodology: A simple literature review of papers presenting the mortality of CABG by BMI group: Underweight (BMI ≤ 18.49 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), mild obesity (BMI 30.0–34.9 kg/m2), moderate obesity (BMI 35.0–39.9 kg/m2), or morbid obesity (BMI ≥ 40.0 kg/m2). Results: We identified 18 relevant studies with 1,027,711 patients in total. Their variability in size of samples and choice of BMI groups precluded us from attempting inferential statistics. The overall cumulative mortality was 2.7%. Underweight patients had by far the highest mortality (6.6%). Overweight patients had the lowest group mortality (2.1%). The group mortality for morbidly obese patients was 3.44%. Discussion: Patients with extreme BMI’s undergoing CABG (underweight ones more than morbidly obese) suffer increased crude mortality. This simple observation indicates that under nutrition and morbid obesity need be further explored as risk factors for coronary surgery. PMID:28217179

  15. Evidence for an Association Between Infant Mortality and Homozygosity For the Arctic Variant of Carnitine Palmitoyltransferase 1A

    PubMed Central

    Gessner, Bradford D.; Wood, Thalia; Johnson, Monique A.; Richards, Carolyn Sue; Koeller, David M.

    2015-01-01

    PURPOSE Infant mortality in Alaska is highest among Alaska Native people from Western/Northern Alaska, a population with a high prevalence of a genetic variant (c.1436C>T; The Arctic Variant) of carnitine palmitoyltransferase 1A (CPT1A). METHODS We performed an unmatched case-control study to determine the relationship between the arctic variant and infant mortality. Cases were 110 Alaska Native infant deaths from 2006 to 2010 and controls were 395 Alaska Native births from the same time period. In addition to the overall analysis we conducted two sub-analyses, one limited to subjects from Western/Northern Alaska, and one limited to infants heterozygous or homozygous for the arctic variant. RESULTS Among Western/Northern Alaska residents, 66% of cases and 61% of controls were homozygous (adjusted odds ratio [aOR] 2.5; 95% confidence interval, 1.3, 5.0). Among homozygous or heterozygous infants, 58% of cases and 44% of controls were homozygous (aOR, 2.3; 95% CI, 1.3, 4.0). Deaths associated with infection were more likely to be homozygous (OR, 2.9; 95% CI, 1.0 to 8.0). Homozygosity was strongly associated with a pre-morbid history of pneumonia, sepsis, or meningitis. CONCLUSION Homozygosity for the arctic variant is associated with increased risk of infant mortality, which may be mediated in part by an increase in infectious disease risk. Further studies will be needed to determine if the association we report represents a causal association between the CPT1A arctic variant and overall, and infectious disease specific mortality. PMID:26820065

  16. Spending to save? State health expenditure and infant mortality in India.

    PubMed

    Bhalotra, Sonia

    2007-09-01

    There are severe inequalities in health in the world, poor health being concentrated amongst poor people in poor countries. Poor countries spend a much smaller share of national income on health expenditure than do richer countries. What potential lies in political or growth processes that raise this share? This depends upon how effective government health spending in developing countries is. Existing research presents little evidence of an impact on childhood mortality. Using specifications similar to those in the existing literature, this paper finds a similar result for India, which is that state health spending saves no lives. However, upon allowing lagged effects, controlling in a flexible way for trended unobservables and restricting the sample to rural households, a significant effect of health expenditure on infant mortality emerges, the long run elasticity being about -0.24. There are striking differences in the impact by social group. Slicing the data by gender, birth order, religion, maternal and paternal education and maternal age at birth, I find the weakest effects in the most vulnerable groups (with the exception of a large effect for scheduled tribes).

  17. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis

    PubMed Central

    Katz, Joanne; Lee, Anne CC; Kozuki, Naoko; Lawn, Joy E; Cousens, Simon; Blencowe, Hannah; Ezzati, Majid; Bhutta, Zulfiqar A; Marchant, Tanya; Willey, Barbara A; Adair, Linda; Barros, Fernando; Baqui, Abdullah H; Christian, Parul; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kolsteren, Patrick; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Osrin, David; Roberfroid, Dominique; Sania, Ayesha; Schmiegelow, Christentze; Silveira, Mariangela F; Tielsch, James; Vaidya, Anjana; Velaphi, Sithembiso C; Victora, Cesar G; Watson-Jones, Deborah; Black, Robert E

    2013-01-01

    Summary Background Babies with low birthweight (<2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associated with these two characteristics in low-income and middle-income countries. Methods For this pooled analysis, we searched all available studies and identified 20 cohorts (providing data for 2 015 019 livebirths) from Asia, Africa, and Latin America that recorded data for birthweight, gestational age, and vital statistics through 28 days of life. Study dates ranged from 1982 through to 2010. We calculated relative risks (RR) and risk differences (RD) for mortality associated with preterm birth (<32 weeks, 32 weeks to <34 weeks, 34 weeks to <37 weeks), small-for-gestational-age (SGA; babies with birthweight in the lowest third percentile and between the third and tenth percentile of a US reference population), and preterm and SGA combinations. Findings Pooled overall RRs for preterm were 6·82 (95% CI 3·56–13·07) for neonatal mortality and 2·50 (1·48–4·22) for post-neonatal mortality. Pooled RRs for babies who were SGA (with birthweight in the lowest tenth percentile of the reference population) were 1·83 (95% CI 1·34–2·50) for neonatal mortality and 1·90 (1·32–2·73) for post-neonatal mortality. The neonatal mortality risk of babies who were both preterm and SGA was higher than that of babies with either characteristic alone (15·42; 9·11–26·12). Interpretation Many babies in low-income and middle-income countries are SGA. Preterm birth affects a smaller number of neonates than does SGA, but is associated with a higher mortality risk. The mortality risks associated with both characteristics extend beyond the neonatal period. Differentiation of the burden and risk of babies born preterm and SGA rather than with low birthweight could guide

  18. Infant mortality in a deprived area of Papua New Guinea: priorities for antenatal services and health education.

    PubMed

    Garner, P; Heywood, P; Baea, M; Lai, D; Smith, T

    1996-03-01

    This cross-sectional study of women was conducted in a deprived area of Papua New Guinea with an estimated infant mortality rate of 133/1000 live births. Mortality patterns derived from birth histories showed that neonatal deaths contribute proportionally more to infant mortality than postneonatal deaths, emphasizing the need for better care at delivery. To examine possible mechanisms for intervention, pregnant women were interviewed to determine patterns of antenatal clinic use, antimalarial drugs and micronutrient supplements given, and how much the women smoked. The results showed that the health system was failing to implement current routine supplementation and prophylaxis regimens, and that there was a need to revise national guidelines. A large proportion of pregnant women smoked during pregnancy, and this behaviour could be a target for future public health campaigns and health worker promotion advice to women.

  19. Maternal HIV status affects the infant hemoglobin level

    PubMed Central

    Feleke, Berhanu Elfu

    2016-01-01

    Abstract Children, especially infants, are highly vulnerable to iron-deficiency anemia because of their rapid growth of the brain and the rest of the body. The objectives of this study were to compare the prevalence of iron-deficiency anemia in infants born from HIV-positive mothers and HIV-negative mothers and to identify the determinants of iron-deficiency anemia in infants. A comparative cross-sectional study was conducted in Bahir Dar city. Simple random sampling technique was used to select the study participants. Mothers were interviewed; blood samples were collected from mothers and infants to measure the hemoglobin level and anthropometric indicators were obtained from the infants using world health organization standards. Descriptive statistics were used to estimate the prevalence of infantile anemia. Binary logistic regression and multiple linear regressions were used to identify the determinants of infant anemia. A total of 1459 infants born from HIV-positive and HIV-negative mothers were included. The prevalence of iron-deficiency anemia in infants born from HIV-positive and HIV-negative mothers was 41.9% (95% CI: 39–44). Infantile iron-deficiency anemia was associated with maternal HIV infection (adjusted odds ratio [AOR] 2.54 [95% CI: 1.65–3.9]), stunting (AOR 3.46 [95% CI: 2.41–4.97]), low income (AOR 2.72 [95% CI: 2–3.73]), maternal malaria during pregnancy (AOR 1.81 [95% CI: 1.33–2.47]), use of cow milk before 6 month (AOR 1.82 [95% CI: 1.35–2.45]), residence (AOR 0.09 [95% CI: 0.06–0.13]), history of cough or fever 7 days preceding the survey (AOR 2.71 [95% CI: 1.99–3.69]), maternal hemoglobin (B 0.65 [95% CI: 0.61–0.68]), educational status of mother (B 0.22 [95% CI: 0.2–0.23]), age of the mother (B –0.03 [95% CI: –0.03, –0.02]), and family size (B –0.14 [95% CI: –0.18,–0.11]). PMID:27495044

  20. Socio-Economic Status (SES) Affects Infants' Selective Exploration

    ERIC Educational Resources Information Center

    Tacke, Nicholas F.; Bailey, Lillian S.; Clearfield, Melissa W.

    2015-01-01

    Infants change their behaviours in accordance with the objects they are exploring. They also tailor their exploratory actions to the physical context. This selectivity of exploratory actions represents a foundational cognitive skill that underlies higher-level cognitive processes. The present study compared the development of selective exploratory…

  1. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    PubMed Central

    Lin, Hui-Jia; Du, Li-Zhong; Ma, Xiao-Lu; Shi, Li-Ping; Pan, Jia-Hua; Tong, Xiao-Mei; Li, Qiu-Ping; Zhou, Jian-Guo; Yi, Bing; Liu, Ling; Chen, Yun-Bing; Wei, Qiu-Fen; Wu, Hui-Qing; Li, Mei; Liu, Cui-Qing; Gao, Xi-Rong; Xia, Shi-Wen; Li, Wen-Bin; Yan, Chao-Ying; He, Ling; Liang, Kun; Zhou, Xiao-Yu; Han, Shu-Ping; Lyu, Qin; Qiu, Yin-Ping; Li, Wen; Chen, Dong-Mei; Lu, Hong-Ru; Liu, Xiao-Hong; Liu, Hong; Lin, Zhen-Lang; Liu, Li; Zhu, Jia-Jun; Xiong, Hong; Yue, Shao-Jie; Zhuang, Si-Qi

    2015-01-01

    Background: With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China. Methods: All infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results: A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions: Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed

  2. Human Infant Faces Provoke Implicit Positive Affective Responses in Parents and Non-Parents Alike

    PubMed Central

    Senese, Vincenzo Paolo; De Falco, Simona; Bornstein, Marc H.; Caria, Andrea; Buffolino, Simona; Venuti, Paola

    2013-01-01

    Human infants' complete dependence on adult caregiving suggests that mechanisms associated with adult responsiveness to infant cues might be deeply embedded in the brain. Behavioural and neuroimaging research has produced converging evidence for adults' positive disposition to infant cues, but these studies have not investigated directly the valence of adults' reactions, how they are moderated by biological and social factors, and if they relate to child caregiving. This study examines implicit affective responses of 90 adults toward faces of human and non-human (cats and dogs) infants and adults. Implicit reactions were assessed with Single Category Implicit Association Tests, and reports of childrearing behaviours were assessed by the Parental Style Questionnaire. The results showed that human infant faces represent highly biologically relevant stimuli that capture attention and are implicitly associated with positive emotions. This reaction holds independent of gender and parenthood status and is associated with ideal parenting behaviors. PMID:24282537

  3. Does Acute Maternal Stress in Pregnancy Affect Infant Health Outcomes? Examination of a Large Cohort of Infants Born After the Terrorist Attacks of September 11, 2001

    DTIC Science & Technology

    2009-01-01

    Spandorfer S, Grill E, Davis O, Fasouliotis S, Rosenwaks Z: Septem- ber 11th in New York City (NYC): the effect of a catastrophe on IVF outcome in a...Naval Health Research Center Does acute maternal stress in pregnancy affect infant health outcomes ? Examination of A Large Cohort of Infants Born...California 92106 BioMed CentralBMC Public Health ssOpen AcceResearch article Does acute maternal stress in pregnancy affect infant health outcomes

  4. Greater mortality and mordidity in extremely preterm infants fed a diet containing cow milk protein products

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Provision of human milk has important implications for the health and outcomes of extremely preterm (EP) infants. This study evaluated the effects of an exclusive human milk diet on the health of EP infants during their stay in the neonatal intensive care unit. EP infants <1,250 g birth weight recei...

  5. Determinants of infant mortality in the Jequitinhonha Valley and in the North and Northeast regions of Brazil

    PubMed Central

    Leal, Maria do Carmo; Bittencourt, Sonia Duarte de Azevedo; Torres, Raquel Maria Cardoso; Niquini, Roberta Pereira; de Souza, Paulo Roberto Borges

    2017-01-01

    ABSTRACT OBJECTIVE This study aims to identify the social and demographic determinants, in addition to the determinants of reproductive health and use of health services, associated with infant mortality in small and medium-sized cities of the North, Northeast and Southeast regions of Brazil. METHODS This is a case-control study with 803 cases of death of children under one year and 1,969 live births (controls), whose mothers lived in the selected cities in 2008. The lists of the names of cases and controls were extracted from the Sistema de Informação sobre Mortalidade (SIM – Mortality Information System) and the Sistema de Informação sobre Nascidos Vivos (SINASC – Live Birth Information System) and supplemented by data obtained by the research of “active search of death and birth”. Data was collected in the household using a semi-structured questionnaire, and the analysis was carried out using multiple logistic regression. RESULTS The final model indicates that the following items are positively and significantly associated with infant mortality: family working in agriculture, mother having a history of fetal and infant losses, no prenatal or inadequate prenatal, and not being associated to the maternity hospital during the prenatal period. We have observed significant interactions to explain the occurrence of infant mortality between race and socioeconomic score and between high-risk pregnancy and pilgrimage for childbirth. CONCLUSIONS The excessive number of home deliveries and pilgrimage for childbirth indicates flaws in the line of maternity care and a lack of collaboration between the levels of outpatient and hospital care. The study reinforces the need for an integrated management of the health care networks, leveraging the capabilities of cities in meeting the needs of pregnancy, delivery and birth with quality. PMID:28273228

  6. Mortality and Length of Stay of Very Low Birth Weight and Very Preterm Infants: A EuroHOPE Study

    PubMed Central

    Numerato, Dino; Fattore, Giovanni; Tediosi, Fabrizio; Zanini, Rinaldo; Peltola, Mikko; Banks, Helen; Mihalicza, Péter; Lehtonen, Liisa; Sveréus, Sofia; Heijink, Richard; Klitkou, Søren Toksvig; Fletcher, Eilidh; van der Heijden, Amber; Lundberg, Fredrik; Over, Eelco; Häkkinen, Unto; Seppälä, Timo T.

    2015-01-01

    The objective of this paper was to compare health outcomes and hospital care use of very low birth weight (VLBW), and very preterm (VLGA) infants in seven European countries. Analysis was performed on linkable patient-level registry data from seven European countries between 2006 and 2008 (Finland, Hungary, Italy (the Province of Rome), the Netherlands, Norway, Scotland, and Sweden). Mortality and length of stay (LoS) were adjusted for differences in gestational age (GA), sex, intrauterine growth, Apgar score at five minutes, parity and multiple births. The analysis included 16,087 infants. Both the 30-day and one-year adjusted mortality rates were lowest in the Nordic countries (Finland, Sweden and Norway) and Scotland and highest in Hungary and the Netherlands. For survivors, the adjusted average LoS during the first year of life ranged from 56 days in the Netherlands and Scotland to 81 days in Hungary. There were large differences between European countries in mortality rates and LoS in VLBW and VLGA infants. Substantial data linkage problems were observed in most countries due to inadequate identification procedures at birth, which limit data validity and should be addressed by policy makers across Europe. PMID:26121647

  7. African American infant mortality and the Genesee County, MI REACH 2010 initiative: an evaluation of the Undoing Racism Workshop.

    PubMed

    Shultz, Cameron; Skorcz, Stephen

    2012-01-01

    The authors examine African American African American and White socioeconomic and infant mortality outcomes in Genesee County, Michigan, assess the stated effects of the Undoing Racism Workshop (URW) on its participants and the greater-Genesee County community, and introduce the ecological approach to the cycle of socialization as a tool to help identify sources of racially linked tension and sites for ameliorative intervention. Findings show that African Americans in Flint are geographically and socioeconomically isolated, have fewer resources to sustain health, and experience higher rates of infant mortality when compared to Whites in Flint's surrounding suburbs. Between two thirds and three fourths of URW follow-up survey respondents endorse the belief that the URW can help reduce infant mortality, and results suggest the workshop helps elicit individual and institutional/policy-related changes intended to lessen the disparity. Authors assert the URW offers a common language and framework for discussing racism as a structural phenomenon rather than merely racial prejudice within individuals.

  8. Infant Mortality Risk and Paternity Certainty Are Associated with Postnatal Maternal Behavior toward Adult Male Mountain Gorillas (Gorilla beringei beringei).

    PubMed

    Rosenbaum, Stacy; Hirwa, Jean Paul; Silk, Joan B; Vigilant, Linda; Stoinski, Tara S

    2016-01-01

    Sexually selected infanticide is an important source of infant mortality in many mammalian species. In species with long-term male-female associations, females may benefit from male protection against infanticidal outsiders. We tested whether mountain gorilla (Gorilla beringei beringei) mothers in single and multi-male groups monitored by the Dian Fossey Gorilla Fund's Karisoke Research Center actively facilitated interactions between their infants and a potentially protective male. We also evaluated the criteria mothers in multi-male groups used to choose a preferred male social partner. In single male groups, where infanticide risk and paternity certainty are high, females with infants <1 year old spent more time near and affiliated more with males than females without young infants. In multi-male groups, where infanticide rates and paternity certainty are lower, mothers with new infants exhibited few behavioral changes toward males. The sole notable change was that females with young infants proportionally increased their time near males they previously spent little time near when compared to males they had previously preferred, perhaps to encourage paternity uncertainty and deter aggression. Rank was a much better predictor of females' social partner choice than paternity. Older infants (2-3 years) in multi-male groups mirrored their mothers' preferences for individual male social partners; 89% spent the most time in close proximity to the male their mother had spent the most time near when they were <1 year old. Observed discrepancies between female behavior in single and multi-male groups likely reflect different levels of postpartum intersexual conflict; in groups where paternity certainty and infanticide risk are both high, male-female interests align and females behave accordingly. This highlights the importance of considering individual and group-level variation when evaluating intersexual conflict across the reproductive cycle.

  9. Infant Mortality Risk and Paternity Certainty Are Associated with Postnatal Maternal Behavior toward Adult Male Mountain Gorillas (Gorilla beringei beringei)

    PubMed Central

    Rosenbaum, Stacy; Hirwa, Jean Paul; Silk, Joan B.; Vigilant, Linda; Stoinski, Tara S.

    2016-01-01

    Sexually selected infanticide is an important source of infant mortality in many mammalian species. In species with long-term male-female associations, females may benefit from male protection against infanticidal outsiders. We tested whether mountain gorilla (Gorilla beringei beringei) mothers in single and multi-male groups monitored by the Dian Fossey Gorilla Fund’s Karisoke Research Center actively facilitated interactions between their infants and a potentially protective male. We also evaluated the criteria mothers in multi-male groups used to choose a preferred male social partner. In single male groups, where infanticide risk and paternity certainty are high, females with infants <1 year old spent more time near and affiliated more with males than females without young infants. In multi-male groups, where infanticide rates and paternity certainty are lower, mothers with new infants exhibited few behavioral changes toward males. The sole notable change was that females with young infants proportionally increased their time near males they previously spent little time near when compared to males they had previously preferred, perhaps to encourage paternity uncertainty and deter aggression. Rank was a much better predictor of females’ social partner choice than paternity. Older infants (2–3 years) in multi-male groups mirrored their mothers’ preferences for individual male social partners; 89% spent the most time in close proximity to the male their mother had spent the most time near when they were <1 year old. Observed discrepancies between female behavior in single and multi-male groups likely reflect different levels of postpartum intersexual conflict; in groups where paternity certainty and infanticide risk are both high, male-female interests align and females behave accordingly. This highlights the importance of considering individual and group-level variation when evaluating intersexual conflict across the reproductive cycle. PMID:26863300

  10. Relationship of infant and fetal mortality to operations at the Hanford Nuclear Reservation, Washington State, 1946-1982

    SciTech Connect

    Cate, S.; Hansom, J.

    1986-09-01

    The relationship of infant and fetal mortality to numbers of nuclear reactors at the Hanford Nuclear Reservation was investigated. Mortality rates were obtained using 36 years of United States vital statistics data. Three different exposure groups were selected based on meteorologic studies of the Hanford area: group 1, counties downwind of Hanford all year; group 2, counties seasonally downwind; and group 3, counties not downwind. Washington state was used as an additional comparison group. Four periods of operation based on fluctuations in numbers of reactors were characterized. Log-linear analysis revealed that the three groups and Washington state had similar trends in infant mortality rates over the four time periods. On the other hand, the trend in fetal mortality rates for group 1 did differ significantly from trends for the two other groups and Washington state. The trends of fetal mortality rates for group 2, group 3, and Washington state were not statistically different. Fetal mortality rates in group 1, however, failed to decline from period 1 (1946-1954) to period 2 (1955-1964) as expected by the trends for the two groups and Washington state. During period 2, the greatest number of reactors were operating. County-specific analysis showed that, of the counties in group 1, the trend in fetal mortality for Benton County, where Hanford is located, was significantly different from that for Washington state. A possible link between Hanford and an excess in fetal deaths is suggested by the deviation in trend of group 1, which appears localized to Benton County and the period of peak activity at Hanford.

  11. Secular trends in infant mortality by age-group and avoidable components in the State of São Paulo, 1996–2012

    PubMed Central

    Areco, Kelsy Catherina Nema; Konstantyner, Tulio; Taddei, José Augusto de Aguiar Carrazedo

    2016-01-01

    Abstract Objective: To describe trends and composition of infant mortality rate in the State of São Paulo, from 1996 to 2012. Methods: An ecological study was conducted, based on official secondary data of births and infant deaths of residents in São Paulo, from 1996 to 2012. The infant mortality rate was calculated by the direct method and was analyzed by graphs and polynomial regression models for age groups (early neonatal, late neonatal and post-neonatal) and for groups of avoidable causes of death. Results: The mortality rate in the State of São Paulo tended to fall, ranging from 22.5 to 11.5 per thousand live births. Half of the infant deaths occurred in the early neonatal group. The proportion of avoidable infant deaths varied from 76.0 to 68.7%. The deaths which were avoidable by adequate attention to women during pregnancy and childbirth and newborn care accounted for 54% of infant deaths throughout the period. Conclusions: The mortality rate levels are still far from those in developed countries, which highlight the need to prioritize access and quality of healthcare services during pregnancy, childbirth and newborn care, especially in the first week of life, aiming at achieving standards of infant mortality similar to those of developed societies. PMID:27105575

  12. Cancer, Infant Mortality and Birth Sex-Ratio in Fallujah, Iraq 2005–2009

    PubMed Central

    Busby, Chris; Hamdan, Malak; Ariabi, Entesar

    2010-01-01

    There have been anecdotal reports of increases in birth defects and cancer in Fallujah, Iraq blamed on the use of novel weapons (possibly including depleted uranium) in heavy fighting which occurred in that town between US led forces and local elements in 2004. In Jan/Feb 2010 the authors organised a team of researchers who visited 711 houses in Fallujah, Iraq and obtained responses to a questionnaire in Arabic on cancer, birth defects and infant mortality. The total population in the resulting sample was 4,843 persons with and overall response rate was better than 60%. Relative Risks for cancer were age-standardised and compared to rates in the Middle East Cancer Registry (MECC, Garbiah Egypt) for 1999 and rates in Jordan 1996–2001. Between Jan 2005 and the survey end date there were 62 cases of cancer malignancy reported (RR = 4.22; CI: 2.8, 6.6; p < 0.00000001) including 16 cases of childhood cancer 0–14 (RR = 12.6; CI: 4.9, 32; p < 0.00000001). Highest risks were found in all-leukaemia in the age groups 0–34 (20 cases RR = 38.5; CI: 19.2, 77; p < 0.00000001), all lymphoma 0–34 (8 cases, RR = 9.24;CI: 4.12, 20.8; p < 0.00000001), female breast cancer 0–44 (12 cases RR = 9.7;CI: 3.6, 25.6; p < 0.00000001) and brain tumours all ages (4 cases, RR = 7.4;CI: 2.4, 23.1; P < 0.004). Infant mortality was based on the mean birth rate over the 4 year period 2006–2009 with 1/6th added for cases reported in January and February 2010. There were 34 deaths in the age group 0–1 in this period giving a rate of 80 deaths per 1,000 births. This may be compared with a rate of 19.8 in Egypt (RR = 4.2 p < 0.00001) 17 in Jordan in 2008 and 9.7 in Kuwait in 2008. The mean birth sex-ratio in the recent 5-year cohort was anomalous. Normally the sex ratio in human populations is a constant with 1,050 boys born to 1,000 girls. This is disturbed if there is a genetic damage stress. The ratio of boys to 1,000 girls in the 0–4, 5–9, 10–14 and 15–19 age cohorts in the

  13. Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings.

    PubMed

    Siddiqi, Arjumand; Jones, Marcella K; Erwin, Paul Campbell

    2015-04-01

    As the struggle continues to explain the relatively high rates of infant mortality (IMR) exhibited in the United States, a renewed emphasis is being placed on the role of possible 'contextual' determinants. Cross-sectional and short time-series studies have found that higher income inequality is associated with higher IMR at the state level. Yet, descriptively, the longer-term trends in income inequality and in IMR seem to call such results into question. To assess whether, over the period 1990-2007, state-level income inequality is associated with state-level IMR; to examine whether the overall effect of income inequality on IMR over this period varies by state; to test whether the association between income inequality and IMR varies across this time period. IMR data--number of deaths per 1000 live births in a given state and year--were obtained from the U.S. Centers for Disease Control Wonder database. Income inequality was measured using the Gini coefficient, which varies from zero (complete equality) to 100 (complete inequality). Covariates included state-level poverty rate, median income, and proportion of high school graduates. Fixed and random effects regressions were conducted to test hypotheses. Fixed effects models suggested that, overall, during the period 1990-2007, income inequality was inversely associated with IMR (β = -0.07, SE (0.01)). Random effects models suggested that when the relationship was allowed to vary at the state-level, it remained inverse (β = -0.05, SE (0.01)). However, an interaction between income inequality and time suggested that, as time increased, the effect of income inequality had an increasingly positive association with total IMR (β = 0.009, SE (0.002)). The influence of state income inequality on IMR is dependent on time, which may proxy for time-dependent aspects of societal context.

  14. Infant mortality, season of birth and the health of older Puerto Rican adults.

    PubMed

    McEniry, Mary

    2011-03-01

    The increasing prevalence of heart disease and diabetes among aging populations in low and middle income countries leads to questions regarding the degree to which endogenous early life exposures (exposures in utero) are important determinants of these health conditions. We devised a test using infant mortality (IMR) to verify if season of birth is a good indicator of early life (in utero) conditions that precipitate adult onset of disease. We linked annual IMR at the municipality (municipio) level from the late 1920s to early 1940s with individual birth year and place using a representative sample of older Puerto Rican adults (n = 1447) from the Puerto Rican Elderly: Health Conditions (PREHCO) study. We estimated the effects of season of birth on adult heart disease and diabetes for all respondents and then for respondents according to whether they were born when IMR was lower or higher, controlling for age, gender, obesity, respondent's educational level, adult behavior (smoking and exercise) and other early life exposures (childhood health, knee height and childhood socioeconomic status (SES)). The pattern of effects suggests that season of birth reflects endogenous causes: (1) odds of heart disease and diabetes were strong and significant for those born during the lean season in years when IMR was lower; (2) effects remained consistent even after controlling for other childhood conditions and adult behavior; but (3) no seasonality effects on adult health for adults born when IMR was higher. We conclude that in this population of older Puerto Rican adults there is continued support that the timing of adverse endogenous (in utero) conditions such as poor nutrition and infectious diseases is associated with adult heart disease and diabetes. It will be important to test the validity of these findings in other similar populations in the developing world.

  15. Early experience affects the strength of vigilance for threat in rhesus monkey infants

    PubMed Central

    Mandalaywala, Tara M.; Parker, Karen J.; Maestripieri, Dario

    2014-01-01

    Both human and nonhuman primates exhibit a cognitive bias to social threat, but little is known about how this bias develops. We investigated the development of threat bias in free-ranging infant rhesus macaques (Macaca mulatta) at 3 (N = 45) and 9 (N = 46) months of age. Three-month-old infant monkeys did not display bias, but 9-month-olds exhibited increased maintenance of attention to threatening social stimuli (vigilance for threat). To examine whether the social environment affected vigilance for threat, behavioral data on maternal rank and protectiveness were collected across the first 12 weeks of life for infants tested at 9 months. Nine-month-old infants of high-ranking mothers and more protective mothers displayed greater vigilance for threat than infants of lower-ranking and less protective mothers. These results demonstrate that infant social cognition is malleable and shaped by mothers both directly (protectiveness) and indirectly (rank), as maternal characteristics affect infants’ social experiences. PMID:25125426

  16. Time to focus child survival programmes on the newborn: assessment of levels and causes of infant mortality in rural Pakistan.

    PubMed Central

    Fikree, Fariyal F.; Azam, Syed Iqbal; Berendes, Heinz W.

    2002-01-01

    OBJECTIVE: Population-based surveys were conducted in selected clusters of Pakistan's least developed provinces, Balochistan and North-West Frontier Province (NWFP), including the Federally Administered Tribal Areas (FATA), to assess levels and causes of neonatal and postneonatal mortality. METHODS: Interviews were conducted in a total of 54 834 households: Balochistan, 20 486; NWFP, 26 175; and FATA, 8173. Trained interviewers administered questionnaires after obtaining verbal informed consent from the respondents. Verbal autopsy interviews were conducted for infant deaths reported for the previous year. FINDINGS: The infant mortality rate based on combined data from the different sites was 99.7 per 1000 live births (range 129.0-70.1). The contribution of neonatal deaths to all infant deaths was much higher for NWFP (67.2%), where the overall rate was lowest, than for Balochistan (50.8%) and FATA (56.8%). Around 70% of all neonatal deaths occurred in the early neonatal period. The three main clinical causes of infant deaths were diarrhoea syndrome (21.6%), tetanus (11.7%) and acute respiratory infections (11.6%). In the neonatal period, however, tetanus (18.3%), small size for gestational age or low birth weight (15.3%), and birth injury (12.0%) accounted for nearly half (45.6%) of all deaths, while the contributions of diarrhoea syndrome (5.1%) and acute respiratory infections (6.0%) were less significant (11.1%). Tetanus was the cause of death for 21.7% and 17.1% of all infant deaths in FATA and NWFP respectively. CONCLUSION: The results suggest that there should be a shift in child survival programmes to give greater emphasis to maternal and neonatal health, in particular to maternal tetanus immunization, safe delivery and cord care. PMID:12075362

  17. Patterns of infant mortality from Armenian parish records: a study from 10 countries of the diaspora, 1737-1982.

    PubMed

    Armenian, H K; McCarthy, J F; Balbanian, S G

    1993-06-01

    Using parish records from 10 different countries with small Armenian communities, this study compared patterns of infant mortality in these countries over a period of 245 years. Deaths registered as aged < or = 1 year were used to estimate the numerator for the infant mortality rates (IMR) while the denominator was estimated from births in the same year based on baptisms in the appropriate registers. To check on the validity of using the baptisms as the denominator for the IMR, records of infant deaths were linked with the baptismal records. Thus, from a sample of 273 infant deaths 78.4% had a baptismal record in the registers of the same church in which the death was recorded. Of the deaths 60% had a recorded cause of death. Over the past 245 years, IMR have fallen substantially in all parishes. However, there were notable exceptions to this general pattern of declining IMR over time. For example, the IMR was tripled in Palestine during the decade of the First World War, possibly as a result of the influx of refugees deported from Turkey. A study of the seasonal occurrence of the deaths revealed peaking of deaths between May and August, a pattern influenced by the relative importance of gastroenteritis as a cause of death during the summer months in Egypt where the majority of these infant deaths were recorded. A review of the most important causes of death helped identify an outbreak of undetermined cause in Belgrade in 1737 and an outbreak of dysentery deaths in Alexandria, Egypt, in 1909.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. 77 FR 7594 - Advisory Committee on Infant Mortality; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ... and Territorial Health Officials; a State-level presentation on activities related to reducing infant... . Dated: February 7, 2012. Reva Harris, Acting Director, Division of Policy and Information...

  19. Positive Affect Is Inversely Associated with Mortality in Individuals without Depression

    PubMed Central

    Martín-María, Natalia; Caballero, Francisco Félix; Olaya, Beatriz; Rodríguez-Artalejo, Fernando; Haro, Josep Maria; Miret, Marta; Ayuso-Mateos, José Luis

    2016-01-01

    Background: Some studies have analyzed the relation between well-being and mortality but none of them have attempted to disentangle the differential influence that positive affect, negative affect, and evaluative well-being might have on mortality using a longitudinal design in the general population and measuring independently and accurately each component of well-being. The aim of the present study is to assess the association of these well-being components with mortality after adjusting for health and other lifestyle factors and to analyze whether this association is different in people with and without depression. Methods: A nationally representative sample of 4753 people from Spain was followed up after 3 years. Analyses were performed with Cox regression models among the total sample and separately in people with and without depression. Results: In the analyses adjusted for age, sex, and years of education, all three well-being variables showed separately a statistically significant association with mortality. However, after adjustment for health status and other confounders including the other well-being components, only positive affect remained as marginally associated with a decreased risk of mortality in the overall sample [HR = 0.87; 95% CI = 0.73–1.03], in particular among individuals without depression [HR = 0.82; 95% CI = 0.68–0.99]. Conclusion: Positive affect is inversely associated with mortality in individuals without depression. Future research should focus on assessing interventions associated with a higher level of positive affect. PMID:27462289

  20. When death is not a problem: Regulating implicit negative affect under mortality salience.

    PubMed

    Lüdecke, Christina; Baumann, Nicola

    2015-12-01

    Terror management theory assumes that death arouses existential anxiety in humans which is suppressed in focal attention. Whereas most studies provide indirect evidence for negative affect under mortality salience by showing cultural worldview defenses and self-esteem strivings, there is only little direct evidence for implicit negative affect under mortality salience. In the present study, we assume that this implicit affective reaction towards death depends on people's ability to self-regulate negative affect as assessed by the personality dimension of action versus state orientation. Consistent with our expectations, action-oriented participants judged artificial words to express less negative affect under mortality salience compared to control conditions whereas state-oriented participants showed the reversed pattern.

  1. High rates of mortality and morbidity occur in infants with perenteral nutrition - associated cholestasis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is very little data available about the natural history of parenteral nutrition (PN)-associated cholestasis. The authors evaluated a cohort of infants at a large center to determine the outcome of PN-associated cholestasis in infants with some gastrointestinal function. The authors reviewed th...

  2. Menstrual cycle phase affects discrimination of infant cuteness.

    PubMed

    Lobmaier, Janek S; Probst, Fabian; Perrett, David I; Heinrichs, Markus

    2015-04-01

    Recent studies have shown that women are more sensitive than men to subtle cuteness differences in infant faces. It has been suggested that raised levels in estradiol and progesterone may be responsible for this advantage. We compared young women's sensitivity to computer-manipulated baby faces varying in cuteness. Thirty-six women were tested once during ovulation and once during the luteal phase of their menstrual cycle. In a two alternative forced-choice experiment, participants chose the baby which they thought was cuter (Task 1), younger (Task 2), or the baby that they would prefer to babysit (Task 3). Saliva samples to assess levels of estradiol, progesterone and testosterone were collected at each test session. During ovulation, women were more likely to choose the cuter baby than during the luteal phase, in all three tasks. These results suggest that cuteness discrimination may be driven by cyclic hormonal shifts. However none of the measured hormones were related to increased cuteness sensitivity. We speculate that other hormones than the ones measured here might be responsible for the increased sensitivity to subtle cuteness differences during ovulation.

  3. Determinants of infant and early childhood mortality in Cameroon: the role of socioeconomic factors, housing characteristics, and immunization status.

    PubMed

    Kuate Defo, B

    1994-01-01

    This study examines factors impinging on the survival of children in Cameroon using longitudinal data collected by the United Nations Demographic Training and Research Institute of Yaoundé, Cameroon. It deals especially with the role of socioeconomic factors (mother's education, employment, marital status, ethnicity, and household income), housing characteristics (construction materials, power source, source of water supply, extent of crowding), and immunization status on infant and child mortality. Two-state parametric and nonparametric hazards models for the risk of death at any time within the course of the study are used, with and without accounting for unmeasured heterogeneity. Overall, overcrowding has robust deleterious effects on infant and child survival. As regards the effects of socioeconomic variables, the robustness of the effects of household income and ethnic differentials are unchanged, even after controlling for unmeasured heterogeneity; the deleterious effects of marital status are also apparent, but these effects are largely explained by unmeasured covariates. The data also suggest that the protective effects of full immunization status are robust and not contaminated by confounding factors, at least in the first 16 months of life. These findings provide solid ground to support immunization programs and efforts as a means to reduce significantly infant and child mortality.

  4. Physical Effort Affects Heatstroke Thermoregulatory Response and Mortality in Rats.

    PubMed

    Geng, Yan; Peng, Na; Liu, Ya-Nan; Li, Xing-Gui; Li, Bing-Lin; Peng, Li-Qiong; Ma, Qiang; Su, Lei

    2015-08-01

    Animals suffering from heatstroke (HS) after physical effort may have different heat-related core temperature (Tc) responses compared with passive HS. In the present study, conscious and unrestrained rats were exposed to ambient temperature (Ta) of 39.5°C ± 0.2°C with or without running (run-heated or rest-heated, respectively) until HS onset, which was defined as the systolic blood pressure starting to drop. In comparison with rest-heated rats, run-heated rats had a significantly shorter latency of HS onset. Physical effort did not have significant influence on hyperthermia severity (43.3°C ± 0.2°C at rest-heated, and 43.4°C ± 0.2°C at run-heated), but it could significantly decrease the thermal load to develop HS (315.1°C ± 37.3°C·min for rest-heated, and 133.5 ± 21.4 °C·min for run-heated). Working component during heat exposure may contribute to a decreased survival rate of HS (46.9% at rest-heated and 31.3% at run-heated). Impaired heat dissipation during recovery may be responsible for relative poor survival of run-heated rats. In both groups, survival was affected by Tc at HS onset and thermal area. Hypothermia (Tc <35°C) developed after HS onset, with no significant difference in Tc,min between the rest-heated and run-heated groups. These thermoregulatory responses to HS after physical effort may provide insight into HS pathophysiology.

  5. [Social and biological determinants of infant mortality in population cohort in the city of Passo Fundo, Rio Grande do Sul State].

    PubMed

    Geib, Lorena Teresinha Consalter; Fréu, Cheila Mara; Brandão, Marlise; Nunes, Magda Lahorgue

    2010-03-01

    One investigated the social and biological determinants of infant mortality of a population cohort of 2,331 live births in the period February 2003 to January 2004, in the city of Passo Fundo, Rio Grande do Sul State, including 56 infant deaths. The databank of deaths had been increased to the databank of the birth cohort, which contained the social and biological variables obtained from live birth certificates and with home interviews. The coefficient of infant mortality of this cohort was 22.8%. Multivariate analyses with logistic regression and hierarchic model had shown that the following aspects were significantly associated with infant death: maternal educational level lower than eight years (RR= 5.7; IC 95%: 1.92-16.75), antecedent of dead children (RR= 3.7 (IC 95%: 1.07-12.10); low birth weight, with RR= 6.7 (IC 95%: 2.07-21.65) to 79.7 (IC 95%:14.36-441.92) for infants of low birth weight and weighing less than 1500g, respectively; Apgar scores < or =7 (RR=8.7; IC 95%: 2.85-26.32) and absence of breastfeeding (RR=15.75; IC 95%: 6.7663.68). As infant mortality in Passo Fundo is socially determined by the low maternal educational level and biologically determined by birth conditions, low birth weight and interruption of breastfeeding, one recommend the inclusion of these factors in the classification of risk for follow up of infant mortality in Passo Fundo.

  6. Differential associations between infant affective and cortisol responses during the still face paradigm among infants born very low birth weight versus full-term.

    PubMed

    Erickson, Sarah J; Maclean, Peggy; Qualls, Clifford; Lowe, Jean R

    2013-06-01

    Psychological stress responses may have both emotional and cortisol reactivity correlates, but there are limited data addressing the association between generalized negative and positive emotional states and cortisol reactivity to a psychological stressor among infants born very low birth weight (VLBW; <1250 g) compared to infants born full-term. Examining this relationship between behavioral (affect) and physiological (cortisol) responses may provide insight into the nature of regulation difficulties identified in infants born VLBW. The purpose of this study was to assess the association between infant affective and cortisol responses to the Still Face paradigm (SF) in a cohort of six- to eight-month old infants born VLBW compared with infants born full-term (N=53 total; N=29 and N=24, respectively). Infant affect was coded in 1-s intervals while mother-infant dyads participated in the SF paradigm, and percent positive affect and percent negative affect were calculated separately for each SF episode. We had hypothesized that because infants born VLBW are at increased risk for dysregulation, they would show, compared to full-term controls, greater dysregulation in the form of less synchrony (i.e., less correlated affective and cortisol responses) across the two SF stressors (episodes 2 and 4). This hypothesis was largely supported: the associations between affective and cortisol responses were different for the two groups across the two stressors for percent positive affect (both stressor episodes 2 and 4) and percent negative affect (episode 4 only). For the full-term group, follow up correlations revealed significant negative associations between percent positive affective and cortisol responses for both stressors. Mothers' responsiveness did not explain the term group association differences between infant affective and cortisol responses across stressors. The (lack of) association of stress reactivity systems may index dysregulation or dysregulation correlates

  7. Eye Contact Affects Object Representation in 9-Month-Old Infants

    PubMed Central

    Okumura, Yuko; Kobayashi, Tessei; Itakura, Shoji

    2016-01-01

    Social cues in interaction with others enable infants to extract useful information from their environment. Although previous research has shown that infants process and retain different information about an object depending on the presence of social cues, the effect of eye contact as an isolated independent variable has not been investigated. The present study investigated how eye contact affects infants’ object processing. Nine-month-olds engaged in two types of social interactions with an experimenter. When the experimenter showed an object without eye contact, the infants processed and remembered both the object’s location and its identity. In contrast, when the experimenter showed the object while making eye contact with the infant, the infant preferentially processed object’s identity but not its location. Such effects might assist infants to selectively attend to useful information. Our findings revealed that 9-month-olds’ object representations are modulated in accordance with the context, thus elucidating the function of eye contact for infants’ object representation. PMID:27776155

  8. Bystanders affect the outcome of mother–infant interactions in rhesus macaques

    PubMed Central

    Semple, Stuart; Gerald, Melissa S.; Suggs, Dianne N.

    2009-01-01

    Animal communication involves the transfer of information between a sender and one or more receivers. However, such interactions do not happen in a social vacuum; third parties are typically present, who can potentially eavesdrop upon or intervene in the interaction. The importance of such bystanders in shaping the outcome of communicative interactions has been widely studied in humans, but has only recently received attention in other animal species. Here, we studied bouts of infant crying among rhesus macaques (Macaca mulatta) in order to investigate how the presence of bystanders may affect the outcome of this signalling interaction between infants and mothers. It was hypothesized that, as crying is acoustically aversive, bystanders may be aggressive to the mother or the infant in order to bring the crying bout to a close. Consequently, it was predicted that mothers should acquiesce more often to crying if in the presence of potentially aggressive animals. In line with this prediction, it was found that mothers gave infants access to the nipple significantly more often when crying occurred in the presence of animals that posed a high risk of aggression towards them. Both mothers and infants tended to receive more aggression from bystanders during crying bouts than outside of this time, although such aggression was extremely rare and was received by less than half of the mothers and infants in the study. Mothers were also found to be significantly more aggressive to their infants while the latter were crying than outside of crying bouts. These results provide new insight into the complex dynamics of mother–offspring conflict, and indicate that bystanders may play an important role in shaping the outcome of signalling interactions between infants and their mothers. PMID:19324744

  9. Survival of Enterobacter sakazakii in infant cereal as affected by composition, water activity, and temperature.

    PubMed

    Lin, Li-Chun; Beuchat, Larry R

    2007-01-01

    Enterobacter sakazakii infections in preterm neonates and infants have been epidemiologically associated with consumption of reconstituted powdered infant formula. The bacterium has been isolated from grain, infant cereals, and cereal factory environments. A study was done to determine the survival characteristics of E. sakazakii initially at populations of 0.31 and 5.03 logCFU/g of infant rice cereal (a(w) 0.30, 0.45-0.46, and 0.68-0.69). Cereal was stored at 4, 21, and 30 degrees C and populations were monitored for up to 12 months. Survival of the pathogen in infant rice, barley, oatmeal, and mixed grain cereals (a(w) 0.63-0.66, 0.76, or 0.82-0.83) initially containing a population of 4.93-5.64 logCFU/g and held at 4, 21, and 30 degrees C up to 24 weeks was determined. Populations decreased significantly (p < or = 0.05) in all cereals stored at 21 and 30 degrees C regardless of a(w). Increases in a(w) or storage temperature accelerated the rate of death of E. sakazakii in dry infant cereals. However, at an initial population of 0.31 logCFU/g, E. sakazakii survived in rice cereal (a(w) 0.30-0.69) for up to 12 months at all storage temperatures. Survival of E. sakazakii was not affected by the composition of dry infant rice, barley, mixed grain, and oatmeal cereals (initial a(w) 0.63-0.83) stored for up to 24 weeks at 4, 21, or 30 degrees C. This study demonstrated that E. sakazakii can survive for up to 12 months in infant cereals having a wide range of a(w) when storage is at temperatures simulating those to which they may be exposed during distribution, at retail, and in the home.

  10. Violence against women increases the risk of infant and child mortality: a case-referent study in Nicaragua.

    PubMed Central

    Asling-Monemi, Kajsa; Peña, Rodolfo; Ellsberg, Mary Carroll; Persson, Lars Ake

    2003-01-01

    OBJECTIVE: To investigate the impact of violence against mothers on mortality risks for their offspring before 5 years of age in Nicaragua. METHODS: From a demographic database covering a random sample of urban and rural households in Le n, Nicaragua, we identified all live births among women aged 15-49 years. Cases were defined as those who had died before the age of 5 years, between January 1993 and June 1996. For each case, two referents, matched for sex and age at death, were selected from the database. A total of 110 mothers of the cases and 203 mothers of the referents were interviewed using a standard questionnaire covering mothers' experience of physical and sexual violence. The data were analysed for the risk associated with maternal experience of violence of infant and under-5 mortality. FINDINGS: A total of 61% of mothers of cases had a lifetime experience of physical and/or sexual violence compared with 37% of mothers of referents, with a significant association being found between such experiences and mortality among their offspring. Other factors associated with higher infant and under-5 mortality were mother's education (no formal education), age (older), and parity (multiparity). CONCLUSIONS: The results suggest an association between physical and sexual violence against mothers, either before or during pregnancy, and an increased risk of under-5 mortality of their offspring. The type and severity of violence was probably more relevant to the risk than the timing, and violence may impact child health through maternal stress or care-giving behaviours rather than through direct trauma itself. PMID:12640470

  11. Recent Declines in Infant Mortality in the United States, 2005-2011

    MedlinePlus

    ... Mortality Series 21. Data on Natality, Marriage, and Divorce Series 22. Data from the National Natality and ... Compilations of Data on Natality, Mortality, Marriage, and Divorce Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard ...

  12. Cluster analysis of social and environment inequalities of infant mortality. A spatial study in small areas revealed by local disease mapping in France.

    PubMed

    Padilla, Cindy M; Deguen, Severine; Lalloue, Benoit; Blanchard, Olivier; Beaugard, Charles; Troude, Florence; Navier, Denis Zmirou; Vieira, Verónica M

    2013-06-01

    Mapping spatial distributions of disease occurrence can serve as a useful tool for identifying exposures of public health concern. Infant mortality is an important indicator of the health status of a population. Recent literature suggests that neighborhood deprivation status can modify the effect of air pollution on preterm delivery, a known risk factor for infant mortality. We investigated the effect of neighborhood social deprivation on the association between exposure to ambient air NO2 and infant mortality in the Lille and Lyon metropolitan areas, north and center of France, respectively, between 2002 and 2009. We conducted an ecological study using a neighborhood deprivation index estimated at the French census block from the 2006 census data. Infant mortality data were collected from local councils and geocoded using the address of residence. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. The average death rate was 4.2‰ and 4.6‰ live births for the Lille and Lyon metropolitan areas during the period. We found evidence of statistically significant precise clusters of elevated infant mortality for Lille and an east-west gradient of infant mortality risk for Lyon. Exposure to NO2 did not explain the spatial relationship. The Lille MA, socioeconomic deprivation index explained the spatial variation observed. These techniques provide evidence of clusters of significantly elevated infant mortality risk in relation with the neighborhood socioeconomic status. This method could be used for public policy management to determine priority areas for interventions. Moreover, taking into account the relationship between social and environmental exposure may help identify areas with cumulative inequalities.

  13. Cluster analysis of social and environment inequalities of infant mortality. A spatial study in small areas revealed by local disease mapping in France

    PubMed Central

    Padilla, Cindy M.; Deguen, Severine; Lalloue, Benoit; Blanchard, Olivier; Beaugard, Charles; Troude, Florence; Navier, Denis Zmirou; Vieira, Verónica M.

    2014-01-01

    Mapping spatial distributions of disease occurrence can serve as a useful tool for identifying exposures of public health concern. Infant mortality is an important indicator of the health status of a population. Recent literature suggests that neighborhood deprivation status can modify the effect of air pollution on preterm delivery, a known risk factor for infant mortality. We investigated the effect of neighborhood social deprivation on the association between exposure to ambient air NO2 and infant mortality in the Lille and Lyon metropolitan areas, north and center of France, respectively, between 2002 and 2009. We conducted an ecological study using a neighborhood deprivation index estimated at the French census block from the 2006 census data. Infant mortality data were collected from local councils and geocoded using the address of residence. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. The average death rate was 4.2‰ and 4.6‰ live births for the Lille and Lyon metropolitan areas during the period. We found evidence of statistically significant precise clusters of elevated infant mortality for Lille and an east-west gradient of infant mortality risk for Lyon. Exposure to NO2 did not explain the spatial relationship. The Lille MA, socioeconomic deprivation index explained the spatial variation observed. These techniques provide evidence of clusters of significantly elevated infant mortality risk in relation with the neighborhood socioeconomic status. This method could be used for public policy management to determine priority areas for interventions. Moreover, taking into account the relationship between social and environmental exposure may help identify areas with cumulative inequalities. PMID:23563257

  14. Infant mortality among singletons and twins in Japan during 1999-2008 on the basis of risk factors.

    PubMed

    Imaizumi, Yoko; Hayakawa, Kazuo

    2013-04-01

    The infant mortality rate (IMR) among single and twin births from 1999 to 2008 was analyzed using Japanese Vital Statistics. The IMR was 5.3-fold higher in twins than in singletons in 1999 and decreased to 3.9-fold in 2008. The reduced risk of infant mortality in twins relative to singletons may be related, partially, to survival rates, which improved after fetoscopic laser photocoagulation for twin - twin transfusion syndrome. The proportion of neonatal deaths among total infant deaths was 54% for singletons and 74% for twins. Thus, intensive care of single and twin births may be very important during the first month of life to reduce the IMR. The IMR decreased as gestational age (GA) rose in singletons, whereas the IMR in twins decreased as GA rose until 37 weeks and increased thereafter. The IMR was significantly higher in twins than in singletons from the shortest GA (<24 weeks) to 28 weeks as well as ≥38 weeks, whereas the IMR was significantly higher in singletons than in twins from 30 to 36 weeks. As for maternal age, the early neonatal and neonatal mortality rates as well as the IMR in singletons were significantly higher in the youngest maternal age group than in the oldest one, whereas the opposite result was obtained in twins. The lowest IMR in singletons was 1.1 per 1,000 live births for ≥38 weeks of gestation and heaviest birth weight (≥2,000 g), while the lowest IMR in twins was 1.8 at 37 weeks and ≥2,000 g.

  15. Affective Facial Expression Processing in 15 Month-old Infants Who Have Experienced Maltreatment: An Event-Related Potential Study

    PubMed Central

    Curtis, W. John; Cicchetti, Dante

    2014-01-01

    This study examined the neural correlates of facial affect processing in 15 month-old maltreated and nonmaltreated infants. Event-related potentials (ERPs) were elicited while infants passively viewed standardized pictures of female models posing angry, happy, and neutral facial expressions. Differences between maltreated (N=25) and nonmaltreated (N=20) infants were observed on three ERP components: P1, P260, and Nc. Compared to nonmaltreated infants, maltreated infants had greater P1 amplitude in response to happy facial affect while nonmaltreated infants had greater P1 amplitude in response to angry faces compared to the maltreated infants. Within the maltreated group, P1 was greater in response to happy relative to angry facial affect, whereas for nonmaltreated infants the opposite pattern was observed, with greater P1 amplitude in response to angry affect relative to happy. For the P260, nonmaltreated infants had greater amplitude than maltreated infants in response to happy facial affect. P260 amplitude was greater in response to angry relative to happy facial affect within the maltreated group. Amplitude of the Nc component in response to angry facial affect was greater in the nonmaltreated infants relative to the maltreated infants. Further, within the maltreated group, Nc was greater for happy compared to angry faces. In contrast, within the nonmaltreated group, Nc amplitude was greater in response to angry versus happy faces. The results provided further support for the hypothesis that the experience of maltreatment and the predominantly negative emotional tone in maltreating families alters the functioning of neural systems associated with the processing facial emotion. These results exemplify the importance of early preventive interventions focused on emotion for children who have experienced maltreatment early in life. PMID:23644415

  16. Risk Factors for Cause-specific Mortality of Very-Low-Birth-Weight Infants in the Korean Neonatal Network.

    PubMed

    Lim, Jae Woo; Chung, Sung-Hoon; Kang, Dae Ryong; Kim, Chang-Ryul

    2015-10-01

    This study attempted to assess the risk factors for mortality of very-low-birth-weight (VLBW) infants in the neonatal intensive care unit (NICU, n=2,386). Using data from the Korean Neonatal Network, we investigated infants with birth weights <1,500 g and gestational ages (GAs) of 22-31 weeks born between January 2013 and June 2014. Cases were defined as death at NICU discharge. Controls were randomly selected from live VLBW infants and frequency matched to case subjects by GA. Relevant variables were compared between the cases (n=236) and controls (n=236) by Cox proportional hazards regression to determine their associations with cause-specific mortality (cardiorespiratory, neurologic, infection, gastrointestinal, and others). In a Cox regression analysis, cardiorespiratory death were associated with a foreign mother (hazard ratio, HR, 4.33; 95% confidence interval, CI, 2.08-9.02), multiple gestation (HR, 1.65; 95% CI, 1.07-2.54), small for gestational age (HR, 2.06; 95% CI, 1.25-3.41), male gender (HR, 1.69; 95% CI, 1.10-2.60), Apgar score ≤3 at 5 min (HR, 1.97; 95% CI, 1.18-3.31), and delivery room resuscitation (HR, 2.60; 95% CI, 1.53-4.40). An Apgar score ≤3 at 5 min was also associated with neurological death (HR, 2.95; 95% CI, 1.29-6.73). Death due to neonatal infection was associated with outborn delivery (HR, 5.09; 95% CI, 1.46-17.74). Antenatal steroid and preterm premature rupture of membranes reduced risk of cardiorespiratory death (HR, 0.43; 95% CI, 0.27-0.67) and gastrointestinal death (HR, 0.30; 95% CI, 0.13-0.70), respectively. In conclusion, foreign mother, multiple gestation, small gestation age, male gender, Apgar score ≤3 at 5 min, and resuscitation in the delivery room are associated with cardiorespiratory mortality of VLBW infants in NICU. An Apgar score ≤3 at 5 min and outborn status are associated with neurological and infection mortality, respectively.

  17. Girl child marriage and its association with national rates of HIV, maternal health, and infant mortality across 97 countries.

    PubMed

    Raj, Anita; Boehmer, Ulrike

    2013-04-01

    This study was designed to assess associations between national rates of girl child marriage and national rates of HIV and maternal and child health (MCH) concerns, using national indicator data from 2009 United Nations reports. Current analyses were limited to the N = 97 nations (of 188 nations) for which girl child marriage data were available. Regression analyses adjusted for development and world region demonstrate that nations with higher rates of girl child marriage are significantly more likely to contend with higher rates of maternal and infant mortality and nonutilization of maternal health services, but not HIV.

  18. Disparities and Trends in Birth Outcomes, Perinatal and Infant Mortality in Aboriginal vs. Non-Aboriginal Populations: A Population-Based Study in Quebec, Canada 1996–2010

    PubMed Central

    Chen, Lu; Xiao, Lin; Auger, Nathalie; Torrie, Jill; McHugh, Nancy Gros-Louis; Zoungrana, Hamado; Luo, Zhong-Cheng

    2015-01-01

    Background Aboriginal populations are at substantially higher risks of adverse birth outcomes, perinatal and infant mortality than their non-Aboriginal counterparts even in developed countries including Australia, U.S. and Canada. There is a lack of data on recent trends in Canada. Methods We conducted a population-based retrospective cohort study (n = 254,410) using the linked vital events registry databases for singleton births in Quebec 1996–2010. Aboriginal (First Nations, Inuit) births were identified by mother tongue, place of residence and Indian Registration System membership. Outcomes included preterm birth, small-for-gestational-age, large-for-gestational-age, low birth weight, high birth weight, stillbirth, neonatal death, postneonatal death, perinatal death and infant death. Results Perinatal and infant mortality rates were 1.47 and 1.80 times higher in First Nations (10.1 and 7.3 per 1000, respectively), and 2.37 and 4.46 times higher in Inuit (16.3 and 18.1 per 1000, respectively) relative to non-Aboriginal (6.9 and 4.1 per 1000, respectively) births (all p<0.001). Compared to non-Aboriginal births, preterm birth rates were persistently (1.7–1.8 times) higher in Inuit, large-for-gestational-age birth rates were persistently (2.7–3.0 times) higher in First Nations births over the study period. Between 1996–2000 and 2006–2010, as compared to non-Aboriginal infants, the relative risk disparities increased for infant mortality (from 4.10 to 5.19 times) in Inuit, and for postneonatal mortality in Inuit (from 6.97 to 12.33 times) or First Nations (from 3.76 to 4.25 times) infants. Adjusting for maternal characteristics (age, marital status, parity, education and rural vs. urban residence) attenuated the risk differences, but significantly elevated risks remained in both Inuit and First Nations births for the risks of perinatal mortality (1.70 and 1.28 times, respectively), infant mortality (3.66 and 1.47 times, respectively) and postneonatal

  19. Does acute maternal stress in pregnancy affect infant health outcomes? Examination of a large cohort of infants born after the terrorist attacks of September 11, 2001

    PubMed Central

    Endara, Skye M; Ryan, Margaret AK; Sevick, Carter J; Conlin, Ava Marie S; Macera, Caroline A; Smith, Tyler C

    2009-01-01

    Background Infants in utero during the terrorist attacks of September 11, 2001 may have been negatively affected by maternal stress. Studies to date have produced contradictory results. Methods Data for this retrospective cohort study were obtained from the Department of Defense Birth and Infant Health Registry and included up to 164,743 infants born to active-duty military families. Infants were considered exposed if they were in utero on September 11, 2001, while the referent group included infants gestating in the same period in the preceding and following year (2000 and 2002). We investigated the association of this acute stress during pregnancy with the infant health outcomes of male:female sex ratio, birth defects, preterm birth, and growth deficiencies in utero and in infancy. Results No difference in sex ratio was observed between infants in utero in the first trimester of pregnancy on September 11, 2001 and infants in the referent population. Examination of the relationship between first-trimester exposure and birth defects also revealed no significant associations. In adjusted multivariable models, neither preterm birth nor growth deficiencies were significantly associated with the maternal exposure to the stress of September 11 during pregnancy. Conclusion The findings from this large population-based study suggest that women who were pregnant during the terrorist attacks of September 11, 2001 had no increased risk of adverse infant health outcomes. PMID:19619310

  20. A Report on the Health of Montana's Infants. 1996 Montana Special Report No. 1.

    ERIC Educational Resources Information Center

    Healthy Mothers, Healthy Babies--The Montana Coalition, Helena.

    This brief Kids Count report reviews principal adverse birth outcomes that affect the status of infants in Montana, including infant mortality and low birth weight. Statistics and brief summaries are provided in the following areas: (1) infant mortality (on the decline since 1989); (2) low birth rate (remaining steady from 1988 through 1992); (3)…

  1. Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22–25 weeks gestation

    PubMed Central

    Carlo, Waldemar A.; McDonald, Scott A.; Fanaroff, Avroy A.; Vohr, Betty R.; Stoll, Barbara J.; Ehrenkranz, Richard A.; Andrews, William W.; Wallace, Dennis; Das, Abhik; Bell, Edward F.; Walsh, Michele C.; Laptook, Abbot R.; Shankaran, Seetha; Poindexter, Brenda B.; Hale, Ellen C.; Newman, Nancy S.; Davis, Alexis S.; Schibler, Kurt; Kennedy, Kathleen A.; Sanchez, Pablo J.; Van Meurs, Krisa P.; Goldberg, Ronald N.; Watterberg, Kristi L.; Faix, Roger G.; Frantz, Ivan D.; Higgins, Rosemary D.

    2013-01-01

    Context Current guidelines, initially published in 1995, recommend antenatal corticosteroids for mothers with preterm labor from 24–34 weeks gestational age, but not before 24 weeks because of lack of data. However, many infants born before 24 weeks are provided intensive care now. Objective To determine if antenatal corticosteroids are associated with improvement in major outcomes in infants born at 22 and 23 weeks. Design, Setting, Participants Data for this cohort study were collected prospectively on 401–1000 gram inborn infants (N=10,541) of 22–25 weeks gestation born between 1993–2009 at 23 academic perinatal centers in the United States. Certified examiners unaware of exposure to antenatal corticosteroids performed follow-up examinations on 4,924 (86.5%) of the infants born in 1993–2008 who survived to 18–22 months. Logistic regression models generated adjusted odds ratios, controlling for maternal and neonatal variables. Main Outcome Measures Mortality and neurodevelopmental impairment at 18–22 months corrected age RESULTS Death or neurodevelopmental impairment at 18–22 months was lower for infants whose mothers received antenatal corticosteroids born at 23 weeks (antenatal corticosteroids, 83.4% vs no antenatal corticosteroids, 90.5%; adjusted odds ratio 0.58; 95% CI, 0.42–0.80), at 24 weeks (antenatal corticosteroids, 68.4% vs no antenatal corticosteroids, 80.3%; adjusted odds ratio 0.62; 95% CI, 0.49–0.78), and at 25 weeks (antenatal corticosteroids, 52.7% vs no antenatal corticosteroids, 67.9%; adjusted odds ratio 0.61; 95% CI, 0.50–0.74) but not at 22 weeks (antenatal corticosteroids, 90.2% vs no antenatal corticosteroids, 93.1%; adjusted odds ratio 0.80; 95% CI, 0.29–12.21). Death by 18–22 months, hospital death, death/intraventricular hemorrhage/periventricular leukomalacia, and death/necrotizing enterocolitis were significantly lower for infants born at 23, 24, and 25 weeks gestational age if the mothers had received

  2. Posttreatment Feeding Affects Mortality of Bed Bugs (Hemiptera: Cimicidae) Exposed to Insecticides.

    PubMed

    Singh, Narinderpal; Wang, Changlu; Cooper, Richard

    2016-02-01

    Insecticide sprays and dusts are used for controlling bed bugs, Cimex lectularius L. In natural environments, bed bugs have daily access to hosts after they are exposed to insecticides. The established laboratory insecticide bioassay protocols do not provide feeding after insecticide treatments, which can result in inflated mortality compared with what would be encountered in the field. We evaluated the effect of posttreatment feeding on mortality of bed bugs treated with different insecticides. None of the insecticides tested had a significant effect on the amount of blood consumed and percent feeding. The effect of posttreatment feeding on bed bug mortality varied among different insecticides. Feeding significantly reduced mortality in bed bugs exposed to deltamethrin spray, an essential oil mixture (Bed Bug Fix) spray, and diatomaceous earth dust. Feeding increased the mean survival time for bed bugs treated with chlorfenapyr spray and a spray containing an essential oil mixture (Ecoraider), but did not affect the final mortality. First instars hatched from eggs treated with chlorfenapyr liquid spray had reduced feeding compared with nymphs hatched from nontreated eggs. Those nymphs hatched from eggs treated with chlorfenapyr liquid spray and successfully fed had reduced mortality and a higher mean survival time than those without feeding. We conclude that the availability of a bloodmeal after insecticide exposure has a significant effect on bed bug mortality. Protocols for insecticide efficacy testing should consider offering a bloodmeal to the treated bed bugs within 1 to 3 d after treatment.

  3. Family Planning and Child Survival: The Role of Reproductive Factors in Infant and Child Mortality.

    ERIC Educational Resources Information Center

    Conly, Shanti R.

    This report summarizes the evidence that family planning can reduce deaths of children under 5 years of age at a reasonable cost. The report also: (1) identifies the major reproductive factors associated with child mortality; (2) estimates the approximate reduction in child mortality that could be achieved through improved childbearing patterns;…

  4. The Frequency and Outcome of Acute Kidney Injury in a Tertiary Hospital: Which Factors Affect Mortality?

    PubMed

    Ulusoy, Sukru; Arı, Derya; Ozkan, Gulsum; Cansız, Muammer; Kaynar, Kubra

    2015-07-01

    Acute kidney injury (AKI) is a major cause of mortality and morbidity in hospitalized patients. Incidence and mortality rates vary from country to country, and according to different in-hospital monitoring units and definitions of AKI. The aim of this study was to determine factors affecting frequency of AKI and mortality in our hospital. We retrospectively evaluated data for 1550 patients diagnosed with AKI and 788 patients meeting the Kidney Disease: Improving Global Outcomes (KDIGO) guideline AKI criteria out of a total of 174 852 patients hospitalized in our institution between January 1, 2007 and December 31, 2012. Staging was performed based on KDIGO Clinical Practice for Acute Kidney Injury and RIFLE (Risk, Injury, Failure, Loss of kidney function and End-stage renal failure). Demographic and biochemical data were recorded and correlations with mortality were assessed. The frequency of AKI in our hospital was 0.9%, with an in-hospital mortality rate of 34.6%. At multivariate analysis, diastolic blood pressure (OR 0.89, 95% CI 0.87-0.92; P < 0.001), monitoring in the intensive care unit (OR 0.18, 95% CI 0.09-0.38; P < 0.001), urine output (OR 4.00, 95% CI 2.03-7.89; P < 0.001), duration of oliguria (OR 1.51, 95% CI 1.34-1.69; P < 0.001), length of hospitalization (OR 0.83, 95% CI 0.79-0.88; P < 0.001), dialysis requirement (OR 2.30, 95% CI 1.12-4.71; P < 0.05), APACHE II score (OR 1.16, 95% CI 1.09-1.24; P < 0.001), and albumin level (OR 0.32, 95% CI 0.21-0.50; P < 0.001) were identified as independent determinants affecting mortality. Frequency of AKI and associated mortality rates in our regional reference hospital were compatible with those in the literature. This study shows that KDIGO criteria are more sensitive in determining AKI. Mortality was not correlated with staging based on RIFLE or KDIGO. Nonetheless, our identification of urine output as one of the independent determinants of mortality suggests that this

  5. The impact of prenatal care quality on neonatal, infant and child mortality in Zimbabwe: evidence from the demographic and health surveys.

    PubMed

    Makate, Marshall; Makate, Clifton

    2016-12-19

    The impact of the quality of prenatal care on child mortality outcomes has received less attention in sub-Saharan Africa. This study endeavoured to explore the effect of the quality of prenatal care and its individual components on neonatal, infant and under-five mortality. The empirical analysis uses data from the three most recent waves of the nationally representative Demographic and Health Survey for Zimbabwe conducted in 1999, 2005/06 and 2010/11. The results indicate that a one-unit increase in the quality of prenatal care lowers the prospect of neonatal, infant and under-five mortality by approximately 42.33, 30.86 and 28.65%, respectively. These findings remained roughly the same even after adjusting for potential mediating factors. Examining the effect of individual prenatal care components on child mortality revealed that women who receive information on possible complications arising during pregnancy are less liable to experience a neonatal death. Similarly, women who had blood pressure checks and tetanus immunizations were less likely to experience an infant or under-five death. We did not find any statistically meaningful impact on child mortality outcomes of blood and urine sample checks, iron tablet consumption, and the receipt of malarial tablets. Overall, our results suggest the need for public health policymakers to focus on ensuring high-quality prenatal care to enhance the survival prospects of Zimbabwe's infants.

  6. Smoking during Pregnancy Affects Speech-Processing Ability in Newborn Infants

    PubMed Central

    Key, Alexandra P.F.; Ferguson, Melissa; Molfese, Dennis L.; Peach, Kelley; Lehman, Casey; Molfese, Victoria J.

    2007-01-01

    Background Tobacco smoking during pregnancy is known to adversely affect development of the central nervous system in babies of smoking mothers by restricting utero–placental blood flow and the amount of oxygen available to the fetus. Behavioral data associate maternal smoking with lower verbal scores and poorer performance on specific language/auditory tests. Objectives In the current study we examined the effects of maternal smoking during pregnancy on newborns’ speech processing ability as measured by event-related potentials (ERPs). Method High-density ERPs were recorded within 48 hr of birth in healthy newborn infants of smoking (n = 8) and nonsmoking (n = 8) mothers. Participating infants were matched on sex, gestational age, birth weight, Apgar scores, mother’s education, and family income. Smoking during pregnancy was determined by parental self-report and medical records. ERPs were recorded in response to six consonant–vowel syllables presented in random order with equal probability. Results Brainwaves of babies of nonsmoking mothers were characterized by typical hemisphere asymmetries, with larger amplitudes over the left hemisphere, especially over temporal regions. Further, infants of nonsmokers discriminated among a greater number of syllables whereas the newborns of smokers began the discrimination process at least 150 msec later and differentiated among fewer stimuli. Conclusions Our findings indicate that prenatal exposure to tobacco smoke in otherwise healthy babies is linked with significant changes in brain physiology associated with basic perceptual skills that could place the infant at risk for later developmental problems. PMID:17450234

  7. The establishment of the infant intestinal microbiome is not affected by rotavirus vaccination

    PubMed Central

    Ang, Li; Arboleya, Silvia; Lihua, Guo; Chuihui, Yuan; Nan, Qin; Suarez, Marta; Solís, Gonzalo; de los Reyes-Gavilán, Clara G.; Gueimonde, Miguel

    2014-01-01

    The microbial colonization of the intestine during the first months of life constitutes the most important process for the microbiota-induced host-homeostasis. Alterations in this process may entail a high-risk for disease in later life. However, the potential factors affecting this process in the infant are not well known. Moreover, the potential impact of orally administered vaccines upon the establishing microbiome remains unknown. Here we assessed the intestinal microbiome establishment process and evaluated the impact of rotavirus vaccination upon this process. Metagenomic, PCR-DGGE and faecal short chain fatty acids analyses were performed on faecal samples obtained from three infants before and after the administration of each dose of vaccine. We found a high inter-individual variability in the early life gut microbiota at microbial composition level, but a large similarity between the infants' microbiomes at functional level. Rotavirus vaccination did not show any major effects upon the infant gut microbiota. Thus, the individual microbiome establishment and development process seems to occur in a defined manner during the first stages of life and rotavirus vaccination appears to be inconsequential for this process. PMID:25491920

  8. Do conditions in early life affect old-age mortality directly and indirectly? Evidence from 19th-century rural Sweden.

    PubMed

    Bengtsson, Tommy; Broström, Göran

    2009-05-01

    Previous research has shown that the disease load experienced during the birth year, measured as the infant mortality rate, had a significant influence on old-age mortality in nineteenth-century rural Sweden. We know that children born in years with very high rates of infant mortality, due to outbreaks of smallpox or whooping cough, and who still survived to adulthood and married, faced a life length several years shorter than others. We do not know, however, whether this is a direct effect, caused by permanent physical damage leading to fatal outcomes later in life, or an indirect effect, via its influence on accumulation of wealth and obtained socio-economic status. The Scanian Demographic Database, with information on five rural parishes in southern Sweden between 1813 and 1894, contains the data needed to distinguish between the two mechanisms. First, the effects of conditions in childhood on obtained socio-economic status as an adult are analyzed, then the effects of both early-life conditions and socio-economic status at various stages of life on old-age mortality. By including random effects, we take into account possible dependencies in the data due to kinship and marriage. We find that a high disease load during the first year of life had a strong negative impact on a person's ability to acquire wealth, never before shown for a historical setting. This means that it is indeed possible that the effects of disease load in the first year of life indirectly affect mortality in old age through obtained socio-economic status. We find, however, no effects of obtained socio-economic status on old-age mortality. While the result is interesting per se, constituting a debatable issue, it means that the argument that early-life conditions indirectly affect old-age mortality is not supported. Instead, we find support for the conclusion that the effect of the disease load in early-life is direct or, in other words, that physiological damage from severe infections at the

  9. Necrotising enterocolitis and mortality in preterm infants after introduction of probiotics: a quasi-experimental study

    PubMed Central

    Samuels, Noor; van de Graaf, Rob; Been, Jasper V.; de Jonge, Rogier C. J.; Hanff, Lidwien M.; Wijnen, René M. H.; Kornelisse, René F.; Reiss, Irwin K. M.; Vermeulen, Marijn J.

    2016-01-01

    Evidence on the clinical effectiveness of probiotics in the prevention of necrotising enterocolitis (NEC) in preterm infants is conflicting and cohort studies lacked adjustment for time trend and feeding type. This study investigated the association between the introduction of routine probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum; Infloran®) on the primary outcome ‘NEC or death’. Preterm infants (gestational age <32 weeks or birth weight <1500 gram) admitted before (Jan 2008–Sep 2012; n = 1288) and after (Oct 2012–Dec 2014; n = 673) introduction of probiotics were compared. Interrupted time series logistic regression models were adjusted for confounders, effect modification by feeding type, seasonality and underlying temporal trends. Unadjusted and adjusted analyses showed no difference in ‘NEC or death’ between the two periods. The overall incidence of NEC declined from 7.8% to 5.1% (OR 0.63, 95% CI 0.42–0.93, p = 0.02), which was not statistically significant in the adjusted models. Introduction of probiotics was associated with a reduced adjusted odds for ‘NEC or sepsis or death’ in exclusively breastmilk-fed infants (OR 0.43, 95% CI 0.21–0.93, p = 0.03) only. We conclude that introduction of probiotics was not associated with a reduction in ‘NEC or death’ and that type of feeding seems to modify the effects of probiotics. PMID:27545195

  10. Individual- and Community-Level Disparities in Birth Outcomes and Infant Mortality among First Nations, Inuit and Other Populations in Quebec.

    PubMed

    Simonet, Fabienne; Wassimi, Spogmai; Heaman, Maureen; Smylie, Janet; Martens, Patricia; McHugh, Nancy G L; Labranche, Elena; Wilkins, Russell; Fraser, William D; Luo, Zhong-Cheng

    2010-01-01

    OBJECTIVE: We assessed individual- and community-level disparities and trends in birth outcomes and infant mortality among First Nations (North American Indians) and Inuit versus other populations in Quebec, Canada. METHODS: A retrospective birth cohort study of all births to Quebec residents, 1991-2000. At the individual level, we examined outcomes comparing births to First Nations and Inuit versus other mother tongue women. At the community level, we compared outcomes among First Nations and Inuit communities versus other communities. RESULTS: First Nations and Inuit births were much less likely to be small-for-gestational-age but much more likely to be large-for-gestational-age compared to other births at the individual or community level, especially for First Nations. At both levels, Inuit births were 1.5 times as likely to be preterm. At the individual level, total fetal and infant mortality rates were 2 times as high for First Nations, and 3 times as high for Inuit. Infant mortality rates were 2 times as high for First Nations, and 4 times as high for Inuit. There were no reductions in these disparities between 1991-1995 and 1996-2000. Modestly smaller disparities in total fetal and infant mortality were observed for First Nations at the community level (risk ratio=1.6), but for Inuit there were similar disparities at both levels. These disparities remained substantial after adjusting for maternal characteristics. CONCLUSION: There were large and persistent disparities in fetal and infant mortality among First Nations and Inuit versus other populations in Quebec based on individual- or community-level assessments, indicating a need to improve socioeconomic conditions as well as perinatal and infant care for Aboriginal peoples.

  11. The effects of designation and volume of neonatal care on mortality and morbidity outcomes of very preterm infants in England: retrospective population-based cohort study

    PubMed Central

    Watson, S I; Arulampalam, W; Petrou, S; Marlow, N; Morgan, A S; Draper, E S; Santhakumaran, S; Modi, N

    2014-01-01

    Objective To examine the effects of designation and volume of neonatal care at the hospital of birth on mortality and morbidity outcomes in very preterm infants in a managed clinical network setting. Design A retrospective, population-based analysis of operational clinical data using adjusted logistic regression and instrumental variables (IV) analyses. Setting 165 National Health Service neonatal units in England contributing data to the National Neonatal Research Database at the Neonatal Data Analysis Unit and participating in the Neonatal Economic, Staffing and Clinical Outcomes Project. Participants 20 554 infants born at <33 weeks completed gestation (17 995 born at 27–32 weeks; 2559 born at <27 weeks), admitted to neonatal care and either discharged or died, over the period 1 January 2009–31 December 2011. Intervention Tertiary designation or high-volume neonatal care at the hospital of birth. Outcomes Neonatal mortality, any in-hospital mortality, surgery for necrotising enterocolitis, surgery for retinopathy of prematurity, bronchopulmonary dysplasia and postmenstrual age at discharge. Results Infants born at <33 weeks gestation and admitted to a high-volume neonatal unit at the hospital of birth were at reduced odds of neonatal mortality (IV regression odds ratio (OR) 0.70, 95% CI 0.53 to 0.92) and any in-hospital mortality (IV regression OR 0.68, 95% CI 0.54 to 0.85). The effect of volume on any in-hospital mortality was most acute among infants born at <27 weeks gestation (IV regression OR 0.51, 95% CI 0.33 to 0.79). A negative association between tertiary-level unit designation and mortality was also observed with adjusted logistic regression for infants born at <27 weeks gestation. Conclusions High-volume neonatal care provided at the hospital of birth may protect against in-hospital mortality in very preterm infants. Future developments of neonatal services should promote delivery of very preterm infants at hospitals with high

  12. Integrated approaches to improve birth outcomes: perinatal periods of risk, infant mortality review, and the Los Angeles Mommy and Baby Project.

    PubMed

    Chao, Shin Margaret; Donatoni, Giannina; Bemis, Cathleen; Donovan, Kevin; Harding, Cynthia; Davenport, Deborah; Gilbert, Carol; Kasehagen, Laurin; Peck, Magda G

    2010-11-01

    This article provides an example of how Perinatal Periods of Risk (PPOR) can provide a framework and offer analytic methods that move communities to productive action to address infant mortality. Between 1999 and 2002, the infant mortality rate in the Antelope Valley region of Los Angeles County increased from 5.0 to 10.6 per 1,000 live births. Of particular concern, infant mortality among African Americans in the Antelope Valley rose from 11.0 per 1,000 live births (7 cases) in 1999 to 32.7 per 1,000 live births (27 cases) in 2002. In response, the Los Angeles County Department of Public Health, Maternal, Child, and Adolescent Health Programs partnered with a community task force to develop an action plan to address the issue. Three stages of the PPOR approach were used: (1) Assuring Readiness; (2) Data and Assessment, which included: (a) Using 2002 vital records to identify areas with the highest excess rates of feto-infant mortality (Phase 1 PPOR), and (b) Implementing Infant Mortality Review (IMR) and the Los Angeles Mommy and Baby (LAMB) Project, a population-based study to identify potential factors associated with adverse birth outcomes. (Phase 2 PPOR); and (3) Strategy and Planning, to develop strategic actions for targeted prevention. A description of stakeholders' commitments to improve birth outcomes and monitor infant mortality is also given. The Antelope Valley community was engaged and ready to investigate the local rise in infant mortality. Phase 1 PPOR analysis identified Maternal Health/Prematurity and Infant Health as the most important periods of risk for further investigation and potential intervention. During the Phase 2 PPOR analyses, IMR found a significant proportion of mothers with previous fetal loss (45%) or low birth weight/preterm (LBW/PT) birth, late prenatal care (39%), maternal infections (47%), and infant safety issues (21%). After adjusting for potential confounders (maternal age, race, education level, and marital status), the

  13. Analysis of ethnic influence on stillbirths and infant mortality in Bradford 1975-81.

    PubMed Central

    Gillies, D R; Lealman, G T; Lumb, K M; Congdon, P

    1984-01-01

    The patterns of mortality from birth to 1 year in Bradford were studied in the seven year period 1975-81. Large differences in mortality between the Asian and non-Asian population were shown. In 1981 77% of Bradford Asian families were of Pakistani origin, the remaining 23% consisting of families from other parts of the Indian subcontinent and a few from East Africa. There were excess mortality with associated congenital abnormality in the Asian population. From 1975 to 1981 there were 133 deaths associated with congenital abnormality (a rate of 12.4 per 1000 total births) in the Asian population compared with a figure of 129 (4.8 per 1000) in the non-Asian population. The differences between the two groups are shown to be largely independent of social class, and other possible reasons for the discrepancy between the Asian and non-Asian populations are discussed. PMID:6470598

  14. Maternal mindfulness and anxiety during pregnancy affect infants' neural responses to sounds.

    PubMed

    van den Heuvel, Marion I; Donkers, Franc C L; Winkler, István; Otte, Renée A; Van den Bergh, Bea R H

    2015-03-01

    Maternal anxiety during pregnancy has been consistently shown to negatively affect offspring neurodevelopmental outcomes. However, little is known about the impact of positive maternal traits/states during pregnancy on the offspring. The present study was aimed at investigating the effects of the mother's mindfulness and anxiety during pregnancy on the infant's neurocognitive functioning at 9 months of age. Mothers reported mindfulness using the Freiburg Mindfulness Inventory and anxiety using the Symptom Checklist (SCL-90) at ± 20.7 weeks of gestation. Event-related brain potentials (ERPs) were measured from 79 infants in an auditory oddball paradigm designed to measure auditory attention-a key aspect of early neurocognitive functioning. For the ERP responses elicited by standard sounds, higher maternal mindfulness was associated with lower N250 amplitudes (P < 0.01, η(2) = 0.097), whereas higher maternal anxiety was associated with higher N250 amplitudes (P < 0.05, η(2) = 0.057). Maternal mindfulness was also positively associated with the P150 amplitudes (P < 0.01, η(2) = 0.130). These results suggest that infants prenatally exposed to higher levels of maternal mindfulness devote fewer attentional resources to frequently occurring irrelevant sounds. The results show that positive traits and experiences of the mother during pregnancy may also affect the unborn child. Emphasizing the beneficial effects of a positive psychological state during pregnancy may promote healthy behavior in pregnant women.

  15. Neonatal and Infant Mortality in Korea, Japan, and the U.S.: Effect of Birth Weight Distribution and Birth Weight-Specific Mortality Rates

    PubMed Central

    2016-01-01

    Difference in crude neonatal and infant mortality rates (NMR and IMR) among different countries is due to the differences in its two determinants: birth weight distribution (BWD) and birth weight-specific mortality rates (BW-SMRs). We aimed to determine impact of BWD and BW-SMRs on differences in crude NMR and IMR among Korea, Japan, and the U.S. Our study used the live birth data of the period 2009 through 2010. Crude NMR/IMR are the lowest in Japan, 1.1/2.1, compared to 1.8/3.2, in Korea, and 4.1/6.2, in the U.S., respectively. Japanese had the best BW-SMRs of all birth weight groups compared to the Koreans and the U.S. The U.S. BWD was unfavorable with very low birth weight (< 1,500 g) rate of 1.4%, compared to 0.6% in Korea, and 0.8% in Japan. If Koreans and Japanese had the same BWD as in the U.S., their crude NMR/IMR would be 3.9/6.1 for the Koreans and 1.5/2.5 for the Japanese. If both Koreans and Japanese had the same BW-SMRs as in the U.S., the crude NMR/IMR would be 2.0/3.8 for the Koreans and 2.7/5.0 for the Japanese. In conclusion, compared to the U.S., lower crude NMR or IMR in Japan is mainly attributable to its better BW-SMRs. Koreans had lower crude NMR and IMR, primarily from its favorable BWD. Comparing crude NMR or IMR among different countries should include further exploration of its two determinants, BW-SMRs reflecting medical care, and BWD reflecting socio-demographic conditions. PMID:27510390

  16. Self-regulation and Beyond: Affect Regulation and the Infant-Caregiver Dyad.

    PubMed

    Taipale, Joona

    2016-01-01

    In the available psychological literature, affect regulation is fundamentally considered in terms of self-regulation, and according to this standard picture, the contribution of other people in our affect regulation has been viewed in terms of socially assisted self-regulation. The present article challenges this standard picture. By focusing on affect regulation as it unfolds in early infancy, it will be argued that instead of being something original and fundamental, self-regulation developmentally emerges from the basis of a further type of affect regulation. While infants' capacities in recognizing, understanding, and modifying their own affective states are initially immature and undeveloped, affect regulation is initially managed by the other: it is initially the self, and not the other, that plays the role of an assistant in affect regulation. To capture this phenomenon, the concepts of "auto-matic," "hetero-matic," and "altero-matic" affect regulation will be introduced and their interrelations elaborated. By showing how the capacity of affective self-regulation, which is characteristic to maturity, is developmentally achieved by internalizing regulative functions that, at the outset of development, are managed by the caregiver, it will be argued that altero-matic affect regulation is an autonomous type of affect regulation and the developmental basis for self-regulation.

  17. Public Health Service Act Infant Mortality Amendments of 1987. Report from the Committee on Labor and Human Resources (To accompany S. 1441). 100th Congress, 1st Session.

    ERIC Educational Resources Information Center

    Kennedy, Edward M.

    This report provides a summary of the Public Health Service Act Infant Mortality Amendments of 1987 (S. 1441), background information and rationale for the legislation, the text of the bill as reported, views of the Senate Committee on Labor and Human Resources, a statement of approval by the Committee, the Congressional Budget Office cost…

  18. Underascertainment of Child Abuse Fatalities in France: Retrospective Analysis of Judicial Data to Assess Underreporting of Infant Homicides in Mortality Statistics

    ERIC Educational Resources Information Center

    Tursz, Anne; Crost, Monique; Gerbouin-Rerolle, Pascale; Cook, Jon M.

    2010-01-01

    Objectives: Test the hypothesis of an underestimation of infant homicides in mortality statistics in France; identify its causes; examine data from the judicial system and their contribution in correcting this underestimation. Methods: A retrospective, cross-sectional study was carried out in 26 courts in three regions of France of cases of infant…

  19. Analysis of prognostic factors affecting mortality in Fournier’s gangrene: A study of 72 cases

    PubMed Central

    Tarchouli, Mohamed; Bounaim, Ahmed; Essarghini, Mohamed; Ratbi, Moulay Brahim; Belhamidi, Mohamed Said; Bensal, Abdelhak; Zemmouri, Adil; Ali, Abdelmounaim Ait; Sair, Khalid

    2015-01-01

    Introduction: Fournier’s gangrene is a rapidly progressing necrotizing fasciitis of the perineum and genital area associated with a high mortality rate. We presented our experience in managing this entity and identified prognostic factors affecting mortality. Methods: We carried out a retrospective study of 72 patients treated for Fournier’s gangrene at our institution between January 2005 and December 2014. Patients were divided into survivors and non-survivors and potential prognostic factors were analyzed. Results: Of the 72 patients, 64 were males (89%) and 8 females (11%), with a mean age of 51 years. The most common predisposing factor was diabetes mellitus (38%). The mortality rate was 17% (12 patients died). Statistically significant differences were not found in age, gender, and predisposing factors, except in heart disease (p = 0.038). Individual laboratory parameters significantly correlating with mortality included hemoglobin (p = 0.023), hematocrit (p = 0.019), serum urea (p = 0.009), creatinine (p = 0.042), and potassium (p = 0.026). Severe sepsis on admission and the extent of affected surface area also predicted higher mortality. Others factors, such as duration of symptoms before admission, number of surgical debridement, diverting colostomy and length of hospital stay, did not show significant differences. The median Fournier’s Gangrene Severity Index (FGSI) was significantly higher in non-survivors (p = 0.002). Conclusion: Fournier’s gangrene is a severe surgical emergency requiring early diagnosis and aggressive therapy. Identification of prognostic factors is essential to establish an optimal treatment and to improve outcome. The FGSI is a simple and valid method for predicting disease severity and patient survival. PMID:26600888

  20. Infant iron status affects iron absorption in Peruvian breastfed infants at 2 and 5 mo of age

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Effects of prenatal iron supplementation on maternal postpartum iron status and early infant iron homeostasis remain largely unknown. We examined iron absorption and growth in exclusively breastfed infants in relation to fetal iron exposure and iron status during early infancy. Longitudinal, paired ...

  1. Does aggressive and expectant management of severe preeclampsia affect the neurologic development of the infant?

    PubMed Central

    Ertekin, Arif Aktuğ; Kapudere, Bilge; Eken, Meryem Kurek; İlhan, Gülşah; Dırman, Şükriye; Sargın, Mehmet Akif; Deniz, Engin; Karatekin, Güner; Çöğendez, Ebru; Api, Murat

    2015-01-01

    Objective: To compare and evaluate the influences of expectant and aggressive management of severe preeclampsia on the first year neurologic development of the infants in pregnancies between 27 and 34 weeks of pregnancy. Methods: Seventy women with severe preeclampsia between 27 and 34 weeks of gestation were included in the study. 37 patients were managed aggressively (Group 1) and 33 patients were managed expectantly (Group 2). Glucocorticoids, magnesium sulfate infusion and antihypertensive drugs were administered to each group. After glucocorticoid administration was completed Group 1 was delivered either by cesarean section or vaginal delivery. In Group 2 magnesium sulfate infusion was stopped after glucocorticoid administration was completed. Antihypertensive drugs were given, bed rest and intensive fetal monitorization were continued in this group. Results: The average weeks of gestation, one minute and five minute apgar scores and hospitalization time in intensive care unit were similar in both groups (P > 0.05). Three neonatal complications in Group 2 and five in Group 1 were detected according to the Denver Developmental Screening Test-II and one pathologic case was detected in both groups following neurologic examination. Neonatal mortality was seen in seven patients in Group 1 and one in Group 2. There were no significant differences between groups in terms of neonatal mortality and morbidity and maternal morbidity (P > 0.05). The average latency period was 3.45 ± 5.48 days in Group 2 and none in Group 1. Conclusion: There was no significant difference in the first year neurological development of infants whose mothers underwent either expectant and aggressive management for severe preeclampsia. PMID:26770571

  2. The long-term impact of infant rearing background on the affective state of adult common marmosets (Callithrix jacchus)

    PubMed Central

    Ash, Hayley; Buchanan-Smith, Hannah M.

    2016-01-01

    Early life environment, including temporary family separation, can have a major influence on affective state. Using a battery of tests, the current study compared the performance of adult common marmosets (Callithrix jacchus), reared as infants under 3 different conditions: family-reared twins, family-reared animals from triplet litters where only 2 remain (2stays) and supplementary fed triplets. No significant differences were found in latency to approach and obtain food from a human or a novel object between rearing conditions, suggesting no effect on neophobia. There were no differences in cognitive bias task acquisition time, or proportion of responses to each ambiguous probe. Very minor differences were found in response to the probes, with only supplementary fed marmosets making fewer responses to the middle probe, compared to the probe nearest the rewarded stimuli. Similarly, in a test for anhedonia, no difference was found between rearing conditions in consumption of milkshake at different concentrations. There was just one very small difference in reward motivation, with only supplementary fed triplets demonstrating a lack of preference for milkshake over water at the lowest concentration. This consistent pattern of results suggests that the supplementary feeding of large litters of marmosets at this facility did not have a major effect on welfare, and is unlikely to influence performance in reward-related scientific tasks. Therefore, while family separation is not recommended, this particular practice should be used if it is necessary, such as to reduce infant mortality. Regular positive interactions with humans are also encouraged, to reduce fear and improve welfare of marmosets kept in captivity. PMID:26912940

  3. 78 FR 23941 - Advisory Committee on Infant Mortality; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... Committee should contact Michael C. Lu, M.D., M.P.H., Executive Secretary, ACIM, Health Resources and... meeting should contact David S. de la Cruz, Ph.D., M.P.H., ACIM Designated Federal Official, Health... Mortality (ACIM). Dates and Times: April 24, 2013, 8:00 a.m.-5:00 p.m., April 25, 2013, 8:00 a.m.-3:00...

  4. The influence of infant and child mortality on fertility in selected countries of the Asian and Pacific region.

    PubMed

    1985-01-01

    Data from the World Fertility Survey (WFS) on 10 countries are used to measure the strength of 1 of 3 types of behavior (insurance behavior, breastfeeding and replacement behavior) influencing the relationship between infant mortality and fertility. 2 variables, the use of contraception at the time of the survey and the stated desire to stop bearing children, are cross-classified by the parity of women, whether they had experienced the death of a child, and if so, whether it was the last or an earlier child. Other tabulations measure the effect of the death of sons, as opposed to daughters, on the decision to have another child. Demographic and socioeconomic controls are introduced using multiple classification analysis. The 10 countries surveyed in the region are Bangladesh, Fiji, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, Sri Lanka and Thailand. Results indicate that the replacement effect operated most strongly in countries such as Fiji and Korea which have relatively low fertility rates and high contraceptive practice. In countries with high mortality, e.g., Bangladesh, Nepal and Pakistan, the effect of replacement behavior on the practice of contraception was minimal. However, where the desire to have no more children was studied, women who had lost a child were far less likely to say they wanted no more children. The direct experience of losing a child tended to make women, especially low parity women, more pronatalist. While the measurable effects of child mortality on fertility were small, the findings about attitudes were highly suggestive. They support the belief that population which are pronatalist are so in part because high mortality causes concern about the ultimate chances of the survival of their children. It is thus not difficult to believe that people insure against the deaths of their children by trying to have more children than they need. Of the 10 countries surveyed, the evidence for such insurance behavior

  5. Associates of Neonatal, Infant and Child Mortality in the Islamic Republic of Pakistan: A Multilevel Analysis Using the 2012-2013 Demographic and Health Surveys.

    PubMed

    Helova, Anna; Hearld, Kristine R; Budhwani, Henna

    2017-02-01

    Objectives Pakistan is one of five nations contributing to half of the world's child mortality and holds under-five mortality rates which are nearly double global targets. Reasons for this shortfall include civil conflicts, political uncertainty, low education, poverty, rural-urban disparities, and limited health care access. The aim of this study was to explore associations between individual characteristics, community factors, and child mortality in Pakistan. Methods Data were derived from the 2012 to 2013 Pakistan Demographic and Health Survey, and included 7399 live births and 380 child deaths. Multivariate, multilevel logistic regression was used to model risk of neonatal, infant and under-five child deaths. Results Seventy-one percent of child deaths occurred during the neonatal period. Significant factors (p < 0.05) associated with lower odds of child mortality included adhering to recommended minimum of 24 months interpregnancy interval and higher household wealth. These were significant for neonatal (OR 0.448; 0.871), infancy (OR 0.465; 0.881), and under-five deaths (OR 0.465; 0.879). Employed mothers had higher odds of neonatal (OR 1.479), infant (OR 1.506), and child mortality (OR 1.459). Likewise, women living in consanguineous marriages had higher odds of infant (OR 1.454) and under-five deaths (OR 1.381). Children in Balochistan, Punjab, and Sindh, regions disproportionately poor, rural with low levels of education, were at highest risk of dying. Conclusions for Practice Findings may assist in designing targeted interventions, developing appropriate public health messaging, and implementing policies designed to lower child mortality. Focusing on lowering rates of maternal poverty, increasing opportunities for education, and improving access to health care could assist in reducing child mortality in Pakistan.

  6. Surrogate mobility and orientation affect the early neurobehavioral development of infant rhesus macaques (Macaca mulatta).

    PubMed

    Dettmer, Amanda M; Ruggiero, Angela M; Novak, Melinda A; Meyer, Jerrold S; Suomi, Stephen J

    2008-05-01

    A biological mother's movement appears necessary for optimal development in infant monkeys. However, nursery-reared monkeys are typically provided with inanimate surrogate mothers that move very little. The purpose of this study was to evaluate the effects of a novel, highly mobile surrogate mother on motor development, exploration, and reactions to novelty. Six infant rhesus macaques (Macaca mulatta) were reared on mobile hanging surrogates (MS) and compared to six infants reared on standard stationary rocking surrogates (RS) and to 9-15 infants reared with their biological mothers (MR) for early developmental outcome. We predicted that MS infants would develop more similarly to MR infants than RS infants. In neonatal assessments conducted at Day 30, both MS and MR infants showed more highly developed motor activity than RS infants on measures of grasping (p = .009), coordination (p = .038), spontaneous crawl (p = .009), and balance (p = .003). At 2-3 months of age, both MS and MR infants displayed higher levels of exploration in the home cage than RS infants (p = .016). In a novel situation in which only MS and RS infants were tested, MS infants spent less time near their surrogates in the first five minutes of the test session than RS infants (p = .05), indicating a higher level of comfort. Collectively, these results suggest that when nursery-rearing of infant monkeys is necessary, a mobile hanging surrogate may encourage more normative development of gross motor skills and exploratory behavior and may serve as a useful alternative to stationary or rocking surrogates.

  7. Adding zinc to supplemental iron and folic acid does not affect mortality and severe morbidity in young children.

    PubMed

    Bhandari, Nita; Taneja, Sunita; Mazumder, Sarmila; Bahl, Rajiv; Fontaine, Olivier; Bhan, Maharaj K

    2007-01-01

    Studies have found a substantial reduction in diarrhea and respiratory morbidity in young children receiving zinc supplementation. The impact of daily zinc supplementation administered with iron plus folic acid (IFA) in young children on all-cause hospitalizations and mortality in comparison with IFA alone was evaluated. In a double blind cluster-randomized controlled trial, 94,359 subjects aged 1-23 mo were administered a daily dose of zinc plus IFA or IFA alone for a duration of 12 mo after enrollment. The intervention group tablet contained 10 mg of elemental zinc, 12.5 mg of iron, and 50 microg of folic acid. The control group tablets were similar except that they contained a placebo for zinc. Infants aged <6 mo were administered half a tablet, and those older received 1 tablet dissolved in breast milk or water. Hospitalizations were captured by trained study physicians through the surveillance of 8 hospitals. Deaths and hospitalizations were ascertained through visits to households by study supervisors once every 2 mo. The overall death rates did not differ significantly between the 2 groups when adjusted for cluster randomization (hazard ratio = 1.02, 95% CI 0.87, 1.19). Zinc and IFA supplementation compared with IFA alone did not affect adjusted hospitalization rates (overall rate ratio = 1.08, 95% CI 0.98, 1.19; diarrhea-specific rate ratio = 1.15, 95% CI 0.99, 1.34; or pneumonia-specific rate ratio = 1.09, 95% CI 0.94, 1.25). The lack of impact of zinc on mortality and hospitalization rates in this study may have been due to the use of lower daily zinc dosing than used in some of the morbidity prevention trials or from an interaction between zinc and iron, where the addition of iron may have adversely affected potential effects of zinc on immune function and morbidity. Future research should address iron and zinc interaction effects on important functional outcomes.

  8. Preventing infant and child morbidity and mortality due to maternal depression.

    PubMed

    Surkan, Pamela J; Patel, Shivani A; Rahman, Atif

    2016-10-01

    This review provides an overview of perinatal depression and its impacts on the health of mothers, their newborns, and young children in low- and middle-income countries (LMICs). We define and describe the urgency and scope of the problem of perinatal depression for mothers, while highlighting some specific issues such as suicidal ideation and decreased likelihood to seek health care. Pathways through which stress may link maternal depression to childhood growth and development (e.g., the hypo-pituitary axis) are discussed, followed by a summary of the adverse effects of depression on birth outcomes, parenting practices, and child growth and development. Although preliminary studies on the association between maternal depressive symptoms and maternal and child mortality exist, more research on these topics is needed. We describe the available interventions and suggest strategies to reduce maternal depressive symptoms in LMICs, including integration of services with existing primary health-care systems.

  9. Research report--Volunteer infant feeding and care counselors: a health education intervention to improve mother and child health and reduce mortality in rural Malawi.

    PubMed

    Rosato, Mikey; Lewycka, Sonia; Mwansambo, Charles; Kazembe, Peter; Phiri, Tambosi; Chapota, Hilda; Vergnano, Stefania; Newell, Marie-Louise; Osrin, David; Costello, Anthony

    2012-06-01

    The aim of this report is to describe a health education intervention involving volunteer infant feeding and care counselors being implemented in Mchinji district, Malawi. The intervention was established in January 2004 and involves 72 volunteer infant feeding and care counselors, supervised by 24 government Health Surveillance Assistants, covering 355 villages in Mchinji district. It aims to change the knowledge, attitudes and behaviour of women to promote exclusive breastfeeding and other infant care practices. The main target population are women of child bearing age who are visited at five key points during pregnancy and after birth. Where possible, their partners are also involved. The visits cover exclusive breastfeeding and other important neonatal and infant care practices. Volunteers are provided with an intervention manual and picture book. Resource inputs are low and include training allowances and equipment for counselors and supervisors, and a salary, equipment and materials for a coordinator. It is hypothesized that the counselors will encourage informational and attitudinal change to enhance motivation and risk reduction skills and self-efficacy to promote exclusive breastfeeding and other infant care practices and reduce infant mortality. The impact is being evaluated through a cluster randomised controlled trial and results will be reported in 2012.

  10. [Infant mortality by cause of death in the Rio de Janeiro metropolitan area, 1976-1986: association with socioeconomic, climatic and air pollution variables].

    PubMed

    Duchiade, M P; Beltrao, K I

    1992-01-01

    The Metropolitan Region of Rio de Janeiro (RMR) consists of the capital (the city of Rio de Janeiro) and 13 surrounding cities. The city of Rio de Janeiro itself was divided into 24 rather heterogeneous administrative regions (RAS) based on the income level of their inhabitants, the supply of public services such as water and sewerage, and population density or air pollution. Three different socioeconomic covariables were selected in three residential zones (ZONA) or subareas: the central rich nucleus, the intermediary zone of transition, and the distant periphery. As dependent variables the specific rate of infant, neonatal, or postneonatal mortality were considered for causes. The RMRJ Civil Register mortality data were utilized. A factor of correction was estimated according to the technique of Brass using the fertility rate and the rate of delivery for specific 5-year age groups of mothers. A multivariate analysis, the adjusted generalized linear model (MLG), was used for studying associations between socioeconomic, climatic, and air pollution variables and the levels of mortality. The MLG was formulated by means of the statistical package, GLIM or Generalized Linear Interactive Modelling. Analysis of infant mortality trends during 1976-1986 for the large subareas of RMRJ and the outlying region showed that the peak months of total neonatal and perinatal mortality were March and February, while the lowest months were November and October. May and June represented maximum rates of postneonatal mortality for pneumonia, diarrhea, other respiratory infections, malnutrition, and other diseases. MLG indicated that there was a statistically significant association between the annual mortality rate for selected causes and socioeconomic indicators (INS, FS and Zona); the rates of mortality also varied depending on time (ANO and ANOQ); and the mortality rates also appeared to be associated with the variations of the log of average pollution (LPM).

  11. Differences in mortality and morbidity according to gestational ages and birth weights in infants with trisomy 18

    PubMed Central

    Uchiyama, Atsushi; Okamura, Tomoka; Ago, Mako; Suenaga, Hideyo; Sugita, Eri; Ono, Hideko; Shuri, Kyoko; Masumoto, Kenichi; Totsu, Satsuki; Nakanishi, Hidehiko; Kusuda, Satoshi

    2015-01-01

    The aim of this study was to clarify the effects of gestational age and birth weight on outcomes of the infants. Medical records of 36 infants with trisomy 18 admitted to Tokyo Women's Medical University Hospital from 1991 to 2012 were reviewed retrospectively. We compared clinical characteristics between term infants (n = 15) and preterm infants (n = 21). There were one very‐low‐birth‐weight (VLBW) term infant (5%) and 12 VLBW preterm infants (80%). Although there were no significant differences in clinical characteristics and provided management between the two groups, none of the preterm infants achieved survival to discharge. On the other hand, 6 of 21 term infants (29%) achieved survival to discharge (P < 0.05). Similar results were obtained for comparisons between the VLBW infants and non‐VLBW infants. Multiple logistic regression analysis revealed that shorter gestational age had a more negative impact than lower birth weight to survival to discharge in infants with trisomy 18. In both preterm and term groups, the infants who died before 30 days commonly died of respiratory failure or apnea. Whereas, the infants who survived more than 30 days mostly died of heart failure. © 2015 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc. PMID:26307940

  12. Differences in mortality and morbidity according to gestational ages and birth weights in infants with trisomy 18.

    PubMed

    Imai, Ken; Uchiyama, Atsushi; Okamura, Tomoka; Ago, Mako; Suenaga, Hideyo; Sugita, Eri; Ono, Hideko; Shuri, Kyoko; Masumoto, Kenichi; Totsu, Satsuki; Nakanishi, Hidehiko; Kusuda, Satoshi

    2015-11-01

    The aim of this study was to clarify the effects of gestational age and birth weight on outcomes of the infants. Medical records of 36 infants with trisomy 18 admitted to Tokyo Women's Medical University Hospital from 1991 to 2012 were reviewed retrospectively. We compared clinical characteristics between term infants (n = 15) and preterm infants (n = 21). There were one very-low-birth-weight (VLBW) term infant (5%) and 12 VLBW preterm infants (80%). Although there were no significant differences in clinical characteristics and provided management between the two groups, none of the preterm infants achieved survival to discharge. On the other hand, 6 of 21 term infants (29%) achieved survival to discharge (P < 0.05). Similar results were obtained for comparisons between the VLBW infants and non-VLBW infants. Multiple logistic regression analysis revealed that shorter gestational age had a more negative impact than lower birth weight to survival to discharge in infants with trisomy 18. In both preterm and term groups, the infants who died before 30 days commonly died of respiratory failure or apnea. Whereas, the infants who survived more than 30 days mostly died of heart failure.

  13. Birth Weight Independently Affects Morbidity and Mortality of Extremely Preterm Neonates

    PubMed Central

    Mamopoulos, Apostolos; Petousis, Stamatios; Tsimpanakos, John; Masouridou, Sophia; Kountourelli, Kelly; Margioula-Siarkou, Chrysoula; Papouli, Maria; Rousso, David

    2015-01-01

    Background Neonates born between 24 + 0 and 27 + 6 gestational weeks, widely known as extremely preterm neonates, present a category characterized by increased neonatal mortality and morbidity. Main objective of the present study is to analyze the effect of various epidemiological and pregnancy-related parameters on unfavorable neonatal mortality and morbidity outcomes. Methods A retrospective study was performed enrolling cases delivered during 2003 - 2008 in our department. Cases of neonatal death as well as pathological Apgar score (≤ 4 in the first and ≤ 7 in the fifth minute of life), need for emergency resuscitation, respiratory disease syndrome (RDS), neonatal asphyxia, intraventricular hemorrhage (IVH) and neonatal death were recorded for neonates of our analysis. A multivariate regression model was used to correlate these outcomes with gestational week at delivery, maternal age, parity, kind of gestation (singleton or multiple), intrauterine growth restriction (IUGR), birth weight (BW), preterm premature rupture of membranes (PPROM), mode of delivery (vaginal delivery or cesarean section) and antenatal use of corticosteroids. Results Out of 5,070 pregnancies delivered, 57 extremely preterm neonates were born (1.1%). Mean BW was 780.35 ± 176.0, RDS was observed in 93.0% (n = 53), resuscitation was needed in 54.4% (n = 31) while overall mortality rate was 52.6% (n = 30). BW was independently associated with neonatal death (P = 0.004), pathological Apgar score in the first (P = 0.05) and fifth minute of life (P = 0.04) as well as neonatal sepsis (P = 0.05). Conclusion BW at delivery is independently affecting neonatal mortality and morbidity parameters in extremely preterm neonates. PMID:26015815

  14. Dyadic co-regulation, affective intensity and infant's development at 12 months: A comparison among extremely preterm and full-term dyads.

    PubMed

    Sansavini, Alessandra; Zavagli, Veronica; Guarini, Annalisa; Savini, Silvia; Alessandroni, Rosina; Faldella, Giacomo

    2015-08-01

    Extremely low gestational age children (ELGA, born below 28 weeks of GA) represent the most at-risk preterm group in terms of survival, developmental sequelae and rates of impairment and cognitive delays. However, the impact of an extremely preterm birth on mother-infant co-regulation and affective intensity which may affect early infant's development has not been investigated. Based on a relational dynamic system approach, our study aimed to investigate the quality of co-regulation and affective intensity during spontaneous play interaction in 20 mother-infant ELGA dyads compared to 20 full-term (FT) dyads at 12 months (corrected age for ELGA infants). Relationships between the quality of dyadic co-regulation and the infant's level of cognitive, motor and language development were also investigated. The quality of dyadic co-regulation was assessed using the Revised Relational Coding System (R-RCS) by Fogel et al. (2003), the mothers' and infants' affective intensity was coded using a coding system by Lunkenheimer, Olson, Hollenstein, Sameroff, and Winter (2011). Infants' development was assessed using the Bayley Scales (BSID-III, 2006). With respect to FT dyads, ELGA dyads were characterised by less frequent symmetric and more frequent unilateral co-regulation patterns and by less positive and more neutral affective intensity of both infants and mothers. Cognitive, motor and language scores were lower in ELGA infants than in FT infants. Symmetrical co-regulation was related to motor scores in ELGA infants, and to cognitive scores in FT infants. Our findings contribute to the literature by demonstrating the difficulties of ELGA mother-infant dyads at 12 months in sharing the symmetric co-regulation and positive affective intensity and how symmetric co-regulation is strictly related to motor development in ELGA infants. Based on these findings, intervention programmes to foster joint attention, active involvement and positive affective intensity in ELGA dyads and

  15. Invasion in patchy landscapes is affected by dispersal mortality and mate-finding failure.

    PubMed

    Walter, Jonathan A; Firebaugh, Ariel L; Tobin, Patrick C; Haynes, Kyle J

    2016-12-01

    Range expansions are a function of population growth and dispersal, and nascent populations often must overcome demographic Allee effects (positive density dependence at low population densities) driven by factors such as mate-finding failure. Given the importance of individual movement to mate finding, links between landscape structure and movement may be critical to range expansion; however, landscape effects on other factors including mortality may be equally or more important. In one of the most comprehensive investigations of the interactions of these processes to date, we combined field experiments, simulation modeling, and analysis of empirical spread patterns to investigate how landscape structure affected the spread of the gypsy moth in Virginia and West Virginia. In experiments designed to assess how landscape attributes affect mate finding, we found adult males resisted leaving forest patches and the probability of locating a pheromone source declined more rapidly over distance in non-forest matrix than in forest. We used these findings to develop individual-based simulation models of gypsy moth population dynamics and spread in complex patch-matrix landscapes. The models produced an Allee effect that strengthened with reductions in forested area, but owing more so to dispersal mortality than to effects on mate location. Predicted maximum rates of population spread grew with increases in forest area due to increasing success of long-distance transport events. Evaluations of empirical data showed relationships between spread rates and landscape structure largely consistent with model predictions. We conclude rates of spread were largely driven by long-distance dispersal events, the success of which was influenced primarily by dispersal mortality of larvae in unsuitable matrix, and that landscape effects on mate location played a secondary role. Though influences of landscape structure on mate location appear to be unimportant to the spread of the gypsy

  16. The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review

    PubMed Central

    Kim, Daniel; Saada, Adrianna

    2013-01-01

    Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world. PMID:23739649

  17. Head and eye movements affect object processing in 4-month-old infants more than an artificial orientation cue.

    PubMed

    Wahl, Sebastian; Michel, Christine; Pauen, Sabina; Hoehl, Stefanie

    2013-06-01

    This study investigates the effects of attention-guiding stimuli on 4-month-old infants' object processing. In the human head condition, infants saw a person turning her head and eye gaze towards or away from objects. When presented with the objects again, infants showed increased attention in terms of longer looking time measured by eye tracking and an increased Nc amplitude measured by event-related potentials (ERP) for the previously uncued objects versus the cued objects. This suggests that the uncued objects were previously processed less effectively and appeared more novel to the infants. In a second condition, a car instead of a human head turned towards or away from objects. Eye-tracking results did not reveal any significant difference in infants' looking time. ERPs indicated only a marginally significant effect in late slow-wave activity associated with memory encoding for the uncued objects. We conclude that human head orientation and gaze direction affect infants' object-directed attention, whereas movement and orientation of a car have only limited influence on infants' object processing.

  18. The bonnie baby: experimentally manipulated temperament affects perceived cuteness and motivation to view infant faces.

    PubMed

    Parsons, Christine E; Young, Katherine S; Bhandari, Ritu; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; Stein, Alan; Kringelbach, Morten L

    2014-03-01

    Attractive individuals are perceived as having various positive personality qualities. Positive personality qualities can in turn increase perceived attractiveness. However, the developmental origins of the link between attractiveness and personality are not understood. This is important because infant attractiveness ('cuteness') elicits caregiving from adults, and infant personality ('temperament') shapes caregiving behaviour. While research suggests that adults have more positive attitudes towards cuter infants, it is not known whether positive infant temperament can increase the perception of infant cuteness. We investigated the impact of experimentally established infant temperament on adults' perception of cuteness and desire to view individual faces. Ataseline, adults rated the cuteness of, and keypressed to view, images of unfamiliar infants with neutral facial expressions. Training required adults to learn about an infant's 'temperament', through repeated pairing of the neutral infant face with positive or negative facial expressions and vocalizations. Adults then re-rated the original neutral infant faces. Post-training, there were significant changes from baseline: infants who were mostly happy were perceived as cuter and adults expended greater effort to view them. Infants who were mostly sad were not perceived as cuter and adults expended less effort to view them. Our results suggest that temperament has clear consequences for how adults perceive 'bonnie' babies. Perception of infant cuteness is not based on physical facial features alone, and is modifiable through experience.

  19. Infant botulism.

    PubMed

    Fenicia, Lucia; Anniballi, Fabrizio

    2009-01-01

    Infant botulism is a rare disease that affects infant less than 12 months of age. The illness results from absorption of botulinum toxin produced in situ by neurotoxigenic clostridia that can temporarily colonize the intestinal tract of infants. To date, all inhabited continents except Africa have reported cases of infant botulism. Recognition of cases seem directly related to physician awareness and clinical suspicion. This review summarizes microbiological, clinical and epidemiological features of infant botulism.

  20. The effect of changes in health sector resources on infant mortality in the short-run and the long-run: a longitudinal econometric analysis.

    PubMed

    Farahani, Mansour; Subramanian, S V; Canning, David

    2009-06-01

    While countries with higher levels of human resources for health typically have better population health, the evidence that increases in the level of human resources for health leads to improvements in population health is limited. We use a dynamic regression model to obtain estimates of both the short-run and long-term effects of changes in physicians per capita, our measure of health system resources, on infant mortality. Using a dataset of 99 countries at 5-year intervals from 1960-2000, we estimate that increasing the number of physicians by one per 1000 population (roughly a doubling of current levels of provision) decreases the infant mortality rate by 15% within 5 years and by 45% in the long-run with half the long-run gain being achieved in 15 years. We conclude that the long-run effects of heath system resources are substantially larger than previously estimated. Our results suggest, however, that countries that have delayed action on the Millennium Development Goal of reducing infant and child mortality rate by two-thirds by 2015 (relative to 1990) may have difficulty meeting this goal even if they rapidly increase resources now.

  1. Effect of neonatal vitamin A supplementation on mortality in infants in Tanzania (Neovita): a randomised, double-blind, placebo-controlled trial

    PubMed Central

    Masanja, Honorati; Smith, Emily R; Muhihi, Alfa; Briegleb, Christina; Mshamu, Salum; Ruben, Julia; Noor, Ramadhani Abdallah; Khudyakov, Polyna; Yoshida, Sachiyo; Martines, Jose; Bahl, Rajiv; Fawzi, Wafaie W

    2015-01-01

    Summary Background Supplementation of vitamin A in children aged 6–59 months improves child survival and is implemented as global policy. Studies of the efficacy of supplementation of infants in the neonatal period have inconsistent results. We aimed to assess the efficacy of oral supplementation with vitamin A given to infants in the first 3 days of life to reduce mortality between supplementation and 180 days (6 months). Methods We did an individually randomised, double-blind, placebo-controlled trial of infants born in the Morogoro and Dar es Salaam regions of Tanzania. Women were identified during antenatal clinic visits or in the labour wards of public health facilities in Dar es Salaam. In Kilombero, Ulanga, and Kilosa districts, women were seen at home as part of the health and demographic surveillance system. Newborn infants were eligible for randomisation if they were able to feed orally and if the family intended to stay in the study area for at least 6 months. We randomly assigned infants to receive one dose of 50 000 IU of vitamin A or placebo in the first 3 days after birth. Infants were randomly assigned in blocks of 20, and investigators, participants’ families, and data analysis teams were masked to treatment assignment. We assessed infants on day 1 and day 3 after dosing, as well as at 1, 3, 6, and 12 months after birth. The primary endpoint was mortality at 6 months, assessed by field interviews. The primary analysis included only children who were not lost to follow-up. This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), number ACTRN12610000636055. Findings Between Aug 26, 2010, and March 3, 2013, 31 999 newborn babies were randomly assigned to receive vitamin A (n=15 995) or placebo (n=16 004; 15 428 and 15 464 included in analysis of mortality at 6 months, respectively). We did not find any evidence for a beneficial effect of vitamin A supplementation on mortality in infants at 6 months (26 deaths per

  2. Iron supplementation does not affect copper and zinc absorption in breastfed infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Iron supplements are commonly recommended for infants but were suggested to inhibit zinc and copper absorption. The objective of this study was to investigate potential effects of iron supplementation, infant age, and mineral status on zinc and copper absorption in infants at 6 and 9 mo of age. Twen...

  3. Maternal Drug Use during Pregnancy: Are Preterm and Full-Term Infants Affected Differently?

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Bakeman, Roger; Coles, Claire D.; Sexson, William R.; Demi, Alice S.

    1998-01-01

    Examined effects of prenatal drug exposure on infants born preterm and full-term to African American mothers. Found more extreme fetal growth deficits in later-born infants, and more extreme irritability increases in earlier-born infants. Gestation length did not moderate cardiorespiratory reactivity effects. Exposure effects occurred for…

  4. Impact of suboptimal breastfeeding on the healthcare and mortality costs of necrotizing enterocolitis in extremely low birthweight infants

    PubMed Central

    Colaizy, Tarah T.; Bartick, Melissa C.; Jegier, Briana J.; Green, Brittany D.; Reinhold, Arnold G.; Schaefer, Andrew J.; Bogen, Debra L.; Schwarz, Eleanor Bimla; Stuebe, Alison M.

    2017-01-01

    Objective To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs. Design We used adjusted odds ratios (aORs) derived from the Glutamine Trial to perform Monte Carlo simulation of a cohort of ELBW infants under current suboptimal feeding practices, compared to a theoretical cohort in which 90% of infants received at least 98% MM. Results NEC incidence among infants receiving ≥98% MM was 1.3%; 11.1% among infants fed only preterm formula; and 8.2% among infants fed a mixed diet (p=0.002). In adjusted models, compared with infants fed predominantly MM, we found an increased risk of NEC associated with exclusive preterm formula (aOR=12.1, 95% CI 1.5, 94.2), or a mixed diet (aOR 8.7, 95% CI 1.2-65.2). In Monte Carlo simulation, current feeding of ELBW infants was associated with 928 excess NEC cases and 121 excess deaths annually, compared with a model in which 90% of infants received ≥ 98% MM. These models estimated an annual cost of suboptimal feeding of ELBW infants of $27.1 million (CI $24million, $30.4 million) in direct medical costs, $563,655 (CI $476,191, $599,069) in indirect nonmedical costs, and $1.5 billion (CI $1.3 billion, $1.6 billion) in cost attributable to premature death. Conclusions Among ELBW infants, not being fed predominantly MM is associated with an increased risk of NEC. Efforts to support milk production by mothers of ELBW infants may prevent infant deaths and reduce costs. PMID:27131403

  5. Temperature-related mortality in 17 large Chinese cities: how heat and cold affect mortality in China.

    PubMed

    Ma, Wenjuan; Chen, Renjie; Kan, Haidong

    2014-10-01

    Few multicity studies have been conducted to investigate the acute health effects of cold and hot temperatures in China. We aimed to examine the relationship between temperature and daily mortality in 17 large Chinese cities. We first calculated city-specific effect of temperature using time-series regression models combined with distributed lag nonlinear models; then we pooled the city-specific estimates with the Bayesian hierarchical models. The cold effects lasted longer than the hot effects. For the cold effects, a 1 °C decrease from the 25th to 1st percentiles of temperature over lags 0-14 days was associated with increases of 1.69% [95% posterior intervals (PI): 1.01%, 2.36%], 2.49% (95% PI: 1.53%, 3.46%) and 1.60% (95% PI: 0.32%, 2.87%) in total, cardiovascular and respiratory mortality, respectively. For the hot effects, a 1 °C increase from the 75th to 99th percentiles of temperature was associated with corresponding increases of 2.83% (95% PI: 1.42%, 4.24%), 3.02% (95% PI: 1.33%, 4.71%) and 4.64% (95% PI: 1.96%, 7.31%). The latitudes, number of air conditioning per household and disposable income per capita were significant modifiers for cold effects; the proportion of the elderly was a significant modifier for hot effects. This largest epidemiological study of temperature to date in China suggested that both cold and hot temperatures were associated with increased mortality. Our findings may have important implications for the public health policies in China.

  6. Are tuition-free primary education policies associated with lower infant and neonatal mortality in low- and middle-income countries?

    PubMed

    Quamruzzaman, Amm; Mendoza Rodríguez, José M; Heymann, Jody; Kaufman, Jay S; Nandi, Arijit

    2014-11-01

    Robust evidence from low- and middle-income countries (LMICs) suggests that maternal education is associated with better child health outcomes. However, whether or not policies aimed at increasing access to education, including tuition-free education policies, contribute to lower infant and neonatal mortality has not been empirically tested. We joined country-level data on national education policies for 37 LMICs to information on live births to young mothers aged 15-21 years, who were surveyed as part of the population-based Demographic and Health Surveys. We used propensity scores to match births to mothers who were exposed to a tuition-free primary education policy with births to mothers who were not, based on individual-level, household, and country-level characteristics, including GDP per capita, urbanization, and health expenditures per capita. Multilevel logistic regression models, fitted using generalized estimating equations, were used to estimate the effect of exposure to tuition-free primary education policies on the risk of infant and neonatal mortality. We also tested whether this effect was modified by household socioeconomic status. The propensity score matched samples for analyses of infant and neonatal mortality comprised 24,396 and 36,030 births, respectively, from 23 countries. Multilevel regression analyses showed that, on average, exposure to a tuition-free education policy was associated with 15 (95% CI=-32, 1) fewer infant and 5 (95% CI=-13, 4) fewer neonatal deaths per 1000 live births. We found no strong evidence of heterogeneity of this effect by socioeconomic level.

  7. Affect recognition and the quality of mother-infant interaction: understanding parenting difficulties in mothers with schizophrenia.

    PubMed

    Healy, Sarah J; Lewin, Jona; Butler, Stephen; Vaillancourt, Kyla; Seth-Smith, Fiona

    2016-02-01

    This study investigated the quality of mother-infant interaction and maternal ability to recognise adult affect in three study groups consisting of mothers with a diagnosis of schizophrenia, mothers with depression and healthy controls. Sixty-four mothers were recruited from a Mother and Baby Unit and local children's centres. A 5-min mother-infant interaction was coded on a number of caregiving variables. Affect recognition and discrimination abilities were tested via a series of computerised tasks. Group differences were found both in measures of affect recognition and in the mother-infant interaction. Mothers with schizophrenia showed consistent impairments across most of the parenting measures and all measures of affect recognition and discrimination. Mothers with depression fell between the mothers with schizophrenia and healthy controls on most measures. However, depressed women's parenting was not significantly poorer than controls on any of the measures, and only showed trends for differences with mothers with schizophrenia on a few measures. Regression analyses found impairments in affect recognition and a diagnosis of schizophrenia to predict the occurrence of odd or unusual speech in the mother-infant interaction. Results add to the growing body of knowledge on the mother-infant interaction in mothers with schizophrenia and mothers with depression compared to healthy controls, suggesting a need for parenting interventions aimed at mothers with these conditions. While affect recognition impairments were not found to fully explain differences in parenting among women with schizophrenia, further research is needed to understand the psychopathology of parenting disturbances within this clinical group.

  8. The Development of Infant Discrimination of Affect in Multimodal and Unimodal Stimulation: The Role of Intersensory Redundancy

    ERIC Educational Resources Information Center

    Flom, Ross; Bahrick, Lorraine E.

    2007-01-01

    This research examined the developmental course of infants' ability to perceive affect in bimodal (audiovisual) and unimodal (auditory and visual) displays of a woman speaking. According to the intersensory redundancy hypothesis (L. E. Bahrick, R. Lickliter, & R. Flom, 2004), detection of amodal properties is facilitated in multimodal stimulation…

  9. Factors Affecting Length of Hospital Stay and Mortality in Infected Diabetic Foot Ulcers Undergoing Surgical Drainage without Major Amputation.

    PubMed

    Kim, Tae Gyun; Moon, Sang Young; Park, Moon Seok; Kwon, Soon-Sun; Jung, Ki Jin; Lee, Taeseung; Kim, Baek Kyu; Yoon, Chan; Lee, Kyoung Min

    2016-01-01

    This study aimed to investigate factors affecting length of hospital stay and mortality of a specific group of patients with infected diabetic foot ulcer who underwent surgical drainage without major amputation, which is frequently encountered by orthopedic surgeons. Data on length of hospital stay, mortality, demographics, and other medical information were collected for 79 consecutive patients (60 men, 19 women; mean age, 66.1 [SD, 12.3] yr) with infected diabetic foot ulcer who underwent surgical drainage while retaining the heel between October 2003 and May 2013. Multiple linear regression analysis was performed to determine factors affecting length of hospital stay, while multiple Cox regression analysis was conducted to assess factors contributing to mortality. Erythrocyte sedimentation rate (ESR, P=0.034), glycated hemoglobin (HbA1c) level (P=0.021), body mass index (BMI, P=0.001), and major vascular disease (cerebrovascular accident or coronary artery disease, P=0.004) were significant factors affecting length of hospital stay, whereas age (P=0.005) and serum blood urea nitrogen (BUN) level (P=0.024) were significant factors contributing to mortality. In conclusion, as prognostic factors, the length of hospital stay was affected by the severity of inflammation, the recent control of blood glucose level, BMI, and major vascular disease, whereas patient mortality was affected by age and renal function in patients with infected diabetic foot ulcer undergoing surgical drainage and antibiotic treatment.

  10. The development of infant discrimination of affect in multimodal and unimodal stimulation: The role of intersensory redundancy.

    PubMed

    Flom, Ross; Bahrick, Lorraine E

    2007-01-01

    This research examined the developmental course of infants' ability to perceive affect in bimodal (audiovisual) and unimodal (auditory and visual) displays of a woman speaking. According to the intersensory redundancy hypothesis (L. E. Bahrick, R. Lickliter, & R. Flom, 2004), detection of amodal properties is facilitated in multimodal stimulation and attenuated in unimodal stimulation. Later in development, however, attention becomes more flexible, and amodal properties can be perceived in both multimodal and unimodal stimulation. The authors tested these predictions by assessing 3-, 4-, 5-, and 7-month-olds' discrimination of affect. Results demonstrated that in bimodal stimulation, discrimination of affect emerged by 4 months and remained stable across age. However, in unimodal stimulation, detection of affect emerged gradually, with sensitivity to auditory stimulation emerging at 5 months and visual stimulation at 7 months. Further temporal synchrony between faces and voices was necessary for younger infants' discrimination of affect. Across development, infants first perceive affect in multimodal stimulation through detecting amodal properties, and later their perception of affect is extended to unimodal auditory and visual stimulation. Implications for social development, including joint attention and social referencing, are considered.

  11. Decreased carbon limitation of litter respiration in a mortality-affected piñon-juniper woodland

    NASA Astrophysics Data System (ADS)

    Berryman, E.; Marshall, J. D.; Rahn, T.; Litvak, M.; Butnor, J.

    2012-10-01

    Microbial respiration depends on microclimatic variables and carbon (C) substrate availability, all of which are altered when ecosystems experience major disturbance. Widespread tree mortality, currently affecting piñon-juniper ecosystems in Southwestern North America, may affect C substrate availability in several ways; for example, via litterfall pulses and loss of root exudation. To determine piñon mortality effects on C and water limitation of microbial respiration, we applied field amendments (sucrose and water) to two piñon-juniper sites in central New Mexico, USA: one with a recent (< 1 yr), experimentally-induced mortality event and a nearby site with live canopy. We monitored the respiration response to water and sucrose applications to the litter surface and to the underlying mineral soil surface, testing the following hypotheses: (1) soil respiration in a piñon-juniper woodland is water- and labile C-limited in both the litter layer and mineral soil; (2) water and sucrose applications increase temperature sensitivity of respiration; (3) the mortality-affected site will show a reduction in C limitation in the litter; (4) the mortality-affected site will show an enhancement of C limitation in the mineral soil. Litter respiration at both sites responded to increased water availability, yet surprisingly, mineral soil respiration was not limited by water. Temperature sensitivity was enhanced by some of the sucrose and water treatments. Consistent with hypothesis 3, C limitation of litter respiration was lower at the recent mortality site compared to the intact canopy site. Results following applications to the mineral soil suggest the presence of abiotic effects of increasing water availability, precluding our ability to measure labile C limitation in soil. Widespread piñon mortality may decrease labile C limitation of litter respiration, at least during the first growing season following mortality.

  12. Customised and Noncustomised Birth Weight Centiles and Prediction of Stillbirth and Infant Mortality and Morbidity: A Cohort Study of 979,912 Term Singleton Pregnancies in Scotland

    PubMed Central

    Iliodromiti, Stamatina; Mackay, Daniel F.; Pell, Jill P.; Sattar, Naveed; Nelson, Scott M.

    2017-01-01

    Background There is limited evidence to support the use of customised centile charts to identify those at risk of stillbirth and infant death at term. We sought to determine birth weight thresholds at which mortality and morbidity increased and the predictive ability of noncustomised (accounting for gestational age and sex) and partially customised centiles (additionally accounting for maternal height and parity) to identify fetuses at risk. Methods This is a population-based linkage study of 979,912 term singleton pregnancies in Scotland, United Kingdom, between 1992 and 2010. The main exposures were noncustomised and partially customised birth weight centiles. The primary outcomes were infant death, stillbirth, overall mortality (infant and stillbirth), Apgar score <7 at 5 min, and admission to the neonatal unit. Optimal thresholds that predicted outcomes for both non- and partially customised birth weight centiles were calculated. Prediction of mortality between non- and partially customised birth weight centiles was compared using area under the receiver operator characteristic curve (AUROC) and net reclassification index (NRI). Findings Birth weight ≤25th centile was associated with higher risk for all mortality and morbidity outcomes. For stillbirth, low Apgar score, and neonatal unit admission, risk also increased from the 85th centile. Similar patterns and magnitude of associations were observed for both non- and partially customised birth weight centiles. Partially customised birth weight centiles did not improve the discrimination of mortality (AUROC 0.61 [95%CI 0.60, 0.62]) compared with noncustomised birth weight centiles (AUROC 0.62 [95%CI 0.60, 0.63]) and slightly underperformed in reclassifying pregnancies to different risk categories for both fatal and non-fatal adverse outcomes (NRI -0.027 [95% CI -0.039, -0.016], p < 0.001). We were unable to fully customise centile charts because we lacked data on maternal weight and ethnicity. Additional

  13. Decisions at the Brink: Locomotor Experience Affects Infants' Use of Social Information on an Adjustable Drop-off.

    PubMed

    Karasik, Lana B; Tamis-LeMonda, Catherine S; Adolph, Karen E

    2016-01-01

    How do infants decide what to do at the brink of a precipice? Infants could use two sources of information to guide their actions: perceptual information generated by their own exploratory activity and social information offered by their caregivers. The current study investigated the role of locomotor experience in using social information-both encouragement and discouragement-for descending drop-offs. Mothers of 30 infants (experienced 12-month-old crawlers, novice 12-month-old walkers, and experienced 18-month-old walkers) encouraged and discouraged descent on a gradation of drop-offs (safe "steps" and risky "cliffs"). Novice walkers descended more frequently than experienced crawlers and walkers and fell while attempting to walk over impossibly high cliffs. All infants showed evidence of integrating perceptual and social information, but locomotor experience affected infants' use of social messages, especially on risky drop-offs. Experienced crawlers and walkers selectively deferred to social information when perceptual information is ambiguous. In contrast, novice walkers took mothers' advice inconsistently and only at extreme drop-offs.

  14. The influence of IgM-enriched immunoglobulin therapy on neonatal mortality and hematological variables in newborn infants with blood culture-proven sepsis.

    PubMed

    Abbasoğlu, Aslıhan; Ecevit, Ayşe; Tuğcu, Ali Ulaş; Yapakçı, Ece; Tekindal, Mustafa Agah; Tarcan, Aylin; Ecevit, Zafer

    2014-01-01

    The aim of this study was to determine the effects of adjuvant immunoglobulin M (IgM)-enriched intravenous immunoglobulin (IVIG) therapy on mortality rate, hematological variables and length of hospital stay in newborn infants with blood culture-proven sepsis. Demographic and clinical features and outcome measures of 63 newborn infants with blood culture-proven sepsis were documented retrospectively from the medical records. The patients were divided into two groups according to their treatment history. The patients in Group 1 received antibiotic therapy only and the patients in Group 2 received both antibiotic and adjuvant IgMenriched IVIG. The study revealed that mortality rates were 28.1% and 12.9% in Group 1 and Group 2, respectively. The mortality rate was lower in Group 2, but the difference between the two groups was not statistically significant (p=0.21). Coagulase-negative Staphylococcus was the most common type of bacteria isolated from the blood culture in both groups. When changing laboratory results were compared between the two groups, hemoglobin, leukocyte count and C-reactive protein levels were different during the first three days of antibiotic treatment. Our study revealed that if diagnosed at an early stage and treated aggressively with appropriate and effective antibiotics, adjuvant IgM-enriched IVIG treatment has no additional benefits in neonatal sepsis.

  15. Is Infant Initiation of Joint Attention by Pointing Affected by Type of Interaction?

    ERIC Educational Resources Information Center

    Franco, Fabia; Perucchini, Paola; March, Barbara

    2009-01-01

    This article reports the results of two experiments studying the effects of type of interaction on infant production of declarative pointing. In Experiment 1, intensity of social presence was manipulated in adult-infant interaction with 12-19-month-olds (no social presence; adult responding only; adult also initiating joint attentional bids).…

  16. Bilingualism Affects 9-Month-Old Infants' Expectations about How Words Refer to Kinds

    ERIC Educational Resources Information Center

    Byers-Heinlein, Krista

    2017-01-01

    Infants are precocious word learners, and seem to possess systematic expectations about how words refer to object kinds. For example, while monolingual infants show a one-to-one mapping bias (e.g. mutual exclusivity), expecting each object to have only one basic level label, previous research has shown that this is less robust in bi- and…

  17. Positive Affect Processing and Joint Attention in Infants at High Risk for Autism: An Exploratory Study

    ERIC Educational Resources Information Center

    Key, Alexandra P.; Ibanez, Lisa V.; Henderson, Heather A.; Warren, Zachary; Messinger, Daniel S.; Stone, Wendy L.

    2015-01-01

    Few behavioral indices of risk for autism spectrum disorders (ASD) are present before 12 months, and potential biomarkers remain largely unexamined. This prospective study of infant siblings of children with ASD (n = 16) and low-risk comparison infants (n = 15) examined group differences in event-related potentials (ERPs) indexing processing of…

  18. Modified Spectral Tilt Affects Older, but Not Younger, Infants' Native-Language Fricative Discrimination

    ERIC Educational Resources Information Center

    Beach, Elizabeth Francis; Kitamura, Christine

    2011-01-01

    Purpose: It is important to ensure that hearing aid fitting strategies for infants take into account the infant's developing speech perception system. As a way of exploring this issue, this study examined how 6- and 9-month-olds with normal hearing perceive native-language speech in which the natural spectral shape was altered to emphasize either…

  19. Infant Colic

    PubMed Central

    Gelfand, Amy A.

    2015-01-01

    This article reviews the evidence for an association between infant colic and migraine. Infant colic, or excessive crying in an otherwise healthy and well-fed infant, affects approximately 5–19% of infants. Multiple case-control studies, a cross-sectional study, and a prospective cohort study have all found an association between infant colic and migraine. While infant colic is often assumed to have a gastrointestinal cause, several treatment trials aimed at gastrointestinal etiologies have been negative. Teaching parents how best to respond to inconsolable crying may be helpful and important for preventing shaken baby syndrome. Given accumulating evidence for a connection between infant colic and pediatric migraine, future studies should examine migraine-oriented treatments for infant colic. Infant colic should be moved into the main body of International Classification of Headache Disorders (ICHD-III beta) as one of the “Episodic syndromes that may be associated with migraine”. PMID:27017027

  20. Who can communicate with whom? Language experience affects infants' evaluation of others as monolingual or multilingual.

    PubMed

    Pitts, Casey E; Onishi, Kristine H; Vouloumanos, Athena

    2015-01-01

    Adults recognize that people can understand more than one language. However, it is unclear whether infants assume other people understand one or multiple languages. We examined whether monolingual and bilingual 20-month-olds expect an unfamiliar person to understand one or more than one language. Two speakers told a listener the location of a hidden object using either the same or two different languages. When different languages were spoken, monolinguals looked longer when the listener searched correctly, bilinguals did not; when the same language was spoken, both groups looked longer for incorrect searches. Infants rely on their prior language experience when evaluating the language abilities of a novel individual. Monolingual infants assume others can understand only one language, although not necessarily the infants' own; bilinguals do not. Infants' assumptions about which community of conventions people belong to may allow them to recognize effective communicative partners and thus opportunities to acquire language, knowledge, and culture.

  1. "They have already thrown away their chicken": barriers affecting participation by HIV-infected women in care and treatment programs for their infants in Blantyre, Malawi.

    PubMed

    Donahue, Marie Collins; Dube, Queen; Dow, Anna; Umar, Eric; Van Rie, Annelies

    2012-01-01

    HIV-infected infants and young children are at high risk of serious illness and death. Morbidity and mortality can be greatly reduced through early infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy (ART). Despite global efforts to scale-up of EID and infant ART, uptake of these services in resource poor, high HIV burden countries remain low. We conducted a qualitative study of 59 HIV-infected women to identify and explore barriers women face in accessing HIV testing and care for their infants. To capture different perspectives, we included mothers whose infants were known positive (n=9) or known negative (n=14), mothers of infants with unknown HIV status (n=13), and pregnant HIV-infected women (n=20). Five important themes emerged: lack of knowledge regarding EID and infant ART, the perception of health care workers as authority figures, fear of disclosure of own and/or child's HIV status, lack of psychosocial support, and intent to shorten the life of the child. A complex array of cultural, economic, and psychosocial factors creates barriers for HIV-infected women to participate in early infant HIV testing and care programs. For optimal impact of EID and infant ART, reasons for poor uptake should be better understood and addressed in a culturally sensitive manner.

  2. Factors affecting swimming performance of fasted rainbow trout with implications of exhaustive exercise on overwinter mortality

    USGS Publications Warehouse

    Simpkins, D.G.; Hubert, W.A.; Del Rio, C.M.; Rule, D.C.

    2004-01-01

    We evaluated the effects of body size, water temperature, and sustained swimming activity on swimming performance and the effects of exhaustive exercise on mortality of fasted juvenile rainbow trout. Fasting caused swimming performance to decline more rapidly for small fish than large fish, and warmer water temperatures and sustained swimming activity further decreased swimming performance. Exhaustive exercise increased mortality among fasted fish. Our observations suggest that juvenile rainbow trout with little or no food intake during winter can swim for long periods of time with little effect on mortality, but swimming to exhaustion can enhance mortality, especially among the smallest juveniles.

  3. Mortality and morbidity in the city of Bern, Switzerland, 1805-1815 with special emphasis on infant, child and maternal deaths.

    PubMed

    Rüttimann, D; Loesch, S

    2012-02-01

    This article contributes to the research on demographics and public health of urban populations of preindustrial Europe. The key source is a burial register that contains information on the deceased, such as age and sex, residence and cause of death. This register is one of the earliest compilations of data sets of individuals with this high degree of completeness and consistency. Critical assessment of the register's origin, formation and upkeep promises high validity and reliability. Between 1805 and 1815, 4,390 deceased inhabitants were registered. Information concerning these individuals provides the basis for this study. Life tables of Bern's population were created using different models. The causes of death were classified and their frequency calculated. Furthermore, the susceptibility of age groups to certain causes of death was established. Special attention was given to causes of death and mortality of newborns, infants and birth-giving women. In comparison to other cities and regions in Central Europe, Bern's mortality structure shows low rates for infants (q0=0.144) and children (q1-4=0.068). This could have simply indicated better living conditions. Life expectancy at birth was 43 years. Mortality was high in winter and spring, and decreased in summer to a low level with a short rise in August. The study of the causes of death was inhibited by difficulties in translating early 19th century nomenclature into the modern medical system. Nonetheless, death from metabolic disorders, illnesses of the respiratory system, and debilitation were the most prominent causes in Bern. Apparently, the worst killer of infants up to 12 months was the "gichteren", an obsolete German term for lethal spasmodic convulsions. The exact modern identification of this disease remains unclear. Possibilities such as infant tetanus or infant epilepsy are discussed. The maternal death rate of 0.72% is comparable with values calculated from contemporaneous sources. Relevance of

  4. Indigenous Ethnicity and Low Maternal Education Are Associated with Delayed Diagnosis and Mortality in Infants with Congenital Heart Defects in Panama

    PubMed Central

    Zúñiga, Julio; Higuera, Gladys; Carrión Donderis, María; Gómez, Beatriz; Motta, Jorge

    2016-01-01

    Background This is the first study in Panama and Central America that has included indigenous populations in an assessment of the association between socioeconomic variables with delayed diagnosis and mortality due to congenital heart defects (CHD). Methods A retrospective observational study was conducted. A sample calculation was performed and 954 infants born from 2010 to 2014 were randomly selected from clinical records of all Panamanian public health institutions with paediatric cardiologists. Critical CHD was defined according to the defects listed as targets of newborn pulse oximetry screening. Diagnoses were considered delayed when made after the third day of life for the critical CHD and after the twentieth day of life for the non-critical. A logistic regression model was performed to examine the association between socioeconomic variables and delayed diagnosis. A Cox proportional hazards model was used to assess the relationship between socioeconomic features and mortality. Results An increased risk of delayed diagnosis was observed in infants with indigenous ethnicity (AOR, 1.56; 95% CI, 1.03–2.37), low maternal education (AOR, 1.57; 95% CI, 1.09–2.25) and homebirth (AOR, 4.32; 95% CI, 1.63–11.48). Indigenous infants had a higher risk of dying due to CHD (HR, 1.43; 95% CI, 1.03–1.99), as did those with low maternal education (HR, 1.95; 95% CI, 1.45–2.62). Conclusion Inequalities in access to health care, conditioned by unfavourable socioeconomic features, may play a key role in delayed diagnosis and mortality of CHD patients. Further studies are required to study the relationship between indigenous ethnicity and these adverse health outcomes. PMID:27648568

  5. Decreased carbon limitation of litter respiration in a mortality-affected piñon-juniper woodland

    NASA Astrophysics Data System (ADS)

    Berryman, E.; Marshall, J. D.; Rahn, T.; Litvak, M.; Butnor, J.

    2013-03-01

    Microbial respiration depends on microclimatic variables and carbon (C) substrate availability, all of which are altered when ecosystems experience major disturbance. Widespread tree mortality, currently affecting piñon-juniper ecosystems in southwestern North America, may affect C substrate availability in several ways, for example, via litterfall pulses and loss of root exudation. To determine piñon mortality effects on C and water limitation of microbial respiration, we applied field amendments (sucrose and water) to two piñon-juniper sites in central New Mexico, USA: one with a recent (< 1 yr), experimentally induced mortality event and a nearby site with live canopy. We monitored the respiration response to water and sucrose applications to the litter surface and to the underlying mineral soil surface, testing the following hypotheses: (1) soil respiration in a piñon-juniper woodland is water- and labile C-limited in both the litter layer and mineral soil; (2) piñon mortality reduces the C limitation of litter respiration; and (3) piñon mortality enhances the C limitation of mineral soil respiration. Litter respiration at both sites responded to increased water availability, yet surprisingly, mineral soil respiration was not limited by water. Consistent with hypothesis 2, C limitation of litter respiration was lower at the recent mortality site compared to the intact canopy site. Applications to the mineral soil showed evidence of reduction in CO2 flux on the girdled site and a non-significant increase on the control. We speculate that the reduction may have been driven by water-induced carbonate dissolution, which serves as a sink for CO2 and would reduce the net flux. Widespread piñon mortality may decrease labile C limitation of litter respiration, at least during the first growing season following mortality.

  6. Raw Water Consumption Does Not Affect All-Cause or Cardiovascular Mortality: A Secondary Analysis.

    PubMed

    Loomba, Rohit S; Aggarwal, Saurabh; Arora, Rohit R

    Previous studies have examined water quality and its association with all-cause and cardiovascular mortality. However, there is a lack of data regarding association between the amount of water consumption and risk of mortality. We used the third National Health and Nutrition Examination Survey (NHANES III) database and its subsequent follow-up data. Only patients older than 45 years who reported amount of average water consumption and for whom follow-up mortality data were available were included in the study. Patients were stratified into following groups of average daily raw water consumption: (1) no water consumption, (2) ≤2 cups, (3) >2 to ≤ 4 cups, (4) >4 to ≤6 cups, (5) >6 to ≤8 cups, and (6) ≥8 cups. End points studied were all-cause mortality, ischemia-related mortality, congestive heart failure-related mortality, and stroke-related mortality. Baseline characteristics were compared using t tests and Mann-Whitney U tests. Odds ratios, 95% confidence intervals, and P values were calculated for univariate analysis using >6 cups to ≤8 cups of water a day group as reference. Multivariate analysis was then performed adjusting for various factors. P values of less than 0.05 were considered statistically significant. A total of 7666 patients were ultimately included in the study. Multivariate analysis demonstrated no significant differences in all-cause, ischemia-related, heart failure-related, or stroke-related mortality among various raw water intake groups when compared with the reference group. The significance noted for all-cause mortality in >2 glasses to ≤4 glasses a day group in the univariate analysis was not seen with multivariate analysis (odds ratio: 0.747; 95% confidence interval: 0.437-1.276; P = 0.285). Daily raw water consumption does not seem to impact all-cause mortality or cause-specific cardiovascular mortality.

  7. Frontal Brain Electrical Activity (EEG) and Heart Rate in Response to Affective Infant-Directed (ID) Speech in 9-Month-Old Infants

    ERIC Educational Resources Information Center

    Santesso, Diane L.; Schmidt, Louis A.; Trainor, Laurel J.

    2007-01-01

    Many studies have shown that infants prefer infant-directed (ID) speech to adult-directed (AD) speech. ID speech functions to aid language learning, obtain and/or maintain an infant's attention, and create emotional communication between the infant and caregiver. We examined psychophysiological responses to ID speech that varied in affective…

  8. Observing Third-Party Attentional Relationships Affects Infants' Gaze Following: An Eye-Tracking Study

    PubMed Central

    Meng, Xianwei; Uto, Yusuke; Hashiya, Kazuhide

    2017-01-01

    Not only responding to direct social actions toward themselves, infants also pay attention to relevant information from third-party interactions. However, it is unclear whether and how infants recognize the structure of these interactions. The current study aimed to investigate how infants' observation of third-party attentional relationships influence their subsequent gaze following. Nine-month-old, 1-year-old, and 1.5-year-old infants (N = 72, 37 girls) observed video clips in which a female actor gazed at one of two toys after she and her partner either silently faced each other (face-to-face condition) or looked in opposite directions (back-to-back condition). An eye tracker was used to record the infants' looking behavior (e.g., looking time, looking frequency). The analyses revealed that younger infants followed the actor's gaze toward the target object in both conditions, but this was not the case for the 1.5-year-old infants in the back-to-back condition. Furthermore, we found that infants' gaze following could be negatively predicted by their expectation of the partner's response to the actor's head turn (i.e., they shift their gaze toward the partner immediately after they realize that the actor's head will turn). These findings suggested that the sensitivity to the difference in knowledge and attentional states in the second year of human life could be extended to third-party interactions, even without any direct involvement in the situation. Additionally, a spontaneous concern with the epistemic gap between self and other, as well as between others, develops by this age. These processes might be considered part of the fundamental basis for human communication. PMID:28149284

  9. Affective matching of odors and facial expressions in infants: shifting patterns between 3 and 7 months.

    PubMed

    Godard, Ornella; Baudouin, Jean-Yves; Schaal, Benoist; Durand, Karine

    2016-01-01

    Recognition of emotional facial expressions is a crucial skill for adaptive behavior. Past research suggests that at 5 to 7 months of age, infants look longer to an unfamiliar dynamic angry/happy face which emotionally matches a vocal expression. This suggests that they can match stimulations of distinct modalities on their emotional content. In the present study, olfaction-vision matching abilities were assessed across different age groups (3, 5 and 7 months) using dynamic expressive faces (happy vs. disgusted) and distinct hedonic odor contexts (pleasant, unpleasant and control) in a visual-preference paradigm. At all ages the infants were biased toward the disgust faces. This visual bias reversed into a bias for smiling faces in the context of the pleasant odor context in the 3-month-old infants. In infants aged 5 and 7 months, no effect of the odor context appeared in the present conditions. This study highlights the role of the olfactory context in the modulation of visual behavior toward expressive faces in infants. The influence of olfaction took the form of a contingency effect in 3-month-old infants, but later evolved to vanish or to take another form that could not be evidenced in the present study.

  10. Connecting the dots: how local structure affects global integration in infants.

    PubMed

    Palomares, Melanie; Pettet, Mark; Vildavski, Vladimir; Hou, Chuan; Norcia, Anthony

    2010-07-01

    Glass patterns are moirés created from a sparse random-dot field paired with its spatially shifted copy. Because discrimination of these patterns is not based on local features, they have been used extensively to study global integration processes. Here, we investigated whether 4- to 5.5-month-old infants are sensitive to the global structure of Glass patterns by measuring visual-evoked potentials. Although we found strong responses to the appearance of the constituent dots, we found sensitivity to the global structure of the Glass patterns in the infants only over a very limited range of spatial separation. In contrast, we observed robust responses in the infants when we connected the dot pairs of the Glass pattern with lines. Moreover, both infants and adults showed differential responses to exchanges between line patterns portraying different global structures. A control study varying luminance contrast in adults suggests that infant sensitivity to global structure is not primarily limited by reduced element visibility. Together our results suggest that the insensitivity to structure in conventional Glass patterns is due to inefficiencies in extracting the local orientation cues generated by the dot pairs. Once the local orientations are made unambiguous or when the interpolation span is small, infants can integrate these signals over the image.

  11. Connecting the dots: how local structure affects global integration in infants

    PubMed Central

    Palomares, Melanie; Pettet, Mark; Vildavski, Vladimir; Hou, Chuan; Norcia, Anthony

    2009-01-01

    Glass patterns are moirés created from a sparse random dot field paired with its spatially-shifted copy. Because discrimination of these patterns is not based on local features, they have been used extensively to study global integration processes. Here, we investigated whether 4–5.5 month old infants are sensitive to the global structure of Glass patterns by measuring Visual Evoked Potentials (VEPs). Although we found strong responses to the appearance of the constituent dots, we found sensitivity to the global structure of the Glass patterns in the infants only over a very limited range of spatial separation. In contrast, we observed robust responses in the infants when we connected the dot pairs of the Glass pattern with lines. Moreover, both infants and adults showed differential responses to exchanges between line patterns portraying different global structures. A control study varying luminance contrast in adults suggests that infant sensitivity to global structure is not primarily limited by reduced element visibility. Together our results suggest that the insensitivity to structure in conventional Glass patterns is due to inefficiencies in extracting the local orientation cues generated by the dot pairs. Once the local orientations are made unambiguous or when the interpolation span is small, infants can integrate these signals over the image. PMID:19642888

  12. How Communication Among Members of the Health Care Team Affects Maternal Morbidity and Mortality.

    PubMed

    Brennan, Rita Allen; Keohane, Carol Ann

    In the United States, rates of severe maternal morbidity and mortality have escalated in the past decade. Communication failure among members of the health care team is one associated factor that can be modified. Nurses can promote effective communication. We provide strategies that incorporate team training principles and structured communication processes for use by providers and health care systems to improve the quality and safety of patient care and reduce the incidence of maternal mortality and morbidity.

  13. Randomised controlled trial testing the effect of cotrimoxazole prophylaxis on morbidity and mortality outcomes in breastfed HIV-exposed uninfected infants: study protocol

    PubMed Central

    Coutsoudis, Anna; Daniels, Brodie; Moodley-Govender, Eshia; Ngomane, Noluthando; Zako, Linda; Spooner, Elizabeth; Kiepiela, Photini; Reddy, Shabashini; Kuhn, Louise; Ramjee, Gita

    2016-01-01

    Introduction No randomised controlled trial (RCT) has examined the efficacy of cotrimoxazole (CTX) prophylaxis in HIV-exposed uninfected (HEU) infants during the breastfeeding period, in this new era of effective prevention of mother-to-child transmission (PMTCT) prophylaxis. The efficacy of CTX prophylaxis has presently been demonstrated only in HIV-infected children. The absence of proven benefits in HEU breastfed infants associated with infectious diseases justifies an RCT as proposed. Herewith lies the rationale for conducting the proposed study. Methods A partially blinded RCT is proposed to evaluate the efficacy of CTX prophylaxis administered from 6 weeks of age to HEU infants receiving a PMTCT regimen. A non-inferiority design will be used, randomising 1298 infants to receive CTX or not to receive CTX. Participants will be reviewed at the following time points: 6 weeks (enrolment and randomisation), 10 weeks, 14 weeks, 4 months and monthly thereafter until 12 months of age. They will be evaluated for anthropometric growth, interval illness, CTX adherence, signs and symptoms of study drug toxicity, concomitant medication use, breastfeeding status and HIV infection status. The study will compare the incidence of grade 3 and grade 4 common childhood illnesses (focusing on pneumonia and diarrhoea) and all-cause mortality until 12 months of age. In a subset of participants, we will compare grade 3 and grade 4 haemoglobin and alanine aminotransferase results as well as investigate gut integrity. Ethics and dissemination The study has ethical approval from the University of KwaZulu-Natal Biomedical Research Ethics Committee (BFC212/13). Trial registration numbers PACTR201311000621110 and DOH-27-0614-4728; Pre-results. PMID:27406638

  14. Infant Botulism (For Parents)

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Infant Botulism KidsHealth > For Parents > Infant Botulism A A A ... babies younger than 1 year old. About Infant Botulism This illness usually affects babies who are between ...

  15. Do Sustained Lung Inflations during Neonatal Resuscitation Affect Cerebral Blood Volume in Preterm Infants? A Randomized Controlled Pilot Study

    PubMed Central

    Schwaberger, Bernhard; Pichler, Gerhard; Avian, Alexander; Binder-Heschl, Corinna; Baik, Nariae; Urlesberger, Berndt

    2015-01-01

    Background Sustained lung inflations (SLI) during neonatal resuscitation may promote alveolar recruitment in preterm infants. While most of the studies focus on respiratory outcome, the impact of SLI on the brain hasn’t been investigated yet. Objective Do SLI affect cerebral blood volume (CBV) in preterm infants? Methods Preterm infants of gestation 28 weeks 0 days to 33 weeks 6 days with requirement for respiratory support (RS) were included in this randomized controlled pilot trial. Within the first 15 minutes after birth near-infrared spectroscopy (NIRS) measurements using ‘NIRO-200-NX’ (Hamamatsu, Japan) were performed to evaluate changes in CBV and cerebral tissue oxygenation. Two groups were compared based on RS: In SLI group RS was given by applying 1–3 SLI (30 cmH2O for 15 s) continued by respiratory standard care. Control group received respiratory standard care only. Results 40 infants (20 in each group) with mean gestational age of 32 weeks one day (±2 days) and birth weight of 1707 (±470) g were included. In the control group ΔCBV was significantly decreasing, whereas in SLI group ΔCBV showed similar values during the whole period of 15 minutes. Comparing both groups within the first 15 minutes ΔCBV showed a tendency toward different overall courses (p = 0.051). Conclusion This is the first study demonstrating an impact of SLI on CBV. Further studies are warranted including reconfirmation of the present findings in infants with lower gestational age. Future investigations on SLI should not only focus on respiratory outcome but also on the consequences on the developing brain. Trial Registration German Clinical Trials Register DRKS00005161 https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do PMID:26406467

  16. Do sudden air temperature and pressure changes affect cardiovascular morbidity and mortality?

    NASA Astrophysics Data System (ADS)

    Plavcová, E.; Davídkovová, H.; Kyselý, J.

    2012-04-01

    Previous studies have shown that sudden changes in weather (usually represented by air temperature and/or pressure) are associated with increases in daily mortality. Little is understood about physiological mechanisms responsible for the impacts of weather changes on mortality, and whether similar patterns appear for morbidity as well. Relatively little is known also about differences in the magnitude of the mortality response in provincial regions and in cities, where the impacts may be exacerbated by air pollution effects and/or heat island. The present study examines the effects of sudden air temperature and pressure changes on morbidity (represented by hospital admissions) and mortality due to cardiovascular diseases in the population of the Czech Republic (approx. 10 million inhabitants) and separately in the city of Prague (1.2 million inhabitants). The events are selected from data covering 1994-2009 using the methodology introduced by Plavcová and Kyselý (2010), and they are compared with the datasets on hospital admissions and daily mortality (both standardized to account for long-term changes and the seasonal and weekly cycles). Relative deviations of morbidity/mortality from the baseline were averaged over the selected events for days D-2 (2 days before a change) up to D+7 (7 days after), and their statistical significance was tested by means of the Monte Carlo method. The study aims at (i) identifying those weather changes associated with increased cardiovascular morbidity/mortality, separately in summer and winter, (ii) comparing the effects of weather changes on morbidity and mortality, (iii) identifying whether urban population of Prague is more/less vulnerable in comparison to the population of the whole Czech Republic, (iv) comparing the effects for different cardiovascular diseases (ischaemic heart diseases, ICD-10 codes I20-I25; cerebrovascular diseases, I60-I69; hypertension, I10; atherosclerosis, I70) and individual population groups (by age

  17. Age and Diet Affect Genetically Separable Secondary Injuries that Cause Acute Mortality Following Traumatic Brain Injury in Drosophila

    PubMed Central

    Katzenberger, Rebeccah J.; Ganetzky, Barry; Wassarman, David A.

    2016-01-01

    Outcomes of traumatic brain injury (TBI) vary because of differences in primary and secondary injuries. Primary injuries occur at the time of a traumatic event, whereas secondary injuries occur later as a result of cellular and molecular events activated in the brain and other tissues by primary injuries. We used a Drosophila melanogaster TBI model to investigate secondary injuries that cause acute mortality. By analyzing mortality percentage within 24 hr of primary injuries, we previously found that age at the time of primary injuries and diet afterward affect the severity of secondary injuries. Here, we show that secondary injuries peaked in activity 1–8 hr after primary injuries. Additionally, we demonstrate that age and diet activated distinct secondary injuries in a genotype-specific manner, and that concurrent activation of age- and diet-regulated secondary injuries synergistically increased mortality. To identify genes involved in secondary injuries that cause mortality, we compared genome-wide mRNA expression profiles of uninjured and injured flies under age and diet conditions that had different mortalities. During the peak period of secondary injuries, innate immune response genes were the predominant class of genes that changed expression. Furthermore, age and diet affected the magnitude of the change in expression of some innate immune response genes, suggesting roles for these genes in inhibiting secondary injuries that cause mortality. Our results indicate that the complexity of TBI outcomes is due in part to distinct, genetically controlled, age- and diet-regulated mechanisms that promote secondary injuries and that involve a subset of innate immune response genes. PMID:27754853

  18. Modified spectral tilt affects infants' native-language discrimination of approximants and vowels.

    PubMed

    Beach, Elizabeth Francis; Noble, William; Kitamura, Christine

    2015-09-01

    This study's aim was to determine if 6- and 9-month-old infants discriminate approximants and vowels when the spectral shape is modified to emphasize high- or low-frequency information. Infants were presented with /r/-/l/ and /ɔ/-/ɐ/ in three conditions: (a) unmodified; (b) -6 dB/octave tilt; and (c) +6 dB/octave tilt. Six-month-olds discriminated /ɔ/-/ɐ/ in conditions (a) and (b), and /r/-/l/ in conditions (a) and (c), but 9-month-olds only discriminated when unmodified. The results reflect native-language attunement. Six-month-olds discriminate spectrally modified sounds that emphasize relevant cues, but by 9 months, infants are sensitive to the native spectral profiles of speech.

  19. Preterm infant gut microbiota affects intestinal epithelial development in a humanized microbiome gnotobiotic mouse model.

    PubMed

    Yu, Yueyue; Lu, Lei; Sun, Jun; Petrof, Elaine O; Claud, Erika C

    2016-09-01

    Development of the infant small intestine is influenced by bacterial colonization. To promote establishment of optimal microbial communities in preterm infants, knowledge of the beneficial functions of the early gut microbiota on intestinal development is needed. The purpose of this study was to investigate the impact of early preterm infant microbiota on host gut development using a gnotobiotic mouse model. Histological assessment of intestinal development was performed. The differentiation of four epithelial cell lineages (enterocytes, goblet cells, Paneth cells, enteroendocrine cells) and tight junction (TJ) formation was examined. Using weight gain as a surrogate marker for health, we found that early microbiota from a preterm infant with normal weight gain (MPI-H) induced increased villus height and crypt depth, increased cell proliferation, increased numbers of goblet cells and Paneth cells, and enhanced TJs compared with the changes induced by early microbiota from a poor weight gain preterm infant (MPI-L). Laser capture microdissection (LCM) plus qRT-PCR further revealed, in MPI-H mice, a higher expression of stem cell marker Lgr5 and Paneth cell markers Lyz1 and Cryptdin5 in crypt populations, along with higher expression of the goblet cell and mature enterocyte marker Muc3 in villus populations. In contrast, MPI-L microbiota failed to induce the aforementioned changes and presented intestinal characteristics comparable to a germ-free host. Our data demonstrate that microbial communities have differential effects on intestinal development. Future studies to identify pioneer settlers in neonatal microbial communities necessary to induce maturation may provide new insights for preterm infant microbial ecosystem therapeutics.

  20. Early life stress affects mortality rate more than social behavior, gene expression or oxidative damage in honey bee workers.

    PubMed

    Rueppell, Olav; Yousefi, Babak; Collazo, Juan; Smith, Daniel

    2017-04-01

    Early life stressors can affect aging and life expectancy in positive or negative ways. Individuals can adjust their behavior and molecular physiology based on early life experiences but relatively few studies have connected such mechanisms to demographic patterns in social organisms. Sociality buffers individuals from environmental influences and it is unclear how much early life stress affects later life history. Workers of the honey bee (Apis mellifera L.) were exposed to two stressors, Varroa parasitism and Paraquat exposure, early in life. Consequences were measured at the molecular, behavioral, and demographic level. While treatments did not significantly affect levels of oxidative damage, expression of select genes, and titers of the common deformed wing virus, most of these measures were affected by age. Some of the age effects, such as declining levels of deformed wing virus and oxidative damage, were opposite to our predictions but may be explained by demographic selection. Further analyses suggested some influences of worker behavior on mortality and indicated weak treatment effects on behavior. The latter effects were inconsistent among the two experiments. However, mortality rate was consistently reduced by Varroa mite stress during development. Thus, mortality was more responsive to early life stress than our other response variables. The lack of treatment effects on these measures may be due to the social organization of honey bees that buffers the individual from the impact of stressful developmental conditions.

  1. Factors affecting road mortality of white-tailed deer in eastern South Dakota

    USGS Publications Warehouse

    Grovenburg, Troy W.; Jenks, Jonathan A.; Klaver, Robert W.; Monteith, Kevin L.; Galster, Dwight H.; Schauer, Ron J.; Morlock, Wilbert W.; Delger, Joshua A.

    2008-01-01

    White-tailed deer (Odocoileus virginianus) mortalities (n = 4,433) caused by collisions with automobiles during 2003 were modeled in 35 counties in eastern South Dakota. Seventeen independent variables and 5 independent variable interactions were evaluated to explain deer mortalities. A negative binomial regression model (Ln Y = 1.25 – 0.12 [percentage tree coverage] + 0.0002 [county area] + 5.39 [county hunter success rate] + 0.0023 [vehicle proxy 96–104 km/hr roads], model deviance = 33.43, χ2 = 27.53, df = 27) was chosen using a combination of a priori model selection and AICc. Management options include use of the model to predict road mortalities and to increase the number of hunting licenses, which could result in fewer DVCs.

  2. Infant mortality and morbidity associated with preterm and small-for-gestational-age births in Southern Mozambique: A retrospective cohort study

    PubMed Central

    García-Basteiro, Alberto L.; Quintó, Llorenç; Macete, Eusebio; Bardají, Azucena; González, Raquel; Nhacolo, Arsenio; Sigauque, Betuel; Sacoor, Charfudin; Rupérez, María; Sicuri, Elisa; Bassat, Quique; Sevene, Esperança; Menéndez, Clara

    2017-01-01

    Background Preterm and small for gestational age (SGA) births have been associated with adverse outcomes during the first stages of life. We evaluated the morbidity and mortality associated with preterm and SGA births during the first year of life in a rural area of Southern Mozambique. Methods This is a retrospective cohort study using previously collected data from children born at the Manhiça District Hospital in two different periods (2003–2005 and 2010–2012). Newborns were classified as being preterm and/or SGA or as babies not fulfilling any of the previous conditions (term non-SGA). All children were followed up for a year for morbidity and mortality outcomes. Results A total of 5574 live babies were included in the analysis. The prevalence of preterm delivery was 6.2% (345/5574); the prevalence of SGA was 14.0% (776/5542) and 2.2% (114/5542) of the children presented both conditions. During the neonatal period, preterm delivery and SGA were associated with 13 (HR: 13.0, 95% CI 4.0–42.2) and 5 times (HR: 4.5, 95% CI: 1.6–12.6) higher mortality compared to term non SGA babies. Risk of hospitalization was only increased when both conditions were present (IRR: 3.5, 95%CI: 1.5–8.1). Mortality is also increased during the entire first year, although at a lower rate. Conclusions Neonatal and infant mortality rates are remarkably high among preterm and SGA babies in southern Mozambique. These increased rates are concentrated within the neonatal period. Prompt identification of these conditions is needed to implement interventions aimed at increasing survival of these high-risk newborns. PMID:28212393

  3. Memory Load Affects Object Individuation in 18-Month-Old Infants

    ERIC Educational Resources Information Center

    Zosh, Jennifer M.; Feigenson, Lisa

    2012-01-01

    Accurate representation of a changing environment requires individuation--the ability to determine how many numerically distinct objects are present in a scene. Much research has characterized early individuation abilities by identifying which object features infants can use to individuate throughout development. However, despite the fact that…

  4. How Do Object Size and Rigidity Affect Reaching and Grasping in Infants with Down Syndrome?

    ERIC Educational Resources Information Center

    de Campos, Ana Carolina; Francisco, Kelly Regina; Savelsbergh, Geert J. P.; Rocha, Nelci Adriana Cicuto Ferreira

    2011-01-01

    Reaching and grasping skills have been described to emerge from a dynamic interaction between intrinsic and extrinsic factors. The purpose of the present study was to investigate the interaction between such an intrinsic factor, Down syndrome, and extrinsic factors, such as different object properties. Seven infants with Down syndrome and seven…

  5. Affective Influences on Startle in Five-Month-Old Infants: Reactions to Facial Expressions of Emotion.

    ERIC Educational Resources Information Center

    Balaban, Marie T.

    1995-01-01

    While 18 5-month-old infants viewed photographic slides of faces posed in happy, neutral, or angry expressions, a brief acoustic noise burst was presented to elicit the blink component of human startle. It was found that blink size was augmented during the viewing of angry expressions and reduced during viewing of happy expressions. (MDM)

  6. Growth of Enterobacter sakazakii in reconstituted infant formula as affected by composition and temperature.

    PubMed

    Gurtler, Joshua B; Beuchat, Larry R

    2007-09-01

    The ability of Enterobacter sakazakii to cause infections in infants, coupled with its documented presence in some lots of commercially manufactured powdered infant formula, raises a concern about the potential for its growth in reconstituted formula, with consequent increased safety risk. A study was done to determine these characteristics in four commercial milk-based powdered infant formulas and two soy-based formulas reconstituted with water and inoculated with a 10-strain mixture of E. sakazakii at populations of 0.02 and 0.53 CFU/ml (ca. 13 CFU/100 g and ca. 409 CFU/100 g of powdered formula, respectively). Reconstituted formulas were stored at 4, 12, 21, and 30 degrees C, and populations were monitored up to 72 h. E. sakazakii did not grow in formulas stored at 4 degrees C, although it was detected by enrichment of all formulas 72 h after reconstitution. Initially at a population of 0.02 CFU/ml, E. sakazakii grew to populations > or = 1 log CFU/ml of reconstituted formulas held at 12, 21, and 30 degrees C for 48, 12, and 8 h, respectively. At an initial population of 0.53 CFU/ml, the pathogen grew to populations > or = 1 log CFU/ml in reconstituted infant formula held at 12 and 21 degrees C for 24 and 8 h, respectively, and to populations 2.55 to 3.14 log CFU/ml when held at 30 degrees C for 8 h. Populations initially at 0.02 and 0.53 CFU/ml of reconstituted formula increased to < or = 0.25 and 0.4 log CFU/ml, respectively, when formulas were held at 30 degrees C for 4 h. Growth was not greatly influenced by the composition of formulas. Results show that the hang time for reconstituted infant formula held at temperatures in neonatal intensive care units should be no longer than 4 h. Portions of reconstituted infant formula not fed to infants should be stored at < or = 4 degrees C, a temperature at which E. sakazakii will not grow.

  7. Maternal and infant affect at 4 months predicts performance and verbal IQ at 4 and 7 years in a diverse population.

    PubMed

    Sheinkopf, Stephen J; Tenenbaum, Elena J; Messinger, Daniel S; Miller-Loncar, Cynthia L; Tronick, Ed; Lagasse, Linda L; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles; Whitaker, Toni; Hammond, Jane; Lester, Barry M

    2016-10-23

    Using existing longitudinal data from 570 infants in the Maternal Lifestyle Study, we explored the predictive value of maternal and infant affect and maternal vocalizations during 2 minutes of face-to-face interactions at 4 months on IQ scores at 4.5 and 7 years. After controlling for demographic factors, maternal depression, and prenatal drug exposure, maternal positive affect and maternal positive vocalizations emerged as predictors of both verbal and performance IQ at 4.5 and 7 years. Although infant positive affect during the interaction with the mother was not predictive of these outcome measures, infant positive affect towards an examiner predicted verbal but not performance IQ at 4.5 years. These results suggest that maternal positive affect may index emotional engagement in interaction that facilitates both verbal and nonverbal cognitive development, while infant social positive affect is specifically related to the acquisition of verbal reasoning abilities. These findings are significant because they are based on a discrete snapshot of observable behavior in infancy (just 2 minutes of interaction), because they extend the range of maternal behaviors and characteristics known to support positive developmental outcomes, and because they are derived from high-risk infants where prevention efforts may be beneficial. Potential mechanisms for these associations are discussed, as are the clinical implications for identifying dyads most in need of targeted interventions.

  8. Measurement confounding affects the extent to which verbal IQ explains social gradients in mortality

    PubMed Central

    Chapman, Benjamin; Fiscella, Kevin; Duberstein, Paul; Kawachi, Ichiro; Muennig, Peter

    2016-01-01

    Background IQ is thought to explain social gradients in mortality. IQ scores are based roughly equally on Verbal IQ (VIQ) and Performance IQ tests. VIQ tests, however, are suspected to confound true verbal ability with socioeconomic status (SES), raising the possibility that associations between SES and IQ scores might be overestimated. We examined, first, whether two of the most common types of VIQ tests exhibited differential item functioning (DIF) favouring persons of higher SES and/or majority race/ethnicity. Second, we assessed what impact, if any, this had on estimates of the extent to which VIQ explains social gradients in mortality. Methods Data from the General Social Survey-National Death Index cohort, a US population representative dataset, was used. Item response theory models queried social-factor DIF on the Thorndike Verbal Intelligence Scale and Wechsler Adult Intelligence Scales, Revised Similarities test. Cox models examined mortality associations among SES and VIQ scores corrected and uncorrected for DIF. Results When uncorrected for DIF, VIQ was correlated with income, education, occupational prestige and race, with correlation coefficients ranging between |0.12| and |0.43|. After correcting for DIF, correlations ranged from |0.06| to |0.16|. Uncorrected VIQ scores explained 11–40% of the Relative Index of Inequalities in mortality for social factors, while DIF-corrected scores explained 2–29%. Conclusions Two of the common forms of VIQ tests appear confound verbal intelligence with SES. Since these tests appear in most IQ batteries, circumspection may be warranted in estimating the amount of social inequalities in mortality attributable to IQ. PMID:24729404

  9. Factors affecting fungus-induced larval mortality in Anopheles gambiae and Anopheles stephensi

    PubMed Central

    2010-01-01

    Background Entomopathogenic fungi have shown great potential for the control of adult malaria vectors. However, their ability to control aquatic stages of anopheline vectors remains largely unexplored. Therefore, how larval characteristics (Anopheles species, age and larval density), fungus (species and concentration) and environmental effects (exposure duration and food availability) influence larval mortality caused by fungus, was studied. Methods Laboratory bioassays were performed on the larval stages of Anopheles gambiae and Anopheles stephensi with spores of two fungus species, Metarhizium anisopliae and Beauveria bassiana. For various larval and fungal characteristics and environmental effects the time to death was determined and survival curves established. These curves were compared by Kaplan Meier and Cox regression analyses. Results Beauveria bassiana and Metarhizium anisopliae caused high mortality of An. gambiae and An. stephensi larvae. However, Beauveria bassiana was less effective (Hazard ratio (HR) <1) compared to Metarhizium anisopliae. Anopheles stephensi and An. gambiae were equally susceptible to each fungus. Older larvae were less likely to die than young larvae (HR < 1). The effect of increase in fungus concentration on larval mortality was influenced by spore clumping. One day exposure to fungal spores was found to be equally effective as seven days exposure. In different exposure time treatments 0 - 4.9% of the total larvae, exposed to fungus, showed infection at either the pupal or adult stage. Mortality rate increased with increasing larval density and amount of available food. Conclusions This study shows that both fungus species have potential to kill mosquitoes in the larval stage, and that mortality rate depends on fungus species itself, larval stage targeted, larval density and amount of nutrients available to the larvae. Increasing the concentration of fungal spores or reducing the exposure time to spores did not show a proportional

  10. Infant feeding practices in St. Vincent and factors which affect them.

    PubMed

    Greiner, T; Latham, M C

    1981-03-01

    A survey was conducted in the summer of 1975 in 2 towns in St. Vincent--Layou and Georgetown--in the effort to obtain information regarding infant feeding practices and some of the factors which may influence them. Mothers of children from 1-2 years of age were interviewed in their homes. Complete data sets were obtained on 192 of the 216 eligible children in the 2 towns. For most children the period of exclusive breastfeeding (no other milk product given) was very short. About 1/2 of the children had received milk by 2 weeks of age, and 75% by 1 month. This was followed by a much longer period of "mixed" feeding--both breast and bottle--until breastfeeding was stopped at a median age of 6.8 months. Many types of milk were used for infant feeding. For 73% of the infants, infant formula was the 1st type of milk given. This was commonly replaced by a "heavier" full cream powdered milk at a few months of age. Prelacteal feeds were very common, predominantly glucose water. "Tonics," often consisting of vitamin preparations, were another common supplement during the early months of life. Among solid foods, arrowroot, "custard," and commercial infant cereals were the first to be introduced. Relatively inexpensive locally bagged staple foods and milk powders were available in both towns, but most mothers relied heavily on packaged brand name products for infant feeding even though the cost was 2-10 times higher. It was not possible to pinpoint the exact causes for the high levels of bottle feeding, nor for the possible recent decline in breastfeeding, but several important factors were identified. Part of the problem appeared to be due to poor health and nutritional status of the mothers. In addition, in several cases the mothers reported that they had wanted to continue breastfeeding but had received no support from health professionals, and in a few instances had been ordered to stop for seemingly trivial medical reasons.

  11. Seizure Clustering during Drug Treatment Affects Seizure Outcome and Mortality of Childhood-Onset Epilepsy

    ERIC Educational Resources Information Center

    Sillanpaa, Matti; Schmidt, Dieter

    2008-01-01

    To provide evidence of whether seizure clustering is associated with drug resistance and increased mortality in childhood-onset epilepsy, a prospective, long-term population-based study was performed. One hundred and twenty patients who had been followed since disease onset (average age 37.0 years, SD 7.1, median 40.0, range 11-42; incident cases)…

  12. Does fine sediment source as well as quantity affect salmonid embryo mortality and development?

    PubMed

    Sear, D A; Jones, J I; Collins, A L; Hulin, A; Burke, N; Bateman, S; Pattison, I; Naden, P S

    2016-01-15

    Fine sediments are known to be an important cause of increased mortality in benthic spawning fish. To date, most of the research has focussed on the relationship between embryo mortality and the quantity of fine sediment accumulated in the egg pocket. However, recent evidence suggests a) that the source of fine sediment might also be important, and b) that fitness of surviving embryos post-hatch might also be impacted by the accumulation of fine sediments. In this paper, we report an experiment designed to simulate the incubation environment of brown trout (Salmo trutta) and Atlantic salmon (Salmo salar). During the experiment, the incubating embryos were exposed to different quantities of fine (<63 μm) sediment derived from four different sources; agricultural topsoils, damaged road verges, eroding river channel banks and tertiary level treated sewage. Results showed that mass and source are independently important for determining the mortality and fitness of alevin. Differences between species were observed, such that brown trout are less sensitive to mass and source of accumulated sediment. We demonstrate for the first time that sediment source is an additional control on the impact of fine sediment, and that this is primarily controlled by the organic matter content and oxygen consumption of the catchment source material.

  13. Solid-stemmed wheat does not affect overwintering mortality of the wheat stem sawfly, Cephus cinctus.

    PubMed

    Cárcamo, Héctor A; Beres, Brian L; Herle, Carolyn E; McLean, Hugh; McGinne, Sean

    2011-01-01

    The wheat stem sawfly, Cephus cinctus Norton (Hymenoptera: Cephidae), is a key pest of wheat in the northern Great Plains of North America. Host plant resistance in the form of solid-stemmed wheat cultivars is the main control strategy for C. cinctus. This study investigated the effect of novel and traditional solid wheat hosts on the overwintering mortality and cold-hardiness of C. cinctus. Field conditions from 2003-2005 showed that overwintering mortality in various wheat cultivars averaged 8% and was not related to the type of wheat cultivar. Similarly, supercooling points (-22° C) were not influenced by wheat host type. C. cintus are cold-hardy; up to 80% survive 10 days at -20° C and 10% survive 40 days. Its overwintering microhabitat near the crown area of the plant is well insulated for temperatures above -10° C and remains ~ 20° C above ambient minima. These data suggest that winter mortality is a minor factor in the population dynamics of wheat stem sawfly, and despite clear detrimental effects on larval weight and adult fitness, solid-stemmed cultivars do not reduce the ability of larvae to survive winters.

  14. The Continuing Infant Mortality Crisis in Illinois. Part 2. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundredth Congress, First Session (Chicago, Illinois, October 5, 1987).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

    Testimony concerned: (1) problems a high-risk, low-income mother had in receiving prenatal care; (2) dimensions of the infant mortality problem in Chicago, Illinois; (3) programs of the Illinois Department of Public Aid (IDPA) that address the problem; (3) the need for the IDPA to design a plan to implement SOBRA (the 1986 Sixth Omnibus Budget…

  15. Factors Affecting Mortality and Treatment Completion of Tuberculosis Patients in Isfahan Province from 2006 to 2011

    PubMed Central

    Shahrezaei, Marzieh; Maracy, Mohammad Reza; Farid, Fariba

    2015-01-01

    Background: Regarding cases of infectious diseases tuberculosis (TB) is the most important cause of death and according to the DALY criteria, this disease has the seventh position in global disease ranking. In this study, we aim to determine the risk factors, which have a significant effect on the treatment completion and mortality of TB patients. Methods: This study is a retrospective cohort study. The sample is made up of registered TB patients in the Isfahan Province from 2006 to 2011. Information of the patients was collected from their files in health centers in the Isfahan Province. Variables such as age, sex, weight, nationality, residence, type of TB, imprisonment, human immunodeficiency virus, TB case were measured. Descriptive statistics (including frequency, percentage, mean and standard deviation) and statistical analysis (including Cox proportional hazard model) were used. Results: The result showed that imprisonment (hazard ratio [HR] = 4.76, P = 0.019), age (HR = 4.44, P = 0.001) and the TB case (HR = 2.73, P = 0.037) of pulmonary TB had significant impacts on mortality of the patients, also in the case of treatment completion, the TB case (HR = 0.34, P < 0.001) proved to have a significant impact on completion of the treatment. Type of extra-pulmonary TB in extra-pulmonary TB patients also had an effect on treatment completion. Conclusions: We can conclude that factors such as age, imprisonment, TB case and type of extra-pulmonary TB are effective on the treatment completion and mortality of the patients. It may be useful for policy makers to make more control of high-risk patients. PMID:26445638

  16. Socio-economic factors affect mortality in 47,XYY syndrome-A comparison with the background population and Klinefelter syndrome.

    PubMed

    Stochholm, Kirstine; Juul, Svend; Gravholt, Claus Højbjerg

    2012-10-01

    Mortality among males with 47,XYY is increased due to a host of conditions and diseases. Clinical studies have suggested a poorer educational level and social adaptation among 47,XYY persons. We wanted to study the socio-economic profile in 47,XYY persons and the impact on mortality. We conducted a register study using several Danish nationwide registries. 206 47,XYY men and 20,078 controls from the background population and 1,049 controls with Klinefelter syndrome were included. Information concerning marital status, fatherhood, education, income, and retirement were obtained. Compared to the background population, 47,XYY men had fewer partnerships, were less likely to become fathers, had lower income and educational level, and retired at an earlier age. The mortality among 47,XYY men was significantly increased with a hazard ratio (HR) of 3.6 (95% confidence interval: 2.6-5.1). Adjusting for marital and educational status reduced this HR to 2.7. Compared to Klinefelter syndrome, 47,XYY had significantly fewer partnerships, were more likely to become fathers, but had lower income. Mortality among 47,XYY men was increased compared with Klinefelter syndrome with a HR of 1.36. The results show a severely inferior outcome in all investigated socio-economic parameters compared to the background population and an affected profile compared with Klinefelter syndrome, even though the population in Denmark has equal and free access to health care and education. We conclude that 47,XYY is often associated with a poorer socio-economic profile, which partly explains the increased mortality.

  17. The Development of Infant Discrimination of Affect in Multimodal and Unimodal Stimulation: The Role of Intersensory Redundancy

    PubMed Central

    Flom, Ross; Bahrick, Lorraine E.

    2009-01-01

    This research examined the developmental course of infants’ ability to perceive affect in bimodal (audiovisual) and unimodal (auditory and visual) displays of a woman speaking. According to the intersensory redundancy hypothesis (L. E. Bahrick, R. Lickliter, & R. Flom, 2004), detection of amodal properties is facilitated in multimodal stimulation and attenuated in unimodal stimulation. Later in development, however, attention becomes more flexible, and amodal properties can be perceived in both multimodal and unimodal stimulation. The authors tested these predictions by assessing 3-, 4-, 5-, and 7-month-olds’ discrimination of affect. Results demonstrated that in bimodal stimulation, discrimination of affect emerged by 4 months and remained stable across age. However, in unimodal stimulation, detection of affect emerged gradually, with sensitivity to auditory stimulation emerging at 5 months and visual stimulation at 7 months. Further temporal synchrony between faces and voices was necessary for younger infants’ discrimination of affect. Across development, infants first perceive affect in multimodal stimulation through detecting amodal properties, and later their perception of affect is extended to unimodal auditory and visual stimulation. Implications for social development, including joint attention and social referencing, are considered. PMID:17201522

  18. Preventing Infant Mortality: Intergovernmental Dimensions of a National Problem. Joint Hearings and Report on S. 1209: To Establish the National Commission To Prevent Infant Mortality, before the Subcommittee on Intergovernmental Relations of the Committee on Governmental Affairs and the Committee on the Budget. United States Senate, Ninety-Ninth Congress, First Session (Miami, Florida, September 11, 1985; Pensacola, Florida, October 11, 1985; Washington, D.C., October 31, 1985).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

    A subcommittee report introduces the subject of these joint hearings--the problem of infant mortality in the United States; addresses the need for the legislation; summarizes the proposed legislation; and lists endorsing organizations. The hearings examine both the scope of the problem and S. 1209, legislation to create a national commission to…

  19. How a face may affect object-based attention: evidence from adults and 8-month-old infants

    PubMed Central

    Valenza, Eloisa; Franchin, Laura; Bulf, Hermann

    2013-01-01

    Object-based attention operates on perceptual objects, opening the possibility that the costs and benefits humans have to pay to move attention between-objects might be affected by the nature of the stimuli. The current study reported two experiments with adults and 8-month-old infants investigating whether object-based-attention is affected by the type of stimulus (faces vs. non-faces stimuli). Using the well-known cueing task developed by Egly et al. (1994) to study the object-based component of attention, in Experiment 1 adult participants were presented with two upright, inverted or scrambled faces and an eye-tracker measured their saccadic latencies to find a target that could appear on the same object that was just cued or on the other object that was uncued. Data showed that an object-based effect (a smaller cost to shift attention within- compared to between-objects) occurred only with scrambled face, but not with upright or inverted faces. In Experiment 2 the same task was performed with 8-month-old infants, using upright and inverted faces. Data revealed that an object-based effect emerges only for inverted faces but not for upright faces. Overall, these findings suggest that object-based attention is modulated by the type of stimulus and by the experience acquired by the viewer with different objects. PMID:24723860

  20. Watermelon seedling growth and mortality as affected by Anasa tristis (Heteroptera: Coreidae).

    PubMed

    Edelson, J V; Duthie, J; Roberts, W

    2002-06-01

    Adult squash bugs, Anasa tristis (De Geer), were confined on seedling watermelon plants at densities of zero, one, two, and four per plant. Squash bugs were allowed to feed on the plants until plants died or reached 30 cm in height. Number of leaves and length of plant vine were recorded at 2- or 3-d intervals. Seedling foliage, stems, and roots were harvested and dried after plants reached 30 cm in height. Growth of seedlings was regressed on number of squash bugs and results indicated that an increasing density of squash bugs feeding on seedlings resulted in a significant reduction in plant growth. Additionally, increased density of squash bugs resulted in reduced weight of foliage and root dry biomass. Seedling mortality increased as the density of squash bugs increased.

  1. Zinc Absorption from Micronutrient Powder Is Low but Is not Affected by Iron in Kenyan Infants

    PubMed Central

    Esamai, Fabian; Liechty, Edward; Ikemeri, Justus; Westcott, Jamie; Kemp, Jennifer; Culbertson, Diana; Miller, Leland V.; Hambidge, K. Michael; Krebs, Nancy F.

    2014-01-01

    Interference with zinc absorption is a proposed explanation for adverse effects of supplemental iron in iron-replete children in malaria endemic settings. We examined the effects of iron in micronutrient powder (MNP) on zinc absorption after three months of home fortification with MNP in maize-based diets in rural Kenyan infants. In a double blind design, six-month-old, non-anemic infants were randomized to MNP containing 5 mg zinc, with or without 12.5 mg of iron (MNP + Fe and MNP − Fe, respectively); a control (C) group received placebo powder. After three months, duplicate diet collections and zinc stable isotopes were used to measure intake from MNP + non-breast milk foods and fractional absorption of zinc (FAZ) by dual isotope ratio method; total absorbed zinc (TAZ, mg/day) was calculated from intake × FAZ. Mean (SEM) TAZ was not different between MNP + Fe (n = 10) and MNP − Fe (n = 9) groups: 0.85 (0.22) and 0.72 (0.19), respectively, but both were higher than C (n = 9): 0.24 (0.03) (p = 0.04). Iron in MNP did not significantly alter zinc absorption, but despite intakes over double estimated dietary requirement, both MNP groups’ mean TAZ barely approximated the physiologic requirement for age. Impaired zinc absorption may dictate need for higher zinc doses in vulnerable populations. PMID:25493942

  2. Race and Mortality.

    ERIC Educational Resources Information Center

    Scanlan, James P.

    2000-01-01

    Discusses increasing racial and socioeconomic disparities in mortality despite general declines in mortality, examining disparities in infant mortality and explaining that whenever two groups differ in their susceptibility to some condition, the less prevalent the condition, the greater will be the disparity in rates of experiencing the condition.…

  3. A national registry of haemoglobinopathies in Greece: deducted demographics, trends in mortality and affected births.

    PubMed

    Voskaridou, Ersi; Ladis, Vasilis; Kattamis, Antonis; Hassapopoulou, Eleni; Economou, Marina; Kourakli, Alexandra; Maragkos, Konstantinos; Kontogianni, Kalliopi; Lafioniatis, Stilianos; Vrettou, Eleni; Koutsouka, Freideriki; Papadakis, Alexandros; Mihos, Andreas; Eftihiadis, Eftihios; Farmaki, Kallistheni; Papageorgiou, Ourania; Tapaki, Georgia; Maili, Polixeni; Theohari, Maria; Drosou, Marouso; Kartasis, Zafeiris; Aggelaki, Maria; Basileiadi, Artemis; Adamopoulos, Ioannis; Lafiatis, Ioannis; Galanopoulos, Athanasios; Xanthopoulidis, Georgios; Dimitriadou, Efthimia; Mprimi, Agapi; Stamatopoulou, Maria; Haile, Elanso Damba; Tsironi, Maria; Anastasiadis, Athanasios; Kalmanti, Maria; Papadopoulou, Margarita; Panori, Evaggelia; Dimoxenou, Peristera; Tsirka, Antigoni; Georgakopoulos, Dimitrios; Drandrakis, Pantelis; Dionisopoulou, Dionisia; Ntalamaga, Androniki; Davros, Ioannis; Karagiorga, Markisia

    2012-09-01

    Haemoglobinopathies are the most common hereditary disorders in Greece. Although there is a successful national prevention program, established 35 years ago, there is lack of an official registry and collection of epidemiological data for haemoglobinopathies. This paper reports the results of the first National Registry for Haemoglobinopathies in Greece (NRHG), recently organized by the Greek Society of Haematology. NRHG records all patients affected by thalassaemia major (TM), thalassaemia intermedia (TI), "H" Haemoglobinopathy (HH) and sickle cell disease (SCD). Moreover, data about the annual rate of new affected births along with deaths, between 2000 and 2010, are reported. A total of 4,506 patients are registered all over the country while the number of affected newborns was significantly decreased during the last 3 years. Main causes for still having affected births are: (1) lack of medical care due to financial reasons or low educational level; (2) unawareness of time limitations for prenatal diagnosis (PD); due either to obstetricians' malpractice or to delayed demand of medical care of couples at risk; and (3) religious, social or bioethical reasons. Cardiac and liver disorders consist main causes for deaths while life expectancy of patients lengthened after 2005 (p < 0.01). The NRHG of patients affected by haemoglobinopathies in Greece provides useful data about the haemoglobinopathies in the Greek population and confirms the efficacy of the National Thalassaemia Prevention Program on impressively decreasing the incidence of TM and sickle cell syndromes.

  4. Essential fats: how do they affect growth and development of infants and young children in developing countries? A literature review.

    PubMed

    Huffman, Sandra L; Harika, Rajwinder K; Eilander, Ans; Osendarp, Saskia J M

    2011-10-01

    Omega-3 and omega-6 fatty acids, particularly docosahexaenoic acid (DHA), are known to play an essential role in the development of the brain and retina. Intakes in pregnancy and early life affect growth and cognitive performance later in childhood. However, total fat intake, alpha-linolenic acid (ALA) and DHA intakes are often low among pregnant and lactating women, infants and young children in developing countries. As breast milk is one of the best sources of ALA and DHA, breastfed infants are less likely to be at risk of insufficient intakes than those not breastfed. Enhancing intake of ALA through plant food products (soy beans and oil, canola oil, and foods containing these products such as lipid-based nutrient supplements) has been shown to be feasible. However, because of the low conversion rates of ALA to DHA, it may be more efficient to increase DHA status through increasing fish consumption or DHA fortification, but these approaches may be more costly. In addition, breastfeeding up to 2 years and beyond is recommended to ensure an adequate essential fat intake in early life. Data from developing countries have shown that a higher omega-3 fatty acid intake or supplementation during pregnancy may result in small improvements in birthweight, length and gestational age based on two randomized controlled trials and one cross-sectional study. More rigorous randomized controlled trials are needed to confirm this effect. Limited data from developing countries suggest that ALA or DHA supplementation during lactation and in infants may be beneficial for growth and development of young children 6-24 months of age in these settings. These benefits are more pronounced in undernourished children. However, there is no evidence for improvements in growth following omega-3 fatty acid supplementation in children >2 years of age.

  5. Amniotic Fluid Infection, Cytokine Levels, and Mortality and Adverse Pulmonary, Intestinal, and Neurologic Outcomes in Infants at 32 Weeks' Gestation or Less

    PubMed Central

    2017-01-01

    To what extent the risks of neonatal morbidities are directly related to premature birth or to biological mechanisms of preterm birth remains uncertain. We aimed to examine the effect of exposure to amniotic fluid (AF) infection and elevated cytokine levels on the mortality and pulmonary, intestinal, and neurologic outcomes of preterm infants, and whether these associations persist after adjustment for gestational age at birth. This retrospective cohort study included 152 premature singleton infants who were born at ≤ 32 weeks. AF obtained by amniocentesis was cultured; and interleukin-6 (IL-6) and IL-8 levels in AF were determined. The primary outcome was adverse perinatal outcome defined as the presence of one or more of the followings: stillbirth, neonatal death, bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, and periventricular leukomalacia. Logistic regression analysis was adjusted for gestational age at birth and other potential confounders. In bivariate analyses, elevated AF IL-6 and IL-8 levels were significantly associated with adverse perinatal outcome. These results were not changed after adjusting for potential confounders, such as low Apgar scores, mechanical ventilation, and surfactant application. However, the independent effect of elevated cytokine levels in AF disappeared when additionally adjusted for low gestational age at birth; consequently, low gestational age remained strongly associated with the risk of adverse perinatal outcome. In conclusion, elevated levels of pro-inflammatory cytokines in AF are associated with increased risk of adverse perinatal outcomes, but this risk is not independent of low gestational age at birth. Culture-proven AF infection is not associated with this risk. PMID:28145652

  6. The Effect of Coffee and Quantity of Consumption on Specific Cardiovascular and All-Cause Mortality: Coffee Consumption Does Not Affect Mortality.

    PubMed

    Loomba, Rohit S; Aggarwal, Saurabh; Arora, Rohit R

    2016-01-01

    Previous studies have examined whether or not an association exists between the consumption of caffeinated coffee to all-cause and cardiovascular mortality. This study aimed to delineate this association using population representative data from the National Health and Nutrition Examination Survey III. Patients were included in the study if all the following criteria were met: (1) follow-up mortality data were available, (2) age of at least 45 years, and (3) reported amount of average coffee consumption. A total of 8608 patients were included, with patients stratified into the following groups of average daily coffee consumption: (1) no coffee consumption, (2) less than 1 cup, (3) 1 cup a day, (4) 2-3 cups, (5) 4-5 cups, (6) more than 6 cups a day. Odds ratios, 95% confidence intervals, and P values were calculated for univariate analysis to compare the prevalence of all-cause mortality, ischemia-related mortality, congestive heart failure-related mortality, and stroke-related mortality, using the no coffee consumption group as reference. These were then adjusted for confounding factors for a multivariate analysis. P < 0.05 were considered statistically significant. Univariate analysis demonstrated an association between coffee consumption and mortality, although this became insignificant on multivariate analysis. Coffee consumption, thus, does not seem to impact all-cause mortality or specific cardiovascular mortality. These findings do differ from those of recently published studies. Coffee consumption of any quantity seems to be safe without any increased mortality risk. There may be some protective effects but additional data are needed to further delineate this.

  7. County-level environmental quality is differentially associated with individual- and county-level infant mortality by race

    EPA Science Inventory

    Human health is affected by simultaneous exposure to stressors and amenities, but research typically considers single exposures. In order to account for multiple ambient environmental conditions, we constructed an Environmental Quality Index (EQI) using principle components analy...

  8. Alpha-lactalbumin and casein-glycomacropeptide do not affect iron absorption from formula in healthy term infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Iron absorption from infant formula is relatively low. Alpha-lactalbumin and casein-glycomacropeptide have been suggested to enhance mineral absorption. We therefore assessed the effect of alpha-lactalbumin and casein-glycomacropeptide on iron absorption from infant formula in healthy term infants. ...

  9. Head and Eye Movements Affect Object Processing in 4-Month-Old Infants More than an Artificial Orientation Cue

    ERIC Educational Resources Information Center

    Wahl, Sebastian; Michel, Christine; Pauen, Sabina; Hoehl, Stefanie

    2013-01-01

    This study investigates the effects of attention-guiding stimuli on 4-month-old infants' object processing. In the human head condition, infants saw a person turning her head and eye gaze towards or away from objects. When presented with the objects again, infants showed increased attention in terms of longer looking time measured by eye…

  10. The risks and benefits of infant feeding practices for women and their children.

    PubMed

    Stuebe, A M; Schwarz, E B

    2010-03-01

    Infant feeding decisions affect maternal and child health outcomes, worldwide. Even in settings with clean water and good sanitation, infants who are not breast-fed face an increased risk of infectious, as well as non-infectious morbidity and mortality. The decision not to breast-feed can also adversely affect mothers' health by increasing the risk of pre-menopausal breast cancer, ovarian cancer, type II diabetes, hypertension, hyperlipidemia and cardiovascular disease. Clinicians who counsel mothers about the health impact of infant feeding and provide evidence-based care to maximize successful breast-feeding, can improve the short and long-term health of both mothers and infants.

  11. Combined exposure to endocrine disrupting pesticides impairs parturition, causes pup mortality and affects sexual differentiation in rats.

    PubMed

    Jacobsen, P R; Christiansen, S; Boberg, J; Nellemann, C; Hass, U

    2010-04-01

    Risk assessment is currently based on the no observed adverse effect levels (NOAELs) for single compounds. Humans are exposed to a mixture of chemicals and recent studies in our laboratory have shown that combined exposure to endocrine disrupters can cause adverse effects on male sexual development, even though the doses of the single compounds are below their individual NOAELs for anti-androgenic effects. Consequently, we have initiated a large project where the purpose is to study mixture effects of endocrine disrupting pesticides at low doses. In the initial range-finding mixture studies, rats were gavaged during gestation and lactation with five doses of a mixture of the fungicides procymidone, mancozeb, epoxyconazole, tebuconazole and prochloraz. The mixture ratio was chosen according to the doses of each individual pesticide that produced no observable effects on pregnancy length and pup survival in our laboratory and the dose levels used ranged from 25 to 100% of this mixture. All dose levels caused increased gestation length and dose levels above 25% caused impaired parturition leading to markedly decreased number of live born offspring and high pup perinatal mortality. The sexual differentiation of the pups was affected at 25% and higher as anogenital distance was affected in both male and female offspring at birth and the male offspring exhibited malformations of the genital tubercle, increased nipple retention, and decreased prostate and epididymis weights at pup day 13. The results show that doses of endocrine disrupting pesticides, which appear to induce no effects on gestation length, parturition and pup mortality when judged on their own, induced marked adverse effects on these endpoints in concert with other pesticides. In addition, the sexual differentiation of the offspring was affected. This as well as the predictability of the combination effects based on dose-additivity modelling will be studied further in a large dose-response study.

  12. Case report: long-term survival of an infant syndromic patient affected by atypical teratoid-rhabdoid tumor

    PubMed Central

    2013-01-01

    Background Atypical teratoid rhabdoid tumor (ATRT) patients display a dismal median overall survival of less than 1 year. A consistent fraction of cases carries de-novo SMARCB1/INI1 constitutional mutations in the setting of the “rhabdoid tumor predisposition syndrome” and the outcome is worst in infant syndromic ATRT patients. Case presentation We here describe a patient affected by mosaic Klinefelter syndrome and by rhabdoid tumor predisposition syndrome caused by constitutional SMARCB1/INI1 heterozygous mutation c.118C>T (Arg40X). Patient’s ATRT primary tumor occurred at 2 years of age concurrent with metastatic lesions. The patient was rendered without evidence of disease by combined surgery, high-dose poli-chemotherapy and craniospinal irradiation, followed by autologous hematopoietic stem cell transplantation. At the onset of a spinal lesion 5.5 years later, both tumors were pathologically and molecularly evaluated at the national central pathology review board and defined as ATRT in a syndromic patient, with strong evidence of a clonal origin of the two lesions. The patient was then treated according to SIOP guidelines and is now alive without evidence of disease 24 months after the detection of metastatic disease and 90 months after the original diagnosis. Conclusion The report underscores the current utility of multiple comprehensive approaches for the correct diagnosis and clinical management of patients affected by rare and atypical brain neoplasms. Successful local control of disease and achievement of long-term survival is possible in ATRT patients even in the setting of rhabdoid tumor predisposition syndrome, infant age at diagnosis and metastatic spread of disease, thus justifying the efforts for the management of this severe condition. PMID:23510391

  13. Wolf population dynamics in the U.S. Northern Rocky Mountains are affected by recruitment and human-caused mortality

    USGS Publications Warehouse

    Gude, J.A.; Mitchell, M.S.; Russell, R.E.; Sime, C.A.; Bangs, E.E.; Mech, L.D.; Ream, R.R.

    2012-01-01

    Reliable analyses can help wildlife managers make good decisions, which are particularly critical for controversial decisions such as wolf (Canis lupus) harvest. Creel and Rotella (2010) recently predicted substantial population declines in Montana wolf populations due to harvest, in contrast to predictions made by Montana Fish, Wildlife and Parks (MFWP). We replicated their analyses considering only those years in which field monitoring was consistent, and we considered the effect of annual variation in recruitment on wolf population growth. Rather than assuming constant rates, we used model selection methods to evaluate and incorporate models of factors driving recruitment and human-caused mortality rates in wolf populations in the Northern Rocky Mountains. Using data from 27 area-years of intensive wolf monitoring, we show that variation in both recruitment and human-caused mortality affect annual wolf population growth rates and that human-caused mortality rates have increased with the sizes of wolf populations. We document that recruitment rates have decreased over time, and we speculate that rates have decreased with increasing population sizes and/or that the ability of current field resources to document recruitment rates has recently become less successful as the number of wolves in the region has increased. Estimates of positive wolf population growth in Montana from our top models are consistent with field observations and estimates previously made by MFWP for 2008-2010, whereas the predictions for declining wolf populations of Creel and Rotella (2010) are not. Familiarity with limitations of raw data, obtained first-hand or through consultation with scientists who collected the data, helps generate more reliable inferences and conclusions in analyses of publicly available datasets. Additionally, development of efficient monitoring methods for wolves is a pressing need, so that analyses such as ours will be possible in future years when fewer resources

  14. Early diet affects the development of 3-6 Hz EEG activity in infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This longitudinal study investigated whether diet affects brain physiological functions during infancy. Power spectra (3-6 Hz) of electroencephalographic signals (high density recordings) in the bilateral prefrontal, frontal, central, parietal, occipital, anterior temporal, mid-temporal, and posteri...

  15. A new non-indigenous Crassostrea species in Southwest Atlantic salt marshes affects mortality of the cordgrass Spartina alterniflora

    NASA Astrophysics Data System (ADS)

    Lomovasky, Betina J.; Alvarez, Graciela; Addino, Mariana; Montemayor, Diana I.; Iribarne, Oscar

    2014-07-01

    Biological invasions in marine and coastal systems may produce new trophic and nontrophic interactions influencing the structure of the invaded community. In the intertidal salt marshes of Samborombón Bay (36°19‧20″S, 56°46‧26″W; mouth of La Plata River; Argentina), there is a new non-indigenous oyster species, Crassostrea sp., which settles on the dominant smooth cordgrass Spartina alterniflora. Here, we analyzed if the oyster affects S. alterniflora. Sampling showed that density of live plant was similar across intertidal levels, but there were higher density of dead plant stems at low intertidal levels. This pattern coincides with higher density and larger shell size of Crassostrea sp. at the low intertidal where oysters are attached to the basal part of the plant stems. An experiment manipulating oysters attached to S. alterniflora stems and oyster mimics shows that Crassostrea sp. can indeed increase mortality of S. alterniflora. The negative effect of bivalves on plant could be because several oysters settle around the Spartina stem, and by growing during the year, strangle the plants increasing their mortality rate. Together, all these evidences strongly suggest that these non-indigenous oysters can control the lower intertidal level of plant distribution in this system.

  16. Hospital treatment, mortality and healthcare costs in relation to socioeconomic status among people with bipolar affective disorder

    PubMed Central

    Yeh, Ling-Ling; Chen, Yu-Chun; Kuo, Kuei-Hong; Chang, Chin-Kuo

    2016-01-01

    Background Evidence regarding the relationships between the socioeconomic status and long-term outcomes of individuals with bipolar affective disorder (BPD) is lacking. Aims We aimed to estimate the effects of baseline socioeconomic status on longitudinal outcomes. Method A national cohort of adult participants with newly diagnosed BPD was identified in 2008. The effects of personal and household socioeconomic status were explored on outcomes of hospital treatment, mortality and healthcare costs, over a 3-year follow-up period (2008–2011). Results A total of 7987 participants were recruited. The relative risks of hospital treatment and mortality were found elevated for the ones from low-income households who also had higher healthcare costs. Low premium levels did not correlate with future healthcare costs. Conclusions Socioeconomic deprivation is associated with poorer outcome and higher healthcare costs in BPD patients. Special care should be given to those with lower socioeconomic status to improve outcomes with potential benefits of cost savings in the following years. Declaration of interest None. Copyright and usage © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703748

  17. Factors affecting morbidity, mortality and survival in patients undergoing surgery for rectal cancer in a district general hospital.

    PubMed Central

    Macadam, Robert; Yeomans, Neil; Wilson, Jonathan; Case, William; White, Clive; Lovegrove, John; Lyndon, Philip

    2005-01-01

    INTRODUCTION: This is a review of elective rectal cancer surgery during 1993-1999 at a single district general hospital to investigate the variables that affected the care of these patients. PATIENTS AND METHODS: A retrospective study of patients presenting with rectal adenocarcinoma to a district general hospital where total mesorectal excision was practiced over a 7-year period was performed to identify factors associated with complications, death and disease recurrence. RESULTS: Sixty-one patients developed a total of 89 complications and 30-day mortality was 8.3%. Overall, 81% of all resections and 86% of potentially curative resections were free of tumour at the circumferential resection margin. A positive circumferential resection margin and 30-day mortality were both associated with increased postoperative blood transfusion volume. Twenty-nine recurrences were detected during the follow-up period (mean, 21.7 months) and circumferential margin involvement by tumour, Dukes' stage, pre-operative functional status (ASA grade) and length of hospital stay correlated with disease-free survival. CONCLUSIONS: Surgical outcomes in lower volume hospitals are comparable with those reported by larger centres. PMID:16176691

  18. Intraguild predation by shore crabs affects mortality, behavior, growth, and densities of California horn snails

    USGS Publications Warehouse

    Lorda, J.; Hechinger, R.F.; Cooper, S. D.; Kuris, A. M.; Lafferty, Kevin D.

    2016-01-01

    The California horn snail, Cerithideopsis californica, and the shore crabs, Pachygrapsus crassipesand Hemigrapsus oregonensis, compete for epibenthic microalgae, but the crabs also eat snails. Such intraguild predation is common in nature, despite models predicting instability. Using a series of manipulations and field surveys, we examined intraguild predation from several angles, including the effects of stage-dependent predation along with direct consumptive and nonconsumptive predator effects on intraguild prey. In the laboratory, we found that crabs fed on macroalgae, snail eggs, and snails, and the size of consumed snails increased with predator crab size. In field experiments, snails grew less in the presence of crabs partially because snails behaved differently and were buried in the sediment (nonconsumptive effects). Consistent with these results, crab and snail abundances were negatively correlated in three field surveys conducted at three different spatial scales in estuaries of California, Baja California, and Baja California Sur: (1) among 61 sites spanning multiple habitat types in three estuaries, (2) among the habitats of 13 estuaries, and (3) among 34 tidal creek sites in one estuary. These results indicate that shore crabs are intraguild predators on California horn snails that affect snail populations via predation and by influencing snail behavior and performance.

  19. Cross-reactive immunologic material status affects treatment outcomes in Pompe disease infants

    PubMed Central

    Kishnani, Priya S.; Goldenberg, Paula C.; DeArmey, Stephanie L.; Heller, James; Benjamin, Danny; Young, Sarah; Bali, Deeksha; Smith, Sue Ann; Li, Jennifer S.; Mandel, Hanna; Koeberl, Dwight; Rosenberg, Amy; Chen, Y-T

    2013-01-01

    Deficiency of acid alpha glucosidase (GAA) causes Pompe disease, which is usually fatal if onset occurs in infancy. Patients synthesize a non-functional form of GAA or are unable to form native enzyme. Enzyme replacement therapy with recombinant human GAA (rhGAA) prolongs survival in infantile Pompe patients but may be less effective in cross-reactive immunologic material (CRIM)-negative patients. We retrospectively analyzed the influence of CRIM status on outcome in 21 CRIM-positive and 11 CRIM-negative infantile Pompe patients receiving rhGAA. Patients were from the clinical setting and from clinical trials of rhGAA, were ≤6 months of age, were not invasively ventilated, and were treated with IV rhGAA at a cumulative or total dose of 20 or 40 mg/kg/2 weeks. Outcome measures included survival, invasive ventilator-free survival, cardiac status, gross motor development, development of antibodies to rhGAA, and levels of urinary Glc4. Following 52 weeks of treatment, 6/11 (54.5%) CRIM-negative and 1/21 (4.8%) CRIM-positive patients were deceased or invasively ventilated (p < 0.0001). By age 27.1 months, all CRIM-negative patients and 4/21 (19.0%) CRIM-positive patients were deceased or invasively ventilated. Cardiac function and gross motor development improved significantly more in the CRIM-positive group. IgG antibodies to rhGAA developed earlier and serotiters were higher and more sustained in the CRIM-negative group. CRIM-negative status predicted reduced overall survival and invasive ventilator-free survival and poorer clinical outcomes in infants with Pompe disease treated with rhGAA. The effect of CRIM status on outcome appears to be mediated by antibody responses to the exogenous protein. PMID:19775921

  20. Cross-reactive immunologic material status affects treatment outcomes in Pompe disease infants.

    PubMed

    Kishnani, Priya S; Goldenberg, Paula C; DeArmey, Stephanie L; Heller, James; Benjamin, Danny; Young, Sarah; Bali, Deeksha; Smith, Sue Ann; Li, Jennifer S; Mandel, Hanna; Koeberl, Dwight; Rosenberg, Amy; Chen, Y-T

    2010-01-01

    Deficiency of acid alpha glucosidase (GAA) causes Pompe disease, which is usually fatal if onset occurs in infancy. Patients synthesize a non-functional form of GAA or are unable to form native enzyme. Enzyme replacement therapy with recombinant human GAA (rhGAA) prolongs survival in infantile Pompe patients but may be less effective in cross-reactive immunologic material (CRIM)-negative patients. We retrospectively analyzed the influence of CRIM status on outcome in 21 CRIM-positive and 11 CRIM-negative infantile Pompe patients receiving rhGAA. Patients were from the clinical setting and from clinical trials of rhGAA, were 6 months of age, were not invasively ventilated, and were treated with IV rhGAA at a cumulative or total dose of 20 or 40 mg/kg/2 weeks. Outcome measures included survival, invasive ventilator-free survival, cardiac status, gross motor development, development of antibodies to rhGAA, and levels of urinary Glc(4). Following 52 weeks of treatment, 6/11 (54.5%) CRIM-negative and 1/21 (4.8%) CRIM-positive patients were deceased or invasively ventilated (p<0.0001). By age 27.1 months, all CRIM-negative patients and 4/21 (19.0%) CRIM-positive patients were deceased or invasively ventilated. Cardiac function and gross motor development improved significantly more in the CRIM-positive group. IgG antibodies to rhGAA developed earlier and serotiters were higher and more sustained in the CRIM-negative group. CRIM-negative status predicted reduced overall survival and invasive ventilator-free survival and poorer clinical outcomes in infants with Pompe disease treated with rhGAA. The effect of CRIM status on outcome appears to be mediated by antibody responses to the exogenous protein.

  1. Comparison of the Mortality and In-Hospital Outcomes of Preterm Infants Treated with Ibuprofen for Patent Ductus Arteriosus with or without Clinical Symptoms Attributable to the Patent Ductus Arteriosus at the Time of Ibuprofen Treatment

    PubMed Central

    2017-01-01

    The aim of this study was to assess the differences in the mortality and in-hospital outcomes of preterm infants with < 28 weeks of gestation who received ibuprofen treatment according to the presence of clinical symptoms (any of oliguria, hypotension, or moderate to severe respiratory difficulty) attributable to hemodynamically-significant patent ductus arteriosus (hsPDA) at the time of first ibuprofen treatment. In total, 91 infants born from April 2010 to March 2015 were included. Fourteen infants (15.4%) received ibuprofen treatment when there were clinical symptoms due to hsPDA (clinical symptoms group). In clinical symptoms group, infants were younger (25 [23–27] vs. 26 [23–27] weeks; P = 0.012) and lighter (655 [500–930] vs. 880 [370–1,780] grams; P < 0.001). Also, the clinical risk index for babies (CRIB)-II scores were higher and more infants received invasive ventilator care ≤ 2 postnatal days. More infants received multiple courses of ibuprofen in clinical symptoms group. Although the frequency of secondary patent ductus arteriosus (PDA) ligation and the incidence of bronchopulmonary dysplasia (BPD) was higher in the clinical symptoms group in the univariate analysis, after multivariate logistic regression analysis adjusting for the CRIB-II score, birthweight, birth year, and the invasive ventilator care ≤ 2 postnatal days, there were no significant differences in mortality, frequency of secondary ligation and in-hospital outcomes including necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), BPD or death. Our data suggest that we can hold off on PDA treatment until the clinical symptoms become prominent. PMID:27914140

  2. Mortality in the first 24h of very low birth weight preterm infants in the Northeast of Brazil

    PubMed Central

    de Castro, Eveline Campos Monteiro; Leite, Álvaro Jorge Madeiro; Guinsburg, Ruth

    2016-01-01

    Abstract Objective: To evaluate factors associated with neonatal death within 24 hours after birth in very low birth weight preterm newborns. Methods: Prospective cohort of live births with gestational age of 230/7–316/7 weeks, birth weight of 500–1499g without malformations, in 19 public maternity hospitals in nine capitals in northeastern Brazil from July to December 2007. The 19 hospitals were assessed in relation to physical resources, equipment, human resources and aiming at quality in care initiatives. Hospital, maternal and neonatal characteristics, neonatal morbidity, neonatal procedures and interventions were compared between preterm newborns that died or survived up to 24 hours of life. The variables associated with death within 24 hours after birth were determined by logistic regression. Results: Of the 627 newborns enrolled in the study, 179 (29%) died within 168 hours after birth, of which 59 (33%) up to 24 hours and 97 (54%) up to 48 hours after birth. The variables associated with death <24h were: weight <1000g (2.94; 1.32–6.53), 5th minute Apgar <7 (7.17; 3.46–14.88), male gender (2.99; 1.39–6.47). A better hospital structure was a protective factor for early neonatal death (odds ratio: 0.34; 95% confidence interval: 0.17–0.71). Conclusions: The high neonatal mortality on the first day of life in capital cities of Northeast Brazil is associated with biological variables such as weight and gender of the newborn, as well as low vitality at birth and a worse infrastructure of the hospital where the birth occurred. PMID:26726002

  3. Lutein supplementation increases breast milk and plasma lutein concentrations in lactating women and infant plasma concentrations but does not affect other carotenoids.

    PubMed

    Sherry, Christina L; Oliver, Jeffery S; Renzi, Lisa M; Marriage, Barbara J

    2014-08-01

    Lutein is a carotenoid that varies in breast milk depending on maternal intake. Data are lacking with regard to the effect of dietary lutein supplementation on breast milk lutein concentration during lactation and subsequent plasma lutein concentration in breast-fed infants. This study was conducted to determine the impact of lutein supplementation in the breast milk and plasma of lactating women and in the plasma of breast-fed infants 2-3 mo postpartum. Lutein is the dominant carotenoid in the infant brain and the major carotenoid found in the retina of the eye. Eighty-nine lactating women 4-6 wk postpartum were randomly assigned to be administered either 0 mg/d of lutein (placebo), 6 mg/d of lutein (low-dose), or 12 mg/d of lutein (high-dose). The supplements were consumed for 6 wk while mothers followed their usual diets. Breast milk carotenoids were measured weekly by HPLC, and maternal plasma carotenoid concentrations were measured at the beginning and end of the study. Infant plasma carotenoid concentrations were assessed at the end of the study. No significant differences were found between dietary lutein + zeaxanthin intake and carotenoid concentrations in breast milk and plasma or body mass index at baseline. Total lutein + zeaxanthin concentrations were greater in the low- and high-dose-supplemented groups than in the placebo group in breast milk (140% and 250%, respectively; P < 0.0001), maternal plasma (170% and 250%, respectively; P < 0.0001), and infant plasma (180% and 330%, respectively; P < 0.05). Lutein supplementation did not affect other carotenoids in lactating women or their infants. Lactating women are highly responsive to lutein supplementation, which affects plasma lutein concentrations in the infant. This trial was registered at clinicaltrials.gov as NCT01747668.

  4. Maternal, neonatal and community factors influencing neonatal mortality in Brazil.

    PubMed

    Machado, Carla Jorge; Hill, Kenneth

    2005-03-01

    Child mortality (the mortality of children less than five years old) declined considerably in the developing world in the 1990s, but infant mortality declined less. The reductions in neonatal mortality were not impressive and, as a consequence, there is an increasing percentage of infant deaths in the neonatal period. Any further reduction in child mortality, therefore, requires an understanding of the determinants of neonatal mortality. 209,628 birth and 2581 neonatal death records for the 1998 birth cohort from the city of São Paulo, Brazil, were probabilistically matched. Data were from SINASC and SIM, Information Systems on Live Births and Deaths of Brazil. Logistic regression was used to find the association between neonatal mortality and the following risk factors: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. Infants of older mothers were less likely to die in the neonatal period. Caesarean delivery was not found to be associated with neonatal mortality. Low birth weight, pre-term birth and low Apgar scores were associated with neonatal death. Having a mother who lives in the highest developed community decreased the odds of neonatal death, suggesting that factors not measured in this study are behind such association. This result may also indicate that other factors over and above biological and more proximate factors could affect neonatal death.

  5. FDA Approves Immunotherapy for a Cancer that Affects Infants and Children | Poster

    Cancer.gov

    By Frank Blanchard, Staff Writer The U.S. Food and Drug Administration (FDA) recently approved dinutuximab (ch14.18) as an immunotherapy for neuroblastoma, a rare type of childhood cancer that offers poor prognosis for about half of the children who are affected. The National Cancer Institute’s (NCI) Biopharmaceutical Development Program (BDP) at the Frederick National Laboratory for Cancer Research produced ch14.18 for the NCI-sponsored clinical trials that proved the drug’s effectiveness against the disease.

  6. Ten-Year Review of Major Birth Defects in VLBW Infants

    PubMed Central

    Hansen, Nellie I.; Shankaran, Seetha; Bell, Edward F.; Boghossian, Nansi S.; Murray, Jeffrey C.; Laptook, Abbot R.; Walsh, Michele C.; Carlo, Waldemar A.; Sánchez, Pablo J.; Van Meurs, Krisa P.; Das, Abhik; Hale, Ellen C.; Newman, Nancy S.; Ball, M. Bethany; Higgins, Rosemary D.; Stoll, Barbara J.

    2013-01-01

    OBJECTIVE: Birth defects (BDs) are an important cause of infant mortality and disproportionately occur among low birth weight infants. We determined the prevalence of BDs in a cohort of very low birth weight (VLBW) infants cared for at the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) centers over a 10-year period and examined the relationship between anomalies, neonatal outcomes, and surgical care. METHODS: Infant and maternal data were collected prospectively for infants weighing 401 to 1500 g at NRN sites between January 1, 1998, and December 31, 2007. Poisson regression models were used to compare risk of outcomes for infants with versus without BDs while adjusting for gestational age and other characteristics. RESULTS: A BD was present in 1776 (4.8%) of the 37 262 infants in our VLBW cohort. Yearly prevalence of BDs increased from 4.0% of infants born in 1998 to 5.6% in 2007, P < .001. Mean gestational age overall was 28 weeks, and mean birth weight was 1007 g. Infants with BDs were more mature but more likely to be small for gestational age compared with infants without BDs. Chromosomal and cardiovascular anomalies were most frequent with each occurring in 20% of affected infants. Mortality was higher among infants with BDs (49% vs 18%; adjusted relative risk: 3.66 [95% confidence interval: 3.41–3.92]; P < .001) and varied by diagnosis. Among those surviving >3 days, more infants with BDs underwent major surgery (48% vs 13%, P < .001). CONCLUSIONS: Prevalence of BDs increased during the 10 years studied. BDs remain an important cause of neonatal morbidity and mortality among VLBW infants. PMID:23733791

  7. The optimal mode of delivery for the haemophilia carrier expecting an affected infant is vaginal delivery.

    PubMed

    Ljung, R

    2010-05-01

    The optimal mode of delivery of a haemophilia carrier expecting a child is still a matter of uncertainty and debate. The aim of this commentary/review is to suggest that normal vaginal delivery should be the recommended mode of delivery for the majority of carriers, based on review of studies on obstetric aspects of haemophilia. About 2.0-4.0% of all haemophilia boys born in countries with a good standard of health care will suffer from ICH during the neonatal period. This is an average figure including all modes of delivery and regardless of whether the carrier status of the mother or the haemophilia status of the foetus was known or not at the time of delivery. On the basis of current literature, one may conclude that the risk of serious bleeding in the neonate affected with haemophilia is small in conjunction with normal vaginal delivery. It should be possible to further reduce the low frequency of complications if appropriate precautions are taken when planning the delivery in pregnant woman with known carrier status, if the sex of the foetus is known and, even more, when the haemophilia status of the foetus is known. Instrumental delivery such as use of vacuum extraction and foetal scalp monitors must be avoided at delivery of carriers.

  8. Maternal prenatal distress and poor nutrition – mutually influencing risk factors affecting infant neurocognitive development

    PubMed Central

    Monk, Catherine; Georgieff, Michael K.; Osterholm, Erin A.

    2012-01-01

    Background Accumulating data from animal and human studies indicate that the prenatal environment plays a significant role in shaping children’s neurocognitive development. Clinical, epidemiologic, and basic science research suggests that two experiences relatively common in pregnancy — an unhealthy maternal diet and psychosocial distress — significantly affect children’s future neurodevelopment. These prenatal experiences exert their influence in the context of one another and yet, almost uniformly, are studied independently. Scope and Method of Review In this review, we suggest that studying neurocognitive development in children in relation to both prenatal exposures is ecologically most relevant, and methodologically most sound. To support this approach, we selectively review two research topics that demonstrate the need for dual exposure studies, including exemplar findings on (1) the associations between pregnant women’s inadequate maternal intake of key nutrients – protein, fat, iron, zinc, and choline – as well as distress in relation to overlapping effects on children’s neurocognitive development; and (2) cross-talk between the biology of stress and nutrition that can amplify each experience for the mother and fetus,. We also consider obstacles to this kind of study design, such as questions of statistical methods for ‘disentangling’ the exposure effects, and aim to provide some answers. Conclusion Studies that specifically include both exposures in their design can begin to determine the relative and/or synergistic impact of these prenatal experiences on developmental trajectories — and thereby contribute most fully to the understanding of the early origins of health and disease. PMID:23039359

  9. Mortality, Morbidity, and Developmental Outcomes in Infants Born to Women Who Received Either Mefloquine or Sulfadoxine-Pyrimethamine as Intermittent Preventive Treatment of Malaria in Pregnancy: A Cohort Study

    PubMed Central

    Rupérez, María; González, Raquel; Mombo-Ngoma, Ghyslain; Kabanywanyi, Abdunoor M.; Sevene, Esperança; Ouédraogo, Smaïla; Kakolwa, Mwaka A.; Vala, Anifa; Accrombessi, Manfred; Briand, Valérie; Aponte, John J.; Manego Zoleko, Rella; Adegnika, Ayôla A.; Cot, Michel; Kremsner, Peter G.; Massougbodji, Achille; Abdulla, Salim; Ramharter, Michael; Macete, Eusébio; Menéndez, Clara

    2016-01-01

    Background Little is known about the effects of intermittent preventive treatment of malaria in pregnancy (IPTp) on the health of sub-Saharan African infants. We have evaluated the safety of IPTp with mefloquine (MQ) compared to sulfadoxine-pyrimethamine (SP) for important infant health and developmental outcomes. Methods and Findings In the context of a multicenter randomized controlled trial evaluating the safety and efficacy of IPTp with MQ compared to SP in pregnancy carried out in four sub-Saharan countries (Mozambique, Benin, Gabon, and Tanzania), 4,247 newborns, 2,815 born to women who received MQ and 1,432 born to women who received SP for IPTp, were followed up until 12 mo of age. Anthropometric parameters and psychomotor development were assessed at 1, 9, and 12 mo of age, and the incidence of malaria, anemia, hospital admissions, outpatient visits, and mortality were determined until 12 mo of age. No significant differences were found in the proportion of infants with stunting, underweight, wasting, and severe acute malnutrition at 1, 9, and 12 mo of age between infants born to women who were on IPTp with MQ versus SP. Except for three items evaluated at 9 mo of age, no significant differences were observed in the psychomotor development milestones assessed. Incidence of malaria, anemia, hospital admissions, outpatient visits, and mortality were similar between the two groups. Information on the outcomes at 12 mo of age was unavailable in 26% of the infants, 761 (27%) from the MQ group and 377 (26%) from the SP group. Reasons for not completing the study were death (4% of total study population), study withdrawal (6%), migration (8%), and loss to follow-up (9%). Conclusions No significant differences were found between IPTp with MQ and SP administered in pregnancy on infant mortality, morbidity, and nutritional outcomes. The poorer performance on certain psychomotor development milestones at 9 mo of age in children born to women in the MQ group compared

  10. Estimating the net effect of HIV on child mortality in African populations affected by generalized HIV epidemics.

    PubMed

    Marston, Milly; Zaba, Basia; Salomon, Joshua A; Brahmbhatt, Heena; Bagenda, Danstan

    2005-02-01

    For a given prevalence, HIV has a relatively higher impact on child mortality when mortality from other causes is low. To project the effect of the epidemic on child mortality, it is necessary to estimate a realistic schedule of "net" age-specific mortality rates that would operate if HIV were the only cause of child death observable. We assume that this net pattern would be independent of mortality from other causes. We used African studies that measured the survival of HIV-infected children (direct data) or survival of children of HIV-infected mothers (indirect data). We developed a mathematic procedure to estimate the mortality of infected children from indirect data sources and obtained net HIV mortality patterns for each study population. The net age-specific HIV mortality pattern for infected children can be described by a double Weibull curve fitted to empiric data; this gives a functional representation of age-specific mortality rates that decline after infancy and rise in the preteens. The fitted curve that we would expect if HIV were the only effective cause of death shows 67% net survival at 1 year and 39% at 5 years. The curve also predicts 13% net survival at 10 years using constraints based on survival of infected adults.

  11. Infant Mortality and African Americans

    MedlinePlus

    ... for Action Campaigns and Initiatives Performance Improvement and Management System Report to Congress Knowledge Center Capacity Building Information Services Events Calendar Resource Guide Justice and Health ...

  12. Environmental quality and infant mortality

    EPA Science Inventory

    The relationship between environmental conditions and human health varies by environmental media. In order to account for multiple ambient environmental conditions, we constructed an Environmental Quality Index (EQI)for use in health research. We used u.s. county level data repre...

  13. Infant Mortality and Hispanic Americans

    MedlinePlus

    ... and Management System Report to Congress Knowledge Center Capacity Building Information Services Events Calendar Resource Guide Justice ... Workforce Diversity Grants Youth Program Grants Other Grants Planning and Evaluation Grantee Best Practices Hispanic/Latino Asthma ...

  14. The impact of water supply and sanitation on area differentials in the decline of diarrhoeal disease mortality among infants in Stockholm 1878-1925.

    PubMed

    Macassa, Gloria; De Leon, Antonio Ponce; Burström, Bo

    2006-01-01

    This study analyses the impact of improved water supply and sanitation on the level and rate of decline of child diarrhoea mortality in Stockholm 1878-1925. Previous studies have failed to demonstrate an effect of improved water supply on the risk of diarrhoea mortality at the individual level. Using data on access to water and sanitation from a household survey in 1895 and mortality rates and sociodemographic information from individual data 1878-1925 to analyse area differentials in diarrhoea mortality, it was found that the proportion having their own latrine in the household was associated with lower mortality risk in 1895-1900, while the proportion having water in the household was associated with lower diarrhoea mortality risk during the mortality decline until 1925. Population effects of improved water and sanitation on diarrhoea mortality may be better measured at area level than at individual level.

  15. Modeling compensatory responses of ecosystem-scale water fluxes in forests affected by pine and spruce beetle mortality

    NASA Astrophysics Data System (ADS)

    Millar, D.; Ewers, B. E.; Peckham, S. D.; Mackay, D. S.; Frank, J. M.; Massman, W. J.; Reed, D. E.

    2015-12-01

    Mountain pine beetle (Dendroctonus ponderosae) and spruce beetle (Dendroctonus rufipennis) epidemics have led to extensive mortality in lodgepole pine (Pinus contorta) and Engelmann spruce (Picea engelmannii) forests in the Rocky Mountains of the western US. In both of these tree species, mortality results from hydraulic failure within the xylem, due to blue stain fungal infection associated with beetle attack. However, the impacts of these disturbances on ecosystem-scale water fluxes can be complex, owing to their variable and transient nature. In this work, xylem scaling factors that reduced whole-tree conductance were initially incorporated into a forest ecohydrological model (TREES) to simulate the impact of beetle mortality on evapotranspiration (ET) in both pine and spruce forests. For both forests, simulated ET was compared to observed ET fluxes recorded using eddy covariance techniques. Using xylem scaling factors, the model overestimated the impact of beetle mortality, and observed ET fluxes were approximately two-fold higher than model predictions in both forests. The discrepancy between simulated and observed ET following the onset of beetle mortality may be the result of spatial and temporal heterogeneity of plant communities within the foot prints of the eddy covariance towers. Since simulated ET fluxes following beetle mortality in both forests only accounted for approximately 50% of those observed in the field, it is possible that newly established understory vegetation in recently killed tree stands may play a role in stabilizing ecosystem ET fluxes. Here, we further investigate the unaccounted for ET fluxes in the model by breaking it down into multiple cohorts that represent live trees, dying trees, and understory vegetation that establishes following tree mortality.

  16. Social stress in pregnant squirrel monkeys (Saimiri boliviensis peruviensis) differentially affects placental transfer of maternal antibody to male and female infants.

    PubMed

    Coe, C L; Crispen, H R

    2000-11-01

    The capacity of prenatal stress to disrupt the placental transfer of maternal antibody was evaluated in neonatal squirrel monkeys (Saimiri boliviensis peruviensis) gestated under different pregnancy conditions. Normal squirrel monkey offspring (n = 63) were compared with infants generated from pregnancies that involved either a single or 3 periods of disturbance (ns = 21 and 29, respectively). At parturition, levels of antibody (IgG) were determined in mothers and neonates. Only the chronic disturbance condition significantly altered antibody levels in the mothers, resulting in lower IgG. Antibody transfer to the fetus was also affected only by chronic disturbance. In this case the effect was bidirectional, influenced by the sex of the infant. Males were born with lower levels, whereas female infants actually had higher-than-normal IgG, despite lower titers in their mothers. Because virtually all IgG is derived from the prenatal transfer of maternal antibody, it indicates that the sex of the fetus differentially affected this placental process. The IgG receptor may have been up-regulated selectively on the placentas of female fetuses, compensating for reduced antibody in the disturbed mothers.

  17. Biotic mortality factors affecting emerald ash borer (Agrilus planipennis) are highly dependent on life stage and host tree crown condition.

    PubMed

    Jennings, D E; Duan, J J; Shrewsbury, P M

    2015-10-01

    Emerald ash borer (EAB), Agrilus planipennis, is a serious invasive forest pest in North America responsible for killing tens to hundreds of millions of ash trees since it was accidentally introduced in the 1990 s. Although host-plant resistance and natural enemies are known to be important sources of mortality for EAB in Asia, less is known about the importance of different sources of mortality at recently colonized sites in the invaded range of EAB, and how these relate to host tree crown condition. To further our understanding of EAB population dynamics, we used a large-scale field experiment and life-table analyses to quantify the fates of EAB larvae and the relative importance of different biotic mortality factors at 12 recently colonized sites in Maryland. We found that the fates of larvae were highly dependent on EAB life stage and host tree crown condition. In relatively healthy trees (i.e., with a low EAB infestation) and for early instars, host tree resistance was the most important mortality factor. Conversely, in more unhealthy trees (i.e., with a moderate to high EAB infestation) and for later instars, parasitism and predation were the major sources of mortality. Life-table analyses also indicated how the lack of sufficient levels of host tree resistance and natural enemies contribute to rapid population growth of EAB at recently colonized sites. Our findings provide further evidence of the mechanisms by which EAB has been able to successfully establish and spread in North America.

  18. Behavioral profiles of affected and unaffected siblings of children with autism: contribution of measures of mother-infant interaction and nonverbal communication.

    PubMed

    Rozga, Agata; Hutman, Ted; Young, Gregory S; Rogers, Sally J; Ozonoff, Sally; Dapretto, Mirella; Sigman, Marian

    2011-03-01

    We investigated whether deficits in social gaze and affect and in joint attention behaviors are evident within the first year of life among siblings of children with autism who go on to be diagnosed with autism or ASD (ASD) and siblings who are non-diagnosed (NoASD-sib) compared to low-risk controls. The ASD group did not differ from the other two groups at 6 months of age in the frequency of gaze, smiles, and vocalizations directed toward the caregiver, nor in their sensitivity to her withdrawal from interaction. However, by 12 months, infants in the ASD group exhibited lower rates of joint attention and requesting behaviors. In contrast, NoASD-sibs did not differ from comparison infants on any variables of interest at 6 and 12 months.

  19. Forced Migration and Mortality in the Very Long Term: Did Perestroika Affect Death Rates Also in Finland?

    PubMed Central

    SAARELA, JAN; FINNÄS, FJALAR

    2009-01-01

    In this article, we analyze mortality rates of Finns born in areas that were ceded to the Soviet Union after World War II and from which the entire population was evacuated. These internally displaced persons are observed during the period 1971–2004 and compared with people born in the same region but on the adjacent side of the new border. We find that in the 1970s and 1980s, the forced migrants had mortality rates that were on par with those of people in the comparison group. In the late 1980s, the mortality risk of internally displaced men increased by 20% in relation to the expected time trend. This deviation, which manifests particularly in cardiovascular mortality, coincides with perestroika and the demise of the Soviet Union, which were events that resulted in an intense debate in civil society about restitution of the ceded areas. Because state actors were reluctant to engage, the debate declined after some few years, and after the mid-1990s, the death risk again approached the long-term trend. Our findings indicate that when internally displaced persons must adjust to situations for which appropriate coping behaviors are unknown, psychosocial stress might arise several decades after their evacuation. PMID:19771945

  20. Mortality Salience and Positive Affect Influence Adolescents' Attitudes toward Peers with Physical Disabilities: Terror Management and Broaden and Build Theories

    ERIC Educational Resources Information Center

    Taubman-Ben-Ari, Orit; Eherenfreund-Hager, Ahinoam; Findler, Liora

    2011-01-01

    Attitudes toward teenagers with and without physical disabilities, and their social acceptance, were examined from the perspective of terror management theory and the broaden and build theory. Participants (n = 390, aged 13-17) were divided into 3 experimental conditions: positive emotions, mortality salience, and control. Then, they were shown…

  1. The Potential Impact of Changes in Fertility on Infant, Child, and Maternal Mortality. World Bank Staff Working Papers No. 698 and Population and Development Series No. 23.

    ERIC Educational Resources Information Center

    Trussell, James; Pebley, Anne R.

    The relationship between changes in the timing and quantity of fertility, such as those that might result from an effective family planning program in developing countries, and changes in child and maternal mortality is examined. Results from five multivariate studies estimate the changes in mortality that might occur from altering maternal age,…

  2. Does use of flue-cured rather than blended cigarettes affect international variation in mortality from lung cancer and COPD?

    PubMed

    Lee, Peter N; Forey, Barbara A; Fry, John S; Hamling, Jan S; Hamling, John F; Sanders, Edward B; Carchman, Richard A

    2009-04-01

    We compared risk of lung cancer and chronic obstructive pulmonary disease (COPD) associated with flue-cured and blended cigarettes. Mortality and smoking data were collected for 1971-2000 by sex, age, and period for three countries with a mainly flue-cured market and four with a blended market. Epidemiological relative risk estimates for current and ex smoking were summarized. Smoking statistics and mortality were compared between flue-cured cigarette and blended cigarette countries. Unadjusted mortality rates were generally lower in blended cigarette countries early on, with the difference diminishing or reversing by the 1990s. Differences by cigarette type were rarely significant, due to variations, particularly for COPD, between countries within cigarette type. Current smoking prevalence was generally lower in blended cigarette countries in 1971-1975, with the difference reducing over time. Differences by type were never significant, with blended cigarette countries varying markedly. Ex-smoking increased over time and was lower for blended cigarette countries, generally not significantly. Consumption per smoker was somewhat lower for blended cigarette countries. Relative risk estimates for smoking, derived mainly from U.S. and UK studies, varied little by cigarette type. Conclusions based on estimated smoking-related excess mortality were similar to those based on unadjusted mortality rates. There was little indication of any difference between flue-cured and blended cigarettes on risk of lung cancer or COPD. Our approach could have detected differences of about 40% for male lung cancer, or twofold differences for females or for COPD, had they existed. Between-country differences in rates of two major diseases predominantly caused by smoking cannot materially be explained by whether the countries use flue-cured or blended cigarettes.

  3. Interstitial lung disease increases mortality in systemic sclerosis patients with pulmonary arterial hypertension without affecting hemodynamics and exercise capacity.

    PubMed

    Michelfelder, M; Becker, M; Riedlinger, A; Siegert, E; Drömann, D; Yu, X; Petersen, F; Riemekasten, G

    2017-02-01

    Published data suggest that coexisting interstitial lung disease (ILD) has an impact on mortality in patients with systemic sclerosis (SSc) and pulmonary arterial hypertension (PAH), but there is scarce knowledge if this is reflected by hemodynamics, exercise capacity, autoantibody profile, or pulmonary function. In this partially retrospective study, 27 SSc-PAH patients were compared to 24 SSc-PAH patients with coexisting ILD respecting to survival, pulmonary function, hemodynamics, exercise capacity, and laboratory parameters. Survival was significantly worse in SSc-PAH-ILD patients than in SSc patients with isolated PAH (1, 5, and 10-year survival rates 86, 54, and 54% versus 96, 92, and 82%, p = 0.013). Compared to isolated SSc-PAH patients, patients with SSc-PAH-ILD revealed lower forced expiratory volume after 1 s (FEV1) values at the time of PAH diagnosis as well as 1 and 2 years later (p = 0.002) without significant decrease in the PAH course in both groups. At PAH diagnosis, diffusion capacity for carbon monoxide (DLCO) values were lower in the ILD-PAH group. Coexisting ILD was not associated with lower exercise capacity, different FEV1/forced vital capacity (FVC) ratio, higher WHO functional class, or reduced hemodynamics. Higher levels of antibodies against angiotensin and endothelin receptors predict mortality in all SSc-PAH patients but could not differentiate between PAH patients with and without ILD. Our study confirmed an impact of ILD on mortality in SSc-PAH patients. Pulmonary function parameters can be used to distinguish PAH from PAH-ILD. The higher mortality rate cannot be explained by differences in hemodynamics, exercise capacity, or autoantibody levels. Mechanisms of mortality remain to be studied.

  4. Introducing the Oxford Vocal (OxVoc) Sounds database: a validated set of non-acted affective sounds from human infants, adults, and domestic animals

    PubMed Central

    Parsons, Christine E.; Young, Katherine S.; Craske, Michelle G.; Stein, Alan L.; Kringelbach, Morten L.

    2014-01-01

    Sound moves us. Nowhere is this more apparent than in our responses to genuine emotional vocalizations, be they heartfelt distress cries or raucous laughter. Here, we present perceptual ratings and a description of a freely available, large database of natural affective vocal sounds from human infants, adults and domestic animals, the Oxford Vocal (OxVoc) Sounds database. This database consists of 173 non-verbal sounds expressing a range of happy, sad, and neutral emotional states. Ratings are presented for the sounds on a range of dimensions from a number of independent participant samples. Perceptions related to valence, including distress, vocalizer mood, and listener mood are presented in Study 1. Perceptions of the arousal of the sound, listener motivation to respond and valence (positive, negative) are presented in Study 2. Perceptions of the emotional content of the stimuli in both Study 1 and 2 were consistent with the predefined categories (e.g., laugh stimuli perceived as positive). While the adult vocalizations received more extreme valence ratings, rated motivation to respond to the sounds was highest for the infant sounds. The major advantages of this database are the inclusion of vocalizations from naturalistic situations, which represent genuine expressions of emotion, and the inclusion of vocalizations from animals and infants, providing comparison stimuli for use in cross-species and developmental studies. The associated website provides a detailed description of the physical properties of each sound stimulus along with cross-category descriptions. PMID:25009511

  5. Top-down modulation in the infant brain: Learning-induced expectations rapidly affect the sensory cortex at 6 months

    PubMed Central

    Emberson, Lauren L.; Richards, John E.; Aslin, Richard N.

    2015-01-01

    Recent theoretical work emphasizes the role of expectation in neural processing, shifting the focus from feed-forward cortical hierarchies to models that include extensive feedback (e.g., predictive coding). Empirical support for expectation-related feedback is compelling but restricted to adult humans and nonhuman animals. Given the considerable differences in neural organization, connectivity, and efficiency between infant and adult brains, it is a crucial yet open question whether expectation-related feedback is an inherent property of the cortex (i.e., operational early in development) or whether expectation-related feedback develops with extensive experience and neural maturation. To determine whether infants’ expectations about future sensory input modulate their sensory cortices without the confounds of stimulus novelty or repetition suppression, we used a cross-modal (audiovisual) omission paradigm and used functional near-infrared spectroscopy (fNIRS) to record hemodynamic responses in the infant cortex. We show that the occipital cortex of 6-month-old infants exhibits the signature of expectation-based feedback. Crucially, we found that this region does not respond to auditory stimuli if they are not predictive of a visual event. Overall, these findings suggest that the young infant’s brain is already capable of some rudimentary form of expectation-based feedback. PMID:26195772

  6. No evidence of a threshold in traffic volume affecting road-kill mortality at a large spatio-temporal scale

    SciTech Connect

    Grilo, Clara; Ferreira, Flavio Zanchetta; Revilla, Eloy

    2015-11-15

    Previous studies have found that the relationship between wildlife road mortality and traffic volume follows a threshold effect on low traffic volume roads. We aimed at evaluating the response of several species to increasing traffic intensity on highways over a large geographic area and temporal period. We used data of four terrestrial vertebrate species with different biological and ecological features known by their high road-kill rates: the barn owl (Tyto alba), hedgehog (Erinaceus europaeus), red fox (Vulpes vulpes) and European rabbit (Oryctolagus cuniculus). Additionally, we checked whether road-kill likelihood varies when traffic patterns depart from the average. We used annual average daily traffic (AADT) and road-kill records observed along 1000 km of highways in Portugal over seven consecutive years (2003–2009). We fitted candidate models using Generalized Linear Models with a binomial distribution through a sample unit of 1 km segments to describe the effect of traffic on the probability of finding at least one victim in each segment during the study. We also assigned for each road-kill record the traffic of that day and the AADT on that year to test for differences using Paired Student's t-test. Mortality risk declined significantly with traffic volume but varied among species: the probability of finding road-killed red foxes and rabbits occurs up to moderate traffic volumes (< 20,000 AADT) whereas barn owls and hedgehogs occurred up to higher traffic volumes (40,000 AADT). Perception of risk may explain differences in responses towards high traffic highway segments. Road-kill rates did not vary significantly when traffic intensity departed from the average. In summary, we did not find evidence of traffic thresholds for the analysed species and traffic intensities. We suggest mitigation measures to reduce mortality be applied in particular on low traffic roads (< 5000 AADT) while additional measures to reduce barrier effects should take into account

  7. Population structure and connectivity in the Mediterranean sponge Ircinia fasciculata are affected by mass mortalities and hybridization

    PubMed Central

    Riesgo, A; Pérez-Portela, R; Pita, L; Blasco, G; Erwin, P M; López-Legentil, S

    2016-01-01

    Recent episodes of mass mortalities in the Mediterranean Sea have been reported for the closely related marine sponges Ircinia fasciculata and Ircinia variabilis that live in sympatry. In this context, the assessment of the genetic diversity, bottlenecks and connectivity of these sponges has become urgent in order to evaluate the potential effects of mass mortalities on their latitudinal range. Our study aims to establish (1) the genetic structure, connectivity and signs of bottlenecks across the populations of I. fasciculata and (2) the hybridization levels between I. fasciculata and I. variabilis. To accomplish the first objective, 194 individuals of I. fasciculata from 12 locations across the Mediterranean were genotyped at 14 microsatellite loci. For the second objective, mitochondrial cytochrome c oxidase subunit I sequences of 16 individuals from both species were analyzed along with genotypes at 12 microsatellite loci of 40 individuals coexisting in 3 Mediterranean populations. We detected strong genetic structure along the Mediterranean for I. fasciculata, with high levels of inbreeding in all locations and bottleneck signs in most locations. Oceanographic barriers like the Almeria-Oran front, North-Balearic front and the Ligurian-Thyrrenian barrier seem to be impeding gene flow for I. fasciculata, adding population divergence to the pattern of isolation by distance derived from the low dispersal abilities of sponge larvae. Hybridization between both species occurred in some populations that might be increasing genetic diversity and somewhat palliating the genetic loss caused by population decimation in I. fasciculata. PMID:27599575

  8. Sudden Infant Death Syndrome (SIDS)

    MedlinePlus

    ... CA, et al. American Indian and Alaska Native infant and pediatric mortality, United States, 1999-2009. American Journal of Public Health. 2014;104:S320. Oct. 28, 2016 Original article: ... . Mayo Clinic ...

  9. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

    PubMed Central

    Wang, Haidong; Liddell, Chelsea A; Coates, Matthew M; Mooney, Meghan D; Levitz, Carly E; Schumacher, Austin E; Apfel, Henry; Iannarone, Marissa; Phillips, Bryan; Lofgren, Katherine T; Sandar, Logan; Dorrington, Rob E; Rakovac, Ivo; Jacobs, Troy A; Liang, Xiaofeng; Zhou, Maigeng; Zhu, Jun; Yang, Gonghuan; Wang, Yanping; Liu, Shiwei; Li, Yichong; Ozgoren, Ayse Abbasoglu; Abera, Semaw Ferede; Abubakar, Ibrahim; Achoki, Tom; Adelekan, Ademola; Ademi, Zanfina; Alemu, Zewdie Aderaw; Allen, Peter J; AlMazroa, Mohammad AbdulAziz; Alvarez, Elena; Amankwaa, Adansi A; Amare, Azmeraw T; Ammar, Walid; Anwari, Palwasha; Cunningham, Solveig Argeseanu; Asad, Majed Masoud; Assadi, Reza; Banerjee, Amitava; Basu, Sanjay; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Bhutta, Zulfiqar; Blore, Jed; Basara, Berrak Bora; Boufous, Soufiane; Breitborde, Nicholas; Bruce, Nigel G; Bui, Linh Ngoc; Carapetis, Jonathan R; Cárdenas, Rosario; Carpenter, David O; Caso, Valeria; Castro, Ruben Estanislao; Catalá-Lopéz, Ferrán; Cavlin, Alanur; Che, Xuan; Chiang, Peggy Pei-Chia; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Cirillo, Massimo; Leite, Iuri da Costa; Courville, Karen J; Dandona, Lalit; Dandona, Rakhi; Davis, Adrian; Dayama, Anand; Deribe, Kebede; Dharmaratne, Samath D; Dherani, Mukesh K; Dilmen, Uğur; Ding, Eric L; Edmond, Karen M; Ermakov, Sergei Petrovich; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fijabi, Daniel Obadare; Foigt, Nataliya; Forouzanfar, Mohammad H; Garcia, Ana C; Geleijnse, Johanna M; Gessner, Bradford D; Goginashvili, Ketevan; Gona, Philimon; Goto, Atsushi; Gouda, Hebe N; Green, Mark A; Greenwell, Karen Fern; Gugnani, Harish Chander; Gupta, Rahul; Hamadeh, Randah Ribhi; Hammami, Mouhanad; Harb, Hilda L; Hay, Simon; Hedayati, Mohammad T; Hosgood, H Dean; Hoy, Damian G; Idrisov, Bulat T; Islami, Farhad; Ismayilova, Samaya; Jha, Vivekanand; Jiang, Guohong; Jonas, Jost B; Juel, Knud; Kabagambe, Edmond Kato; Kazi, Dhruv S; Kengne, Andre Pascal; Kereselidze, Maia; Khader, Yousef Saleh; Khalifa, Shams Eldin Ali Hassan; Khang, Young-Ho; Kim, Daniel; Kinfu, Yohannes; Kinge, Jonas M; Kokubo, Yoshihiro; Kosen, Soewarta; Defo, Barthelemy Kuate; Kumar, G Anil; Kumar, Kaushalendra; Kumar, Ravi B; Lai, Taavi; Lan, Qing; Larsson, Anders; Lee, Jong-Tae; Leinsalu, Mall; Lim, Stephen S; Lipshultz, Steven E; Logroscino, Giancarlo; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan Anthony; Ma, Stefan; Mahdi, Abbas Ali; Marzan, Melvin Barrientos; Mashal, Mohammad Taufiq; Mazorodze, Tasara T; McGrath, John J; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Miller, Ted R; Mills, Edward J; Mohammad, Karzan Abdulmuhsin; Mokdad, Ali H; Monasta, Lorenzo; Montico, Marcella; Moore, Ami R; Moschandreas, Joanna; Msemburi, William T; Mueller, Ulrich O; Muszynska, Magdalena M; Naghavi, Mohsen; Naidoo, Kovin S; Narayan, KM Venkat; Nejjari, Chakib; Ng, Marie; Ngirabega, Jean de Dieu; Nieuwenhuijsen, Mark J; Nyakarahuka, Luke; Ohkubo, Takayoshi; Omer, Saad B; Caicedo, Angel J Paternina; Wyk, Victoria Pillay-van; Pope, Dan; Prabhakaran, Dorairaj; Rahman, Sajjad UR; Rana, Saleem M; Reilly, Robert Quentin; Rojas-Rueda, David; Ronfani, Luca; Rushton, Lesley; Saeedi, Mohammad Yahya; Salomon, Joshua; Sampson, Uchechukwu; Santos, Itamar S; Sawhney, Monika; Schmidt, Jürgen C; Nazarova, Marina Shakh; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin Hyun; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga Dora; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soshnikov, Sergey S; Sposato, Luciano A; Stathopoulou, Vasiliki Kalliopi; Stroumpoulis, Konstantinos; Tabb, Karen M; Talongwa, Roberto Tchio; Teixeira, Carolina Maria; Terkawi, Abdullah Sulieman; Thomson, Alan J; Lyman, Andrew L Thorne; Toyoshima, Hideaki; Dimbuene, Zacharie Tsala; Uwaliraye, Parfait; Uzun, Selen Begüm; Vasankari, Tommi J; Vasconcelos, Ana Maria Nogales; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Vos, Theo; Waller, Stephen; Wan, Xia; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Westerman, Ronny; Wilkinson, James D; Williams, Hywel C; Yang, Yang C; Yentur, Gokalp Kadri; Yip, Paul; Yonemoto, Naohiro; Younis, Mustafa; Yu, Chuanhua; Jin, Kim Yun; Zaki, Maysaa El Sayed; Zhu, Shankuan; Lopez, Alan D; Murray, Christopher J L

    2014-01-01

    Summary Background Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. Methods We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. Findings We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990

  10. Reproductive Justice and the Pace of Change: Socioeconomic Trends in US Infant Death Rates by Legal Status of Abortion, 1960–1980

    PubMed Central

    Gruskin, Sofia; Singh, Nakul; Kiang, Mathew V.; Chen, Jarvis T.; Waterman, Pamela D.; Gottlieb, Jillian; Beckfield, Jason; Coull, Brent A.

    2015-01-01

    US infant death rates for 1960 to 1980 declined most quickly in (1) 1970 to 1973 in states that legalized abortion in 1970, especially for infants in the lowest 3 income quintiles (annual percentage change = −11.6; 95% confidence interval = −18.7, −3.8), and (2) the mid-to-late 1960s, also in low-income quintiles, for both Black and White infants, albeit unrelated to abortion laws. These results imply that research is warranted on whether currently rising restrictions on abortions may be affecting infant mortality. PMID:25713932

  11. Prolonged, but transient, elevation of liver and biliary function tests in a healthy infant affected with breast milk jaundice.

    PubMed

    Poddighe, Dimitri; Castelli, Lucia; Marseglia, Gian Luigi; Bruni, Paola

    2014-05-28

    Unconjugated hyperbilirubinaemia is a common finding in newborns. When it is exaggerated, it is usually investigated in order to exclude several diseases, such as newborn's haemolytic diseases, infections or hypothyroidism. Breast milk jaundice is a form of neonatal jaundice related to breast feeding and it is not usually associated with any clinical issue and/or other laboratory abnormalities. We describe a case of breast milk jaundice being associated, unexpectedly, to significant elevation of plasmatic liver and biliary enzymes. Despite the infant's good clinical condition and growth, several investigations were performed and these ruled out metabolic, infectious and autoimmune liver diseases. All liver function tests normalised by 6-7 months of life. We suggest that the finding of hypertransaminasaemia and hyper-γ-glutamyl transpeptidase in a benign clinical context (similar to what we described) should be followed for 6-7 months before performing sophisticated and expensive diagnostic investigations which aim at excluding some unlikely and severe diseases in a completely asymptomatic infant.

  12. Milk from different species: Relationship between protein fractions and inflammatory response in infants affected by generalized epilepsy.

    PubMed

    Albenzio, M; Santillo, A; Ciliberti, M G; Figliola, L; Caroprese, M; Marino, R; Polito, A N

    2016-07-01

    The present study was undertaken to evaluate the effect of protein fractions from bovine, caprine, and ovine milk on production of cytokines and reactive oxygen species (ROS) and reactive nitrogen species (RNS) by cultured peripheral blood mononuclear cells (PMBC) from infants with generalized epilepsy. Bovine, caprine, and ovine bulk milks were pasteurized and analyzed for chemical composition. Then, PBMC were isolated from 10 patients with generalized epilepsy (5 males; mean age 33.6±5.4mo). Production of tumor necrosis factor-α (TNF-α), IL-10, IL-6, and IL-1β was studied in cultured PBMC (from infants with epilepsy and controls) stimulated by bovine, caprine, and ovine milk and casein and whey protein fractions, and levels of ROS and RNS were measured in the culture supernatant. The ability of PBMC to secrete cytokines in response to milk and protein fraction stimulation may predict the secretion of soluble factor TNF-α in the bloodstream of challenged patients. Bovine, caprine, and ovine bulk milks induced low-level production of IL-10 by cultured PBMC in at least 50% of cases; the same behavior was observed in both casein and whey protein fractions for all species studied. Bovine and ovine milk and their casein fractions induced production of lower levels of IL-1β in 80% of patients, whereas caprine milk and its casein fraction induced the highest levels in 80% of patients. The amount of IL-6 detected after stimulation of PBMC by milk and its fractions for all species was lower than that of other proinflammatory cytokines. In the bovine, total free radicals were higher in bulk milk and lower in the casein fraction, whereas the whey protein fraction showed an intermediate level; in caprine, ROS/RNS levels were not different among milk fractions, whereas ovine had higher levels for bulk milk and casein than the whey protein fraction. Lower levels of ROS/RNS detected in PBMC cultured with caprine milk fraction could be responsible for the lower levels of

  13. Differences in extreme low salinity timing and duration differentially affect eastern oyster (Crassostrea virginica) size class growth and mortality in Breton Sound, LA

    NASA Astrophysics Data System (ADS)

    La Peyre, Megan K.; Eberline, Benjamin S.; Soniat, Thomas M.; La Peyre, Jerome F.

    2013-12-01

    Understanding how different life history stages are impacted by extreme or stochastic environmental variation is critical for predicting and modeling organism population dynamics. This project examined recruitment, growth, and mortality of seed (25-75 mm) and market (>75 mm) sized oysters along a salinity gradient over two years in Breton Sound, LA. In April 2010, management responses to the Deepwater Horizon oil spill resulted in extreme low salinity (<5) at all sites through August 2010; in 2011, a 100-year Mississippi River flood event resulted in low salinity in late spring. Extended low salinity (<5) during hot summer months (>25 °C) significantly and negatively impacted oyster recruitment, survival and growth in 2010, while low salinity (<5) for a shorter period that did not extend into July (<25 °C) in 2011 had minimal impacts on oyster growth and mortality. In 2011, recruitment was limited, which may be due to a combination of low spring time salinities, high 2010 oyster mortality, minimal 2010 recruitment, cumulative effects from 10 years of declining oyster stock in the area, and poor cultch quality. In both 2010 and 2011, Perkinsus marinus infection prevalence remained low throughout the year at all sites and almost all infection intensities were light. Oyster plasma osmolality failed to match surrounding low salinity waters in 2010, while oysters appeared to osmoconform throughout 2011 indicating that the high mortality in 2010 may be due to extended valve closing and resulting starvation or asphyxiation in response to the combination of low salinity during high temperatures (>25 °C). With increasing management of our freshwater inputs to estuaries combined with predicted climate changes, how extreme events affect different life history stages is key to understanding variation in population demographics of commercially important species and predicting future populations.

  14. Differences in extreme low salinity timing and duration differentially affect eastern oyster (Crassostrea virginica) size class growth and mortality in Breton Sound, LA

    USGS Publications Warehouse

    LaPeyre, Megan K.; Eberline, Benjamin S.; Soniat, Thomas M.; La Peyre, Jerome F.

    2013-01-01

    Understanding how different life history stages are impacted by extreme or stochastic environmental variation is critical for predicting and modeling organism population dynamics. This project examined recruitment, growth, and mortality of seed (25–75 mm) and market (>75 mm) sized oysters along a salinity gradient over two years in Breton Sound, LA. In April 2010, management responses to the Deepwater Horizon oil spill resulted in extreme low salinity (<5) at all sites through August 2010; in 2011, a 100-year Mississippi River flood event resulted in low salinity in late spring. Extended low salinity (<5) during hot summer months (>25 °C) significantly and negatively impacted oyster recruitment, survival and growth in 2010, while low salinity (<5) for a shorter period that did not extend into July (<25 °C) in 2011 had minimal impacts on oyster growth and mortality. In 2011, recruitment was limited, which may be due to a combination of low spring time salinities, high 2010 oyster mortality, minimal 2010 recruitment, cumulative effects from 10 years of declining oyster stock in the area, and poor cultch quality. In both 2010 and 2011, Perkinsus marinusinfection prevalence remained low throughout the year at all sites and almost all infection intensities were light. Oyster plasma osmolality failed to match surrounding low salinity waters in 2010, while oysters appeared to osmoconform throughout 2011 indicating that the high mortality in 2010 may be due to extended valve closing and resulting starvation or asphyxiation in response to the combination of low salinity during high temperatures (>25 °C). With increasing management of our freshwater inputs to estuaries combined with predicted climate changes, how extreme events affect different life history stages is key to understanding variation in population demographics of commercially important species and predicting future populations.

  15. Cell and Gene Therapy for Genetic Diseases: Inherited Disorders Affecting the Lung and Those Mimicking Sudden Infant Death Syndrome

    PubMed Central

    Keeler, Allison M.

    2012-01-01

    Abstract Some of the first human gene therapy trials targeted diseases of the lung and provided important information that will continue to help shape future trials. Here we describe both cell and gene therapies for lung diseases such as cystic fibrosis and alpha-1 antitrypsin disorder as well as fatty acid oxidation disorders that mimic sudden infant death syndrome (SIDS). Human clinical gene therapy trials for cystic fibrosis and alpha-1 antitrypsin have been performed using a variety of vectors including adenovirus, adeno-associated virus, and nonviral vectors. No human clinical gene therapy trials have been performed for disorders of fatty acid oxidation; however, important proof-of-principle studies have been completed for multiple fatty acid oxidation disorders. Important achievements have been made and have yet to come for cell and gene therapies for disorders of the lung and those mimicking SIDS. PMID:22642257

  16. Cell and gene therapy for genetic diseases: inherited disorders affecting the lung and those mimicking sudden infant death syndrome.

    PubMed

    Keeler, Allison M; Flotte, Terence R

    2012-06-01

    Some of the first human gene therapy trials targeted diseases of the lung and provided important information that will continue to help shape future trials. Here we describe both cell and gene therapies for lung diseases such as cystic fibrosis and alpha-1 antitrypsin disorder as well as fatty acid oxidation disorders that mimic sudden infant death syndrome (SIDS). Human clinical gene therapy trials for cystic fibrosis and alpha-1 antitrypsin have been performed using a variety of vectors including adenovirus, adeno-associated virus, and nonviral vectors. No human clinical gene therapy trials have been performed for disorders of fatty acid oxidation; however, important proof-of-principle studies have been completed for multiple fatty acid oxidation disorders. Important achievements have been made and have yet to come for cell and gene therapies for disorders of the lung and those mimicking SIDS.

  17. High risk for RSV bronchiolitis in late preterms and selected infants affected by rare disorders: a dilemma of specific prevention.

    PubMed

    Manzoni, P; Paes, B; Resch, B; Mejias, A; Ramilo, O; Carbonell-Estrany, X; Bont, L

    2012-05-01

    Respiratory syncytial virus (RSV) is the most frequent aetiologic agent that causes bronchiolitis and lower respiratory tract infection in infants. These infections may be severe and even life-threatening in selected high-risk populations. Traditional, well-established, high-risk populations are preterm infants with or without chronic lung disease and children with congenital heart disease. For these children, RSV prophylaxis using palivizumab, a monoclonal anti-RSV humanised antibody against the F-protein of RSV, has proven safe and efficacious in preventing RSV-related hospitalisation. Recently, a number of rare medical conditions have been associated with the risk of severe RSV infections. Evidence of safety and efficacy of RSV prophylaxis in these populations is lacking. Given the low incidence of these conditions, randomised trials are not feasible. A practical, opinion-based approach to this dilemma is offered in this paper. It is proposed that these rare disorders may qualify for RSV prophylaxis if the association between a specific condition and the risk of severe RSV infection is confirmed in at least 3 independent publications, of which at least 1 includes a prospective cohort study. To facilitate pharmaco-economic analyses, at least one of the three studies must also report on the absolute risk of severe RSV infection in the specified illness. The authors believe that qualification criteria will enable caregivers to target RSV prophylaxis more effectively in children with rare conditions and the proposed approach provides direction for future epidemiological studies on the risk of severe RSV infection in children with these uncommon, medical illnesses.

  18. Does neoadjuvant chemotherapy affect morbidity, mortality, reoperations, or readmissions in patients undergoing lumpectomy or mastectomy for breast cancer?

    PubMed Central

    Bennie, Barbara; Bray, Mallory S.; Vang, Choua A.; Linebarger, Jared H.

    2017-01-01

    Background The influence of neoadjuvant chemotherapy (NAC) prior to breast cancer surgery on postoperative complications is unclear. Our objective was to determine whether NAC was associated with postoperative outcomes in patients undergoing lumpectomy or mastectomy without reconstruction. Methods Patients meeting inclusion criteria were identified from the National Surgical Quality Improvement Program (NSQIP) database participant user files from 2005 through 2012, after which NSQIP discontinued the NAC variable. Primary outcome measures included a composite measure of morbidity and mortality (M&M) and reoperations and readmissions within 30 days of the index procedure. Rates of postoperative complications stratified by receipt of NAC were compared by χ2. A logistic regression model was then built that included confounding factors for M&M. Results There were 30,309 patients meeting inclusion criteria. NAC was not associated with any postoperative outcomes from 2005 through 2012, but it was associated with higher M&M in lumpectomy patients during 2011 to 2012 [P=0.011, odds ratio (OR) 2.579; 95% confidence interval (CI), 1.239–5.368]. Conclusions The finding that NAC was associated with higher M&M in lumpectomy patients during 2011 to 2012 warrants further investigation. Therefore, we recommend that the NSQIP database reinstitute the NAC variable to allow monitoring during anticipated changes in chemotherapy agents and protocols. PMID:28210548

  19. Maternal smoking and infant feeding: breastfeeding is better and safer.

    PubMed

    Dorea, Jose G

    2007-05-01

    The rise in smoking rates among young women has implications for children's health aggravated in lower social strata where infant morbidity and mortality rates are higher. The protection afforded by breastfeeding is beneficial to infants in rich and poor countries alike. Women (especially when young, uneducated, and unsupported) who are smokers constitute a risk group for abandoning breastfeeding; moreover, their bottle-fed newborns run a greater risk of morbidity and mortality. Bottle-feeding is attendant on maternal cigarette smoking. The advantages of breastfeeding over bottle-feeding are discussed with regard to systemic effects and the specific effects of cyanide (which can affect the iodine metabolism of infants) and nicotine derived from food and maternal smoking. Despite great strides in bans on smoking, public health policies should be designed to keep in perspective that breastfeeding is an effective tool to counterbalance the health disadvantages that under-privileged infants of smoking mothers face. This paper argues that infants born to smoking parents are better protected by breastfeeding than by formula feeding. Therefore, if public health policies cannot stop addicted mothers from smoking during pregnancy it is fundamental not to miss the chance of encouraging and supporting breastfeeding. The food and health inequalities of socially disadvantaged groups demand well crafted public-health policies to reduce the incidence of diseases and compress morbidity: these policies need to make it clear that breastfeeding is better and safer.

  20. Vestibular Stimulation and Development of the Small Premature Infant.

    ERIC Educational Resources Information Center

    Neal, Mary V.

    This study was designed to explore the effects of vestibular stimulation on the developmental behavior, respiratory functioning, weight and length gains, and morbidity and mortality rates of premature infants. A total of 20 infants participated in this study in 4 groups of 5 infants each. Group A infants were placed in a motorized hammock within…

  1. Brood stock segregation for the control of bacterial kidney disease can affect mortality of progeny chinook salmon (Oncorhynchus tshawytscha) in seawater

    USGS Publications Warehouse

    Elliott, Diane G.; Pascho, Ronald J.; Palmisano, Aldo N.

    1995-01-01

    Segregation of spring chinook salmon (Oncorhynchus tshawytscha) brood stock based on the measurement of maternal Renibacterium salmoninarum infection levels by the enzyme-linked immunosorbent assay (ELISA) and the fluorescent antibody technique (FAT) was previously shown to affect the prevalence and levels of bacterial kidney disease (BKD) in progeny fish during hatchery rearing. Smolts from that study were subjected to standardized fish health and condition evaluation procedures 2 weeks before the conclusion of hatchery rearing and release of the fish for migration to the Pacific Ocean. The results suggested that the general health of the smolts in the progeny group from parents that had low R. salmoninarum infection levels or tested negative for R. salmoninarum (low-BKD group) was better than that of the smolts in the progeny group from female parents with high R. salmoninarum infection levels (high-BKD group). Testing by the ELISA showed that the overall severity of R. salmoninarum infection also was lower in the smolts from the low-BKD group. Subgroups of smolts from the study were acclimated to tanks of seawater for extended holding. After a 22-day acclimation period and 98 days in full-strength (29 ppt salinity) seawater, total mortality was 12% in the low-BKD group and 44% in the high-BKD group. All of the mortality in the low-BKD group and 85% of the mortality in the high-BKD group occurred after the fish were transferred to full-strength seawater. Testing of kidney tissues from all dead fish by the FAT revealed that 85% of the fish that died in the high-BKD group had high R. salmoninarum numbers, indicating that BKD was the cause of death. In contrast, none of the fish that died in the low-BKD group had detectable numbers of R. salmoninarum. We concluded that brood stock segregation by use of the ELISA and the FAT can affect mortality and the R. salmoninarum status of progeny chinook salmon for as long as 21 months after hatching, even after the fish have

  2. Toward a greater understanding of the emotional dynamics of the mortality salience manipulation: revisiting the "affect-free" claim of terror management research.

    PubMed

    Lambert, Alan J; Eadeh, Fade R; Peak, Stephanie A; Scherer, Laura D; Schott, John Paul; Slochower, John M

    2014-05-01

    The experimental manipulation of mortality salience (MS) represents one of the most widely used methodological procedures in social psychology, having been employed by terror management researchers in hundreds of studies over the last 20 years. One of the more provocative conclusions regarding this task is that it does not produce any reliable changes in self-reported affect, a view that we refer to as the affect-free claim. After reviewing 336 published studies that used the standard version of the MS task, we suggest that the evidence on which this claim is based may be less definitive than is commonly supposed. Moreover, we propose that the MS manipulation can, in fact, produce significant and meaningful changes in affect once one employs the appropriate measures and experimental design. In support of this position, we report 4 experiments, each of which demonstrates reliable activation of negative affect, especially with respect to fear-/terror-related sentiments. We discuss the implications of our findings for terror management theory as well as for research and theory on the measurement of mood and emotion.

  3. Availability and temporal heterogeneity of water supply affect the vertical distribution and mortality of a belowground herbivore and consequently plant growth.

    PubMed

    Tsunoda, Tomonori; Kachi, Naoki; Suzuki, Jun-Ichirou

    2014-01-01

    We examined how the volume and temporal heterogeneity of water supply changed the vertical distribution and mortality of a belowground herbivore, and consequently affected plant biomass. Plantago lanceolata (Plantaginaceae) seedlings were grown at one per pot under different combinations of water volume (large or small volume) and heterogeneity (homogeneous water conditions, watered every day; heterogeneous conditions, watered every 4 days) in the presence or absence of a larva of the belowground herbivorous insect, Anomala cuprea (Coleoptera: Scarabaeidae). The larva was confined in different vertical distributions to top feeding zone (top treatment), middle feeding zone (middle treatment), or bottom feeding zone (bottom treatment); alternatively no larva was introduced (control treatment) or larval movement was not confined (free treatment). Three-way interaction between water volume, heterogeneity, and the herbivore significantly affected plant biomass. With a large water volume, plant biomass was lower in free treatment than in control treatment regardless of heterogeneity. Plant biomass in free treatment was as low as in top treatment. With a small water volume and in free treatment, plant biomass was low (similar to that under top treatment) under homogeneous water conditions but high under heterogeneous ones (similar to that under middle or bottom treatment). Therefore, there was little effect of belowground herbivory on plant growth under heterogeneous water conditions. In other watering regimes, herbivores would be distributed in the shallow soil and reduced root biomass. Herbivore mortality was high with homogeneous application of a large volume or heterogeneous application of a small water volume. Under the large water volume, plant biomass was high in pots in which the herbivore had died. Thus, the combinations of water volume and heterogeneity affected plant growth via the change of a belowground herbivore.

  4. Advance Report of Final Mortality Statistics, 1985.

    ERIC Educational Resources Information Center

    Monthly Vital Statistics Report, 1987

    1987-01-01

    This document presents mortality statistics for 1985 for the entire United States. Data analysis and discussion of these factors is included: death and death rates; death rates by age, sex, and race; expectation of life at birth and at specified ages; causes of death; infant mortality; and maternal mortality. Highlights reported include: (1) the…

  5. Sudden infant death syndrome

    MedlinePlus

    Crib death; SIDS ... However, SIDS is still a major cause of death in infants under 1 year old. Thousands of ... affects boys more often than girls. Most SIDS deaths occur in the winter. The following may increase ...

  6. Influence of Terrain and Land Cover on the Isotopic Composition of Seasonal Snowpack in Rocky Mountain Headwater Catchments Affected by Bark Beetle Induced Tree Mortality

    NASA Astrophysics Data System (ADS)

    Kipnis, E. L.; Murphy, M.; Klatt, A. L.; Miller, S. N.; Williams, D. G.

    2015-12-01

    Session H103: The Hydrology-Vegetation-Climate Nexus: Identifying Process Interactions and Environmental Shifts in Mountain Catchments Influence of Terrain and Land Cover on the Isotopic Composition of Seasonal Snowpack in Rocky Mountain Headwater Catchments Affected by Bark Beetle Induced Tree Mortality Evan L Kipnis, Melanie A Murphey, Alan Klatt, Scott N Miller, David G Williams Snowpack accumulation and ablation remain difficult to estimate in forested headwater catchments. How physical terrain and forest cover separately and interactively influence spatial patterns of snow accumulation and ablation largely shapes the hydrologic response to land cover disturbances. Analysis of water isotopes in snowpack provides a powerful tool for examining integrated effects of water vapor exchange, selective redistribution, and melt. Snow water equivalence (SWE), δ2H, δ18O and deuterium excess (D-excess) of snowpack were examined throughout winter 2013-2014 across two headwater catchments impacted by bark beetle induced tree mortality. A USGS 10m DEM and a derived land cover product from 1m NAIP imagery were used to examine the effects of terrain features (e.g., elevation, slope, aspect) and canopy disturbance (e.g., live, bark-beetle killed) as predictors of D-excess, an expression of kinetic isotope effects, in snowpack. A weighting of Akaike's Information Criterion (AIC) values from multiple spatially lagged regression models describing D-excess variation for peak snowpack revealed strong effects of elevation and canopy mortality, and weaker, but significant effects of aspect and slope. Snowpack D-excess was lower in beetle-killed canopy patches compared to live green canopy patches, and at lower compared to high elevation locations, suggesting that integrated isotopic effects of vapor exchange, vertical advection of melted snow, and selective accumulation and redistribution varied systematically across the two catchments. The observed patterns illustrate the potential

  7. Female circumcision and child mortality in urban Somalia.

    PubMed

    Mohamud, O A

    1991-01-01

    In Somalia, a demographer analyzed urban data obtained from the Family Health Survey to examine the effect female circumcision has on child mortality and the mechanism of that effect. Girls undergo female circumcision between 5-12 years old in Somalia. Since sunni circumcision (removal of the clitoral prepuce and tip of the clitoris) and clitoridectomy (removal of the entire clitoris) did not affect child mortality, he used them as the reference group. Infibulation (entire removal of the clitoris and of the labia minora and majora with the remains of the labia majora being sewn together allowing only a small opening for passage of urine) did affect child mortality. Female children who underwent infibulation and whose mothers most likely also underwent infibulation experienced higher mortality (13-72%) than those from other circumcised mothers. Female mortality exceeded male mortality indicating possible son preference. Mothers with clitoridectomy or infibulation had significantly higher infant mortality than those with sunni circumcision with the strongest effects during the neonatal period (95% and 42% higher mortality, respectively; p=.01). The effect of female circumcision on child mortality decreased with increased child's age. This higher than expected mortality among women with clitoridectomy may have been because women with infibulation had more stillbirths which were not counted as births. The exposed vagina of clitoridectomized women is more likely to be infected resulting in high risk of stillbirths and premature births than the closed vagina of infibulated women. The researcher suggested that the policies promoting education and consciousness raising may eventually eradicate female circumcision. This longterm campaign should use mass media, senior women of high status, and respected religious leaders. Legislation prohibiting this practice would only drive it underground under unsanitary conditions. Demographers should no longer ignore female circumcision

  8. [Effect of past abortions and the sequence of gestations on the course of the next pregnancy and labor as well as the state-at-delivery, maturity, dystrophia and mortality rate of the newborn infants].

    PubMed

    Osuch-Jaczewska, R; Tomala, J

    1979-02-01

    Legal abortions have reduced the number of miscarriages by 20%, and of abandoned children by 56%; but at the same time, can be hazardous to the mother both initially (loss of blood, punctured uterus, damaged cervix) and later (infections in the reproductive system, infertility, extrauterine pregnancy, psychological disorders). From 1968 to 1975, 12,795 mothers and their newborns were studied: group 1 (24.8%), were mothers who have had abortions prior to 1st delivery; group 2 (42.3%), mothers having a first delivery with no previous miscarriages or abortions; and group 3 (32.9%), mothers of 2 or more children who had abortions afterwards. Abortion prior to first delivery increased the number of complications (54.4%) during pregnancy (liver and kidney problems, bacterial and viral infections), and during delivery (dirty amniotic fluid, bag of waters ruptured prematurely, pathology of the placenta and membranes, pathology of the umbilical cord). 10% of the deliveries where the mother had a previous history of abortion required medical intervention. Intrauterine dystrophy had occurred in 17% cases and the incidence of premature births was greater, 16%. 29.2% of the infants were in poor condition at delivery according to the Apgar scale (under 4 points) and 42.4% manifested disturbances in environment adaptability. The neonatal mortality rate 6.6% was twice that of the infants from the other 2 groups. The authors conclude that abortions are a threat to the health of mothers and during subsequent pregnancies, endanger the fetus and the newborn. Abortion cannot be regarded as a means of family planning. (Summaries in RUS, ENG).

  9. Accidental ingestion of E-cigarette liquid nicotine in a 15-month-old child: an infant mortality case of nicotine intoxication

    PubMed Central

    Seo, An Deok; Kim, Dong Chan; Yu, Hee Joon

    2016-01-01

    Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents. PMID:28194215

  10. Maternal-infant interaction and autonomic function in healthy infants and infants with transposition of the great arteries.

    PubMed

    Harrison, Tondi M; Ferree, Allison

    2014-12-01

    The quality of maternal-infant interaction is a critical factor in the development of infants' autonomic function and social engagement skills. In this secondary data analysis, relationships among infant and maternal affect and behavior and quality of dyadic interaction, as measured by the Parent-Child Early Relational Assessment, and infant autonomic function, as measured by heart rate variability, were examined during feeding at 2 weeks and 2 months of age in 16 healthy infants and in 15 infants with transposition of the great arteries (TGA). Contrary to previous research, at 2 weeks infant age, mothers of infants with TGA had significantly higher scores in affect and behavior than did mothers of healthy infants. The affect and behavior and quality of dyadic interaction of infants with TGA also did not differ from that of healthy infants. Although infants' social engagement skills did not differ by health condition (TGA or healthy), these skills did differ by parasympathetic nervous system function: infants better able to suppress vagal activity with challenge had more positive and less dysregulated affect and behavior, regardless of health status. These findings suggest that maternal-infant interactions for some cardiac disease subgroups may not differ from healthy dyads. Additional research is required to identify both healthy and ill infants with delayed autonomic maturation and to develop and test interventions to enhance critical interactive functions.

  11. Islam and infant feeding.

    PubMed

    Shaikh, Ulfat; Ahmed, Omar

    2006-01-01

    Few physicians in the United States receive formal education related to principles of infant care in Islamic families. Breastfeeding has a religious basis in Islam and it is recommended that the mother suckle her offspring for 2 years if possible. Weaning from the breast before that period is allowed if mutually decided on by both parents. The infant's father has an obligation to support his wife through any circumstances that may affect breastfeeding and, in case of divorce, provide shelter and financial support to the mother-infant dyad for as long as breastfeeding continues. By showing understanding and respect of Islamic beliefs related to infant feeding, clinicians can help support healthy early feeding of Muslim infants.

  12. Mortality Rates above Emergency Threshold in Population Affected by Conflict in North Kivu, Democratic Republic of Congo, July 2012–April 2013

    PubMed Central

    Carrión Martín, Antonio Isidro; Bil, Karla; Salumu, Papy; Baabo, Dominique; Singh, Jatinder; Kik, Corry; Lenglet, Annick

    2014-01-01

    The area of Walikale in North Kivu, Democratic Republic of Congo, is intensely affected by conflict and population displacement. Médecins-Sans-Frontières (MSF) returned to provide primary healthcare in July 2012. To better understand the impact of the ongoing conflict and displacement on the population, a retrospective mortality survey was conducted in April 2013. A two-stage randomized cluster survey using 31 clusters of 21 households was conducted. Heads of households provided information on their household make-up, ownership of non-food items (NFIs), access to healthcare and information on deaths and occurrence of self-reported disease in the household during the recall period. The recall period was of 325 days (July 2012–April 2013). In total, 173 deaths were reported during the recall period. The crude mortality rate (CMR) was of 1.4/10,000 persons/day (CI95%: 1.2–1.7) and the under-five- mortality rate (U5MR) of 1.9/10,000 persons per day (CI95%: 1.3–2.5). The most frequently reported cause of death was fever/malaria 34.1% (CI95%: 25.4–42.9). Thirteen deaths were due to intentional violence. Over 70% of all households had been displaced at some time during the recall period. Out of households with someone sick in the last two weeks, 63.8% sought health care; the main reason not to seek health care was the lack of money (n = 134, 63.8%, CI95%: 52.2–75.4). Non Food Items (NFI) ownership was low: 69.0% (CI95%: 53.1–79.7) at least one 10 liter jerry can, 30.1% (CI95%: 24.3–36.5) of households with visible soap available and 1.6 bednets per household. The results from this survey in Walikale clearly illustrate the impact that ongoing conflict and displacement are having on the population in this part of DRC. The gravity of their health status was highlighted by a CMR that was well above the emergency threshold of 1 person/10,000/day and an U5MR that approaches the 2 children/10,000/day threshold for the recall period. PMID:25233090

  13. Variation in tree mortality and regeneration affect forest carbon recovery following fuel treatments and wildfire in the Lake Tahoe Basin, California, USA

    PubMed Central

    2012-01-01

    Background Forest fuel treatments have been proposed as tools to stabilize carbon stocks in fire-prone forests in the Western U.S.A. Although fuel treatments such as thinning and burning are known to immediately reduce forest carbon stocks, there are suggestions that these losses may be paid back over the long-term if treatments sufficiently reduce future wildfire severity, or prevent deforestation. Although fire severity and post-fire tree regeneration have been indicated as important influences on long-term carbon dynamics, it remains unclear how natural variability in these processes might affect the ability of fuel treatments to protect forest carbon resources. We surveyed a wildfire where fuel treatments were put in place before fire and estimated the short-term impact of treatment and wildfire on aboveground carbon stocks at our study site. We then used a common vegetation growth simulator in conjunction with sensitivity analysis techniques to assess how predicted timescales of carbon recovery after fire are sensitive to variation in rates of fire-related tree mortality, and post-fire tree regeneration. Results We found that fuel reduction treatments were successful at ameliorating fire severity at our study site by removing an estimated 36% of aboveground biomass. Treated and untreated stands stored similar amounts of carbon three years after wildfire, but differences in fire severity were such that untreated stands maintained only 7% of aboveground carbon as live trees, versus 51% in treated stands. Over the long-term, our simulations suggest that treated stands in our study area will recover baseline carbon storage 10–35 years more quickly than untreated stands. Our sensitivity analysis found that rates of fire-related tree mortality strongly influence estimates of post-fire carbon recovery. Rates of regeneration were less influential on recovery timing, except when fire severity was high. Conclusions Our ability to predict the response of forest

  14. Dynamics of infant habituation: infants' discrimination of musical excerpts.

    PubMed

    Flom, Ross; Pick, Anne D

    2012-12-01

    Schöner and Thelen (2006) summarized the results of many habituation studies as a set of generalizations about the emergence of novelty preferences in infancy. One is that novelty preferences emerge after fewer trials for older than for younger infants. Yet in habituation studies using an infant-controlled procedure, the standard criterion of habituation is a 50% decrement in looking regardless of he ages of the participants. If younger infants require more looking to habituate than do older infants, it might follow that novelty preferences will emerge for younger infants when a more stringent criterion is imposed, e.g., a 70% decrement in looking. Our earlier investigation of infants' discrimination of musical excerpts provides a basis and an opportunity for assessing this idea. Flom et al. (2008) found that 9-month-olds, but not younger infants, unambiguously discriminate "happy" and "sad" musical excerpts. The purpose of the current study was to examine younger infants' discrimination of happy and sad musical excerpts using a more stringent, 70% habituation criterion. In Experiment 1, 5- and 7-month olds were habituated to three musical excerpts rated as happy or sad. Following habituation infants were presented with two musical excerpts from the other affect group. Infants at both ages showed significant discrimination. In Experiment 2, 5- and 7-month-olds were presented with two new excerpts from the same affective group as the habituation excerpts. The infants did not discriminate these novel, yet affectively similar excerpts. In Experiment 3, 5- and 7-month-olds discriminated individual happy and sad excerpts. These results replicate those for the older, 9-month-olds in the previous investigation. The results are important as they demonstrate that whether infants show discrimination using an infant-controlled procedure is affected by the researchers' chosen criterion of habituation.

  15. Early Day Care, Infant-Mother Attachment, and Maternal Responsiveness in the Infant's First Year.

    ERIC Educational Resources Information Center

    Burchinal, Margaret R.; And Others

    1992-01-01

    Examined the relationship between nonmaternal care and infant-mother attachment. Results indicated that full-time, nonmaternal care was not associated with increased insecure attachment and did not negatively affect the associations between infant-mother attachment and the mother's involvement with her infant during the infant's first year of…

  16. Perinatal Mortality in the United States, 1950-81.

    ERIC Educational Resources Information Center

    Powell-Griner, Eve

    1986-01-01

    This report describes long-term trends in perinatal mortality in the United States in three basic parts: development of perinatal mortality measures, components of fetal and infant mortality, and trends and differentials in perinatal mortality. Perinatal deaths refer to the sum of spontaneous fetal deaths occurring after 20 weeks gestation plus…

  17. Costa Rica saves infants' lives.

    PubMed

    Rosero-Bixby, L

    1988-01-01

    Even though Costa Rica is underdeveloped economically, life expectancy has been increasing over the past decade and the illiteracy rate was only 7% in 1984. Infant mortality rates have plummeted since 1972 when the 1st national health plan and social security were instituted (pre-1972: 2.3% annual reduction in infant mortality; 1972-1980: 13% decline annually). Decreased risk in the 1st postnatal month of life was responsible for 34% of the decrease from 1972-1980. Control of disease, especially diarrhea and acute respiratory infection, accounted for most of the decline (51%). Immunizations accounted for 8%, prevention of infectious diseases for 10%, control of malnutrition for 5%, and control of death due to premature birth for 14% of the decrease in mortality. Infant death due to pregnancy and delivery complications and congenital defects did not decrease during this period. Socioeconomic conditions normally influence survival rates strongly, but socioeconomic change in Costa Rica during 1970-1980 accounted for only 1/3 of the reduction in infant mortality. These improvements included an increase in the number of educated women, economic growth and decline in fertility (a decrease from 7.6 to 3.4 births between 1960-1980). The majority of the reduction stemmed from utilization of family planning techniques and the reduction of health risk factors. By 1980, the health program initiated in the 1970's provided primary care to 60% of the population, immunized 95% of the children against poliomyelitis, diptheria, pertussis, tetanus, and measles, and by 1984, provided almost all households with a sewage system. Analyses of the impact of socioeconomic development, fertility regulation, hospital care, outpatient services, and primary health care on infant mortality showed that, before 1970, those areas with better economies had a lower mortality rate, and after 1970, the economy and mortality rate had become independent variables. Furthermore, the introduction of health

  18. Infant botulism

    MedlinePlus

    ... and certain foods (such as honey and some corn syrups). Infant botulism occurs mostly in young infants ... spores. Clostridium spores are found in honey and corn syrup. These foods should not should not be ...

  19. Hyperglycemia - infants

    MedlinePlus

    High blood sugar - infants; High blood glucose level - infants ... have a low insulin level that results in high blood sugar. ... hyperglycemia often have no symptoms. Sometimes, babies with high blood sugar will produce large amounts of urine ...

  20. A regional-scale survey and analysis of forest growth and mortality as affected by site and stand factors and acidic deposition

    SciTech Connect

    Brooks, R.T. )

    1994-08-01

    Regression analyses were used to identify factors most closely related to species growth and