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  1. Infant Mortality

    MedlinePlus

    ... Infant Mortality Infant Mortality: What is CDC Doing? Sudden Infant Death Syndrome Teen Pregnancy Contraception CDC Contraceptive Guidance for ... and low birth weight Maternal complications of pregnancy Sudden Infant Death Syndrome (SIDS) Injuries (e.g., suffocation). The top ...

  2. Infant Mortality

    MedlinePlus

    ... and Social Environment Economic Circumstances Health Care Physical Environment and ... has a significant impact on adolescent development and well-being. Adolescent depression can adversely affect ...

  3. [Infant mortality in Peru].

    PubMed

    Ramos Padilla, M A

    1987-01-01

    Bolivia, Haiti, and Peru have infant mortality levels as high as those of the developed countries a century ago. The decline of general and especially infant mortality experienced in Latin America beginning in the 1940s was uneven throughout the continent. Cuba's infant mortality rate declined by 86% between 1940-80, but Peru's declined by only 48% despite its higher initial level. In 1984, 34% of all deaths in Peru were to children under 1 year and about 21% were to children 1-5 years old. Socioeconomic factors are the major explanation of Peru's poor infant mortality levels. Regional and social disparities in access to housing, food, urban infrastructure, and other vital goods and services are reflected in infant mortality statistics. Infant mortality has declined in both rural and urban areas, but the magnitude of the decline was much greater in urban areas. Between 1960-75, the infant mortality rate declined from 133 to 80/1000 live births in urban areas, but only from 180 to 150/1000 in rural areas. Investment in the infrastructure and services of the cities during the 1950s and 60s was not matched by any significant investment in rural infrastructure. Rural-urban mortality differentials are not as profound in countries which distribute public investment more evenly between rural and urban areas. Cuba's rural infant mortality rate is only 16% greater than its urban rate, while Peru's rural rate is 47% higher. The rural-urban differential in Peru hides a steep gap between the metropolitan zone of Lima-Callao, which has an infant mortality rate of 55/1000, and that of all cities, which have a rate 45% higher. Metropolitan Lima has the highest levels of living in Peru, including the highest incomes and best housing and service infrastructure. A majority of Peru's economic and industrial development has been concentrated in Lima. Peru's infant mortality differentials are also striking at the departmental level. The 5 departments with the highest infant mortality

  4. Socioeconomic, medical care, and public health contexts affecting infant mortality: a study of community-level differentials in Peru.

    PubMed

    Andes, N

    1989-12-01

    Socioeconomic, medical care, and public health contexts are examined in Peruvian communities for their relationship to infant mortality. A deviant case analysis is used to uncover characteristics important in the social structure of Peruvian communities. Results from fieldwork in two "deviant" communities suggest that economic diversity, income disparity, social class fluidity, and women's autonomy, along with refined measures of medical care and public health resources, are important in understanding differentials in mortality. Attention is drawn to the community context and to the interplay of socioeconomic determinants affecting infant mortality. PMID:2600382

  5. 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)

  6. Infant Mortality and Asians and Pacific Islanders

    MedlinePlus

    ... Infant Heath & Mortality Infant Mortality and Asians and Pacific Islanders Among Asian/Pacific Islanders, Sudden Infant Death Syndrome (SIDS) is the fourth leading cause of infant mortality. Asian/Pacific Islanders women generally have lower infant mortality rates ...

  7. [Changes in infant mortality].

    PubMed

    Aguirre, A

    1997-01-01

    Mexico's infant mortality rate is estimated to have declined from 189 in 1930 to 129 in 1950 and 30 in 1995. The infant mortality rate has continued its decline despite the economic crisis of recent years. The use of oral rehydration therapy has reduced mortality from diarrhea, and the spread of family planning has reduced the numbers of births at high risk due to maternal age, parity, or short birth intervals. The types of causes of infant death have changed as the numbers have decreased. They can be grouped in ascending order according to the difficulty of prevention: diseases preventable by immunization, acute diarrhea, acute respiratory infections, perinatal disorders, and congenital anomalies. Over two-thirds of infant deaths recorded since 1950 have been due to these causes. Infectious diseases, including diarrhea, acute respiratory infections, and conditions preventable by immunization predominated as causes of infant mortality before 1930. As the epidemiological transition progresses, diseases preventable by immunization lose importance, and diarrhea and respiratory infections occupy the first two places, with perinatal disorders being third. Between 1980 and 1990, in Mexico, diarrhea and acute respiratory infections dropped to second and third place after perinatal disorders, with congenital anomalies in fourth place. In most developed countries, perinatal disorders and congenital anomalies are the two most frequent causes of death, while diarrhea and respiratory infections no longer appear in the top five. In 1995, the four main causes in Mexico in descending order were perinatal disorders, congenital anomalies, acute respiratory infections, and diarrhea. PMID:12158082

  8. 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…

  9. Ethnicity and infant mortality in Malaysia.

    PubMed

    Dixon, G

    1993-06-01

    Malaysian infant mortality differentials are a worthwhile subject for study, because socioeconomic development has very clearly had a differential impact by ethnic group. The Chinese rates of infant mortality are significantly lower than the Malay or Indian rates. Instead of examining the obvious access to care issues, this study considered factors related to the culture of infant care. Practices include the Chinese confinement of the mother in the first month after childbirth ("pe'i yue") and Pillsbury's 12 normative rules for Malaysian Chinese care. Malay practices vary widely by region and history. Indian mothers are restricted by diet. Data-recording flaws do not permit analysis of Sarawak or Sabah. The general assumption that Western medicine favors better health for mothers and infants is substantiated among peninsular communities, however, there are also negative impacts which affect infant mortality. The complex interaction of factors impacting on infant mortality reported in seven previous studies is discussed. A review of these studies reveals that immediate causes are infections, injuries, and dehydration. Indirect causes are birth weight or social and behavioral factors such as household income or maternal education. Indirect factors, which are amenable to planned change and influence the biological proximate determinants of infant mortality, are identified as birth weight, maternal age at birth, short pregnancy intervals or prior reproductive loss, sex of the child, birth order, duration of breast feeding and conditions of supplementation, types of household water and sanitation, year of child's birth, maternal education, household income and composition, institution of birth, ethnicity, and rural residence. Nine factors are identified empirically as not significant: maternal hours of work in the child's first year, maternal occupation, distance from home to workplace, presence of other children or servants, incidence of epidemics in the child's first

  10. Infant mortality in Rajasthan villages.

    PubMed

    Gupta, S D; Jain, T P; Joshi, S; Mangal, D K

    1981-02-01

    Social, cultural and economic factors, beside medical causes, contribute to the high percentage of infant mortality in India. This study was carried out in 12 villages in the area of the Rural Health Training Centre, Naila, India; all villages were being regularly visited by paramedical staff and doctors. During 1977 62 infants died. Most parents were illiterate and very poor. 50.3% of deaths occurred within the first 28 days of life, and 25.8% within the first 7 days of life; 72.8% of deaths occurred within the first 6 months of life. Infections and malnutrition accounted for 77.3% of all deaths; pneumonia alone claimed 25.8% of lives, malnutrition 19.3%, fever for unknown reasons 16.1%, diarrhea 14.5% and prematurity 12.9%. Deaths for pneumonia were 56.3% in the postneonatal period and 43.7% in the neonatal period, while fever predominated as a cause of death in the neonatal rather than in postneonatal period, with 70% and 30% of deaths respectively. 56.4% of deaths were recorded among children born to mothers aged 21-30, 30.7% among children of mothers over 30, and 12.9% among children of mothers below 20. 51.6% of dead children had a birth order of 5 and over; only 17.8% had first birth order. 50.1% of deaths were observed in infants who were born less than 12 months from the previous conception. Similar studies done in other Indian regions show similar percentages of infant mortality and of causes for mortality. PMID:7263000

  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. Infant Mortality and Native Hawaiians/Pacific Islanders

    MedlinePlus

    ... Infant Heath & Mortality Infant Mortality and Native Hawaiians/Pacific Islanders While the overall infant mortality rate for Asians/Pacific Islanders is comparable to the white population, disparities ...

  13. 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.

  14. Infant Affect and Home Environment.

    ERIC Educational Resources Information Center

    Luster, Tom; And Others

    1993-01-01

    Examined data from National Longitudinal Survey of Youth to investigate relationship between infant affect and quality of home environment. Found that infant irritability was negatively correlated with quality of home environment in both low-risk and high-risk families. Infant positive affect was more strongly related to quality of care in…

  15. Infant Mortality and Hispanic Americans

    MedlinePlus

    ... from the 2013 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports . Table A. http://www. ... from the 2013 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports . Table 5. http://www. ...

  16. Infant Mortality and African Americans

    MedlinePlus

    ... from the 2013 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports . Table A. http://www. ... from the 2013 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports . Table 5. http://www. ...

  17. Infant mortality rates declining, but still high.

    PubMed

    Hoffman, M

    1992-10-01

    Family planning can improve infant survival. Specifically, use of family planning methods can minimize family size, increase birth spacing, and reduce the likelihood of pregnancy for teenagers and women aged 40 or older. Immunizations and oral rehydration are responsible for the falling infant mortality rats since 1977 in developing countries, especially among 1-12 month old infants. Yet, neonatal mortality in developing countries had not changed. WHO intends to step up efforts to improve newborn survival. Accurate data are needed, however. Even in developed countries which keep good statistics, infant mortality bias exists. For example, in Japan, some infant deaths are called fetal deaths. In developing countries, much of the data come from hospitals, yet most birth do not occur in hospitals. Even in surveys, bias exists, such as problems with recall. Many researchers use traditional birth attendants (TBAs) to follow up on all births in an area which may eliminate some biases. Such a prospective and longitudinal study in Trairi county in northeastern Brazil shows the infant mortality rate to be less than half of the official rate (65 vs. 142). The major causes of infant death in developed countries, which tends to occur in the neonatal period, are low birth weight, prematurity, birth complications, and congenital defects; developing countries; they are vaccine preventable infectious diseases, diarrhea and dehydration, and respiratory illnesses, all complicated by malnutrition. To make further strides in reducing infant mortality, public health workers must concentrate on the neonatal period. Training TBAs in sterile techniques, appropriate technology, resuscitation of infants, and identification of potential problems is a positive step. Yet, unpredictable conditions (e.g., AIDS) exist and/or will arise which erode improvements. For example, in Nicaragua, within 1 year after the new government introduced health budget cuts which resulted in the poor paying for

  18. 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. PMID:12286009

  19. Infant mortality and crisis in Mexico.

    PubMed

    Bronfman, M

    1992-01-01

    Data derived from the Encuesta Nacional de Fecundidad y Salud (ENFES) confirm that overall levels of infant mortality in Mexico have been steadily declining. However, a more specific analysis furnishes evidence that this decline has occurred at varying rates within different social groups, reflecting an increase in social inequalities. The analytical strategy used in this article leads to three basic conclusions: (1) the impact of the economic crisis on infant mortality is reflected not in a reversal of the declining trend but an increase in social inequalities; (2) certain variables universally accepted as determinants of infant mortality, such as mother's education, seem nonsignificant for some social sectors; and (3) certain biodemographic characteristics assumed to have a uniform mortality-related behavior vary among sectors, suggesting that even these constants are determined by social factors. PMID:1735623

  20. 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.

  1. Maternal stature, fertility and infant mortality.

    PubMed

    Martorell, R; Delgado, H L; Valverde, V; Klein, R E

    1981-09-01

    380 women of parity 1 or more living in coffee plantations of the Pacific lowlands of Guatemala were studied during the 18-month period from October 1977 to March 1979 to investigate the relationship between maternal stature, parity, offspring mortality, and number of surviving children. Average height was 142 cm or 4 feet 8 inches, average age was 28 years, and average parity was 4.4 children per woman: average number of surviving children per woman was 3. Simple correlation analysis shows that although shorter women appeared to have greater parities but fewer surviving children, the relationships were not statistically significant (p.05). However, when age and/or parity were adjusted, the association between maternal stature and number of surviving children became statistically significant (p.05). Children of shorter mothers exhibited high mortality rates which were not affected by adjustments for maternal age and parity (p.001). A possible explanation of the link between maternal stature and offspring survival is that taller women generally have heavier babies. This study suggests that maternal height can be used to identify infants at high mortality risk; this can have potential use in developing nations where many women do not get examined more than once during pregnancy. PMID:7309018

  2. Infant mortality -- an indicator of development.

    PubMed

    Johnston, M

    1991-12-01

    During 1 of many frequent visits to Leksana village in Central Java in Indonesia, a public health specialist noted an observation made by a leader of village development activities, the wife of the village head. The woman spoke of the decline in infant deaths in the community while the public health specialist and Burmese visitors watched activities involving weighing of children 5 years old. She led the group to the local cemetery to witness direct evidence of her claim. Indeed the considerable decline in infant graves supported her claim. The group discussed possible reasons for the improvement in child survival. Family incomes rose as evidenced by increased onion crops and soybean planting and prosperous clove and cashew harvests. In fact, the village could better market produce since the men improved the roads. Consumption of goat milk had increased in Leksana. These factors indicated better nutritional status. In fact, improved nutritional status most likely resulted in healthier mothers who experienced less anemia thereby contributing to a reduction in infant mortality. A family planning program served the community. Further a new junior high school in a nearby village allowed more children to attend school longer. What the village leader indeed do was discover a new way of measuring community development--using infant mortality. All these improved indicators contributed to healthy infants of good size which bettered their ability to fight infection. PMID:12284690

  3. Infant feeding and infant mortality in rural Chile.

    PubMed

    Plank, S J; Milanesi, M L

    1973-01-01

    This study examines infant feeding practices to: 1) measure the effect of early weaning on mortality; 2) identify characteristics distinguishing mothers who practised early weaning; 3) clarify the respective roles of maternal milk deprivation and factors associated with bottle feeding; and 4) measure the effect on survival of giving bottlefed babies additional foods. 1712 rural mothers who had had deliveries in the preceding years were interviewed. Level of statistical significance was preset at 0.01. Three times as many deaths occurred among babies given bottles before the age of 3 months as among those who were wholly breastfed. As nearly 50% of the children had started bottlefeeding by that age, bottlefeeding was considered a major factor in infant mortality. Additional foods provided these babies with some protection but continued breastfeeding did not. Improvement in living standards accelerated weaning and let to an increase in the proportion of children being fed on bottle alone. Infant mortality consequently increased with income. The findings confirm the claim that early weaning is a concomitant of economic developments. It is suggested however that the risk associated with bottle feeding may be reduced by adding or supplementing other foods to the diet. PMID:4541686

  4. 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

  5. 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…

  6. The main determinants of infant mortality in Nepal.

    PubMed

    Suwal, J V

    2001-12-01

    Infant mortality has reached a low stable rate in developed countries while it is still high and on a slow decline in developing countries. There are many factors that contribute to the incidence of a high or low level of infant mortality. Although credit for contributing to the lowering of infant mortality has been given to health programs by public health personnel and to the improvement in socio-economic status by social scientists, in a traditional and agricultural country such as Nepal, both these factors are found to influence infant mortality. Data on infant mortality obtained by the 1991 Demographic Health Survey of Nepal are analyzed in this study. A logistic regression model is used for analyzing the data. Several hypotheses are tested to explain the incidence of infant mortality in Nepal. The various reasons for the persistence of high infant mortality and the difficulties in lowering it are discussed. The findings suggest that among all the variables analyzed in the study, parity, place of residence, immunization, and ethnicity influence infant mortality the most. PMID:11762892

  7. 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...

  8. Fetal, Infant, and Maternal Mortality During Periods of Economic Instability

    ERIC Educational Resources Information Center

    Brenner, M. H.

    1973-01-01

    One of the most sensitive indicators of the general socioeconomic level of a nation is the infant mortality rate. Evidence indicates that economic recessions and upswings have played a significant role in fetal, infant, and maternal mortality in the last 45 years. (RJ)

  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. Low infant mortality among Palestine refugees despite the odds

    PubMed Central

    Khader, Ali; Sabatinelli, Guido

    2011-01-01

    Abstract Objective To present data from a 2008 infant mortality survey conducted in Jordan, Lebanon, the Syrian Arab Republic, the Gaza Strip and the West Bank and analyse infant mortality trends among Palestine refugees in 1995–2005. Methods Following the preceding birth technique, mothers who were registering a new birth were asked if the preceding child was alive or dead, the day the child was born and the date of birth of the neonate whose birth was being registered. From this information, neonatal, infant and early child mortality rates were estimated. The age at death for early child mortality was determined by the mean interval between successive births and the mean age of neonates at registration. Findings In 2005–2006, infant mortality among Palestine refugees ranged from 28 deaths per 100 000 live births in the Syrian Arab Republic to 19 in Lebanon. Thus, infant mortality in Palestine refugees is among the lowest in the Near East. However, infant mortality has stopped decreasing in recent years, although it remains at a level compatible with the attainment of Millennium Development Goal 4. Conclusion Largely owing to the primary health care provided by the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East and other entities, infant mortality among Palestine refugees had consistently decreased. However, it is no longer dropping. Measures to address the most likely reasons – early marriage and childbearing, poor socioeconomic conditions and limited access to good perinatal care – are needed. PMID:21479095

  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 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

  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.

  13. A Study of Growth, Morbidity and Mortality among Eskimo Infants of Western Alaska

    PubMed Central

    Maynard, James E.; Hammes, Laurel M.

    1970-01-01

    One of the most serious problems affecting the American Eskimo is that of disease and death in infants. A study undertaken to inquire into the growth and development components and the nutritional components of this morbidity and mortality and to verify and amplify the inadequate health statistics relating to this group revealed an infant mortality rate 4 times that for the USA as a whole, with a 16% under-registration of infant deaths. The majority of infant deaths occurred in the post-neonatal period, with respiratory infections constituting the most frequent cause of morbidity and mortality. There was a significant inverse association between infant haemoglobin level and frequency of respiratory and total illness, providing one of the few specific epidemiological confirmations of a synergistic nutritional interaction between anaemia and infection. PMID:5310956

  14. 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

  15. 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. PMID:23106732

  16. 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

  17. 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. PMID:24693615

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Infant Mortality... 92-463), notice is hereby given of the following meeting: Name: Advisory Committee on Infant.../mchbadvisory/InfantMortality . Adobe Connect:...

  20. Are infant mortality rate declines exponential? The general pattern of 20th century infant mortality rate decline

    PubMed Central

    Bishai, David; Opuni, Marjorie

    2009-01-01

    Background Time trends in infant mortality for the 20th century show a curvilinear pattern that most demographers have assumed to be approximately exponential. Virtually all cross-country comparisons and time series analyses of infant mortality have studied the logarithm of infant mortality to account for the curvilinear time trend. However, there is no evidence that the log transform is the best fit for infant mortality time trends. Methods We use maximum likelihood methods to determine the best transformation to fit time trends in infant mortality reduction in the 20th century and to assess the importance of the proper transformation in identifying the relationship between infant mortality and gross domestic product (GDP) per capita. We apply the Box Cox transform to infant mortality rate (IMR) time series from 18 countries to identify the best fitting value of lambda for each country and for the pooled sample. For each country, we test the value of λ against the null that λ = 0 (logarithmic model) and against the null that λ = 1 (linear model). We then demonstrate the importance of selecting the proper transformation by comparing regressions of ln(IMR) on same year GDP per capita against Box Cox transformed models. Results Based on chi-squared test statistics, infant mortality decline is best described as an exponential decline only for the United States. For the remaining 17 countries we study, IMR decline is neither best modelled as logarithmic nor as a linear process. Imposing a logarithmic transform on IMR can lead to bias in fitting the relationship between IMR and GDP per capita. Conclusion The assumption that IMR declines are exponential is enshrined in the Preston curve and in nearly all cross-country as well as time series analyses of IMR data since Preston's 1975 paper, but this assumption is seldom correct. Statistical analyses of IMR trends should assess the robustness of findings to transformations other than the log transform. PMID:19698144

  1. Lessons from history--maternal and infant mortality.

    PubMed

    1989-07-15

    Historical analysis of trends in infant and maternal mortality rates reveal different patterns and factors that influence them. Recent international and urban-rural differences in trends, associations with population density and the influence of parental social class and income has led to questioning the long accepted interpretation of the sharp decline of infant mortality in Britain (at the turn of the century) as due to such measures as pure water supplies, sewage disposal and pasteurization of milk. Several authors now believe that direct control of fertility influenced parity and birth spacing, with all other factors contributing to the decline in infant mortality. While the drop in infant mortality rates can be attributable to social and environmental influence, trends in maternal mortality differ considerably. Even though high maternal mortality has often been associated with areas of poverty, such a link has been indirect; the determining factor is the place of delivery, and the skill and care of the birth attendant. The decline in maternal mortality rates began by the mid-1930's and have been halved every 10 years since. National concerns due to high rates of maternal mortality led to different organizational solutions. The US adopted a specialist obstetrician/hospital-based delivery system; the Netherlands combined midwives with home delivery; New Zealand trained midwives but with delivery in hospitals, and Britain included specialized obstetricians with better training of midwives and general practitioners. All of these variations had no effect on mortality rates. The decline is attributed to the use of sulphonamids followed by penicillin and improvements in medical management. In a recent publication entitled "Working for Patients", mortality rates continue to remain the outcome measures to be used universally while infant mortality rates are considered crude and not amenable to health interventions. PMID:2567902

  2. Generations of loss: contemporary perspectives on black infant mortality.

    PubMed Central

    Headley, Adrienne J.

    2004-01-01

    The U.S. black infant mortality rate (IMR) remains a significant public health concern. Although improved during the last four decades, the U.S. IMR remains within the lowest tier of IMRs for all industrialized countries, and black American infants remain disproportionately represented in low birthweight (LBW) and infant death statistics. Numerous risk factors have been analyzed for their relative contributions to the U.S. IMR and black-white infant survival health disparities. Those factors include prenatal care quality and access, maternal socioeconomic status (SES), HIV/AIDS status, infections, intrapartum risk factors, existing comorbidities, social support, and nutritional status. However, the role of these and other factors have not fully explained the higher infant mortality risks for black infants. This review will discuss a variety of risk factors that contribute to infant mortality disparities between non-Hispanic black and white infants. Among those factors, the goal will be to review selected topics pertaining to maternal SES, LBW, preterm birth, perinatology advances, birth record data quality, maternal stress, prenatal care adequacy, and physical and substance abuse, and the relationships of those topics to black-white IMR health disparities. PMID:15253333

  3. Infant Mortality and American Indians/Alaska Natives

    MedlinePlus

    ... Heath & Mortality Infant Mortality and American Indians/Alaska Natives American Indian/Alaska Natives have 1.5 times the ... Cause of Death (By rank) # American Indian/Alaska Native Deaths American Indian/Alaska Native Death Rate #Non- Hispanic White ...

  4. 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

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

    PubMed

    Gurven, Michael

    2012-12-01

    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

  6. Management Practice and Mortality for Infants with Congenital Diaphragmatic Hernia

    PubMed Central

    Malowitz, Jonathan R.; Hornik, Christoph P.; Laughon, Matthew M.; Testoni, Daniela; Cotten, C. Michael; Clark, Reese H.; Smith, P. Brian

    2015-01-01

    Objective Congenital diaphragmatic hernia (CDH) is fatal in 20–40% of cases, largely due to pulmonary dysmaturity, lung hypoplasia, and persistent pulmonary hypertension. Evidence for survival benefit of inhaled nitric oxide (iNO), extracorporeal membrane oxygenation (ECMO), and other medical interventions targeting pulmonary hypertension is lacking. We assessed medical interventions and mortality over time in a large multicenter cohort of infants with CDH. Study Design We identified all infants ≥34 weeks gestation with CDH discharged from 29 neonatal intensive care units between 1999 and 2012 with an average of ≥2 CDH admissions per year. We examined mortality and the proportion of infants exposed to medical interventions, comparing 4 periods of time: 1999–2001, 2002–2004, 2005–2007, and 2008–2012. Results We identified 760 infants with CDH. From 1999–2001 to 2008–2012, use of iNO increased from 20% of infants to 50%, sildenafil use increased from 0% to 14%, and milrinone use increased from 0% to 22% (p<0.001). Overall mortality (28%) did not significantly change over time compared with the earliest time period. Conclusions Despite changing use of iNO, sildenafil, and milrinone, CDH mortality has not significantly decreased in this population of infants. PMID:25715314

  7. Infant mortality in rural India: a strategy for reduction.

    PubMed

    Pratinidhi, A K; Shrotri, A N; Shah, U; Chavan, H H

    1987-08-01

    A risk-approach-strategy project sponsored by WHO was undertaken in 22 villages of Surur, Pune, by BJ Medical College. All births in the study population of 47,000 were followed, comparing the 3 cohorts born between January 1981 to December 1983. Female village health guides were trained in screening for 11 maternal risk factors, infant risk factors, infant monitoring, and basic health support such as maternal nutrition, rest, breastfeeding and home cleaning, heating, humidifying and infant isolation. There were 123, 97 and 87 infant deaths in the 1981, 1982, and 1983 cohorts, giving infant mortality rats of 91.2, 72.3 and 67.3 respectively. The proportion of neonatal deaths remained at 61 to 62.1% over the period. The most common risk factors seen were illness, low birth weight and growth retardation, often associated with illness. Incidence of low birth weight and prolonged labor both decreased significantly over the duration of the program. Mortality was high among infants with feeding problems and prematurity. 40% of deaths were due to infections, 28% to low birth weight and prematurity, and 9% to birth asphyxia. The lower infant mortality rate achieved here is comparable to urban levels reported in India. These results show that primary health workers are capable of referring and managing risks, and risk management could be applied on a larger scale. PMID:3443502

  8. 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

  9. Sociocultural determinants of infant and child mortality in Turkey.

    PubMed

    Aksit, B; Aksit, B

    1989-01-01

    This paper is an attempt to review and integrate international and Turkish research on infant and child mortality. Recent research and multivariate analyses in African, Latin American and Asian countries have revealed that in many countries mother's education is a powerful predictor of child survival. The present review of research in Turkey has indicated that urban/rural and regional differentials in infant mortality have been clearly established as by-products of fertility, contraception, and health surveys covering nationally representative samples. However, there are only a few multivariate explanatory models of infant/child mortality in Turkey to isolate and measure the effects of mother's education in relation to other variables. Nevertheless, existing studies in Turkey seem to suggest that mother's and father's education might link socio-economic, psychocultural, and biomedical variables with each other at community, household, and individual levels, providing clue for the formulation of future research designs and policy decisions. PMID:2648604

  10. 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. PMID:16382816

  11. Registration artifacts in international comparisons of infant mortality.

    PubMed

    Kramer, Michael S; Platt, Robert W; Yang, Hong; Haglund, Bengt; Cnattingius, Sven; Bergsjo, Per

    2002-01-01

    Large differences in infant mortality are reported among and within industrialised countries. We hypothesised that these differences are at least partly the result of intercountry differences in registration of infants near the borderline of viability (<750 g birthweight) and/or their classification as stillbirths vs. live births. We used the database of the International Collaborative Effort (ICE) on Perinatal and Infant Mortality to compare infant mortality rates and registration practices in Norway (n = 112484), Sweden (n = 215 908), Israeli Jews (n = 148123), Israeli non-Jews (n = 52 606), US Whites (n = 6 074 222) and US Blacks (n = 1328332). To avoid confounding by strong secular trends in these outcomes, we restricted our analysis to 1987-88, the most recent years for which data are available in the ICE database for all six groups. Compared with Norway (with an infant mortality rate of 8.5 per 1000), the crude relative risks [95% confidence intervals] were 0.75 [0.69,0.81] in Sweden, 0.97 [0.90,1.06] in Israeli Jews, 1.98 [1.81,2.17] in Israeli non-Jews, 0.95 [0.89,1.01] in US Whites and 2.05 [1.95,2.19] in US Blacks. For borderline-viable infants, fetal deaths varied twofold as a proportion of perinatal deaths, with Norway reporting the highest (83.9% for births <500 g and 61.8% for births 500-749 g) and US Blacks the lowest (40.3% and 37.6% respectively) proportions. Reported proportions of live births <500 g varied 50-fold from 0.6 and 0.7 per 10000 in Sweden and Israeli Jews and non-Jews to 9.1 and 33.8 per 10000 in US Whites and Blacks respectively. Reported proportions 500-749 g varied sevenfold from 7.5 per 10000 in Sweden to 16.2 and 55.4 in US Whites and Blacks respectively. After eliminating births <750 g, the relative risks (again with Norway as the reference) of infant mortality changed drastically for US Whites and Blacks: 0.82 [0.76,0.87] and 1.42 [1.33,1.53] respectively. The huge disparities in the ratio of fetal to infant deaths <750 g and

  12. Levels and patterns of infant and child mortality in Ghana.

    PubMed

    Gaisie, S K

    1976-02-01

    This paper attempts to measure infant and child mortality levels and also to determine their structures by utilzing the results of the 1968/69 National Demographic sample survey which was conducted under the directorship of the author. The measurement of infant and child mortality in Ghana is severely hampered by lack of reliable and adequate information on infant and child deaths. The existing data from the compulsory registration areas are deficient and can at best give an indication of only the level of urban infant and child mortalities. The tendency of censuses and surveys to miss a considerable proportion of infant and child deaths also imposes a further limitation on the extent to which the infant and child mortality rates can be accurately measured from the available data. This paper is therefore concerned with 2 major problems: 1) the adjustment of the current raw mortality data on the basis of detected errors as revealed by analytical methods and/or by the fitting of models, and 2) the estimation of infant and child mortality from independent source material (e.g., retrospective information on the number of children ever born and the number surviving). The most plausible estimate of infant mortality appears to be 133/thousand live births. Regional estimates range from 56 in the Accra Capital District to 192 in the Upper Region. Further, the urban rate is lower than the rural rate: 98 as against 161/thousand live births. An examination of child death rates by single years has shown that a large proportion of the deaths among children aged 0 to 4 occur in the 2nd year of life and that deaths in this age group account for the bulk of the deaths within the age group 1 to 4 years. The observed proportions of deaths at age 1 among all deaths within the 1 to 4 years age group range between 34 and 43%. These figures may be compared with 53% in Senegal between 1962 and 1968, and with 48 and 74% in Ibadan, Nigeria (1964/1966) and Mauritius (1961) respectively

  13. Determinants of infant and child mortality in rural Haryana.

    PubMed

    Singhi, S; Kumar, R; Raina, N; Kumar, V

    1989-01-01

    To identify the individual and household level variables associated with increased risk of mortality, 159 infant and 50 child deaths (cases) and equal number of age matched live infants and children (controls) and their families were studied in a rural area of Haryana. The social, economic, educational and environmental characteristics of the case and control families were similar. Increased risk of infant and child mortality was associated with maternal age less than 20 and more than 30 years, birth order 4th or higher, unclean cord care at the time of child birth, failure of breast feeding during the first 3 months of age, lack of immunizations, and previous infant or child death(s) in the family (Odds ratio greater than 2; P less than 0.05-0.01 by X2 test). An emphasis on the interventions directed at control of the above mentioned variables may prove most helpful in reducing infant and child mortality in a rural area. PMID:2638678

  14. Women's status and infant mortality in rural Colombia.

    PubMed

    Florez, C E; Hogan, D P

    1990-01-01

    This paper investigates the effects of maternal demographic characteristics and social and economic statuses on infant mortality in rural Colombia. Demographic characteristics include the age of the mother, parity and length of preceding interbirth interval, and sex of infant. Measures of women's status at the time of birth include education, wage labor and occupation, economic stratum, place of residence, and whether the mother is living with a husband. The life history data for the study (involving 4,928 births) were collected in 1986 from a representative sample of two cohorts of women resident in rural central Colombia. Overall differentials in infant mortality by measures of women's status are small and are in good part associated with the differing reproductive behaviors of the women and variations in breastfeeding practices. The sharp declines in infant mortality recorded in rural Colombia in recent years appear less related to improved status of women than to reductions in fertility that enhance infant survivorship and to public health interventions shared by all segments of the population. PMID:2093232

  15. Neonatal mortality of low-birth-weight infants in Bangladesh.

    PubMed Central

    Yasmin, S.; Osrin, D.; Paul, E.; Costello, A.

    2001-01-01

    OBJECTIVE: To ascertain the role of low birth weight (LBW) in neonatal mortality in a periurban setting in Bangladesh. METHODS: LBW neonates were recruited prospectively and followed up at one month of age. The cohort of neonates were recruited after delivery in a hospital in Dhaka, Bangladesh, and 776 were successfully followed up either at home or, in the event of early death, in hospital. FINDINGS: The neonatal mortality rate (NMR) for these infants was 133 per 1000 live births (95% confidence interval: 110-159). The corresponding NMRs (and confidence intervals) for early and late neonates were 112 (91-136) and 21 (12-33) per thousand live births, respectively. The NMR for infants born after fewer than 32 weeks of gestation was 769 (563-910); and was 780 (640-885) for infants whose birth weights were under 1500 g. Eighty-four per cent of neonatal deaths occurred in the first seven days; half within 48 hours. Preterm delivery was implicated in three-quarters of neonatal deaths, but was associated with only one-third of LBW neonates. CONCLUSION: Policy-relevant findings were: that LBW approximately doubles the NMR in a periurban setting in Bangladesh; that neonatal mortality tends to occur early; and that preterm delivery is the most important contributor to the NMR. The group of infants most likely to benefit from improvements in low-cost essential care for the newborn accounted for almost 61% of neonatal mortalities in the cohort. PMID:11477963

  16. Infant Mortality and Life Expectancy in the Arab World.

    ERIC Educational Resources Information Center

    Nijim, Basheer K.

    1990-01-01

    Presents a lesson plan designed to teach about variations in infant mortality and life expectancy in the Arab world, to identify the concept of spatial correlation, and to learn the location of Arab countries. Includes oil exports as a variable. Discusses methods of data and map interpretation. (RW)

  17. 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

  18. Disparities in Infant Mortality Due to Congenital Anomalies on Guam

    PubMed Central

    Namazi, Sara; Haddock, Robert L

    2015-01-01

    In the 1970's and 1980's, there were large inter-village disparities in infant mortality due to congenital anomalies on Guam. A village-level analysis was conducted to determine if these disparities can be explained by behavioral (ie, median age of village females, village fertility ratio), structural (ie, population density, persons per household, single mother households per village, married females per village), and environmental (ie, living in a village where Agent Orange (AO) spraying was conducted) factors. Village-level data for live births and infant mortality due to congenital anomalies (1970–1989) was collected from Guam's Office of Vital Statistics. Data on median age of village females, village fertility ratio, population density, persons per household, single mother households, and married females were obtained from the 1980 US Census. Estimates of village-level AO use were provided through personal communications, and villages were dichotomized into AO and non-AO spray areas. Village location was classified by usual residence of the mother. Linear regression was used to determine associations between infant mortality due to congenital anomalies and the behavioral, structural, and environmental factors. The association between AO spray area and infant mortality due to congenital anomalies was statistically significant under univariable (B [95%CI] = 1.88 [0.64,3.11], P = .005) and multivariable conditions (B [95%CI] = 2.02 [0.08,3.96], P = .042). These results suggest that infants born to mothers whose usual residence was in an AO spray area on Guam are at an increased risk of mortality due to congenital anomalies. Further studies using individual-level data are needed to validate these results. PMID:26668770

  19. Disparities in Infant Mortality Due to Congenital Anomalies on Guam.

    PubMed

    Noel, Jonathan K; Namazi, Sara; Haddock, Robert L

    2015-12-01

    In the 1970's and 1980's, there were large inter-village disparities in infant mortality due to congenital anomalies on Guam. A village-level analysis was conducted to determine if these disparities can be explained by behavioral (ie, median age of village females, village fertility ratio), structural (ie, population density, persons per household, single mother households per village, married females per village), and environmental (ie, living in a village where Agent Orange (AO) spraying was conducted) factors. Village-level data for live births and infant mortality due to congenital anomalies (1970-1989) was collected from Guam's Office of Vital Statistics. Data on median age of village females, village fertility ratio, population density, persons per household, single mother households, and married females were obtained from the 1980 US Census. Estimates of village-level AO use were provided through personal communications, and villages were dichotomized into AO and non-AO spray areas. Village location was classified by usual residence of the mother. Linear regression was used to determine associations between infant mortality due to congenital anomalies and the behavioral, structural, and environmental factors. The association between AO spray area and infant mortality due to congenital anomalies was statistically significant under univariable (B [95%CI] = 1.88 [0.64,3.11], P = .005) and multivariable conditions (B [95%CI] = 2.02 [0.08,3.96], P = .042). These results suggest that infants born to mothers whose usual residence was in an AO spray area on Guam are at an increased risk of mortality due to congenital anomalies. Further studies using individual-level data are needed to validate these results. PMID:26668770

  20. 77 FR 36549 - Advisory Committee on Infant Mortality; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Infant Mortality...-463), notice is hereby given of the following meeting: Name: Advisory Committee on Infant Mortality...: Department of Health and Human Services' programs that focus on reducing infant mortality and improving...

  1. 76 FR 39112 - Advisory Committee on Infant Mortality; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Infant Mortality...-463), notice is hereby given of the following meeting: Name: Advisory Committee on Infant Mortality...: Department of Health and Human Services' programs that focus on reducing infant mortality and improving...

  2. 77 FR 7594 - Advisory Committee on Infant Mortality; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Infant Mortality...-463), notice is hereby given of the following meeting: Name: Advisory Committee on Infant Mortality...: Department of Health and Human Services' programs that focus on reducing infant mortality and improving...

  3. 77 FR 64524 - Advisory Committee on Infant Mortality; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Infant Mortality...-463), notice is hereby given of the following meeting: Name: Advisory Committee on Infant Mortality...: Department of Health and Human Services' programs that focus on reducing infant mortality and improving...

  4. Decline and unevenness of infant mortality in Salvador, Brazil, 1980-1988.

    PubMed

    Paim, J S; Costa, M da C

    1993-01-01

    Data relating to infant mortality in Salvador, Brazil, were analyzed in order to determine how infant mortality evolved in various parts of the city during the period 1980-1988. This analysis showed sharp drops in the numbers of infant deaths, proportional infant mortality (infant deaths as a percentage of total deaths), and the infant mortality coefficient (infant deaths per thousand live births) during the study period despite deteriorating economic conditions. It also suggested that while these declines occurred throughout the city, the overall distribution of infant mortality in different reporting zones remained uneven. Among other things, these findings call attention to a need for further investigation of the roles played by various health measures (including immunization, control of respiratory and diarrheal diseases, encouragement of breast-feeding, and monitoring of growth and development) and of reduced fertility (resulting from birth spacing, use of contraceptives, and female sterilization) in bringing about declines in infant mortality during hard economic times. PMID:8490672

  5. 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

  6. Regional Infant and Child Mortality Review Committee--2011 final report.

    PubMed

    Wilson, Ann L; Sideras, James

    2012-12-01

    The 2011 annual report of the Regional Infant and Child Mortality Review Committee (RICMRC) is presented. Since 1997, the committee has reviewed 224 deaths to achieve its mission to "review infant and child deaths so that information can be transformed into action to protect young lives." In 2011, the committee reviewed 21 deaths (22 met the committee's criteria) of infants and children who were residents of Minnehaha, Turner, Lincoln, Hanson and Brookings counties in South Dakota. The manner of 12 of the reviewed deaths was natural with eight of these the result of progressive neurological diseases or conditions. In 2011 there were no deaths attributed to Sudden Infant Death Syndrome (SIDS), though there were two deaths of infants during sleep. One of these infants was ruled accidental as the baby died of aspiration and the other death occurred in an unsafe environment with its manner determined to be undecided. Six deaths were accidental, one of which occurred as a result of a fire in a home without functional smoke alarms. One motor vehicle death occurred, through no fault of the teen age driver. Another death resulted from tubing over a low head dam on the Big Sioux River. One youth suicide occurred to a resident of the region. PMID:23477038

  7. 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

  8. 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…

  9. Trends in infant mortality by cause of death and other characteristics, 1960-88.

    PubMed

    MacDorman, M F; Rosenberg, H M

    1993-01-01

    From 1960 to 1988 the infant mortality rate for the United States declined by 60 percent from 26.0 to 10.0 infant deaths per 1,000 live births. The infant mortality rate declined slowly from 1960 to 1964, rapidly from 1965 to 1981, and then moderately from 1981 to 1988. Since 1970 neonatal (under 28 days) mortality has declined more rapidly than postneonatal (28 days-11 months) mortality, reversing the historic pattern of more rapid declines in postneonatal mortality. Because of this, a smaller percent of infant deaths occurred during the neonatal period in 1988 (64 percent) than in 1960 (72 percent). The gap in mortality between black and white infants narrowed during the 1960's, but widened during the 1970's and 1980's. The ratio of black to white infant mortality rates (or mortality race ratio) declined from 1,93 in 1960 to 1.77 in 1971, due to a more rapid decline in postneonatal mortality for black than white infants. However, since 1971, the infant mortality race ratio increased substantially to 2.07 in 1988, reflecting the slower decline in neonatal mortality for black infants. While for many years the gap between black and white infant mortality was wider during the postneonatal than the neonatal period, the gap in 1988 was wider during the neonatal period. PMID:25328980

  10. Infant mortality in London, 1538-1850: a methodological study.

    PubMed

    Razzell, Peter

    2011-01-01

    A review of evidence on infant mortality derived from the London bills of mortality and parish registers indicates that there were major registration problems throughout the whole of the parish register period. One way of addressing these problems is to carry out reconstitution studies of individual London parishes, but there are a number of problems with reconstitution methodology, including the traffic in corpses between parishes both inside and outside of London and the negligence of clergymen in registering both baptisms and burials. In this paper the triangulation of sources has been employed to measure the adequacy of burial registration, including the comparison of data from bills of mortality, parish registers and probate returns, as well as the use of the same-name technique. This research indicates that between 20 and 40 per cent of burials went unregistered in London during the parish register period. PMID:22397160

  11. [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. PMID:26172012

  12. Excess infant mortality after nuclear plant startup in rural Mississippi.

    PubMed

    Mangano, Joseph J

    2008-01-01

    In the United States, utility companies have recently begun ordering new nuclear power reactors, the first such orders in the country since 1978. One potential site would be the Grand Gulf plant near Port Gibson, Mississippi. In 1983-1984, the first two years in which the existing Grand Gulf reactor operated, significant increases were observed in local rates of infant deaths (+35.3%) and fetal deaths (+57.8%). Local infant mortality remained elevated for the next two decades. These changes match those experienced in the same five local counties during atomic bomb testing in the 1950s and 1960s. This report examines potential reasons why an indigent, largely African American community may be at higher risk than other populations from exposure to an environmental toxin such as radiation. It also considers potential health risks posed by new reactors at Grand Gulf. PMID:18459281

  13. Regional Infant and Child Mortality Review Committee: 2009 final report.

    PubMed

    Randall, Brad; Wilson, Ann

    2010-10-01

    The 2009 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 2009, the Committee reviewed 23 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 infant death where the cause of death is unapparent or multifactorial. Sudden Infant Death Syndrome (SIDS) is a subset of SUID. No deaths categorized as SIDS occurred in 2009. 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 0.55 per 1000 live births would suggest that our region should have one SIDS death per year. It would appear, on the average, that our region's SIDS incidence is close to that number. Many investigators believe that a "diagnostic drift" is occurring in the SIDS diagnosis. These investigators believe that some deaths certified as SIDS in earlier years may now be classified as "undetermined," or in the new terminology, SUID. Although the committee strives to be consistent year to year in its death investigation protocols, we have noticed that the number of deaths classified as "undetermined" has been increasing over the last few years (Figure 1). The majority of our "undetermined" manners of infant deaths appear to be related to concerns about possible asphyxial

  14. Unattractive infant faces elicit negative affect from adults

    PubMed Central

    Schein, Stevie S.; Langlois, Judith H.

    2015-01-01

    We examined the relationship between infant attractiveness and adult affect by investigating whether differing levels of infant facial attractiveness elicit facial muscle movement correlated with positive and negative affect from adults (N = 87) using electromyography. Unattractive infant faces evoked significantly more corrugator supercilii and levator labii superioris movement (physiological correlates of negative affect) than attractive infant faces. These results suggest that unattractive infants may be at risk for negative affective responses from adults, though the relationship between those responses and caregiving behavior remains elusive. PMID:25658199

  15. Infant mortality and life expectancy in the Arab world.

    PubMed

    Nijim, B K

    1990-01-01

    This exercise illustrates the concept of spatial correlation, the categorizing of data for mapping, and the use of the scatter diagram. It employs the variables of infant mortality and life expectancy as applied to the Arab World, though any region can be used. The factor of oil exports is added to enhance discussion of the findings. An extra advantage of the exercise is the learning of names of countries in a relatively painless way. The exercise teaches both content and methods of interpretation, and it is adaptable to high school and college levels. PMID:12178546

  16. [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. PMID:12178214

  17. Infants' Physical Knowledge Affects Their Change Detection

    ERIC Educational Resources Information Center

    Wang, Su-hua; Baillargeon, Renee

    2006-01-01

    Prior research suggests that infants attend to a variable in an event category when they have identified it as relevant for predicting outcomes in the category, and that the age at which infants identify a variable depends largely on the age at which they are exposed to appropriate observations. Thus, depending on age of exposure, infants may…

  18. Relationship of Paternity Status, Welfare Reform Period, and Racial/Ethnic Disparities in Infant Mortality.

    PubMed

    Ngui, Emmanuel M; Cortright, Alicia L; Michalski, Karen

    2015-09-01

    The objective of this study was to examine the relationship of paternity status, welfare reform period, and racial/ethnic disparities in infant mortality. The study used retrospective analysis of birth outcomes data from singleton birth/infant death data in Milwaukee, Wisconsin, from 1993 to 2009. Multivariate logistic regression was used to examine the relationship between paternity status, welfare reform period, and infant mortality, adjusting for maternal and infant characteristics. Data consisted of almost 185,000 singleton live births and 1,739 infant deaths. Although unmarried women with no father on record made up about 32% of the live births, they accounted for over two thirds of the infant deaths compared with married women with established paternity who made up 39% of live births but had about a quarter of infant deaths. After adjustments, any form of paternity establishment was protective against infant mortality across all racial/ethnic groups. Unmarried women with no father on record had twice to triple the odds of infant mortality among all racial/ethnic groups. The likelihood of infant mortality was only significantly greater for African American women in the postwelfare (1999-2004; odds ratio = 1.27; 95% confidence interval = 1.10-1.46) period compared with the 1993 to 1998 period. Study findings suggest that any form of paternity establishment may have protective effect against infant mortality. Welfare reform changes may have reduced some of the protection against infant mortality among unmarried African American women that was present before the welfare legislation. Policies and programs that promote or support increased paternal involvement and establishment of paternity may improve birth outcomes and help reduce infant mortality. PMID:25061086

  19. Immigrant Latino neighborhoods and mortality among infants born to Mexican-origin Latina women.

    PubMed

    DeCamp, Lisa Ross; Choi, Hwajung; Fuentes-Afflick, Elena; Sastry, Narayan

    2015-06-01

    To compare the association between neighborhood Latino immigrant concentration and infant mortality by maternal nativity among singleton births to Mexican-origin women in Los Angeles County. Information about births, infant deaths, and infant and maternal characteristics were obtained from geocoded Los Angeles County vital statistics records (2002-2005). Linked data on neighborhood characteristics (census tracts) were obtained from the 2000 census. Logistic regression models were used to predict infant mortality while accounting for spatial clustering by census tract. Two-thirds of births to Mexican-origin mothers were to foreign-born women. Foreign-born mothers were older, had less education, and were more likely to have delivery costs paid by Medicaid than US-born mothers. Infants born to foreign-born women had a lower infant mortality rates than infants born to US-born women (3.8/1,000 live births vs. 4.6, p = .002). Among infants of foreign-born mothers, the odds of infant mortality increased with increasing immigrant concentration (OR 1.29; 95 % CI 1.01-1.66). There was a similar pattern of association between immigrant concentration and mortality for infants of US-born mothers (OR 1.29; 95 % CI 0.99-1.67). In Los Angeles County, the odds of infant mortality among foreign-born Mexican-origin Latina were higher in higher-density immigrant neighborhoods, with a similar trend among US-born mothers. Thus, living in immigrant enclaves likely does not help to explain the lower than expected infant mortality rate among infants born to Latina women. Instead, higher neighborhood Latino immigrant concentration may indicate a neighborhood with characteristics that negatively impact maternal and infant health for Latinos. PMID:25430802

  20. Immigrant Latino Neighborhoods and Mortality among Infants Born to Mexican-Origin Latina Women

    PubMed Central

    DeCamp, Lisa Ross; Choi, Hwajung; Fuentes-Afflick, Elena; Sastry, Narayan

    2014-01-01

    Objectives To compare the association between neighborhood Latino immigrant concentration and infant mortality by maternal nativity among singleton births to Mexican-origin women in Los Angeles County. Methods Information about births, infant deaths, and infant and maternal characteristics were obtained from geocoded Los Angeles County vital statistics records (2002–2005). Linked data on neighborhood characteristics (census tracts) were obtained from the 2000 Census. Logistic regression models were used to predict infant mortality while accounting for spatial clustering by census tract. Results Two-thirds of births to Mexican-origin mothers were to foreign-born women. Foreign-born mothers were older, had less education, and were more likely to have delivery costs paid by Medicaid than US-born mothers. Infants born to foreign-born women had a lower infant mortality rates than infants born to US-born women (3.8/1000 live births vs. 4.6, p=.002)). Among infants of foreign-born mothers, the odds of infant mortality increased with increasing immigrant concentration (OR: 1.29; 95%CI: 1.01–1.66). There was a similar pattern of association between immigrant concentration and mortality for infants of US-born mothers (OR: 1.29; 95% CI: 0.99–1.67). Conclusions In Los Angeles County, the odds of infant mortality among foreign-born Mexican-origin Latina were higher in higher-density immigrant neighborhoods, with a similar trend among US-born mothers. Thus, living in immigrant enclaves likely does not help to explain the lower than expected infant mortality rate among infants born to Latina women. Instead, higher neighborhood Latino immigrant concentration may indicate a neighborhood with characteristics that negatively impact maternal and infant health for Latinos. PMID:25430802

  1. Different extent in decline of infant mortality by region and cause in Shenyang, China.

    PubMed

    Huang, Yan-Hong; Wu, Qi-Jun; Li, Li-Li; Li, Da; Li, Jing; Zhou, Chen; Wu, Lang; Zhu, Jingjing; Gong, Ting-Ting

    2016-01-01

    To compare the pattern of cause of death of infant mortality rates by urban/rural areas as well as to generate knowledge for potential strategies to decrease this mortality, we carried out a study by analyzing the infant mortality data from the Shenyang Women and Children Health Care Centre. From 1997 to 2014, 970,583 live births and 6510 infant deaths were registered. Infant mortality rates, percent change, and annual percent change (APC) were calculated. The infant mortality significantly decreased by 5.92%, 7.41%, and 3.92% per year in overall, urban, and rural areas, respectively. Among the categories of causes of infant death, congenital anomalies (APC = -7.87%), asphyxia-related conditions (APC = -9.43), immaturity-related conditions (APC = -3.44%), diseases of the nervous system and sense organs (APC = -6.01%), and diseases of the respiratory system (APC = -6.29%) decreased significantly in the observational periods. Additionally, among selective causes of infant death, pneumonia, congenital heart disease, neural tube defects, preterm birth and low birth weight, birth asphyxia, and intracranial hemorrhage of the newborn significantly decreased by 5.45%, 5.45%, 16.47%, 2.18%, 10.95%, and 10.33% per year, respectively. In conclusion, infant mortality has been continuously decreased in Shenyang from 1997 to 2014, although further efforts are still needed to decrease the infant mortality in rural areas. PMID:27075740

  2. 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

  3. 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,…

  4. Infant mortality in a rural health district in Georgia, 1974 to 1981.

    PubMed

    Buehler, J W; McCarthy, B J; Holloway, J T; Sikes, R K

    1986-04-01

    In 1979 the infant mortality rate (IMR) dropped nearly 50% in a rural health district in southeast Georgia, and this lower rate continued during the next two years. For infants born during 1979 to 1981, the IMR was 12.4 as compared with 21.6 for those born from 1974 to 1978. Using linked birth and infant death records to identify shifts in the components of infant mortality in this district, we found that the change in IMR primarily reflected a decrease in neonatal and postneonatal deaths among infants with birth weight greater than or equal to 2,500 gm, rather than a change in the distribution of birth weights. Although the IMR was approximately twofold higher in white than in black infants, a similar relative decline in mortality was observed in both racial groups. For infants weighing greater than or equal to 2,500 gm, approximately half of the lower death rate was due to fewer deaths caused by infections. The decline in mortality in this district was greater than declines in neighboring districts and accompanied efforts to improve services for medically indigent mothers and infants. The findings suggest that in areas with high infant mortality, initial efforts to lower mortality should focus on primary care programs rather than more specialized interventions. PMID:3704703

  5. Health Human Capital in Sub-Saharan Africa: Conflicting Evidence from Infant Mortality Rates and Adult Heights

    PubMed Central

    Akachi, Yoko; Canning, David

    2011-01-01

    We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1960. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital. PMID:20634153

  6. 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

  7. 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. PMID:23934057

  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. Infant mortality in the Indian slums: case studies of Calcutta metropolis and Raipur city.

    PubMed

    Gupta, H S; Baghel, A

    1999-01-01

    This study was conducted to examine the levels of infant mortality, its causes and determinants, and its differentials in selected slums of Calcutta Metropolis and Raipur in India. Data were gathered through interview of 2142 mothers who had experienced a live birth and/or death of an infant within the year prior to the survey. The study found that although the infant mortality rate (IMR) in the slums was quite high, it was lower compared to rural India. The study¿s finding underlines the importance of "urban residence" as a primary controlling factor of infant mortality. IMR was 1.5 times higher in the slums of Calcutta than in Raipur, indicating that infant death is far worse in the metropolis than in smaller cities. Although a number of individual-, household-, and slum-level factors played an explanatory role in infant mortality, differences in neighborhood environment contributed most significantly to the infant mortality differentials in the two slums. This study also found that mere literacy or low level of education is not an effective depressant of infant mortality. PMID:12349427

  10. 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

  11. Does parity affect mortality among parous women?

    PubMed Central

    Koski‐Rahikkala, H; Pouta, A; Pietiläinen, K; Hartikainen, A‐L

    2006-01-01

    Objective To find out whether there is an association between parity and mortality. Design Prospective cohort study. Setting Northern Finland, 1966–2001. Participants and methods 12 055 women in the two northernmost provinces of Finland were followed up from pregnancy in 1966–2001, the coverage percentage being 96%. The data on age, smoking, body mass index, socioeconomic position, age at menarche and age at first birth were collected during pregnancy, and data on deaths were obtained from the National Cause of Death Statistics, maintained by Statistics Finland. The Cox proportional hazard model was used to estimate relative mortality between parity groups. Results Total mortality was lowest among the women with 2–4 children (reference group). High parity was associated with an up to twofold risk of mortality from vascular complications, but after adjustment for all background factors, this significance disappeared. Mortality from haemorrhagic stroke was fourfold higher among the women with ⩾10 births compared with those of the reference group. No differences in cerebral infarction or total cancer mortality were seen between the groups. Primiparity was associated with increased mortality from accidental death (relative risk 2.6, 95% confidence interval 1.6 to 4.4). Conclusions High parity was associated with an increased risk of mortality from vascular complications, especially haemorrhagic stroke, and primiparity with an increased risk of accidental death. PMID:17053286

  12. 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. PMID:25868145

  13. The Great Equalizer: Health Care Access and Infant Mortality in Thailand

    PubMed Central

    Gruber, Jonathan; Hendren, Nathaniel; Townsend, Robert M.

    2013-01-01

    This paper analyzes Thailand’s 2001 healthcare reform, “30 Baht”. The program increased funding available to hospitals to care for the poor and reduced copays to 30 Baht (~$0.75). Our estimates suggest the supply-side funding of the program increased healthcare utilization, especially amongst the poor. Moreover, we find significant impacts on infant mortality: prior to 30 Baht poorer provinces had significantly higher infant mortality rates than richer provinces. After 30 Baht this correlation evaporates to zero. The results suggest that increased access to healthcare among the poor can significantly reduce their infant mortality rates. PMID:24772234

  14. U.S. differentials in infant mortality: why do they persist?

    PubMed

    Johnson, J H

    1987-01-01

    Large racial differentials in infant mortality persist in the US. While black babies made up 3.54 million singleton deliveries in the US in 1980, they accounted for 35% of all low-birthweight infants nationwide. Because of this disadvantage in birthweight, black babies accounted for 28% of infant deaths. Furthermore, while overall risk of infant mortality declined from 23.3/1000 live births to 11/1000 from 1960 to 1980 due to technological advances, the gap in infant mortality between black and white babies remains. The chances that a black infant wil die during the 1st year of life are still 2 times greater than white infants--the same odds as existed in 1960. Investigators concluded that the higher proportion of low birth weight babies among blacks is due to adverse socioeconomic conditions. Other recent studies cited in Arizona, Ohio, and California expand on this theory, suggesting that cultural, social, and biological factors may interact to create unique mortality patterns among racial and ethnic subgroups. The number of and risk for infant deaths is given for sex of infant, birth order, mother's age and region of birth. PMID:3691767

  15. 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…

  16. Infant mortality and infant care: cultural and economic constraints on nurturing in northeast Brazil.

    PubMed

    Scheper-Hughes, N

    1984-01-01

    The Brazilian 'Economic Miracle' has had an adverse effect on infant and childhood mortality which has been steadily rising throughout Brazil since the late 1960s. An analysis of the reproductive histories of 72 marginally employed residents of a Northeast Brazilian rural shantytown explores the economic and cultural context that inhibits these mother's abilities to rear healthy, living children and which forces them to devise 'ethnoeugenic' childrearing strategies that prejudice the life chances of those offspring judged 'less fit' for survival under the pernicious conditions of life on the Alto. it is suggested that the selective neglect of children is a direct consequence of the selective neglect of their mothers who have been excluded from participating in the national economy. The links between economic exploitation and maternal deprivation are further discussed with reference to the social causes of the 'insufficient breastmilk syndrome' and the commercial powdered milk dependency of these women. PMID:6484639

  17. Birth weight-specific infant mortality due to congenital anomalies, 1960 and 1980.

    PubMed Central

    Berry, R J; Buehler, J W; Strauss, L T; Hogue, C J; Smith, J C

    1987-01-01

    The impact of mortality due to congenital anomalies in single-delivery births was compared in 1960 and 1980 birth cohorts; data were used from the 1960 National Center for Health Statistics national linkage of birth and death certificates and the 1980 National Infant Mortality Surveillance project. In 1960 there were 14,714 deaths due to congenital anomalies, compared with 8,674 in 1980, a 41 percent reduction. The infant mortality risk (IMR) due to congenital anomalies fell 31 percent. This is in contrast with the observed 54 percent decline in IMR due to all causes. This reduction in mortality due to congenital anomalies occurred for both whites and blacks in the postneonatal period and for whites only in the neonatal period. Changes ranged from a 1.8 percent increase for the black neonatal mortality risk to a 46.6 percent decrease for the white postneonatal mortality risk. In spite of these relative reductions, the absolute percentage of all infant deaths due to congenital anomalies had increased from 15.8 percent in 1960 to 24.1 percent in 1980. Two categories, cardiovascular and central nervous system anomalies, accounted for 72 percent of infant deaths due to congenital anomalies in 1960 and for 59 percent in 1980; cardiovascular anomalies accounted for 48 percent of all deaths due to congenital anomalies in 1960 and 40 percent in 1980. Infant mortality risks in the United States showed a 2:1 black to white ratio in both 1960 and 1980. However, for infant mortality due to congenital anomalies, the black and white mortality risks were approximately equal in both 1960 and 1980. For infants with birth weights of 500-2,499 g, the risk of neonatal mortality for blacks was less than half the risk for whites. PMID:3104974

  18. [Infant mortality and births in the 19th and early 20th centuries].

    PubMed

    Treffers, P E

    2008-12-20

    During the 19th century infant mortality was very high in the Netherlands, particularly in the provinces of South Holland and Zeeland (up to 300 per 1000 live births and more), and also in parts of North Brabant and Limburg. In the northern provinces (Drenthe, Groningen and Friesland) mortality was lower. Where breast-feeding was infrequently given (in rural areas of South Holland, Zeeland and from the 1850s also in North Brabant), infant mortality was relatively high. In the northern provinces many mothers breast-fed their infants. The fertility rate of married women was high, especially in those parts of the country where breast-feeding was infrequent. From 1875-1880 fertility rate and infant mortality decreased: the so-called demographic transition. Improved social conditions and employment opportunities played an important role in this as did the vertical social mobility: limitation of the size of families gave children opportunities to climb the social ladder. PMID:19177920

  19. Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates

    MedlinePlus

    ... specific infant mortality rates, by race and Hispanic origin of mother: United States, 2007 Gestational age (weeks) ... ethnic groups is higher than in other developed countries, all U.S. racial and ethnic groups might benefit ...

  20. Different extent in decline of infant mortality by region and cause in Shenyang, China

    PubMed Central

    Huang, Yan-Hong; Wu, Qi-Jun; Li, Li-Li; Li, Da; Li, Jing; Zhou, Chen; Wu, Lang; Zhu, Jingjing; Gong, Ting-Ting

    2016-01-01

    To compare the pattern of cause of death of infant mortality rates by urban/rural areas as well as to generate knowledge for potential strategies to decrease this mortality, we carried out a study by analyzing the infant mortality data from the Shenyang Women and Children Health Care Centre. From 1997 to 2014, 970,583 live births and 6510 infant deaths were registered. Infant mortality rates, percent change, and annual percent change (APC) were calculated. The infant mortality significantly decreased by 5.92%, 7.41%, and 3.92% per year in overall, urban, and rural areas, respectively. Among the categories of causes of infant death, congenital anomalies (APC = −7.87%), asphyxia-related conditions (APC = −9.43), immaturity-related conditions (APC = −3.44%), diseases of the nervous system and sense organs (APC = −6.01%), and diseases of the respiratory system (APC = −6.29%) decreased significantly in the observational periods. Additionally, among selective causes of infant death, pneumonia, congenital heart disease, neural tube defects, preterm birth and low birth weight, birth asphyxia, and intracranial hemorrhage of the newborn significantly decreased by 5.45%, 5.45%, 16.47%, 2.18%, 10.95%, and 10.33% per year, respectively. In conclusion, infant mortality has been continuously decreased in Shenyang from 1997 to 2014, although further efforts are still needed to decrease the infant mortality in rural areas. PMID:27075740

  1. Infant Affect and Affect Regulation during the Still-Face Paradigm with Mothers and Fathers: The Role of Infant Characteristics and Parental Sensitivity.

    ERIC Educational Resources Information Center

    Braungart-Rieker, Julia; Garwood, Molly Murphy; Powers, Bruce P.; Notaro, Paul C.

    1998-01-01

    Examined parents' and 4-month-old infants' behavior during face-to-face interactions. Results indicated that mothers and fathers were equally sensitive to their infants, and that infants' affect and regulatory behaviors were stable across mother-infant and father-infant situations in the still-face model. (BC)

  2. 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.…

  3. 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…

  4. 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

  5. Association of Maternal Smoking during Pregnancy with Infant Hospitalization and Mortality Due to Infectious Diseases

    PubMed Central

    Metzger, Michael J.; Halperin, Abigail C.; Manhart, Lisa E.; Hawes, Stephen E.

    2012-01-01

    Background Maternal smoking is associated with infant respiratory infections and with increased risk of low birthweight (LBW) infants and preterm birth. This study assesses the association of maternal smoking during pregnancy with both respiratory and non-respiratory infectious disease (ID) morbidity and mortality in infants. Methods We conducted two retrospective case-control analyses of infants born in Washington State from 1987–2004 using linked birth certificate, death certificate, and hospital discharge records. One assessed morbidity—infants hospitalized due to ID within one year of birth (47,404 cases/48,233 controls). The second assessed mortality—infants who died within one year due to ID (627 cases/2,730 controls). Results Maternal smoking was associated with both hospitalization (Adjusted Odds Ratio (AOR)=1.52; 95%CI: 1.46, 1.58) and mortality (AOR=1.51; 95%CI: 1.17, 1.96) due to any ID. In subgroup analyses, maternal smoking was associated with hospitalization due to a broad range of ID including both respiratory (AOR=1.69; 95%CI: 1.63, 1.76) and non-respiratory ID (AOR=1.27; 95%CI: 1.20, 1.34). Further stratification by birthweight and gestational age did not appreciably change these estimates. In contrast, there was no association of maternal smoking with ID infant mortality when only LBW infants were considered. Conclusions Maternal smoking was associated with a broad range of both respiratory and non-respiratory ID outcomes. Despite attenuation of the mortality association among LBW infants, ID hospitalization was found to be independent of both birthweight and gestational age. These findings suggest that full-term infants of normal weight whose mothers smoked may suffer an increased risk of serious ID morbidity and mortality. PMID:22929173

  6. Investigating the Decline of Fetal and Infant Mortality Rates in Alaska During 2010 and 2011.

    PubMed

    Prince, Cheryl B; Young, Margaret B; Sappenfield, William; Parrish, Jared W

    2016-04-01

    Introduction The U.S. infant mortality rate has been steadily declining since 2007. Although the downward trend has been notable in Alaska since 2006 when the rate was 6.9 infant deaths per 1000 live births, a dramatic drop in infant mortality occurred in 2010 and 2011 when the infant mortality rate fell to 3.8 infant deaths per 1000 live births during both years. The purpose of this study was to investigate the sudden decrease in fetal and infant mortality rates (FIMR) using the perinatal periods of risk (PPOR) method, an approach that has not been used previously in Alaska. Methods The study was conducted for 251 fetal and infant deaths in 2004-2006, 265 deaths in 2007-2009, and 129 deaths in 2010-2011. Data were stratified by Alaska Native (AN) and White maternal race and urban/rural residence. Results Among both urban and rural White women, the rate ratios (RR) for FIMRs between the earlier and later time periods were not significantly different. The postneonatal mortality rate (PNMR) among AN infants living in rural areas decreased significantly (RR 0.40; 95 % confidence interval 0.21-0.76) between 2007-2009 and 2010-2011. An unexplained increase in sudden unexplained infant death was noted in 2009, followed by a precipitous decrease in 2010-2011. No other unusual distribution of the cause specific mortality rates was observed. Discussion The decrease in the Alaska Native FIMR might have been due to focused efforts for preventing postneonatal sleep associated deaths. Education for prevention of sleep related deaths, particularly in rural communities, is necessary to maintain Alaska's low PNMR. PMID:26754348

  7. The impact of economic recession on maternal and infant mortality: lessons from history

    PubMed Central

    2010-01-01

    Background The effect of the recent world recession on population health has featured heavily in recent international meetings. Maternal health is a particular concern given that many countries were already falling short of their MDG targets for 2015. Methods We utilise 20th century time series data from 14 high and middle income countries to investigate associations between previous economic recession and boom periods on maternal and infant outcomes (1936 to 2005). A first difference logarithmic model is used to investigate the association between short run fluctuations in GDP per capita (individual incomes) and changes in health outcomes. Separate models are estimated for four separate time periods. Results The results suggest a modest but significant association between maternal and infant mortality and economic growth for early periods (1936 to 1965) but not more recent periods. Individual country data display markedly different patterns of response to economic changes. Japan and Canada were vulnerable to economic shocks in the post war period. In contrast, mortality rates in countries such as the UK and Italy and particularly the US appear little affected by economic fluctuations. Conclusions The data presented suggest that recessions do have a negative association with maternal and infant outcomes particularly in earlier stages of a country's development although the effects vary widely across different systems. Almost all of the 20 least wealthy countries have suffered a reduction of 10% or more in GDP per capita in at least one of the last five decades. The challenge for today's policy makers is the design and implementation of mechanisms that protect vulnerable populations from the effects of fluctuating national income. PMID:21106089

  8. 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

  9. 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. PMID:12874842

  10. Statistical Analysis of Factors Affecting Child Mortality in Pakistan.

    PubMed

    Ahmed, Zoya; Kamal, Asifa; Kamal, Asma

    2016-06-01

    Child mortality is a composite indicator reflecting economic, social, environmental, healthcare services, and their delivery situation in a country. Globally, Pakistan has the third highest burden of fetal, maternal, and child mortality. Factors affecting child mortality in Pakistan are investigated by using Binary Logistic Regression Analysis. Region, education of mother, birth order, preceding birth interval (the period between the previous child birth and the index child birth), size of child at birth, and breastfeeding and family size were found to be significantly important with child mortality in Pakistan. Child mortality decreased as level of mother's education, preceding birth interval, size of child at birth, and family size increased. Child mortality was found to be significantly higher in Balochistan as compared to other regions. Child mortality was low for low birth orders. Child survival was significantly higher for children who were breastfed as compared to those who were not. PMID:27354000

  11. Infant mortality in three population-based cohorts in Southern Brazil: trends and differentials.

    PubMed

    Santos, Iná S; Menezes, Ana M B; Mota, Denise M; Albernaz, Elaine P; Barros, Aluísio J D; Matijasevich, Alicia; Barros, Fernando C; Victora, Cesar G

    2008-01-01

    We studied time trends in infant mortality and associated factors between three cohort studies carried out in Pelotas, Rio Grande do Sul State, Brazil, in 1982, 1993, and 2004. All hospital births and deaths were determined by means of regular visits to hospitals, registrar's offices, and cemeteries. This data was used to calculate neonatal, post-neonatal, and infant mortality rates per thousand live births. Rates were also calculated according to cause of death, sex, birth weight, gestational age, and family income. The infant mortality rate fell from 36.4 per 1,000 live births in 1982 to 21.1 in 1993 and 19.4 in 2004. Major causes of infant mortality in 2004 were perinatal causes and respiratory infections. Mortality among low birth weight children from poor families fell 16% between 1993 and 2004; however, this rate increased by more than 100% among high-income families due to the increase in the number of preterm deliveries in this group. The stabilization of infant mortality in the last decade is likely to be due to excess medical interventions relating to pregnancies and delivery care. PMID:18797721

  12. Household Headship and Infant Mortality in India: Evaluating the Determinants and Differentials

    PubMed Central

    Gupta, Ashish Kumar; Borkotoky, M Kakoli; Kumar, Amit

    2015-01-01

    Background: There has been ample discussion on the levels and trends of infant mortality in India over time, but what remains less explored are, the differentials in infant mortality according to household headship. This paper examined the differences in the determinants of infant mortality between male-headed households (MHH) and female-headed households (FHH). Methods: The study used Cox proportional hazard model to examine the determinants of infant death, and Kaplan-Meier estimation technique to examine the survival pattern during infancy using data from Indian National Family Health Survey (2005-06). The analysis is restricted to women who had at least one live birth in the five years preceding the survey. Results: The study observed that household size and number of children below five are significant risk factors of infant mortality in MHH while length of previous birth interval is the only significant risk factor of infant death in FHH. Conclusions and Global Health Implications: The results indicate that children from FHH have higher survival probability at each age than children from MHH irrespective of place of residence and sex of the child.

  13. 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

  14. 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

  15. 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

  16. 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. PMID:25897958

  17. Rate and Time Trend of Perinatal, Infant, Maternal Mortality, Natality and Natural Population Growth in Kosovo

    PubMed Central

    Azemi, Mehmedali; Gashi, Sanije; Berisha, Majlinda; Kolgeci, Selim; Ismaili-Jaha, Vlora

    2012-01-01

    Aim: The aim of work has been the presentation of the rate and time trends of some indicators of the heath condition of mothers and children in Kosovo: fetal mortality, early neonatal mortality, perinatal mortality, infant mortality, natality, natural growth of population etc. The treated patients were the newborn and infants in the post neonatal period, women during their pregnancy and those 42 days before and after the delivery. Methods: The data were taken from: register of the patients treated in the Pediatric Clinic of Prishtina, World Health Organization, Mother and Child Health Care, Reproductive Health Care, Ministry of Health of the Republic of Kosovo, Statistical Department of Kosovo, the National Institute of Public Health and several academic texts in the field of pediatrics. Some indicators were analyzed in a period between year 1945-2010 and 1950-2010, whereas some others were analyzed in a time period between year 2000 and 2011. Results: The perinatal mortality rate in 2000 was 29.1‰, whereas in 2011 it was 18.7‰. The fetal mortality rate was 14.5‰ during the year 2000, whereas in 2011 it was 11.0‰, in 2000 the early neonatal mortality was 14.8‰, in 2011 it was 7.5‰. The infant mortality in Kosovo was 164‰ in 1950, whereas in 2010 it was 20.5‰. The most frequent causes of infant mortality have been: lower respiratory tract infections, acute infective diarrhea, perinatal causes, congenital malformations and unclassified conditions. Maternal death rate varied during this time period. Maternal death in 2000 was 23 whereas in 2010 only two cases were reported. Regarding the natality, in 1950 it reached 46.1 ‰, whereas in 2010 it reached 14‰, natural growth of population rate in Kosovo was 29.1‰ in 1950, whereas in 2011 it was 11.0‰. Conclusion: Perinatal mortality rate in Kosovo is still high in comparison with other European countries (Turkey and Kyrgyzstan have the highest perinatal mortality rate), even though it is in a

  18. Disparities in Infant Mortality: What’s Genetics Got to Do With It?

    PubMed Central

    David, Richard; Collins, James

    2007-01-01

    Since 1950, dramatic advances in human genetics have occurred, racial disparities in infant mortality have widened, and the United States’ international ranking in infant mortality has deteriorated. The quest for a “preterm birth gene” to explain racial differences is now under way. Scores of papers linking polymorphisms to preterm birth have appeared in the past few years. Is this strategy likely to reduce racial disparities? We reviewed broad epidemiological patterns that call this approach into question. Overall patterns of racial disparities in mortality and secular changes in rates of prematurity as well as birth-weight patterns in infants of African immigrant populations contradict the genetic theory of race and point toward social mechanisms. We postulate that a causal link to class disparities in health exists. PMID:17538073

  19. 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.

  20. Perinatal Decision Making for Preterm Infants with Congenital Heart Disease: Determinable Risk Factors for Mortality.

    PubMed

    Lynema, Stephanie; Fifer, Carlen G; Laventhal, Naomi T

    2016-06-01

    For premature infants with congenital heart disease (CHD), it may be unclear when the burdens of treatment outweigh potential benefits. Parents may thus have to choose between comfort care at birth and medical stabilization until surgical repair is feasible. Better defined outcome data, including risk factors for mortality, are needed to counsel expectant parents who are considering intensive care for premature infants with CHD. We sought to evaluate outcomes in this population to inform expectant parents considering intensive versus palliative care at birth. We performed a retrospective cohort study of infants born <34 weeks who received intensive care with critical or moderately severe CHD predicted to require surgery in the neonatal period or the first 6 months of life. 46 % of 54 infants survived. Among non-survivors, 74 % died prior to surgery (median age 24 days). Of the infants that underwent surgery, 75 % survived. Survival was lower among infants <32 weeks gestational age (GA) (p = 0.013), with birth weight (BW) <1500 g (p = 0.011), or with extra-cardiac anomalies (ECA) (p = 0.015). GA and ECA remained significant risk factors for mortality in multiple logistic regression analysis. In summary, GA < 32 weeks, BW < 1500 g, and ECA are determinable prenatally and were significant risk factors for mortality. The majority of infants who survived to cardiac intervention survived neonatal hospitalization, whereas most of the infants who died did so prior to surgery. For some expectant parents, this early declaration of mortality may support a trial of intensive care while avoiding burdensome interventions. PMID:27037550

  1. 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

  2. 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. PMID:24411023

  3. 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.

  4. Relative mortality of unbelted infant passengers and belted non-infant passengers in air accidents with survivors.

    PubMed Central

    Fife, D; Rosner, B; McKibben, W

    1981-01-01

    Aircraft accidents with survivors were examined to determine the relative risk of mortality for unrestrained infant passengers vs seat-belted adult passengers. The crude relative risk was estimated to be 7.1, based on US data, and 7.4, based on worldwide data. More refined estimates allow for possible effect of seat location and for differences in lethality between crashes. Using such estimates, unbelted infant passengers have relative risk of 5.9 based on US data and 9.6 based on worldwide data. The injury experience of restrained vs unrestrained automobile passengers suggests that observed excess risk to infant air passengers may be related to the absence of a mechanical restraint system. Recommendations for a mechanical restraint system are made and the cost and benefits of implementing these recommendations in the US are discussed. PMID:7294268

  5. 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

  6. Association of Arsenic with Adverse Pregnancy Outcomes/Infant Mortality: A Systematic Review and Meta-Analysis

    PubMed Central

    Armah, Frederick Ato; Essumang, David Kofi; Luginaah, Isaac; Clarke, Edith; Marfoh, Kissinger; Cobbina, Samuel Jerry; Nketiah-Amponsah, Edward; Namujju, Proscovia Bazanya; Obiri, Samuel; Dzodzomenyo, Mawuli

    2015-01-01

    Background Exposure to arsenic is one of the major global health problems, affecting > 300 million people worldwide, but arsenic’s effects on human reproduction are uncertain. Objectives We conducted a systematic review and meta-analysis to examine the association between arsenic and adverse pregnancy outcomes/infant mortality. Methods We searched PubMed and Ovid MEDLINE (from 1946 through July 2013) and EMBASE (from 1988 through July 2013) databases and the reference lists of reviews and relevant articles. Studies satisfying our a priori eligibility criteria were evaluated independently by two authors. Results Our systematic search yielded 888 articles; of these, 23 were included in the systematic review. Sixteen provided sufficient data for our quantitative analysis. Arsenic in groundwater (≥ 50 μg/L) was associated with increased risk of spontaneous abortion (6 studies: OR = 1.98; 95% CI: 1.27, 3.10), stillbirth (9 studies: OR = 1.77; 95% CI: 1.32, 2.36), moderate risk of neonatal mortality (5 studies: OR = 1.51; 95% CI: 1.28, 1.78), and infant mortality (7 studies: OR = 1.35; 95% CI: 1.12, 1.62). Exposure to environmental arsenic was associated with a significant reduction in birth weight (4 studies: β = –53.2 g; 95% CI: –94.9, –11.4). There was paucity of evidence for low-to-moderate arsenic dose. Conclusions Arsenic is associated with adverse pregnancy outcomes and infant mortality. The interpretation of the causal association is hampered by methodological challenges and limited number of studies on dose response. Exposure to arsenic continues to be a major global health issue, and we therefore advocate for high-quality prospective studies that include individual-level data to quantify the impact of arsenic on adverse pregnancy outcomes/infant mortality. Citation Quansah R, Armah FA, Essumang DK, Luginaah I, Clarke E, Marfoh K, Cobbina SJ, Nketiah-Amponsah E, Namujju PB, Obiri S, Dzodzomenyo M. 2015. Association of arsenic with adverse pregnancy

  7. 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:…

  8. 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

  9. Infant mortality of Sami and settlers in Northern Sweden: the era of colonization 1750–1900

    PubMed Central

    Sköld, Peter; Axelsson, Per; Karlsson, Lena; Smith, Len

    2011-01-01

    The study deals with infant mortality (IMR) that is one of the most important aspects of indigenous vulnerability. Background The Sami are one of very few indigenous peoples with an experience of a positive mortality transition. Objective Using unique mortality data from the period 1750–1900 Sami and the colonizers in northern Sweden are compared in order to reveal an eventual infant mortality transition. Findings The results show ethnic differences with the Sami having higher IMR, although the differences decrease over time. There were also geographical and cultural differences within the Sami, with significantly lower IMR among the South Sami. Generally, parity has high explanatory value, where an increased risk is noted for children born as number five or higher among siblings. Conclusion There is a striking trend of decreasing IMR among the Sami after 1860, which, however, was not the result of professional health care. Other indigenous peoples of the Arctic still have higher mortality rates, and IMR below 100 was achieved only after 1950 in most countries. The decrease in Sami infant mortality was certainly an important factor in their unique health transition, but the most significant change occurred after 1900. PMID:22043216

  10. [Multiple perceptions of infant mortality in Ceará State, Brazil].

    PubMed

    Sousa, José Roberto Pereira de; Nations, Marilyn

    2011-02-01

    This qualitative study analyzes the perceptions of various social actors towards infant mortality and the program to reduce it in Ceará State, Northeast Brazil. The study compares two municipalities (counties) that showed opposite infant mortality trends from 1993 to 1997, during which time Ceará achieved international visibility for having reduced infant mortality statewide. A total of 48 semi-structured interviews with four groups of key informants health system managers, community health agents, mothers who had lost a child, and neighbor women with children in the same age bracket and content analysis revealed "multiple conflicting voices" on the issue. Although the level of political determination to implement the interventions varied between the two municipalities, the differences in perceptions concerning infant death were more striking between the various groups of social actors, regardless of the municipality. The study revealed a kind of authoritarian educational practice that jeopardizes acceptance of the Community Health Agents Program. Public policies are needed that give voice to the people closest to the experience of infant death. PMID:21359462

  11. 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

  12. Identifying the intergenerational effects of the 1959-1961 Chinese Great Leap Forward Famine on infant mortality.

    PubMed

    Song, Shige

    2013-12-01

    Using the 1959-1961 Chinese Great Leap Forward Famine as a natural experiment, this study examines the relationship between mothers' prenatal exposure to acute malnutrition and their children's infant mortality risk. According to the results, the effect of mothers' prenatal famine exposure status on children's infant mortality risk depends on the level of famine severity. In regions of low famine severity, mothers' prenatal famine exposure significantly reduces children's infant mortality, whereas in regions of high famine severity, such prenatal exposure increases children's infant mortality although the effect is not statistically significant. Such a curvilinear relationship between mothers' prenatal malnutrition status and their children's infant mortality risk is more complicated than the linear relationship predicted by the original fetal origins hypothesis but is consistent with the more recent developmental origins of health and disease theory. PMID:24095302

  13. Medicaid prenatal program reducing rates of low birth weight, infant mortality.

    PubMed

    1997-11-01

    Medicaid prenatal program reduces low birth weight and infant mortality: Christiana Care Health System in Wilmington, DE, rejects the free baby stroller and gift certificate approach to motivating members and instead employs peer moms in the community to mentor pregnant Medicaid members and help them make life-long health improvements. PMID:10175564

  14. 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…

  15. 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…

  16. Infant and early childhood mortality in the Sine-Saloum region of Senegal.

    PubMed

    Goldberg, H I; M'Bodji, F G

    1988-10-01

    Infant and early childhood mortality in Senegal's Sine-Saloum region was investigated through use o f data from a 1982-83 family health survey. The survey involved interviews with 1894 married women 15-44 years of age living in extended family residential units in rural areas. Given evidence of substantial underreporting of early deaths, at least among children born before 1980, an adjustment factor was applied to the survey data. Infant mortality was estimated to be about 113/1000 live births and mortality before age 5 years was 263/1000. Strong mortality differentials, particularly after infancy, were noted according to the 2 socioeconomic variables included in the analysis: type of house and father's occupation. The probability of dying at ages 1-4 years was 50% higher among children living in traditional homes than among those in modern homes as well as among children whose fathers' were engaged in primary sector occupations (farming, livestock, fishing). Infant mortality showed no sex differential, while mortality at ages 1-4 years was 18% higher among females. Diarrheal and respiratory diseases were the 2 leading causes of death, killing at least 15% of all children by 5 years of age. Tetanus was an important cause of death during infancy, while measles and malaria were significant causes only after the 1st birthday. For all causes of death, the effect of socioeconomic status is higher in early childhood than in infancy, presumably because of the protective effect of breastfeeding. 82% of children who died had fever during their terminal illness, 51% had diarrhea, 39% had a cough, and 14% a rash. At least some mortality in this area might be prevented through treatment of these symptoms. However, calculating the degree to which particular interventions such as oral rehydration for diarrhea would reduce mortality is a complex task, requiring knowledge of replacement mortality, effectiveness of interventions, and the numbers of mothers who would utilize them

  17. 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

  18. The Association between Prenatal Exposure to Cigarettes and Infant and Maternal Negative Affect

    PubMed Central

    Schuetze, Pamela; Eiden, Rina D.

    2007-01-01

    This study examined the association between prenatal exposure to cigarettes and infant and maternal negative affect. Participants were 115 mother-infant dyads (69 prenatally exposed to cigarettes and 46 nonexposed). Infant and maternal negative affect were both assessed during the neonatal period (2–4 weeks of age) and again at 7 months of infant age. Results indicated that only prenatal exposure to cigarettes predicted infant negative affect. Infants who were prenatally exposed to more cigarettes had higher levels of negative affect at both time points. Furthermore, regression analyses indicated that both infant and maternal negative affect during the neonatal period predicted maternal negative affect at 7 months of age. These results highlight the importance of considering the reciprocal relationship between infant and maternal behavior when examining developmental outcomes among infants prenatally exposed to cigarettes. PMID:17683750

  19. Which is the best deprivation predictor of foetal and infant mortality rates?

    PubMed

    Joyce, R; Webb, R; Peacock, J L; Stirland, H

    2000-01-01

    This study investigates which, if any, population-based indicator of deprivation best predicts foetal and infant mortality rates in England. For the year 1995, the deprivation levels of 364 English Local Authorities were compared; using the three commonly used indicators, Jarman score, Townsend score and percentage unemployed. The predictive value of these for stillbirth, neonatal and infant mortality rates was then calculated. The three deprivation indicators were highly inter-correlated (r=0.866-0.924). For each mortality rate, the correlation with deprivation did not differ significantly for the three indicators of deprivation. We conclude, when comparing these outcomes in different areas of England, that any of the three deprivation indicators may be used to adjust for deprivation. PMID:10787021

  20. Exploration and innovation in addressing maternal, infant and neonatal mortality.

    PubMed

    Khanal, L; Dawson, P; Silwal, R C; Sharma, J; Kc, N P; Upreti, S R

    2012-05-01

    The Government of Nepal has been remarkably progressive in introducing innovative community-based maternal newborn and child health interventions in an effort to address the major causes of maternal and child mortality in the country. This article describes the introduction of innovative interventions, including a review of the landmark research that precipitated the discussion and provided evidence of practical feasibility, the acceptance of the intervention concept and validity, the approval process and the introduction and results from the pilot interventions. These interventions, which include the use of misoprostol to prevent post partum haemorrhage during homebirths, Morang Innovative Neonatal Intervention, gentamicin in Uniject and for the management of neonatal sepsis and newborn vitamin A supplementation, are in various stages and demonstrate the responsiveness of the Government to new approaches that address the major causes of maternal and child mortality. PMID:23034368

  1. [The drama of maternal, infant and child mortality in Latin America and the Caribbean].

    PubMed

    1990-12-01

    99% of the half-million maternal deaths in the world each year occur in developing countries, and many are the result of inopportune or undesired pregnancies. Each month over a million infants an small children also die. In Latin America and the caribbean, women have a risk 50-100 times greater of dying as a result of pregnancy or delivery than women in the US, and their children have a 5 times greater risk of dying before heir 1st birthday. The majority of infant and maternal deaths are preventable. Education and family planning services, which are neither costly nor complicated, could significantly reduce these high mortality rates. A woman's lifetime risk of maternal death is related in great part to her economic and social environment, how many pregnancies she has had, and the availability of maternal health services, It is often difficult for women in developing countries to maintain good health especially if they are poor. They are frequently poorly nourished, and may be required to perform hard physical labor. Pregnancy places greater physical demands on them and may worsen existing health problems. Maternal health risks are substantially increased as well by age under 18 or over 40 years, parity over 4, previous delivery during the last 2 years, and preexisting health problems that could affect pregnancy. Some 75% of maternal deaths are believed to result from obstetrical complications. Hemorrhage, 1 of the most frequent,is more common among older women who have already had 4 or more deliveries. Hemorrhages can be fatal in areas lacking the capability to provide immediate transfusions. Toxemia can lead to convulsions and death if not treated early. Sepsis usually results from complications of an obstructed delivery in very young mothers. Illegal abortion is another major cause of maternal death. In some Latin American ad Caribbean countries, 1/2 of maternal deaths are due to illegal abortions under unhygienic conditions. The same obstetrical risks exist

  2. Life table analysis of infant mortality and feto-infant mortality distributed on causes of death in Denmark 1983-1987.

    PubMed

    Kristensen, F B; Mac, F

    1992-04-01

    The survival function of 263,322 singletons of the 1983-1987 Danish birth cohorts (262,159 liveborn and 1163 stillborn babies) with mortality distributed on functional groups of underlying causes of death is presented in two graphic forms on the basis of Kaplan-Meier estimates. About half of all first-day deaths in liveborn babies occurred during the first 4 hours. More than half of all first-week deaths happened during the first day. More than half of all deaths from 31 weeks to 76 weeks after the first day of the last menstrual period (LMP) were either fetal deaths prior to the onset of labour unexplained by fetal factors or unexplained sudden infant death syndrome (SIDS) deaths. Graphic presentation of feto-infant mortality distributed on functional cause-of-death groups improved the expression of the relative contribution and timing of the different causes of deaths. Despite a high autopsy rate and a uniform coding practice the distribution on causes of deaths from register data should be interpreted with caution. Full use of the feto-infant approach is only achieved with data which include late abortions. Thus the feto-infant approach is of special interest in countries which have registers of live births and fetal deaths from week 22 of gestation or earlier. The integration of the life table approach and analysis of underlying causes of deaths should be further explored as a way of utilizing vital statistic databases for the evaluation of perinatal care. PMID:1428487

  3. Infant mortality among racial/ethnic minority groups, 1983-1984.

    PubMed

    Kleinman, J C

    1990-07-01

    Infant mortality varies considerably among racial/ethnic groups in the United States. For groups other than whites and blacks, previously published rates based on the vital statistics system have been underestimated because of inconsistencies in the classification of race and Hispanic status on birth and death certificates. For this report, infant mortality rates (IMRs) are based on the 1983 and 1984 linked birth and infant-death files, and mother's race and Hispanic origin are reported in accordance with information shown on the birth certificates. Overall, Asians have somewhat lower infant mortality rates than whites, but the rates vary from 6.0/1,000 among Japanese mothers to 9.0/1,000 among "other Asian" mothers. Hispanic mothers show even wider variation: from 7.8/1,000 among Cubans to 12.9/1,000 among Puerto Ricans. Blacks have an IMR twice as high as that for whites, and the rate for American Indians is nearly 60% above the rate for whites. Mexicans are the third largest minority group in the United States, accounting for one-quarter million births per year. Despite a high rate of poverty and low use of prenatal care, Mexicans have approximately the same IMR (9.0/1,000) as non-Hispanic whites. Further study of this group could assist in the development of prevention strategies. PMID:2115109

  4. Inequality as a Powerful Predictor of Infant and Maternal Mortality around the World

    PubMed Central

    2015-01-01

    Background Maternal and infant mortality are highly devastating, yet, in many cases, preventable events for a community. The human development of a country is a strong predictor of maternal and infant mortality, reflecting the importance of socioeconomic factors in determinants of health. Previous research has shown that the Human Development Index (HDI) predicts infant mortality rate (IMR) and the maternal mortality ratio (MMR). Inequality has also been shown to be associated with worse health in certain populations. The main purpose of the present study was to determine the correlation and predictive power of the Inequality Adjusted Human Development Index (IHDI) as a measure of inequality with the Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), Early Neonatal Mortality Rate (ENMR), Late Neonatal Mortality Rate (LNMR), and the Post Neonatal Mortality Rate (PNMR). Methods and Findings Data for the present study were downloaded from two sources: infant and maternal mortality data were downloaded from the Global Burden of Disease 2013 Cause of Death Database and the Human Development Index (HDI) and Inequality-Adjusted Human Development Index (IHDI) data were downloaded from the United Nations Development Program (UNDP). Pearson correlation coefficients were estimated, following logarithmic transformations to the data, to examine the relationship between HDI and IHDI with MMR, IMR, ENMR, LNMR, and PNMR. Steiger’s Z test for the equality of two dependent correlations was utilized in order to determine whether the HDI or IHDI was more strongly associated with the outcome variables. Lastly, we constructed OLS regression models in order to determine the predictive power of the HDI and IHDI in terms of the MMR, IMR, ENMR, LNMR, and PNMR. Maternal and infant mortality were both strongly and negatively correlated with both HDI and IHDI; however, Steiger’s Z test for the equality of two dependent correlations revealed that IHDI was more strongly correlated

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

    PubMed

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

    2008-01-01

    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. PMID:18560519

  6. 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. PMID:24964721

  7. 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…

  8. 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.

  9. Infant mortality in southern Brazil: a population based study of causes of death.

    PubMed Central

    Barros, F C; Victora, C G; Vaughan, J P; Teixeira, A M; Ashworth, A

    1987-01-01

    The causes of 215 infant deaths occurring in a population based cohort of 5914 infants from southern Brazil were determined. Perinatal problems were responsible for 43% of these deaths and infectious diseases for 32%. In the group who died of infectious diseases, respiratory infections and diarrhoea were equally important, each accounting for 12% of all deaths. A total of 87% of the deaths occurred in the first six months of life, and this proportion remained high (77%) even after perinatal causes had been excluded. On the other hand, 53% of the infants who died were of low birth weight, as opposed to 7.9% of the survivors. This suggests that low birthweight infants need to be carefully followed by health workers at primary level, especially during the first six months. It was estimated that if the incidence of low birth weight was reduced from the present 8.8% to 5% the likely reduction in infant mortality would be 20%. This reduction would be 33% for deaths due to perinatal causes, 14% for respiratory infections, and only 5% for diarrhoea. Efforts for the prevention of infant deaths in southern Brazil are more likely to be effective if they concentrate on improving perinatal health care and environmental conditions. PMID:3606182

  10. 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

  11. 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

  12. A hazards-model analysis of the covariates of infant and child mortality in Sri Lanka.

    PubMed

    Trussell, J; Hammerslough, C

    1983-02-01

    The purpose of this paper is twofold: (a) to provide a complete self-contained exposition of estimating life tables with covariates through the use of hazards models, and (b) to illustrate this technique with a substantive analysis of child mortality in Sri Lanka, thereby demonstrating that World Fertility Survey data are a valuable source for the study of child mortality. We show that life tables with covariates can be easily estimated with standard computer packages designed for analysis of contingency tables. The substantive analysis confirms and supplements an earlier study of infant and child mortality in Sri Lanka by Meegama. Those factors found to be strongly associated with mortality are mother's and father's education, time period of birth, urban/rural/estate residence, ethnicity, sex, birth order, age of the mother at the birth, and type of toilet facility. PMID:6832431

  13. 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.

  14. Determinants of infant mortality in community of Gilgel Gibe Field Research Center, Southwest Ethiopia: a matched case control study

    PubMed Central

    2013-01-01

    Background Infant mortality accounts for almost 67 percent of under-five child mortality that occurs globally. An understanding of factors related to infant mortality is important to guide the development of focused and evidence-based health interventions to reduce infant deaths. But no community based studies have been conducted to identify determinants of infant mortality in Ethiopia for the past two decades. The purpose of this study is to identify determinants of infant mortality in community of Gilgel Gibe Field Research Center, Southwest Ethiopia. Methods A community based matched case–control study was conducted. The study covered 133 infants who died during infancy between January 2010 and February 2011 in the study area. For each case, a control with approximately same date of birth and survived his/her first year of live and alive at time data collection was selected. Conditional logistic regression method was used to identify determinant factors of infant mortality using Epi-info 3.5.1 statistical software. Results According to the final logistic regression model, not attending antenatal care follow-up [AOR=2.04, 95% CI:(1.04,4.02)], not using soap for hand washing before feeding child [AOR=2.50, 95% CI: (1.32,4.76)], negative perceived benefits of mother to modern treatment and prevention [AOR=2.76, 95% CI: (1.21,6.09)], small birth size [AOR=2.91, 95% CI: (1.01,8.46)] and high birth order with short birth interval [AOR=3.80, 95% CI: (1.20,11.98)] were found to be independent determinants of infant mortality. Conclusions Antenatal care follow-up, hand washing habit with soap before feeding child, birth size, perceived benefits of mothers to modern treatment, birth order and preceding birth interval were determinants of infant mortality. PMID:23621915

  15. 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

  16. 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. PMID:21920653

  17. Infant mortality--gynaecological and unemployment aspects in Opole Province, Poland.

    PubMed

    Tukiendorf, Andrzej; Łasocha, Michał; Krasowski, Grzegorz; Orska, Ewa; Porebska, Aleksandra

    2007-03-01

    In the study the results of the relation between infant (neonatal + post-neonatal) mortality and the gynaecological and unemployment factors are presented. The findings are based on Bayesian modelling and indicate the possible influence of the unemployment situation on mortality, whereas no correlation was found as regards access to the availability of gynaecological health care. The main conclusion is that elevated unemployment which could be referred to a poor socioeconomic situation (amongst other factors) may force pregnant women to pay more attention to improving their life conditions, than to sufficient medical controlling. PMID:17491552

  18. 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...

  19. 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. PMID:15177838

  20. The influence of particulate matter on respiratory morbidity and mortality in children and infants.

    PubMed

    Jakubiak-Lasocka, Joanna; Lasocki, Jakub; Badyda, Artur J

    2015-01-01

    Air pollution is the most important environmental health risk leading to premature mortality, respiratory and other health problems. The aim of this study was to quantify its impact on infants and children in Warsaw (Poland), following the principles of Health Impact Assessment method. Particulate matter (PM(2.5) and PM(10)) was considered as the indicator of air pollution. Exposure-response functions between air pollution and health impacts were employed based on the literature. According to the calculations, around 5,201 asthma symptoms and 234 hospital respiratory admissions were caused annually due to air pollution. Hospitalizations due to cardiovascular problems related to air pollution amounted to 13. The mortality among infants and children is relatively low and occurs mostly in the postneonatal period. Nonetheless, approx. 5 mortality cases were assessed to be air pollution-attributable. The study demonstrates a significant impact of air pollution on infants and children, which is manifested primarily as a range of respiratory problems. PMID:25381559

  1. Factors Affecting Mortality After Major Nontraumatic Lower Extremity Amputation.

    PubMed

    Dinc, Tolga; Polat Duzgun, Arife; Kayilioglu, Selami Ilgaz; Erdogan, Ahmet; Yavuz, Zeynep; Coskun, Faruk

    2016-09-01

    Our aim was to evaluate the factors affecting the mortality of patients who underwent nontraumatic major lower limb amputation due to ischemic and/or diabetic causes. A total of 100 patients were included in the study. Among these patients, 70 (70%) underwent below-knee amputation, whereas 30 (30%) underwent above-knee amputation. Eleven (15.7%) of the 70 patients who underwent below-knee amputation and 12 (40%) of the 30 patients who underwent above-knee amputation (P = .008) were deceased. After multivariable Poisson regression analysis, female gender (risk ratio [RR] = 2.00, 95% CI = 1.07-3.74) and a neutrophil lymphocyte ratio (NLR) less than 6.8 (RR = 5.12, 95% CI = 1.86-14.08) were found to be independent risk factors for mortality. The value of 6.8 was used as a cutoff point for the NLR (area under the curve = 0.73, 95% CI = 0.62-0.85), with a sensitivity, specificity, positive predictive value, and negative predictive value of 83%, 66%, 57%, and 92%, respectively. The NLR and female gender were found to be independent factors that are related to increased mortality in patients who underwent lower limb amputation due to diabetic and/or ischemic causes. The coexistence of congestive heart failure and the amputation level (above knee) were found to be predictors of mortality in univariable analysis, but significance could not be demonstrated in multivariable analysis. PMID:27338831

  2. Approval and disapproval: infant responsiveness to vocal affect in familiar and unfamiliar languages.

    PubMed

    Fernald, A

    1993-06-01

    In a series of 5 auditory preference experiments, 120 5-month-old infants were presented with Approval and Prohibition vocalizations in infant-directed (ID) and adult-directed (AD) English, and in ID speech in nonsense English and 3 unfamiliar languages, German, Italian, and Japanese. Dependent measures were looking-time to the side of stimulus presentation, and positive and negative facial affect. No consistent differences in looking-time were found. However, infants showed small but significant differences in facial affect in response to ID vocalizations in every language except Japanese. Infants smiled more to Approvals, and when they showed negative affect, it was more likely to occur in response to Prohibitions. Infants did not show differential affect in response to Approvals and Prohibitions in AD speech. The results indicate that young infants can discriminate affective vocal expressions in ID speech in several languages and that ID speech is more effective than AD speech in eliciting infant affect. PMID:8339687

  3. 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

  4. Examining the spatially non-stationary associations between the second demographic transition and infant mortality: A Poisson GWR approach

    PubMed Central

    Yang, Tse-Chuan; Shoff, Carla; Matthews, Stephen A.

    2014-01-01

    Based on ecological studies, second demographic transition (SDT) theorists concluded that some areas in the US were in vanguard of the SDT compared to others, implying spatial nonstationarity may be inherent in the SDT process. Linking the SDT to the infant mortality literature, we sought out to answer two related questions: Are the main components of the SDT, specifically marriage postponement, cohabitation, and divorce, associated with infant mortality? If yes, do these associations vary across the US? We applied global Poisson and geographically weighted Poisson regression (GWPR) models, a place-specific analytic approach, to county-level data in the contiguous US. After accounting for the racial/ethnic and socioeconomic compositions of counties and prenatal care utilization, we found (1) marriage postponement was negatively related to infant mortality in the southwestern states, but positively associated with infant mortality in parts of Indiana, Kentucky, and Tennessee, (2) cohabitation rates were positively related to infant mortality, and this relationship was stronger in California, coastal Virginia, and the Carolinas than other areas, and (3) a positive association between divorce rates and infant mortality in southwestern and northeastern areas of the US. These spatial patterns suggested that the associations between the SDT and infant mortality were stronger in the areas in vanguard of the SDT than in others. The comparison between global Poisson and GWPR results indicated that a place-specific spatial analysis not only fit the data better, but also provided insights into understanding the non-stationarity of the associations between the SDT and infant mortality. PMID:25383259

  5. Examining the spatially non-stationary associations between the second demographic transition and infant mortality: A Poisson GWR approach.

    PubMed

    Yang, Tse-Chuan; Shoff, Carla; Matthews, Stephen A

    2013-01-01

    Based on ecological studies, second demographic transition (SDT) theorists concluded that some areas in the US were in vanguard of the SDT compared to others, implying spatial nonstationarity may be inherent in the SDT process. Linking the SDT to the infant mortality literature, we sought out to answer two related questions: Are the main components of the SDT, specifically marriage postponement, cohabitation, and divorce, associated with infant mortality? If yes, do these associations vary across the US? We applied global Poisson and geographically weighted Poisson regression (GWPR) models, a place-specific analytic approach, to county-level data in the contiguous US. After accounting for the racial/ethnic and socioeconomic compositions of counties and prenatal care utilization, we found (1) marriage postponement was negatively related to infant mortality in the southwestern states, but positively associated with infant mortality in parts of Indiana, Kentucky, and Tennessee, (2) cohabitation rates were positively related to infant mortality, and this relationship was stronger in California, coastal Virginia, and the Carolinas than other areas, and (3) a positive association between divorce rates and infant mortality in southwestern and northeastern areas of the US. These spatial patterns suggested that the associations between the SDT and infant mortality were stronger in the areas in vanguard of the SDT than in others. The comparison between global Poisson and GWPR results indicated that a place-specific spatial analysis not only fit the data better, but also provided insights into understanding the non-stationarity of the associations between the SDT and infant mortality. PMID:25383259

  6. The Healthy Start Initiative: A Community-Driven Approach to Infant Mortality Reduction. Volume IV: Community Outreach.

    ERIC Educational Resources Information Center

    Lightsey, Debra, Ed.; Gwinner, Valerie, Ed.

    The Healthy Start Initiative is a national 5-year demonstration program that uses a broad range of community-driven, system development approaches to reduce infant mortality and improve the health and well-being of women, infants, children, and families. This volume, fourth in the series, deals with the topic of community outreach and is based on…

  7. Birthweight-specific infant mortality for native Americans compared with whites, six states, 1980.

    PubMed Central

    Vanlandingham, M J; Buehler, J W; Hogue, C J; Strauss, L T

    1988-01-01

    We used data from the National Infant Mortality Surveillance (NIMS) project to compare birthweights and birthweight-specific mortality risks among Native American and White infants. Because race categories in NIMS were limited to White, Black, and all, we studied six states in which greater than 85 per cent of newborns who were neither White nor Black were Native American. In these states, the infant mortality risk (IMR) among Native Americans was 15.3 deaths per 1,000 live births compared with 8.7 deaths among Whites, relative risk (RR) = 1.8 (95% CI = 1.5-2.0). The percentage of Native American infants with less than 2,500 g birthweights was 5.8 per cent versus 5.0 per cent for White infants. Birthweight-specific neonatal mortality risks were similar for the two race groups, but birthweight-specific postneonatal mortality risks (PNMRs) were more than three times as high among Native Americans compared with Whites for infants of greater than or equal to 2,500 g birthweight. PNMRs were elevated for most causes of death and for all categories for maternal age, educational attainment, trimester prenatal care began, and number of previous live births. Leading causes of postneonatal death among Native Americans of greater than or equal to 2,500 g birthweight were sudden infant death syndrome and infections. PMID:3354730

  8. 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

  9. 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%

  10. Maternal postnatal psychiatric symptoms and infant temperament affect early mother-infant bonding.

    PubMed

    Nolvi, Saara; Karlsson, Linnea; Bridgett, David J; Pajulo, Marjukka; Tolvanen, Mimmi; Karlsson, Hasse

    2016-05-01

    Postnatal mother-infant bonding refers to the early emotional bond between mothers and infants. Although some factors, such as maternal mental health, especially postnatal depression, have been considered in relation to mother-infant bonding, few studies have investigated the role of infant temperament traits in early bonding. In this study, the effects of maternal postnatal depressive and anxiety symptoms and infant temperament traits on mother-infant bonding were examined using both mother and father reports of infant temperament. Data for this study came from the first phase of the FinnBrain Birth Cohort Study (n=102, father reports n=62). After controlling for maternal symptoms of depression and anxiety, mother-reported infant positive emotionality, measured by infant smiling was related to better mother-infant bonding. In contrast, infant negative emotionality, measured by infant distress to limitations was related to lower quality of bonding. In regards to father-report infant temperament, only infant distress to limitations (i.e., frustration/anger) was associated with lower quality of mother-infant bonding. These findings underline the importance of infant temperament as one factor contributing to early parent-infant relationships, and counseling parents in understanding and caring for infants with different temperament traits. PMID:27054496

  11. 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

  12. Mortality among infants with high-risk congenital diaphragmatic hernia in Singapore.

    PubMed

    Chan, D K; Ho, L Y; Joseph, V T

    1997-01-01

    Several factors suggested to predict mortality in congenital diaphragmatic hernia (CDH) have not always been applicable in different centers. A retrospective review was conducted of 19 consecutive neonates in Singapore in whom CDH was diagnosed within 12 hours of birth to identify factors associated with mortality. Of the 19 cases, 15 (79%) were diagnosed using antenatal ultrasonography. Eight (42%) underwent primary repair at a median age of 23 hours (range, 12 to 50 hours). Of the 19 infants, 15 died (mortality rate, 79%). Survivors until hospital discharge were compared with nonsurvivors. Antenatal diagnosis and stomach position in left-sided defects had no effect on outcome, although polyhydramnios tended to be associated with nonsurvival. Significant postnatal factors associated with mortality included a low arterial pH level, low initial arterial-alveolar oxygen ratio, high initial alveolar-arterial oxygen gradient, as well as high oxygenation and ventilation indices. These results reflect difficulty in oxygenation because of pulmonary hypoplasia despite evidence of adequate ventilation. There was no difference between survivors and nonsurvivors in either their initial or best postductal blood gases. The "Bohn quadrants" did not aid in predicting survival of infants who underwent repair because all eight such infants had best postductal carbon dioxide values of less than 40 mm Hg and ventilation indices of less than 1,000. Yet only four (50%) survived until hospital discharge. Large-scale evaluation of these factors may be required in the future to demonstrate their validity and reliability because of changing management strategies for CDH. PMID:9021580

  13. 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

  14. Infant mortality and air pollution: a comprehensive analysis of U.S. data for 1990.

    PubMed

    Lipfert, F W; Zhang, J; Wyzga, R E

    2000-08-01

    This paper uses U.S. linked birth and death records to explore associations between infant mortality and environmental factors, based on spatial relationships. The analysis considers a range of infant mortality end points, regression models, and environmental and socioeconomic variables. The basic analysis involves logistic regression modeling of individuals; the cohort comprises all infants born in the United States in 1990 for whom the required data are available from the matched birth and death records. These individual data include sex, race, month of birth, and birth weight of the infant, and personal data on the mother, including age, adequacy of prenatal care, and smoking and education in most instances. Ecological variables from Census and other sources are matched on the county of usual residence and include ambient air quality, elevation above sea level, climate, number of physicians per capita, median income, racial and ethnic distribution, unemployment, and population density. The air quality variables considered were 1990 annual averages of PM10, CO, SO2, SO4(2-), and "non-sulfate PM10" (NSPM10--obtained by subtracting the estimated SO4(2-) mass from PM10). Because all variables were not available for all counties (especially maternal smoking), it was necessary to consider various subsets of the total cohort. We examined all infant deaths and deaths by age (neonatal and postneonatal), by birth weight (normal and low [< 2500 g]), and by specific causes within these categories. Special attention was given to sudden infant death syndrome (SIDS). For comparable modeling assumptions, the results for PM10 agreed with previously published estimates; however, the associations with PM10 were not specific to probable exposures or causes of death and were not robust to changes in the model and/or the locations considered. Significant negative mortality associations were found for SO4(2-). There was no indication of a role for outdoor PM2.5, but possible

  15. 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. PMID:20084831

  16. An exploratory spatial analysis to assess the relationship between deprivation, noise and infant mortality: an ecological study

    PubMed Central

    2013-01-01

    Background Few studies have explored how noise might contribute to social health inequalities, and even fewer have considered infant mortality or its risk factors as the health event of interest. In this paper, we investigate the impact of neighbourhood characteristics - both socio-economic status and ambient noise levels - on the spatial distribution of infant mortality in the Lyon metropolitan area, in France. Methods All infant deaths (n = 715) occurring between 2000 and 2009 were geocoded at census block level. Each census block was assigned multi-component socio-economic characteristics and Lden levels, which measure exposure to noise. Using a spatial–scan statistic, we examined whether there were significant clusters of high risk of infant mortality according to neighbourhood characteristics. Results Our results highlight the fact that infant mortality is non-randomly distributed spatially, with clusters of high risk in the south-east of the Lyon metropolitan area (RR = 1.44; p = 0.09). After adjustments for socio-economic characteristics and noise levels, this cluster disappears or shifts according to in line with different scenarios, suggesting that noise and socio-economic characteristics can partially explain the spatial distribution of infant mortality. Conclusion Our findings show that noise does have an impact on the spatial distribution of mortality after adjustments for socio-economic characteristics. A link between noise and infant mortality seems plausible in view of the three hypothetical, non-exclusive, pathways we propose in our conceptual framework: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an unhealthy behaviours pathway. The lack of studies makes it is difficult to compare our findings with others. They require further research for confirmation and interpretation. PMID:24341620

  17. Study of infant and childhood mortality in an ICDS block of eastern U.P.

    PubMed

    Singh, S P; Reddy, D C; Mohapatra, S C; Gaur, S D

    1993-01-01

    Information on births and deaths was collected in 11 randomly selected AWW areas of Barhaj Mahen ICDS project area in Eastern U.P. by an independent survey team in 1988-89. The findings revealed that the births and deaths were under-reported to the tune of 36.6 and 13.9 percent respectively, by AWWs. The different demographic indicators generated from the data were as follows, CBR and CDR were 30.3 and 7.1 per 1000 population. Neonatal mortality rate, IMR, and MMR were 58.3, 74.7 and 6.5 per 1000 live births. 0-6 yr mortality was 16.3 per 1000 children and constituted 37.5% of the total deaths. ARI, diarrhoea and fever were the major causes of mortality in 0-6 yr old children accounting for 25.9, 22.3 and 14.8% respectively. The findings indicated that there was underreporting in adult mortalities despite the independent investigation, and a reduction in infant and childhood mortality possibly due to the beneficial effect of ICDS services. PMID:8138291

  18. Positive affect in infant siblings of children diagnosed with autism spectrum disorder.

    PubMed

    Filliter, Jillian H; Longard, Julie; Lawrence, Michael A; Zwaigenbaum, Lonnie; Brian, Jessica; Garon, Nancy; Smith, Isabel M; Roncadin, Caroline; Roberts, Wendy; Bryson, Susan E

    2015-04-01

    Research on the expression of positive affect in young children with Autism Spectrum Disorder (ASD) suggests that differences in this domain emerge late in the first year or early in the second year. However, many previous studies in this area employed retrospective research methods and global rating schemes. In the current study, the expression of positive affect was examined prospectively at ages 6, 12, and 18 months in three groups: infant siblings with ASD, infant siblings without ASD, and low-risk comparison infants. Infant siblings were the younger brothers or sisters of children diagnosed with ASD and, therefore, had a higher familial risk of ASD. The frequency and duration of smiles were coded from video excerpts from the Autism Observation Scale for Infants (Bryson, Zwaigenbaum, McDermott, Rombough, and Brian 2008), a standardized, play-based assessment of early signs of ASD. Results indicated that at 12 months, infant siblings with ASD had a lower rate of smiling than the other two groups. At 18 months, infant siblings with ASD continued to display a lower rate of smiling than infant siblings without ASD, but not comparison infants. Overall, these results indicate that infant siblings with ASD demonstrate less positive affect than infant siblings without ASD and low-risk comparison infants at 12 months. This suggests that reduced smiling may be an informative behavioural risk marker for ASD by children's first birthdays and may have implications for our understanding of atypical social development in children with ASD. PMID:25117578

  19. Acute exposure to fine and coarse particulate matter and infant mortality in Tokyo, Japan (2002-2013).

    PubMed

    Yorifuji, Takashi; Kashima, Saori; Doi, Hiroyuki

    2016-05-01

    Few studies have evaluated the effect of short-term exposure to particulate matter (PM) less than 2.5μm in diameter (PM2.5) or to coarse particles on infant mortality. We evaluated the association between short-term exposure to PM and infant mortality in Japan and assessed whether adverse health effects were observable at PM concentrations below Japanese air quality guidelines. We used a time-stratified, case-crossover design. The participants included 2086 infants who died in the 23 urbanized wards of the Tokyo Metropolitan Government between January 2002 and December 2013. We obtained measures of PM2.5 and suspended particulate matter (SPM; PM<7μm in diameter) from one general monitoring station. As a measure of coarse particles, we calculated PM7-2.5 by subtracting PM2.5 from SPM. We then used conditional logistic regression to analyze the data. Same-day PM2.5 was associated with increased risks of infant and postneonatal mortality, especially for mortality related to respiratory causes. For a 10μg/m(3) increase in PM2.5, the odds ratios were 1.06 (95% confidence interval: 1.01-1.12) for infant mortality and 1.10 (1.02-1.19) for postneonatal mortality. PM7-2.5 was also associated with an increased risk of postneonatal mortality, independent of PM2.5. Even when PM2.5 and SPM concentrations were below Japanese air quality guidelines, we observed adverse health effects. This study provides further evidence that acute exposure to PM2.5 and coarse particles (PM7-2.5) is associated with an increased risk of infant mortality. Further, rigorous evaluation of air quality guidelines for daily average PM2.5 and larger particles is needed. PMID:26874762

  20. [Infant and child mortality, marital fertility, and family economy among peasants in Navarre (1860-1930)].

    PubMed

    Erdozain, P; Mikelarena, F

    1996-01-01

    "This article analyzes the following four questions. Firstly, the evolutions of infant and child mortality and the evolution of marital fertility in rural Navarre [Spain] from 1860 to 1930. Secondly, the [registered] changes around the size and the composition of the rural households in the central area of Navarre where the stem-family prevailed....Thirdly, the evolution of the quotient between the numbers of potentially active household members and the number of consumption units. Finally, the technical change effects concerning the family labor requirements: the agrarian mechanization process and the intensification of crops." (EXCERPT) PMID:12321157

  1. Birth weight, infant mortality, and race: twin comparisons and genetic/environmental inputs.

    PubMed

    Conley, Dalton; Strully, Kate W

    2012-12-01

    Genetic and environmental inputs may shape population health disparities in varying ways. In this article, we use unique variation involved in twin births to attempt to untangle how genetic and prenatal environmental variation may make different contributions to infant health among white and black populations in the United States. Using twin fixed effects models and data from the 1995-1997 Matched Multiple Birth Dataset we compare birth weight-mortality associations across twin sex composition, zygosity, and race. Findings reveal suggestive differences between fraternal and imputed identical twin estimates for white and black twin pairs. PMID:23083893

  2. The National Rural Health Mission in India: its impact on maternal, neonatal, and infant mortality.

    PubMed

    Nagarajan, Shyama; Paul, Vinod K; Yadav, Namrata; Gupta, Shuchita

    2015-10-01

    The National Rural Health Mission (NRHM) has been a watershed in the history of India's health sector. As a previously unattempted investment, governance, and mobilization effort, the NRHM succeeded in injecting new energy into India's public health system. A huge expansion of infrastructure and human resources is the hallmark of the NRHM action. Demand-side initiatives led to enhanced utilization of public health facilities, especially for facility births. The impact is visible. The Mission has brought Millennium Development Goals 4 and 5 within India's grasp. Acceleration in infant and neonatal mortality reduction is especially notable. The NRHM has created conditions for the country to move toward universal health coverage. PMID:26385051

  3. 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

  4. High-risk young mothers: infant mortality and morbidity in four areas in the United States, 1973-1978.

    PubMed Central

    McCormick, M C; Shapiro, S; Starfield, B

    1984-01-01

    An examination of the changes in infant mortality and morbidity in four regions in the United States has revealed high levels of health problems among the infants of two groups of mothers: those less than or equal to 17 years and 18-19 year-old multiparas, many of whom began their childbearing under age 18. Despite decreases over the period of observation, neonatal mortality rates remain over one and a half times as high for infants of these mothers as for other mothers, largely due to the relatively high proportion of low birthweight (LBW) infants born to these mothers. Post-neonatal mortality rates also remain high, and may be increasing; this change cannot be explained solely by differences in proportion of LBW infants between these and older mothers. Both the high post-neonatal mortality rates and the type of morbidity experienced by surviving infants is consistent with the socioeconomic disadvantage of young mothers. The data further indicate the limited resources available to these mothers to cope with their children's health needs, and their potential vulnerability to decreases in public programs supporting child health care. PMID:6689836

  5. Mode of Birth Delivery Affects Oral Microbiota in Infants

    PubMed Central

    Lif Holgerson, P.; Harnevik, L.; Hernell, O.; Tanner, A.C.R.; Johansson, I.

    2011-01-01

    Establishment of the microbiota of the gut has been shown to differ between infants delivered by Caesarian section (C-section) and those delivered vaginally. The aim of the present study was to compare the oral microbiota in infants delivered by these different routes. The oral biofilm was assayed by the Human Oral Microbe Identification Microarray (HOMIM) in healthy three-month-old infants, 38 infants born by C-section, and 25 infants delivered vaginally. Among over 300 bacterial taxa targeted by the HOMIM microarray, Slackia exigua was detected only in infants delivered by C-section. Further, significantly more bacterial taxa were detected in the infants delivered vaginally (79 species/species clusters) compared with infants delivered by C-section (54 species/species clusters). Multivariate modeling revealed a strong model that separated the microbiota of C-section and vaginally delivered infants into two distinct colonization patterns. In conclusion, our study indicated differences in the oral microbiota in infants due to mode of delivery, with vaginally delivered infants having a higher number of taxa detected by the HOMIM microarray. PMID:21828355

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

    PubMed

    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

  7. 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. PMID:6711541

  8. 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

  9. Maternal touch and infant affect in the Still Face Paradigm: A cross-cultural examination.

    PubMed

    Lowe, Jean R; Coulombe, Patrick; Moss, Natalia C; Rieger, Rebecca E; Aragón, Crystal; MacLean, Peggy C; Caprihan, Arvind; Phillips, John P; Handal, Alexis J

    2016-08-01

    Touch between mother and infant plays an important role in development starting from birth. Cross-cultural differences surrounding rearing practices have an influence on parent-infant interaction, including types of touch used and the development of emotional regulation. This study was designed to investigate maternal touch and infant emotional regulation in infant-mother dyads from Ecuador (n=25) and Hispanic dyads from the United States (US) (n=26). Mothers and their 4-month-old full-term infants participated in the Still Face Paradigm. Second-by-second coding of maternal touch and infant affect was completed. Overall the analyses showed that Ecuadorian mothers used more nurturing and accompaniment touch and less attention seeking touch than US Hispanic mothers during the pre-stressor (baseline) episode. Lagged multilevel models were used to investigate the effect of the different types of touch on infant emotional regulation in the groups for the episodes. The data suggest that playful touch had a significant increase in infant affect, whereas accompaniment and attention-seeking touch had a significant decrease in infant affect. Overall, this study provides support for the role of touch in mother-infant synchronicity in relation to infant's emotional regulation. Identifying touch that is more calming is important to foster emotional regulation in infancy, which can have important implications for development. PMID:27362780

  10. Impact of environmental sanitation and crowding on infant mortality in rural Bangladesh.

    PubMed

    Rahman, M; Rahaman, M M; Wojtyniak, B; Aziz, K M

    1985-07-01

    In two villages of Bangladesh, 2471 infants born in 1976 and 1977 were followed up for a year to study the impact of environmental sanitation and crowding on their mortality. Neonatal and postneonatal mortality rates in the study cohort were 100 and 75 per 1000 live-births, respectively. Multiple logistic regression analysis was done to estimate the effects of the selected risk factors while controlling for some socioeconomic, demographic, and biological characteristics. Risk of postneonatal mortality (PNNM) in the households which did not use latrines was 3 X 12 times (p less than 0.01) higher than in those which did and 1.5 times (p less than 0.05) higher in the households with 10 or more persons than in smaller households. PNNM in the households which did not use tube-wells (hand-pump) water was higher, but not significantly so, than in those which used tube-well water for all purposes. Neonatal mortality was completely unrelated to the environmental factors investigated. PMID:2861464

  11. Mother-infant dyadic reparation and individual differences in vagal tone affect 4-month-old infants' social stress regulation.

    PubMed

    Provenzi, Livio; Casini, Erica; de Simone, Paola; Reni, Gianluigi; Borgatti, Renato; Montirosso, Rosario

    2015-12-01

    Infants' social stress regulation (i.e., reactivity and recovery) might be affected by mother-infant dyadic functioning and infants' vagal tone (i.e., respiratory sinus arrhythmia, RSA). This study investigated the role of a specific dyadic functioning feature (i.e., dyadic reparation) and individual differences in vagal tone regulation (i.e., RSA suppression vs. non-suppression) in relation to social stress regulation in 4-month-old infants. A total of 65 mother-infant dyads participated in the face-to-face still-face paradigm. Social stress reactivity and recovery were measured as negative emotionality during Still-Face and Reunion episodes, respectively. RSA was measured during Play, Still-Face, and Reunion episodes. Suppressors had higher dyadic reparation during Play and higher recovery from social stress compared with non-suppressors. Higher reparation during Play was associated with lower reactivity and higher recovery only for suppressors. Findings suggest a joint role of infants' RSA individual differences and dyadic reparation in affecting infants' social stress regulation at 4 months of age. PMID:26247809

  12. 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

  13. Infant mortality -- critical analysis of factors and new approach for calculation of I.M.R.

    PubMed

    Gupta, R; Gupta, B D; Singh, R N; Mehta, S C

    1991-01-01

    In India, researchers conducted a household survey of 1050 infants in an urban slum and rural and urban areas of Jodhpur Region to determine the infant mortality rate (IMR) and its correlation with various socioeconomic and demographic factors. They used the data to develop a concrete formula intended to allow precise estimation of IMR, given knowledge of these factors. Overall IMR was 106/1000 live births. The IMR for the slum, rural, and urban areas was 137, 123, and 57, respectively. The 4 most significant quantifiable factors that could be changed to reduce IMR were maternal age (IMR increases with maternal age of 30 years and older), parity (IMR increases with parity, especially at parity 5), literacy (IMR is higher among illiterates than literates), and low socioeconomic status [SES] (IMR increases as SES decreases). Based on the data from the survey, the researchers used regression analysis and other calculations to determine the values of the coefficients and constants. The results of their formula compared favorably with those of the household survey. For example, the IMR for the slum, rural area, urban area, and overall were actually 137, 123, 57, and 106, respectively. The respective IMRs based on the formula were 140, 120, 54, and 100. Assuming that all infant deaths are recorded, the formula allows one to estimate IMR of any area, country, or region. PMID:12346052

  14. 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

  15. 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. PMID:24349025

  16. INFANT EMOTIONAL WITHDRAWAL: A PRECURSOR OF AFFECTIVE AND COGNITIVE DISTURBANCE IN FETAL ALCOHOL SPECTRUM DISORDERS

    PubMed Central

    Molteno, Christopher D.; Jacobson, Joseph L.; Carter, R. Colin; Dodge, Neil C.; Jacobson, Sandra W.

    2013-01-01

    Objectives To test the hypothesis that emotional withdrawal is an early indicator of affective disorder in infants heavily exposed prenatally to alcohol, which is independent of alcohol-related effects on mother-infant interaction and temperament and discriminated between children later diagnosed with fetal alcohol syndrome (FAS) and partial FAS (PFAS) and predicted cognitive and affective outcomes at 5 and 9 years. Methods The sample consisted of Cape Coloured (mixed ancestry) infants, whose mothers were interviewed during pregnancy regarding their alcohol consumption using a timeline follow-back approach. Infant emotional withdrawal (n = 85) was assessed on the Alarm Distress Baby Scale at 6.5 months. Mother-infant interaction was evaluated from video recordings during free play and infant feeding at 6.5 months (n = 127). Infant temperament was assessed by maternal report on the EAS Temperament Survey at 13 months (n = 119). Socio-demographic and psychological correlates of maternal alcohol use and infant iron deficiency were examined as potential confounders. The children were diagnosed for FAS/PFAS by expert dysmorphologists at 5 years; cognitive and affective function, at 5 and 9 years. Results Prenatal alcohol exposure was associated with increased infant emotional withdrawal and decreased activity, but unrelated to mother-infant interaction or any other temperament measures. Children later diagnosed with FAS and PFAS at 5 years exhibited more emotional withdrawal and less responsivity and activity as infants. Infant withdrawal, responsivity, quality of interaction, and maternal sensitivity also predicted poorer IQ and affective response at 5 and 9 years. When all four infant affective measures were examined simultaneously in a regression analysis, only infant emotional withdrawal persisted as a significant predictor of 9-year IQ. Conclusions This study is the first to document a direct effect of fetal alcohol exposure on emotional withdrawal in infancy

  17. 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. PMID:27475054

  18. Disease ecology and a reformist alternative: the case of infant mortality.

    PubMed

    Gesler, W M; Bird, S T; Oljeski, S A

    1997-03-01

    This paper attempts to shed some light on the recent debate between those who advocate a reformed medical geography and those who respond that reform is not necessary. We show that disease ecology and a reformist alternative display certain tendencies in the ways in which they address issues of health and disease. We use the example of geographic variations in infant mortality rates to show how two non-positivist perspectives from social theory, political economy and humanism, support a reformist viewpoint, while also acknowledging the value of a complementary disease ecology approach. Two concepts, the social construction of health and illness and social relevance, are used to portray the political economy approach; humanism is described in terms of the meaning of individual experience and the importance of place. The paper concludes with a discussion of the respective roles of disease ecology and a reformist approach in models of infant mortality and a summary of the main differences between the two perspectives. PMID:9032833

  19. 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.

  20. Quality Indicators but Not Admission Volumes of Neonatal Intensive Care Units Are Effective in Reducing Mortality Rates of Preterm Infants

    PubMed Central

    Rochow, Niels; Lee, Sauyoung; Schünemann, Holger; Fusch, Christoph

    2016-01-01

    Aim To investigate how two different strategies to form larger neonatal intensive care units (NICU) impact neonatal mortality rates. Methods Cross-sectional study modeling admission volumes and mortality rates of 177,086 VLBW infants aggregated into 862 NICUs. Cumulative 3-year data was abstracted from Vermont Oxford Network. The model simulated a reduction in number of NICUs by stepwise exclusion using either admission volume (VOL) or quality (QUAL) cut-offs. After randomly redirecting infants of excluded to remaining NICUs resulting system mortality rates were calculated with and without adjusting for effects of experience levels (EL) using published data to reflect effects of different team-to-patient exposure. Results The quality-based strategy is more effective in reducing mortality; while VOL alone was not able to reduce system mortality, QUAL already achieved a 5% improvement after reducing 8% of NICUs and redirecting 6% of infants. Including “EL”, a 5% improvement of mortality was achieved by reducing 77% (VOL) vs. 7% (QUAL) of NICUs and redirecting 54% (VOL) vs. 5% (QUAL) of VLBW infants, respectively. Conclusion While a critical number of admissions is needed to maintain skills this study emphasizes the importance of including quality parameters to restructure neonatal care. The findings can be generalized to other medical fields. PMID:27508499

  1. Perinatal Depression Influences on Infant Negative Affectivity: Timing, Severity, and Co-Morbid Anxiety

    PubMed Central

    Rouse, Matthew H.; Goodman, Sherryl H.

    2014-01-01

    Accumulating evidence suggests that antenatal depression predicts infants’ negative affectivity, albeit with variable effect sizes. With a prospective longitudinal design, we sought to explain that variability by addressing questions about timing of the depression across pregnancy and the early postpartum, the role of high symptom levels relative to diagnosed depression, comorbidity with anxiety, and the potential mediating role of neuroendocrine functioning. Primiparous women (n = 77) with histories of depression prior to pregnancy were assessed for cortisol levels monthly beginning by mid-pregnancy. Depression symptom levels and diagnostic status were similarly assessed monthly in pregnancy and also until infants reached three months of age, when mothers completed the Infant Behavior Questionnaire – Revised to measure infant negative affectivity. Antenatal depression symptoms and infant negative affectivity were positively associated (r = .39). Controlling for depression symptom levels in other trimesters, only second trimester depression symptoms predicted higher infant negative affectivity (β = .44). With postpartum depression symptom levels in the model, only antenatal depression symptoms predicted infant negative affectivity (β = .45). In the context of depression, neither antenatal anxiety symptoms nor anxiety disorder diagnosis were associated with infant NA scores. The hypothesized role of elevated maternal cortisol as a mechanism for the association between antenatal depression and infant NA was not supported. Our findings contribute to efforts to more precisely identify infants of perinatally depressed mothers who are at greater risk for elevated negative affectivity, suggesting a window of vulnerability in mid pregnancy and the need for further study of potential mechanisms. PMID:25459792

  2. Race Affects Outcome among Infants with Intestinal Failure

    PubMed Central

    Squires, Robert H; Balint, Jane; Horslen, Simon; Wales, Paul W.; Soden, Jason; Duggan, Christopher; Li, Ruosha; Belle, Steven H

    2014-01-01

    Objective Intestinal failure is a rare, devastating condition associated with significant morbidity and mortality. We sought to determine if ethnic and racial differences were associated with patient survival and likelihood of receiving an intestinal transplant in a contemporary cohort of children with intestinal failure. Methods This was an analysis of a multicenter cohort study with data collected from chart review conducted by the Pediatric Intestinal Consortium (PIFCon). Entry criteria included infants < 12 mo receiving parenteral nutrition (PN) for > 60 continuous days and followed for at least 2 years. Outcomes included death and intestinal transplant (ITx). Race and ethnicity were recorded as they were in the medical record. For purposes of statistical comparisons and regression modeling, categories of race were consolidated into “white” and “non-white” children. Results Of 272 subjects enrolled, 204 white and 46 non-white children were available for analysis. The 48 month cumulative incidence probability (CIP) of death without ITx was 0.40 for non-white and 0.16 for white children (p<0.001); the CIP of ITx was 0.07 for non-white vs 0.31 for white children (p=0.003). The associations between race and outcomes remained after accounting for low-birth weight, diagnosis, and being seen at a transplant center. Conclusion Race is associated with death and receiving an ITx in a large cohort of children with intestinal failure. This study highlights the need to investigate reasons for this apparent racial disparity in outcome among children with intestinal failure. PMID:24918984

  3. Genesee County REACH Windshield Tours: enhancing health professionals understanding of community conditions that influence infant mortality.

    PubMed

    Kruger, Daniel J; French-Turner, Tonya; Brownlee, Shannon

    2013-06-01

    The Genesee County Racial and Ethnic Approaches to Community Health (REACH) program is a community-based program designed to reduce African American infant mortality rates in Flint, Michigan. Genesee County REACH activities address three core themes: fostering community mobilization, reducing racism, and enhancing the maternal-infant health care system. The REACH Community Action Plan was generated using a community-based participatory approach, and is based on a socio-ecological model with interventions focused at the individual, organizational, health system, and community levels. Genesee County REACH's Community Windshield Tours were developed to raise awareness of social and environmental barriers to health promotion among health care system staff in Flint, Michigan. These tours provide a close-up examination of the community's environmental conditions and the experiences of mothers, children, and families at risk for poor birth outcomes. In this article, we report our findings from pre-/post-tour surveys, as well as long-term follow-up surveys, to assess the impact of this REACH activity on participants' knowledge and beliefs about Genesee County residents, and to determine any resultant individual, policy, system, or environmental changes. We used t tests to compare participants' responses before and after the tours. We found that several individual- and systems-level changes have resulted from these tours, reflecting greater cultural sensitivity and increased understanding of patients' circumstances. African American infant mortality rates in Genesee County declined to a historic low in 2005, and they remain lower than in previous years. Although REACH coalition partners recognize that this reduction cannot be attributed to a single intervention or activity, REACH activities such as the Community Windshield Tours addressing multiple levels of the socio-ecological model may have had a synergistic effect. PMID:23605377

  4. Vaccination against respiratory syncytial virus in pregnancy: a suitable tool to combat global infant morbidity and mortality?

    PubMed

    Saso, Anja; Kampmann, Beate

    2016-08-01

    Respiratory syncytial virus (RSV) is the most important viral cause of pneumonia in early childhood (ie, younger than 2 years), responsible for high infant morbidity and mortality worldwide. It is widely accepted that an effective vaccine against RSV would have a major impact on child health globally. Despite the setbacks of the clinical trials in the 1960s, there has been a recent and significant revival of interest in vaccines against RSV, with several promising candidates undergoing evaluation. In this Review, we describe the epidemiological and immunological background to RSV infection and subsequently focus on the promising pipeline of RSV vaccine development. We discuss the potential for implementation of a safe and immunogenic RSV vaccine within the context of global health and with regards to a range of strategies, including vaccination of women during pregnancy, which is likely to emerge as a beneficial and feasible public health tool. This approach would provide interim protection to vulnerable, RSV-naive infants and other high risk groups, in which the burden of admission to hospital and death is greatest. Extending research and implementation from resource-rich to resource-poor settings is required to enhance our understanding of RSV immunity and inform vaccine development and delivery strategies for all settings. We summarise key outstanding issues for researchers and policy makers to understand the interplay of biological and non-biological factors affecting design and distribution of a successful RSV vaccine globally. PMID:27317449

  5. The Role of Maternal Affect Mirroring on Social Expectancies in Three-Month-Old Infants.

    ERIC Educational Resources Information Center

    Legerstee, Maria; Varghese, Jean

    2001-01-01

    Assessed the role of maternal affect mirroring on development of prosocial behaviors and social expectancies in 2- to 3-month-olds. Found that infants whose mothers ranked high on affect mirroring (attention maintenance, sensitivity, responsiveness) ranked high on prosocial behaviors and social expectancy, whereas infants whose mothers ranked low…

  6. 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

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

    PubMed

    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

  8. 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. PMID:24709788

  9. The role of maternal affect mirroring on social expectancies in three-month-old infants.

    PubMed

    Legerstee, M; Varghese, J

    2001-01-01

    The role of maternal affect mirroring on the development of prosocial behaviors and social expectancies was assessed in forty-one 2- to 3-month-old infants. Prosocial behavior was characterized as infants' positive behavior and increased attention toward their mothers. Social expectancies were defined as infants' expectancy for affective sharing. Mothers and infants were observed twice, approximately 1 week apart. During Visit 1, mothers and infants were videotaped while interacting over television monitors for 3 min. During Visit 2, infants engaged in a live, 3-min interaction with their mothers over television monitors (live condition) and they also viewed a replay of their mothers' interaction from the preceding week (replay condition). The order of conditions was counterbalanced. Maternal affect mirroring was measured according to the level of attention maintenance, warm sensitivity, and social responsiveness displayed. A natural split was observed with 58% of the mothers ranking high and 42% ranking low on these affect mirroring measures (HAM and LAM, respectively). Infants in the HAM group ranked high on prosocial behaviors and social expectancy--they discriminated between live and replay, conditions with smiles, vocalizations, and gazes. Infants in the LAM group ranked low on these variables--they gazed longer during the live condition than during the replay condition, but only when the live condition was presented first; however, they did not smile or vocalize more. These findings indicate that there is a relation between affect mirroring and social expectancies in infants. PMID:11699672

  10. 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…

  11. Infant and Child Mortality in India in the Last Two Decades: A Geospatial Analysis

    PubMed Central

    Singh, Abhishek; Pathak, Praveen Kumar; Chauhan, Rajesh Kumar; Pan, William

    2011-01-01

    Background Studies examining the intricate interplay between poverty, female literacy, child malnutrition, and child mortality are rare in demographic literature. Given the recent focus on Millennium Development Goals 4 (child survival) and 5 (maternal health), we explored whether the geographic regions that were underprivileged in terms of wealth, female literacy, child nutrition, or safe delivery were also grappling with the elevated risk of child mortality; whether there were any spatial outliers; whether these relationships have undergone any significant change over historical time periods. Methodology The present paper attempted to investigate these critical questions using data from household surveys like NFHS 1992–1993, NFHS 1998–1999 and DLHS 2002–2004. For the first time, we employed geo-spatial techniques like Moran's-I, univariate LISA, bivariate LISA, spatial error regression, and spatiotemporal regression to address the research problem. For carrying out the geospatial analysis, we classified India into 76 natural regions based on the agro-climatic scheme proposed by Bhat and Zavier (1999) following the Census of India Study and all estimates were generated for each of the geographic regions. Result/Conclusions This study brings out the stark intra-state and inter-regional disparities in infant and under-five mortality in India over the past two decades. It further reveals, for the first time, that geographic regions that were underprivileged in child nutrition or wealth or female literacy were also likely to be disadvantaged in terms of infant and child survival irrespective of the state to which they belong. While the role of economic status in explaining child malnutrition and child survival has weakened, the effect of mother's education has actually become stronger over time. PMID:22073208

  12. TulaSalud: An m-health system for maternal and infant mortality reduction in Guatemala

    PubMed Central

    Lobos-Medina, Isabel; Díaz-Molina, Cesar Augusto; Chen-Cruz, Moisés Faraón; Prieto-Egido, Ignacio

    2015-01-01

    Summary The Guatemalan NGO (Non-Governmental Organization) TulaSalud has implemented an m-health project in the Department of Alta Verapaz. This Department has 1.2 million inhabitants (78% living in rural areas and 89% from indigenous communities) and in 2012, had a maternal mortality rate of 273 for every 100,000 live births. This m-health initiative is based on the provision of a cell phone to community facilitators (CFs). The CFs are volunteers in rural communities who perform health prevention, promotion and care. Thanks to the cell phone, the CFs have become tele-CFs who able to carry out consultations when they have questions; send full epidemiological and clinical information related to the cases they attend to; receive continuous training; and perform activities for the prevention and promotion of community health through distance learning sessions in the Q’eqchí and/or Poqomchi’ languages. In this study, rural populations served by tele-CFs were selected as the intervention group while the control group was composed of the rural population served by CFs without Information and Communication Technology (ICT) tools. As well as the achievement of important process results (116,275 medical consultations, monitoring of 6,783 pregnant women, and coordination of 2,014 emergency transfers), the project has demonstrated a statistically significant decrease in maternal mortality (p < 0.05) and in child mortality (p = 0.054) in the intervention group compared with rates in the control group. As a result of the telemedicine initiative, the intervention areas, which were selected for their high maternal and infant mortality rates, currently show maternal and child mortality indicators that are not only lower than the indicators in the control area, but also lower than the provincial average (which includes urban areas). PMID:25766857

  13. TulaSalud: An m-health system for maternal and infant mortality reduction in Guatemala.

    PubMed

    Martínez-Fernández, Andrés; Lobos-Medina, Isabel; Díaz-Molina, Cesar Augusto; Chen-Cruz, Moisés Faraón; Prieto-Egido, Ignacio

    2015-07-01

    The Guatemalan NGO (Non-Governmental Organization) TulaSalud has implemented an m-health project in the Department of Alta Verapaz. This Department has 1.2 million inhabitants (78% living in rural areas and 89% from indigenous communities) and in 2012, had a maternal mortality rate of 273 for every 100,000 live births. This m-health initiative is based on the provision of a cell phone to community facilitators (CFs). The CFs are volunteers in rural communities who perform health prevention, promotion and care. Thanks to the cell phone, the CFs have become tele-CFs who able to carry out consultations when they have questions; send full epidemiological and clinical information related to the cases they attend to; receive continuous training; and perform activities for the prevention and promotion of community health through distance learning sessions in the Q'eqchí and/or Poqomchi' languages. In this study, rural populations served by tele-CFs were selected as the intervention group while the control group was composed of the rural population served by CFs without Information and Communication Technology (ICT) tools. As well as the achievement of important process results (116,275 medical consultations, monitoring of 6,783 pregnant women, and coordination of 2,014 emergency transfers), the project has demonstrated a statistically significant decrease in maternal mortality (p < 0.05) and in child mortality (p = 0.054) in the intervention group compared with rates in the control group. As a result of the telemedicine initiative, the intervention areas, which were selected for their high maternal and infant mortality rates, currently show maternal and child mortality indicators that are not only lower than the indicators in the control area, but also lower than the provincial average (which includes urban areas). PMID:25766857

  14. Infant Sensitivity to Distributional Information Can Affect Phonetic Discrimination.

    ERIC Educational Resources Information Center

    Maye, Jessica; Werker, Janet F.; Gerken, LouAnn

    2002-01-01

    Familiarized 6- and 8-month-olds with speech sounds from a phonetic continuum, exhibiting a bimodal or unimodal frequency distribution. Found that only infants in the bimodal condition discriminated tokens from the endpoints of the continuum. Results demonstrate that infants are sensitive to the statistical distribution of speech sounds in the…

  15. In search for an explanation to the upsurge in infant mortality in Kenya during the 1988–2003 period

    PubMed Central

    2012-01-01

    Background In Kenya, infant mortality rate increased from 59 deaths per 1000 live births in 1988 to 78 deaths per 1000 live births by 2003. This was an increase of about 32 percent in 15 years. The reasons behind this upturn are poorly understood. This paper investigates the probable factors behind the upsurge in infant mortality in Kenya during the 1988–2003 period. Understanding the causes behind the upsurge is critical in designing high impact public health strategies for the acceleration of national and international public health goals such as the Millennium Development Goals (MDGs). The reversals in early child mortality is also regarded as one of the most important topics in contemporary demography. Methods A merged dataset drawn from the Kenya Demographic and Health Surveys of 1993, 1998 and 2003 was used. The merged KDHS included a total of 5265 singletons. Permission to use the KDHS data was obtained from ICF international on the following website: http://www.measuredhs.com. Stata version 11.0 was used for data analysis. The paper used regression decomposition techniques as the main method for analysing the contribution of the selected covariates on the upsurge in infant mortality. Results The duration of breastfeeding; maternal education, regional HIV prevalence and malaria endemicity were the factors that appeared to have contributed much to the observed rise in infant mortality in Kenya over the period. If all the live births that occurred in the 1996/03 period had the same mean values of all explanatory variables as those of live births that occurred in the 1988/95 period, then infant mortality would have increased by a massive 14 deaths per 1000 live births. However, if the live births that occurred in the 1988/95 period had the same mean values of all explanatory variables as those that occurred in the 1996/03 period, the upsurge in infant mortality would have been negligible. While the role of HIV in the upturn in infant mortality in Kenya and

  16. 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…

  17. 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

  18. Morbidity and mortality amongst infants of diabetic mothers admitted into Soba university hospital, Khartoum, Sudan

    PubMed Central

    Kheir, Abdelmoneim E.M.; Berair, Rabih; Gulfan, Islam G.I.; Karrar, Mohamed Z.; Mohammed, Zuhlel A.O.

    2012-01-01

    The prevalence of diabetes during pregnancy is increasing and this is associated with an increased risk of complications in both mother and fetus. The aim of this research is to study the neonatal complications of maternal diabetes. This was a prospective observational study that was conducted in Soba university hospital between September 2010 and March 2011. All infants born to diabetic mothers during the study period were admitted to the neonatal care unit for evaluation. Data on sex, gestational age, and birth weight, mode of delivery, complications, investigations, birth injury, and length of hospital stay were recorded. Maternal data were retrieved from records. Data was analyzed using Minitab 15. A total of 50 infants of diabetic mothers (IDMs) were included in the study. Thirty infants (60%) were females and 20 (40%) were males. Forty two (84%) of the neonates were born by caesarian section, only 7(14%) were born by spontaneous vaginal delivery. Birth injury was observed in 4% of them. The mean gestational age was 37.2±2.051 weeks. The median birth weight was 3.5 kg. 14 (28%) of the babies were macrosomic, and 17 (34%) were large for gestational age (LGA). Congenital anomalies were found in 3 (6%), hypoglycemia in 6 (12%), hyperbillirubinaemia in 10 (20%), hypocalcaemia and hypomagnesaemia each occurred in 2%, transient tachypnea of the newborn occurred in 5 (10%) of the neonates and respiratory distress syndrome in 2%. Cardiomyopathy occurred in 2% and mortality was 4%. We concluded that macrosomia, LGA, and hyperbillirubinaemia were the commonest complications in IDMs, maternal glycaemic control was found to have a significant effect on a number of outcomes.

  19. 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

  20. 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…

  1. 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…

  2. 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…

  3. 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. PMID:27207615

  4. The Relationship Between Affective and Cognitive Development in Down's Syndrome Infants.

    ERIC Educational Resources Information Center

    Cicchetti, Dante; Sroufe, L. Alan

    Examined was the association between affective and cognitive development in 14 Down's Syndrome infants (4- to 8-months-old). Mothers administered a series of 30 laughter items each month, and experimenters gave the Uzgiris-Hunt scales of cognitive development at 13 and 16 months, and the Bayley scales and Infant Behavior Record at 16 months.…

  5. Risk factors for postneonatal, infant, child and under-5 mortality in Nigeria: a pooled cross-sectional analysis

    PubMed Central

    Ezeh, Osita Kingsley; Agho, Kingsley Emwinyore; Dibley, Michael John; Hall, John Joseph; Page, Andrew Nicolas

    2015-01-01

    Objectives To identify common factors associated with post-neonatal, infant, child and under-5 mortality in Nigeria. Design, setting and participants A cross-sectional data of three Nigeria Demographic and Health Surveys (NDHS) for the years 2003, 2008 and 2013 were used. A multistage, stratified, cluster random sampling method was used to gather information on 63 844 singleton live-born infants of the most recent birth of a mother within a 5-year period before each survey was examined using cox regression models. Main outcome measures Postneonatal mortality (death between 1 and 11 months), infant mortality (death between birth and 11 months), child mortality (death between 12 and 59 months) and under-5 mortality (death between birth and 59 months). Results Multivariable analyses indicated that children born to mothers with no formal education was significantly associated with mortality across all four age ranges (adjusted HR=1.30, 95% CI 1.01 to 1.66 for postneonatal; HR=1.38, 95% CI 1.11 to 1.84 for infant; HR=2.13, 95% CI 1.56 to 2.89 for child; HR=1.19, 95% CI 1.02 to 1.41 for under-5). Other significant factors included living in rural areas (HR=1.48, 95% CI 1.16 to 1.89 for postneonatal; HR=1.23, 95% CI 1.03 to 1.47 for infant; HR=1.52, 95% CI 1.16 to 1.99 for child; HR=1.29, 95% CI 1.11 to 1.50 for under-5), and poor households (HR=2.47, 95% CI 1.76 to 3.47 for postneonatal; HR=1.40, 95% CI 1.10 to 1.78 for infant; HR=1.72, 95% CI 1.19 to 2.49 for child; HR=1.43, 95% CI 1.17 to 1.76 for under-5). Conclusions This study found that no formal education, poor households and living in rural areas increased the risk of postneonatal, infant, child and under-5 mortality among Nigerian children. Community-based interventions for reducing under-5 deaths are needed and should target children born to mothers of low socioeconomic status. PMID:25818271

  6. 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

  7. Posture Affects How Robots and Infants Map Words to Objects

    PubMed Central

    Morse, Anthony F.; Benitez, Viridian L.; Belpaeme, Tony; Cangelosi, Angelo; Smith, Linda B.

    2015-01-01

    For infants, the first problem in learning a word is to map the word to its referent; a second problem is to remember that mapping when the word and/or referent are again encountered. Recent infant studies suggest that spatial location plays a key role in how infants solve both problems. Here we provide a new theoretical model and new empirical evidence on how the body – and its momentary posture – may be central to these processes. The present study uses a name-object mapping task in which names are either encountered in the absence of their target (experiments 1–3, 6 & 7), or when their target is present but in a location previously associated with a foil (experiments 4, 5, 8 & 9). A humanoid robot model (experiments 1–5) is used to instantiate and test the hypothesis that body-centric spatial location, and thus the bodies’ momentary posture, is used to centrally bind the multimodal features of heard names and visual objects. The robot model is shown to replicate existing infant data and then to generate novel predictions, which are tested in new infant studies (experiments 6–9). Despite spatial location being task-irrelevant in this second set of experiments, infants use body-centric spatial contingency over temporal contingency to map the name to object. Both infants and the robot remember the name-object mapping even in new spatial locations. However, the robot model shows how this memory can emerge –not from separating bodily information from the word-object mapping as proposed in previous models of the role of space in word-object mapping – but through the body’s momentary disposition in space. PMID:25785834

  8. Posture affects how robots and infants map words to objects.

    PubMed

    Morse, Anthony F; Benitez, Viridian L; Belpaeme, Tony; Cangelosi, Angelo; Smith, Linda B

    2015-01-01

    For infants, the first problem in learning a word is to map the word to its referent; a second problem is to remember that mapping when the word and/or referent are again encountered. Recent infant studies suggest that spatial location plays a key role in how infants solve both problems. Here we provide a new theoretical model and new empirical evidence on how the body - and its momentary posture - may be central to these processes. The present study uses a name-object mapping task in which names are either encountered in the absence of their target (experiments 1-3, 6 & 7), or when their target is present but in a location previously associated with a foil (experiments 4, 5, 8 & 9). A humanoid robot model (experiments 1-5) is used to instantiate and test the hypothesis that body-centric spatial location, and thus the bodies' momentary posture, is used to centrally bind the multimodal features of heard names and visual objects. The robot model is shown to replicate existing infant data and then to generate novel predictions, which are tested in new infant studies (experiments 6-9). Despite spatial location being task-irrelevant in this second set of experiments, infants use body-centric spatial contingency over temporal contingency to map the name to object. Both infants and the robot remember the name-object mapping even in new spatial locations. However, the robot model shows how this memory can emerge -not from separating bodily information from the word-object mapping as proposed in previous models of the role of space in word-object mapping - but through the body's momentary disposition in space. PMID:25785834

  9. Different kinds of infants' smiles in the first six months and contingency to maternal affective behavior.

    PubMed

    Mendes, Deise Maria Leal Fernandes; Seidl-de-Moura, Maria Lucia

    2014-01-01

    Infants' smiling is considered an expression of affection, and an index of cognitive and socio-emotional development. Despite research advances in this area, there is much to explore on the ontogeny of smiling, its meaning and the context in which it is manifested early in life. This study aimed at: (a) investigating smiling patterns in these different developmental moments in early infancy, (b) analyzing patterns of association between babies' smiles and their mothers' affective behaviors, and (c) verifying whether babies can answer contingently, with smiles, to mothers' affective behaviors. Participants were sixty Brazilian mother-infant dyads. Infants in three age levels (one, three, and five months of age) and their mothers were observed. They were videotaped at home, during 20 minutes in free sessions. The results indicate increase in frequency of infants' smiling instances across ages (F(2, 59) = 9.18, p < .05), variations in the frequency of maternal behaviors accompanying the variations in infants' smiling (F(2, 59) = 6.03, p < .05), correlations between infants' smiling and mothers' affective behaviors, and contingency between the behaviors of both mothers and infants. It was verified a strong association between mothers' behavior and their babies' smiles, emphasizing the importance of affective interactions in early stages of development. PMID:26055068

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

    PubMed Central

    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. PMID:26696939

  11. 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

  12. 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…

  13. 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

  14. Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia

    PubMed Central

    Lee, Min; Chen, Solomon Chih-Cheng; Yang, Hsin-Yi; Huang, Jui-Hua; Yeung, Chun-Yan; Lee, Hung-Chang

    2016-01-01

    Abstract Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes. This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death. Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997–2004) to 4.9 to 5.3/case in the later cohort (2005–2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10–1.18) and death (HR = 1.05, 95% CI = 1.01–1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82–6.73) and death (aOR = 1.75, 95% CI = 1.17–2.62). The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the

  15. Human infant faces provoke implicit positive affective responses in parents and non-parents alike.

    PubMed

    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

  16. 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

  17. 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...

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

    PubMed

    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; Heijden, Amber van der; 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

  19. 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

  20. Inclusion of non-viable neonates in the birth record and its impact on infant mortality rates in Shelby County, Tennessee, USA

    PubMed Central

    Williams, Bryan L.; Magsumbol, Melina S.

    2010-01-01

    Rates of infant death are one of the most common indicators of a population's overall health status. Infant mortality rates (IMRs) are used to make broad inferences about the quality of health care, effects of health policies and even environmental quality. The purpose of our study was threefold: i) to examine the characteristics of births in the area in relation to gestational age and birthweight; ii) to estimate infant mortality using variable gestational age and/or birthweight criteria for live birth, and iii) to calculate proportional mortality ratios for each cause of death using variable gestational age and/or birthweight criteria for live birth. We conducted a retrospective analysis of all Shelby County resident-linked birth and infant death certificates during the years 1999 to 2004. Descriptive test statistics were used to examine infant mortality rates in relation to specific maternal and infant risk factors. Through careful examination of 1999–2004 resident-linked birth and infant death data sets, we observed a disproportionate number of non-viable live births (≤20 weeks gestation or ≤350 grams) in Shelby County. Issuance of birth certificates to these non-viable neonates is a factor that contributes to an inflated IMR. Our study demonstrates the complexity and the appropriateness of comparing infant mortality rates in smaller geographic units, given the unique characteristics of live births in Shelby County. The disproportionate number of pre-viable infants born in Shelby County greatly obfuscates neonatal mortality and de-emphasizes the importance of post-neonatal mortality. PMID:21589834

  1. 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. PMID:26863300

  2. 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

  3. The Development of Affect Specificity in Infants' Use of Emotion Cues

    ERIC Educational Resources Information Center

    Martin, Nicole Gendler; Witherington, David C.; Edwards, Alison

    2008-01-01

    This study examined the emergence of affect specificity in infancy. In this study, infants received verbal and facial signals of 2 different, negatively valenced emotions (fear and sadness) as well as neutral affect via a television monitor to determine if they could make qualitative distinctions among emotions of the same valence. Twenty 12- to…

  4. Population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years

    PubMed Central

    2012-01-01

    Background Over the last two decades, improvements in medical care have been associated with a significant increase and better outcome of very preterm (VP, < 32 completed gestational weeks) and very low birth weight (VLBW, < 1500 g) infants. Only a few publications analyse changes of their short-term outcome in a geographically defined area over more than 10 years. We therefore aimed to investigate the net change of VP- and VLBW infants leaving the hospital without major complications. Methods Our population-based observational cohort study used the Minimal Neonatal Data Set, a database maintained by the Swiss Society of Neonatology including information of all VP- and VLBW infants. Perinatal characteristics, mortality and morbidity rates and the survival free of major complications were analysed and their temporal trends evaluated. Results In 1996, 2000, 2004, and 2008, a total number of 3090 infants were enrolled in the Network Database. At the same time the rate of VP- and VLBW neonates increased significantly from 0.87% in 1996 to 1.10% in 2008 (p < 0.001). The overall mortality remained stable by 13%, but the survival free of major complications increased from 66.9% to 71.7% (p < 0.01). The percentage of infants getting a full course of antenatal corticosteroids increased from 67.7% in 1996 to 91.4% in 2008 (p < 0.001). Surfactant was given more frequently (24.8% in 1996 compared to 40.1% in 2008, p < 0.001) and the frequency of mechanical ventilation remained stable by about 43%. However, the use of CPAP therapy increased considerably from 43% to 73.2% (p < 0.001). Some of the typical neonatal pathologies like bronchopulmonary dysplasia, necrotising enterocolitis and intraventricular haemorrhage decreased significantly (p ≤ 0.02) whereas others like patent ductus arteriosus and respiratory distress syndrome increased (p < 0.001). Conclusions Over the 12-year observation period, the number of VP- and VLBW infants increased significantly. An unchanged overall

  5. A three decade analysis of factors affecting burn mortality in the elderly.

    PubMed

    Lionelli, G T; Pickus, E J; Beckum, O K; Decoursey, R L; Korentager, R A

    2005-12-01

    This study's objective was to identify variables that affect the mortality of elderly burn patients and to assess their changes over time. A retrospective review was conducted on all patients 75 or older (n=201) admitted to a university-based burn center between 1972 and 2000. Variables examined were age, sex, TBSA, ABSI, inhalation injury, timing from burn to operative intervention, the number of surgical procedures, the number of pre-morbid conditions, and mortality. There were 95 fatalities. TBSA strongly correlated with mortality (p<0.0001). Adjusting for TBSA and inhalation injury, mortality significantly decreased (p=0.04, odds ratio=0.58). Mortality significantly increased with inhalation injury (p<0.01). Fatality risk increased by 400% with inhalation injury. Absence of inhalation injury was not significant with respect to mortality in the 1970s, however there was a significant decrease (p=0.02) in mortality without an inhalation injury in the 1980s and 1990s. ABSI was strongly predictive of mortality (p<0.0001). On average there was a 200% increase in mortality per unit increase of ABSI. The elderly are 58% less likely to die from burns now as compared to the 1970s. Although mortality rose with increasing TBSA equally in each decade, the absolute risk of mortality decreased over time. This data suggests major strides have been made in burn care, however similar success has not been achieved with inhalation injuries. PMID:16269217

  6. Reducing mortality in HIV-infected infants and achieving the 90–90–90 target through innovative diagnosis approaches

    PubMed Central

    Essajee, Shaffiq; Vojnov, Lara; Penazzato, Martina; Jani, Ilesh; Siberry, George K; Fiscus, Susan A; Markby, Jessica

    2015-01-01

    Introduction Despite significant gains in access to early infant diagnosis (EID) over the past decade, most HIV-exposed infants still do not get tested for HIV in the first two months of life. For those who are tested, the long turnaround time between when the sample is drawn and when the results are returned leads to a high rate of loss to follow-up, which in turn means that few infected infants start antiretroviral treatment. Consequently, there continues to be high mortality from perinatally acquired HIV, and the ambitious goals of 90% of infected children identified, 90% of identified children treated and 90% of treated children with sustained virologic suppression by 2020 seem far beyond our reach. The objective of this commentary is to review recent advances in the field of HIV diagnosis in infants and describe how these advances may overcome long-standing barriers to access to testing and treatment. Discussion Several innovative approaches to EID have recently been described. These include point-of-care testing, use of SMS printers to connect the central laboratory and the health facility through a mobile phone network, expanding paediatric testing to other entry points where children access the health system and testing HIV-exposed infants at birth as a rapid way to identify in utero infection. Each of these interventions is discussed here, together with the opportunities and challenges associated with scale-up. Point-of-care testing has the potential to provide immediate results but is less cost-effective in settings where test volumes are low. Virological testing at birth has been piloted in some countries to identify those infants who need urgent treatment, but a negative test at birth does not obviate the need for additional testing at six weeks. Routine testing of infants in child health settings is a useful strategy to identify exposed and infected children whose mothers were not enrolled in programmes for the prevention of mother

  7. 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

  8. Cancer, infant mortality and birth sex-ratio in Fallujah, Iraq 2005-2009.

    PubMed

    Busby, Chris; Hamdan, Malak; Ariabi, Entesar

    2010-07-01

    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 Fallujah sample were 860

  9. The relationship between affective and cognitive development in Down's Syndrome infants.

    PubMed

    Cicchetti, D; Sroufe, L A

    1976-12-01

    A close association between affective expression and cognitive development was demonstrated in a longitudinal study of 14 Down's syndrome infants. It was found that the Down's syndrome infants laughed to groups of stimulus items in the same order as did previous samples of normal infants. Although the process was delayed by several months, the retarded babies too laughed first at physically intrusive items and only later to items calling for greater cognitive sophistication. In addition, cognitive developmental status, assessed by the Bayley and Uzgiris-Hunt scales, paralleled and was predicted by the level of affective development. Predictive and concurrent correlations between Bayley mental scores and various indices of affectivity ranged from .68 to .92. There was striking individual consistency across affective, mental, and motor measures, suggesting the organized nature of retarded development. Finally, since Down's syndrome infants frequently smiled under conditions when normal babies would laugh, a role for tension production, in addition to cognitive factors, was suggested in accounting for the behavior of these infants. PMID:137105

  10. 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

  11. 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. PMID:20980087

  12. 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

  13. 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) PMID:8359961

  14. 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

  15. 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. PMID:25683277

  16. 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...

  17. 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

  18. 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. PMID:26335149

  19. Factors affecting immunogenicity of BCG in infants, a study in Malawi, The Gambia and the UK

    PubMed Central

    2014-01-01

    Background BCG immunogenicity in infants differs between populations and these differences have been attributed to various factors. In this study, the influence of geographical location, season of birth, timing of vaccination, micronutrient status (zinc) and inflammatory status (C-reactive protein, CRP) were assessed. Methods Immunogenicity was assessed by cytokine signature in culture supernatants from diluted whole blood samples stimulated with M. tuberculosis PPD, using a multiplex bead assay. Results were correlated with the plasma zinc and CRP concentrations at the time of sampling, and with interview and household data. BCG vaccinated infants were recruited in Malawi, The Gambia and the UK. Results In Malawi, infants vaccinated within the first week after birth showed lower production of most cytokines measured than those vaccinated later. The number of cytokines showing significant differences between Malawian and Gambian infants decreased after adjusting for season of birth. In Malawi, a proportion of infants had zinc deficiency and elevated plasma CRP (>10 mg/L), but neither zinc deficiency nor high CRP was associated with production of any of the cytokines measured. Conclusions The cytokine/chemokine signatures observed in response to M. tuberculosis PPD in infants at 3 months post BCG vaccination were affected by geographical location, season of birth, and timing of vaccination but not associated with the concentration of plasma zinc or inflammatory status. These factors should be considered in future trials of new TB vaccines. PMID:24708690

  20. International Collaborative Effort (ICE) on birthweight; plurality; and perinatal and infant mortality. I: Methods of data collection and analysis.

    PubMed

    Alberman, E; Bergsjø, P; Cole, S; Evans, S; Hartford, R; Hoffman, H; McCarthy, B; Pashley, J; Hampton, B

    1989-01-01

    This paper describes the collection and analysis of data by a group of international collaborators (International Collaborative Effort on Perinatal and Infant Mortality) interested in comparative studies on birthweight distributions and reproductive outcome. This is the first of a series of reports on the results of these studies. It gives an account of the countries or states involved, and the collection and characteristics of the data. The countries and states included sixteen of the United States, plus England and Wales, Denmark, Bavaria and North Rhine-Westphalia from the Federal Republic of Germany, Israel, Japan, Norway, Scotland, and Sweden. The data comprised birthweight distributions in 500-gram groups for all births and for singletons separately, for livebirths, stillbirths, first week deaths and, where available, late neonatal and infant deaths, from 1970 up to 1985. PMID:2801030

  1. 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

  2. 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. PMID:23563257

  3. 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. PMID:26009815

  4. 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)…

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

    PubMed Central

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

    2015-01-01

    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. PMID:26566356

  6. 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

  7. Very Low Birth Weight Preterm Infants With Surgical Short Bowel Syndrome: Incidence, Morbidity and Mortality, and Growth Outcomes at 18 to 22 Months

    PubMed Central

    Cole, Conrad R.; Hansen, Nellie I.; Higgins, Rosemary D.; Ziegler, Thomas R.; Stoll, Barbara J.

    2009-01-01

    OBJECTIVES The objective of this study was to determine the (1) incidence of short bowel syndrome in very low birth weight (<1500 g) infants, (2) associated morbidity and mortality during initial hospitalization, and (3) impact on short-term growth and nutrition in extremely low birth weight (<1000 g) infants. METHODS Infants who were born from January 1, 2002, through June 30, 2005, and enrolled in the National Institute of Child Health and Human Development Neonatal Research Network were studied. Risk factors for developing short bowel syndrome as a result of partial bowel resection (surgical short bowel syndrome) and outcomes were evaluated for all neonates until hospital discharge, death, or 120 days. Extremely low birth weight survivors were further evaluated at 18 to 22 months’ corrected age for feeding methods and growth. RESULTS The incidence of surgical short bowel syndrome in this cohort of 12 316 very low birth weight infants was 0.7%. Necrotizing enterocolitis was the most common diagnosis associated with surgical short bowel syndrome. More very low birth weight infants with short bowel syndrome (20%) died during initial hospitalization than those without necrotizing enterocolitis or short bowel syndrome (12%) but fewer than the infants with surgical necrotizing enterocolitis without short bowel syndrome (53%). Among 5657 extremely low birth weight infants, the incidence of surgical short bowel syndrome was 1.1%. At 18 to 22 months, extremely low birth weight infants with short bowel syndrome were more likely to still require tube feeding (33%) and to have been rehospitalized (79%). Moreover, these infants had growth delay with shorter lengths and smaller head circumferences than infants without necrotizing enterocolitis or short bowel syndrome. CONCLUSIONS Short bowel syndrome is rare in neonates but has a high mortality rate. At 18 to 22 months’ corrected age, extremely low birth weight infants with short bowel syndrome were more likely to have

  8. Neonatal Mortality and Long-Term Outcome of Infants Born between 27 and 32 Weeks of Gestational Age in Breech Presentation: The EPIPAGE Cohort Study

    PubMed Central

    Azria, Elie; Kayem, Gilles; Langer, Bruno; Marchand-Martin, Laetitia; Marret, Stephane; Fresson, Jeanne; Pierrat, Véronique; Arnaud, Catherine; Goffinet, François; Kaminski, Monique; Ancel, Pierre-Yves

    2016-01-01

    Objective To determine whether breech presentation is an independent risk factor for neonatal morbidity, mortality, or long-term neurologic morbidity in very preterm infants. Design Prospective population-based cohort. Population Singletons infants without congenital malformations born from 27 to 32 completed weeks of gestation enrolled in France in 1997 in the EPIPAGE cohort. Methods The neonatal and long-term follow-up outcomes of preterm infants were compared between those in breech presentation and those in vertex presentation. The relation of fetal presentation with neonatal mortality and neurodevelopmental outcomes was assessed using multiple logistic regression models. Results Among the 1518 infants alive at onset of labor included in this analysis (351 in breech presentation), 1392 were alive at discharge. Among those eligible to follow up and alive at 8 years, follow-up data were available for 1188 children. Neonatal mortality was significantly higher among breech than vertex infants (10.8% vs. 7.5%, P = 0.05). However the differences were not significant after controlling for potential confounders. Neonatal morbidity did not differ significantly according to fetal presentation. Severe cerebral palsy was less frequent in the group born in breech compared to vertex presentation but there was no difference after adjustment. There was no difference according to fetal presentation in cognitive deficiencies/learning disabilities or overall deficiencies. Conclusion Our data suggest that breech presentation is not an independent risk factor for neonatal mortality or long-term neurologic deficiencies among very preterm infants. PMID:26744838

  9. Correlation or causation? Income inequality and infant mortality in fixed effects models in the period 1960-2008 in 34 OECD countries.

    PubMed

    Avendano, Mauricio

    2012-08-01

    Income inequality is strongly associated with infant mortality across countries, but whether this association is causal has not been established. In their commentary in this issue of Social Science & Medicine, Regidor et al. (2012) argue that this association has disappeared in recent years, and question the premise of a causal link. This paper empirically tests the impact of income inequality on infant mortality in a fixed effects model that exploits the evolution of income inequality over a 38-year period, controlling for all time-invariant differences across countries. Data came from the Standardized World Income Inequality Database, containing yearly estimates for the period 1960-2008 in 34 countries member of the Organization for Economic Co-operation and Development (OECD), linked to infant mortality data from the OECD Health database. Infant mortality was modelled as a function of income inequality in a country and year fixed effects model, incorporating controls for changing economic and labour conditions. In a model without country fixed effects, a one-point increase in the Gini coefficient was associated with a 7% increase in the infant mortality rate (Rate ratio[RR] = 1.07, 95% Confidence Interval [CI] 1.04, 1.09). Controlling for differences across countries in a country fixed effects model, however, income inequality was no longer associated with infant mortality (RR = 1.00, 0.98, 1.01). Similar results were obtained when using lagged values of income inequality for up to 15 years, and in models that controlled for changing labour and economic conditions. Findings suggest that in the short-run, changes in income inequality are not associated with changes in infant mortality. A possible interpretation of the discrepancy between cross-country correlations and fixed effects models is that social policies that reduce infant mortality cluster in countries with low income inequality, but their effects do not operate via income. Findings highlight the

  10. 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

  11. Frontal brain electrical activity (EEG) and heart rate in response to affective infant-directed (ID) speech in 9-month-old infants.

    PubMed

    Santesso, Diane L; Schmidt, Louis A; Trainor, Laurel J

    2007-10-01

    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 content (i.e., love/comfort, surprise, fear) in a group of typically developing 9-month-old infants. Regional EEG and heart rate were collected continuously during stimulus presentation. We found the pattern of overall frontal EEG power was linearly related to affective intensity of the ID speech, such that EEG power was greatest in response to fear, than surprise than love/comfort; this linear pattern was specific to the frontal region. We also noted that heart rate decelerated to ID speech independent of affective content. As well, infants who were reported by their mothers as temperamentally distressed tended to exhibit greater relative right frontal EEG activity during baseline and in response to affective ID speech, consistent with previous work with visual stimuli and extending it to the auditory modality. Findings are discussed in terms of how increases in frontal EEG power in response to different affective intensity may reflect the cognitive aspects of emotional processing across sensory domains in infancy. PMID:17659820

  12. Young and vulnerable: Spatial-temporal trends and risk factors for infant mortality in rural South Africa (Agincourt), 1992-2007

    PubMed Central

    2010-01-01

    Background Infant mortality is an important indicator of population health in a country. It is associated with several health determinants, such as maternal health, access to high-quality health care, socioeconomic conditions, and public health policy and practices. Methods A spatial-temporal analysis was performed to assess changes in infant mortality patterns between 1992-2007 and to identify factors associated with infant mortality risk in the Agincourt sub-district, rural northeast South Africa. Period, sex, refugee status, maternal and fertility-related factors, household mortality experience, distance to nearest primary health care facility, and socio-economic status were examined as possible risk factors. All-cause and cause-specific mortality maps were developed to identify high risk areas within the study site. The analysis was carried out by fitting Bayesian hierarchical geostatistical negative binomial autoregressive models using Markov chain Monte Carlo simulation. Simulation-based Bayesian kriging was used to produce maps of all-cause and cause-specific mortality risk. Results Infant mortality increased significantly over the study period, largely due to the impact of the HIV epidemic. There was a high burden of neonatal mortality (especially perinatal) with several hot spots observed in close proximity to health facilities. Significant risk factors for all-cause infant mortality were mother's death in first year (most commonly due to HIV), death of previous sibling and increasing number of household deaths. Being born to a Mozambican mother posed a significant risk for infectious and parasitic deaths, particularly acute diarrhoea and malnutrition. Conclusions This study demonstrates the use of Bayesian geostatistical models in assessing risk factors and producing smooth maps of infant mortality risk in a health and socio-demographic surveillance system. Results showed marked geographical differences in mortality risk across a relatively small area

  13. 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. PMID:26494709

  14. The Tayside infant morbidity and mortality study: effect on health of using gas for cooking.

    PubMed Central

    Ogston, S A; Florey, C D; Walker, C H

    1985-01-01

    The relation between respiratory illness and the use of gas for cooking was examined from data on 1565 infants born to mothers who were primigravidas living in Dundee in 1980. Episodes of, and admissions to hospital for, respiratory illness were recorded during the first year of life. Both admissions and episodes were more common in infants from families using gas for cooking or heating than in infants from families using any other type of cooking or heating, but the differences were not significant. Results from this and other studies show that there is probably a small relation between respiratory illness and the use of gas appliances without a flue. To show convincingly whether such a relation exists might require a survey of 18 000-23 000 subjects. Respiratory illness was, however, strongly and positively related to parental smoking, a finding that is often made even in small studies. PMID:3919868

  15. 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;…

  16. The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review

    PubMed Central

    2011-01-01

    Background Infant mortality has shown a steady decline in recent years but a marked socioeconomic gradient persists. Antenatal care is generally thought to be an effective method of improving pregnancy outcomes, but the effectiveness of specific antenatal care programmes as a means of reducing infant mortality in socioeconomically disadvantaged and vulnerable groups of women has not been rigorously evaluated. Methods We conducted a systematic review, focusing on evidence from high income countries, to evaluate the effectiveness of alternative models of organising or delivering antenatal care to disadvantaged and vulnerable groups of women vs. standard antenatal care. We searched Medline, Embase, Cinahl, PsychINFO, HMIC, CENTRAL, DARE, MIDIRS and a number of online resources to identify relevant randomised and observational studies. We assessed effects on infant mortality and its major medical causes (preterm birth, congenital anomalies and sudden infant death syndrome (SIDS)) Results We identified 36 distinct eligible studies covering a wide range of interventions, including group antenatal care, clinic-based augmented care, teenage clinics, prenatal substance abuse programmes, home visiting programmes, maternal care coordination and nutritional programmes. Fifteen studies had adequate internal validity: of these, only one was considered to demonstrate a beneficial effect on an outcome of interest. Six interventions were considered 'promising'. Conclusions There was insufficient evidence of adequate quality to recommend routine implementation of any of the programmes as a means of reducing infant mortality in disadvantaged/vulnerable women. Several interventions merit further more rigorous evaluation. PMID:21314944

  17. Variations and Determinants of Mortality and Length of Stay of Very Low Birth Weight and Very Low for Gestational Age Infants in Seven European Countries.

    PubMed

    Fatttore, Giovanni; Numerato, Dino; Peltola, Mikko; Banks, Helen; Graziani, Rebecca; Heijink, Richard; Over, Eelco; Klitkou, Søren Toksvig; Fletcher, Eilidh; Mihalicza, Péter; Sveréus, Sofia

    2015-12-01

    The EuroHOPE very low birth weight and very low for gestational age infants study aimed to measure and explain variation in mortality and length of stay (LoS) in the populations of seven European nations (Finland, Hungary, Italy (only the province of Rome), the Netherlands, Norway, Scotland and Sweden). Data were linked from birth, hospital discharge and mortality registries. For each infant basic clinical and demographic information, infant mortality and LoS at 1 year were retrieved. In addition, socio-economic variables at the regional level were used. Results based on 16,087 infants confirm that gestational age and Apgar score at 5 min are important determinants of both mortality and LoS. In most countries, infants admitted or transferred to third-level hospitals showed lower probability of death and longer LoS. In the meta-analyses, the combined estimates show that being male, multiple births, presence of malformations, per capita income and low population density are significant risk factors for death. It is essential that national policies improve the quality of administrative datasets and address systemic problems in assigning identification numbers at birth. European policy should aim at improving the comparability of data across jurisdictions. PMID:26633869

  18. Positive Affect Processing and Joint Attention in Infants at High Risk for Autism: An Exploratory Study.

    PubMed

    Key, Alexandra P; Ibanez, Lisa V; Henderson, Heather A; Warren, Zachary; Messinger, Daniel S; Stone, Wendy L

    2015-12-01

    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 facial positive affect (N290/P400, Nc) at 9 months and their relation to joint attention at 15 months. Group differences were most pronounced for subtle facial expressions, in that the low-risk group exhibited relatively longer processing (P400 latency) and greater attention resource allocation (Nc amplitude). Exploratory analyses found associations between ERP responses and later joint attention, suggesting that attention to positive affect cues may support the development of other social competencies. PMID:25056131

  19. All-Cause Mortality of Low Birthweight Infants in Infancy, Childhood, and Adolescence: Population Study of England and Wales

    PubMed Central

    Watkins, W. John; Kotecha, Sarah J.; Kotecha, Sailesh

    2016-01-01

    Background Low birthweight (LBW) is associated with increased mortality in infancy, but its association with mortality in later childhood and adolescence is less clear. We investigated the association between birthweight and all-cause mortality and identified major causes of mortality for different birthweight groups. Methods and Findings We conducted a population study of all live births occurring in England and Wales between 1 January 1993 and 31 December 2011. Following exclusions, the 12,355,251 live births were classified by birthweight: 500–1,499 g (very LBW [VLBW], n = 139,608), 1,500–2,499 g (LBW, n = 759,283), 2,500–3,499 g (n = 6,511,411), and ≥3,500 g (n = 4,944,949). The association of birthweight group with mortality in infancy (<1 y of age) and childhood/adolescence (1–18 y of age) was quantified, with and without covariates, through hazard ratios using Cox regression. International Classification of Diseases codes identified causes of death. In all, 74,890 (0.61%) individuals died between birth and 18 y of age, with 23% of deaths occurring after infancy. Adjusted hazard ratios for infant deaths were 145 (95% CI 141, 149) and 9.8 (95% CI 9.5, 10.1) for the VLBW and LBW groups, respectively, compared to the ≥3,500 g group. The respective hazard ratios for death occurring at age 1–18 y were 6.6 (95% CI 6.1, 7.1) and 2.9 (95% CI 2.8, 3.1). Male gender, the youngest and oldest maternal age bands, multiple births, and deprivation (Index of Multiple Deprivation score) also contributed to increased deaths in the VLBW and LBW groups in both age ranges. In infancy, perinatal factors, particularly respiratory issues and infections, explained 84% and 31% of deaths in the VLBW and LBW groups, respectively; congenital malformations explained 36% and 23% in the LBW group and ≥2,500 g groups (2,500–3,499 g and ≥3,500 g groups combined), respectively. Central nervous system conditions explained 20% of deaths in childhood/adolescence in the VLBW

  20. Outcomes and Risk Factors Affecting Mortality in Patients Who Underwent Colorectal Emergency Surgery

    PubMed Central

    Oh, Nam Ho

    2016-01-01

    Purpose Emergency colorectal surgery has a high risk of mortality and morbidity because of incomplete bowel preparation, bacterial proliferation, and contamination. In this study, we investigated the outcomes and the risk factors affecting mortality in patients who had undergone emergency surgery for the treatment of various colorectal diseases. Methods This study is a retrospective analysis of prospectively collected data to survey the clinical results for patients who had undergone emergency colorectal surgery from January 2014 to December 2014. We analyzed various clinicopathologic factors, which were divided into 3 categories: preoperative, intraoperative, and postoperative. Results A total of 50 patients had undergone emergency colorectal surgery during the time period covered by this study. Among them, 10 patients (20%) died during the postoperative period. A simple linear regression analysis showed that the risk factors for mortality were old age, preoperative hypotension, and a high American Society of Anesthesiologist (ASA) score. Moreover, a multiple linear regression analysis showed a high ASA score and preoperative hypotension to be independent risk factors. Conclusion In this study, emergency colorectal surgery showed a relatively high mortality rate. Furthermore, the independent risk factors for mortality were preoperative hypotension and high ASA score; thus, patients with these characteristics need to be evaluated more carefully and receive better care if the mortality rate is to be reduced.

  1. Interactive regulation of affect in postpartum depressed mothers and their infants: an overview.

    PubMed

    Reck, Corinna; Hunt, Aoife; Fuchs, Thomas; Weiss, Robert; Noon, Andrea; Moehler, Eva; Downing, George; Tronick, Edward Z; Mundt, Christoph

    2004-01-01

    Specific patterns of interaction emerging in the first months of life are related to processes regulating mutual affects in the mother-child dyad. Particularly important for the dyad are the matching and interactive repair processes. The interaction between postpartum depressed mothers and their children is characterized by a lack of responsiveness, by passivity or intrusiveness, withdrawal and avoidance, as well as a low level of positive expression of affect. Thus, an impaired capability to regulate the child's affect has been demonstrated in depressed mothers. Maternal aggression, neglect toward infants, infanticidal thoughts, as well as infanticidal behavior are mainly linked to severe postpartum depression, especially with psychotic symptoms. The findings on mother-child interaction reported in this paper are based on mothers with mild to moderate depressive disorders without psychotic symptoms. Considering the stability of interaction patterns in the course of depressive illness as well as the long-term consequences of these interactions, it seems surprising that there are still few systematic studies of depressed mothers interacting with their infants. In connection with an overview on these issues, treatment models for parent-infant psychotherapy are discussed. PMID:15539778

  2. 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

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

    PubMed

    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

  4. Feasibility of intensive multimodal therapy in infants affected by rhabdoid tumors - experience of the EU-RHAB registry.

    PubMed

    Seeringer, A; Bartelheim, K; Kerl, K; Hasselblatt, M; Leuschner, I; Rutkowski, S; Timmermann, B; Kortmann, R-D; Koscielniak, E; Schneppenheim, R; Warmuth-Metz, M; Gerß, J; Siebert, R; Graf, N; Boos, J; Frühwald, M C

    2014-05-01

    Rhabdoid tumors mainly affect infants and other very young children with a marked vulnerability towards intensive therapy such as invasive surgery, high dose chemotherapy (HDCT) and dose intense radiotherapy. Radiotherapy (RT) is a promising option in rhabdoid tumors but its application in infants remains controversial. Neurocognitive and vascular side effects occur even long after completion of therapy. Therapeutic recommendations suggested by the European Rhabdoid Registry including RT, high dose chemotherapy (HDCT) and methotrexate (MTX) were developed by a consensus committee. Unique to our EU-RHAB database is the ability to analyze data of 64 of 81 registered infants (under one year of age) separate from older children. 20 (age at diagnoses 2-12 months) of these had received radiotherapy. To our knowledge, this is the first report specifically analyzing treatment data of infants suffering from malignant rhabdoid tumors. Our results suggest that radiotherapy significantly increases the mean survival time as well as the 3 year overall survival in infants. We detected a doubling of survival times in infants who received RT. Overall, our results suggest that infants benefit from RT with tolerable acute side effects. Severe long term sequelae likely due to intraventricular MTX and/or RT were reported in 4 patients (leukoencephalopathy). No differences in chemotherapy-related toxicity were observed between infants and children. We suggest that a nihilistic therapeutic approach towards young infants is not warranted and that RT may not be a priori rejected as a therapeutic option in infants. PMID:24633978

  5. Dietary restriction of rodents decreases aging rate without affecting initial mortality rate -- a meta-analysis.

    PubMed

    Simons, Mirre J P; Koch, Wouter; Verhulst, Simon

    2013-06-01

    Dietary restriction (DR) extends lifespan in multiple species from various taxa. This effect can arise via two distinct but not mutually exclusive ways: a change in aging rate and/or vulnerability to the aging process (i.e. initial mortality rate). When DR affects vulnerability, this lowers mortality instantly, whereas a change in aging rate will gradually lower mortality risk over time. Unraveling how DR extends lifespan is of interest because it may guide toward understanding the mechanism(s) mediating lifespan extension and also has practical implications for the application of DR. We reanalyzed published survival data from 82 pairs of survival curves from DR experiments in rats and mice by fitting Gompertz and also Gompertz-Makeham models. The addition of the Makeham parameter has been reported to improve the estimation of Gompertz parameters. Both models separate initial mortality rate (vulnerability) from an age-dependent increase in mortality (aging rate). We subjected the obtained Gompertz parameters to a meta-analysis. We find that DR reduced aging rate without affecting vulnerability. The latter contrasts with the conclusion of a recent analysis of a largely overlapping data set, and we show how the earlier finding is due to a statistical artifact. Our analysis indicates that the biology underlying the life-extending effect of DR in rodents likely involves attenuated accumulation of damage, which contrasts with the acute effect of DR on mortality reported for Drosophila. Moreover, our findings show that the often-reported correlation between aging rate and vulnerability does not constrain changing aging rate without affecting vulnerability simultaneously. PMID:23438200

  6. 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

  7. 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

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

    PubMed

    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

  9. 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

  10. [Increasing infant mortality and tuberculosis in China. A dark picture of public health and health care in China].

    PubMed

    Lundberg, S

    1999-02-10

    Lennart Bogg, a prominent researcher at the Karolinska Institute, has been monitoring the development of public health in China since 1984. According to Bogg, the increase in the infant mortality rate in China (from 34.7/1000 children in 1981 to 37.0/1000 children in 1992) and the increase in the number of cases of tuberculosis and schistosomiasis are signs of deteriorating public health. Infant mortality has reached 72/1000 in the interior, but it is only 15/1000 in the large cities: this is indicative of a gap in health care delivery in the country. The number of cases of tuberculosis has increased significantly in recent years, and the disease causes 360,000 deaths per year. In the meantime, though, average life expectancy rose between 1949 and 1982, from 39 to 69 years. In the mid 1960s, collective health insurance and the so-called barefoot doctors system were introduced in the rural areas, with 90% of the villages being served by the system. Simple preventive health care and basic care was financed by this system. Subsequent to the reforms introduced in the late 1970s, the collectives were replaced by an individual contract system for each household, and the health insurance system was dismantled without there being anything else to replace it. Nowadays it is estimated that 10-15% of people are insured; these are mainly people who work in cities. The fee-for- service scheme boosted health care costs eight times between 1983 and 1990. Quality of maternal and child health care has declined in the rural areas, and most deliveries take place in the home with the assistance of untrained personnel. In the countryside even the one-child policy seems to have collapsed. In 1994 a project that aimed at resurrecting cooperative health insurance was initiated PMID:10087814

  11. Morbidity and mortality characteristics of infants hospitalized in the Pediatrics Department of the largest Turkish military hospital in 2001.

    PubMed

    Kiliç, Selim; Tezcan, Sabahat; Taşçilar, Emre; Cakir, Banu; Aydin, Halil Ibrahim; Hasde, Metin; Gökçay, Erdal

    2005-01-01

    A descriptive study was conducted in the pediatric inpatient unit of Gulhane Military Medical Academy, to investigate the morbidity and mortality characteristics of 532 infants hospitalized between January 1 and December 31, 2001, for treatment purposes. Of the study participants, 55.8% were boys and 44.2% were girls. The most common cause of hospitalization was neonatal hyperbilirubinemia (19.7%). The most common admission month was January (12.4%). Of 532 infants, 510 (95.9%) were discharged, whereas 22 patients died in the hospital. Twenty-one patients died in the neonatal period, and respiratory distress syndrome and neonatal sepsis were identified as the most common causes of death. Our finding of associations between male gender and low birth weight and hospital death is consistent with previous knowledge. Despite the high frequencies of pneumonia and gastroenteritis as admission diagnoses, the finding of only one pneumonia-related death and no gastroenteritis-related deaths in the study population is pleasing. PMID:15724854

  12. Affective communication of infants with autistic spectrum disorder and internal representation of their mothers.

    PubMed

    Kobayashi, R

    2000-04-01

    We have been examining the developmental process of affective communication in infants with autistic spectrum disorders from the viewpoint of relationship disturbance through our developmental and psychopathological studies on autism. In particular, the role of internal representation of the mother in the process of development of affective communication is discussed through the presentation of two cases diagnosed as autistic spectrum disorder in early infancy. In these cases, we postulate approach-avoidance motivational conflict as the primary factor impeding development of affective communication, focusing therapeutic intervention on this perspective. As a result, attachment behavior was remarkably improved in the children, but affective communication with their mothers was not readily improved. Taking up the mothers' own internal representation in mother-infant psychotherapy, in particular, the mothers' problems in attachment behavior with their own mothers in infancy precipitated transition in the mothers' internal representation of their children, leading to active evolution in mother-child interaction and development in affective communication between mother and child. In this context, the basis and significance of internal representation of both parties being determinants in the quality of mother-child communication are discussed. PMID:10803821

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

    PubMed

    Kim, Do Hyun; Jeon, Jihyun; Park, Chang Gi; Sriram, Sudhir; Lee, Kwang Sun

    2016-09-01

    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

  14. Positive affect and mortality risk in older adults: A meta-analysis.

    PubMed

    Zhang, Yujing; Han, Buxin

    2016-06-01

    We performed a meta-analysis on the relationship between positive affect (PA) and mortality risk in older adults (55 years and older) and reviewed evidence on the Main Effect Model and the Stress-buffering Model of PA. Four databases (ISI Web of Knowledge, APA PsycNET, PubMed, and Embase) were used to identify potential studies. Three types of effect sizes (ESs), odds ratio, relative risk, and hazard ratio (OR, RR, and HR), were calculated and analyzed within a random effects model. The analysis of the studies in which the effects of other variables were not controlled indicated that older adults with higher levels of positive affect had lower mortality risk (75%, HR = 0.75, 95% confidence interval [CI] = 0.66-0.85) than those with lower positive affect. In studies in which the effects of covariates were controlled, this rate was 85% (HR = 0.85, 95% CI = 0.81-0.89), which was still significant. These results suggest that higher positive affect is associated with lower mortality risk in community-dwelling older adults, even after controlling for medical, psychological, and social factors. The results point to potential methods of improving longevity, and to achieving healthy aging in older adults. PMID:27113246

  15. 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…

  16. 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…

  17. A cluster randomised controlled trial of the community effectiveness of two interventions in rural Malawi to improve health care and to reduce maternal, newborn and infant mortality

    PubMed Central

    2010-01-01

    Background The UN Millennium Development Goals call for substantial reductions in maternal and child mortality, to be achieved through reductions in morbidity and mortality during pregnancy, delivery, postpartum and early childhood. The MaiMwana Project aims to test community-based interventions that tackle maternal and child health problems through increasing awareness and local action. Methods/Design This study uses a two-by-two factorial cluster-randomised controlled trial design to test the impact of two interventions. The impact of a community mobilisation intervention run through women's groups, on home care, health care-seeking behaviours and maternal and infant mortality, will be tested. The impact of a volunteer-led infant feeding and care support intervention, on rates of exclusive breastfeeding, uptake of HIV-prevention services and infant mortality, will also be tested. The women's group intervention will employ local female facilitators to guide women's groups through a four-phase cycle of problem identification and prioritisation, strategy identification, implementation and evaluation. Meetings will be held monthly at village level. The infant feeding intervention will select local volunteers to provide advice and support for breastfeeding, birth preparedness, newborn care and immunisation. They will visit pregnant and new mothers in their homes five times during and after pregnancy. The unit of intervention allocation will be clusters of rural villages of 2500-4000 population. 48 clusters have been defined and randomly allocated to either women's groups only, infant feeding support only, both interventions, or no intervention. Study villages are surrounded by 'buffer areas' of non-study villages to reduce contamination between intervention and control areas. Outcome indicators will be measured through a demographic surveillance system. Primary outcomes will be maternal, infant, neonatal and perinatal mortality for the women's group intervention, and

  18. 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 ...

  19. 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

  20. 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

  1. Growing a Best Babies Zone: Lessons Learned from the Pilot Phase of a Multi-Sector, Place-Based Initiative to Reduce Infant Mortality.

    PubMed

    Pies, Cheri; Barr, Monica; Strouse, Carly; Kotelchuck, Milton

    2016-05-01

    Purpose Infant mortality reduction in the U.S. has been addressed predominantly through clinical approaches. While these efforts have reduced the infant mortality rate overall, they have not reduced disparities between different racial/socioeconomic groups. To address the interrelated social, economic and environmental factors contributing to infant mortality, a place-based approach is needed to complement existing initiatives and clinical practices. Description Best Babies Zone (BBZ) is an early attempt to put life course theory into practice, taking a place-based approach to reducing infant mortality by aligning resources, building community leadership, and transforming educational opportunities, economic development, and community systems in concentrated neighborhoods. BBZ is currently in three neighborhoods: Price Hill (Cincinnati, OH), Hollygrove (New Orleans, LA), and Castlemont (Oakland, CA). Assessment In its first 4 years, each BBZ crafted resident-driven strategies for decreasing the root causes of toxic stress and poor birth outcomes. To address resident priorities, BBZ sites experimented with tools from other fields (like design thinking and health impact assessment), and emphasized existing MCH strategies like leadership development. Early challenges, including shifting from traditional MCH interventions and addressing health equity, point to areas of growth in implementing this approach in the maternal and child health field. Conclusion BBZ aims to elevate local voice and mobilize multiple sectors in order to address the social determinants of infant mortality, and other initiatives working to improve MCH outcomes can learn from the successes and challenges of the first 4 years of BBZ in order to bring life course theory into practice. PMID:27013517

  2. A systematic review and meta-analysis of premature mortality in bipolar affective disorder

    PubMed Central

    Hayes, J. F.; Miles, J.; Walters, K.; King, M.; Osborn, D. P. J.

    2016-01-01

    Objective To review and complete meta-analysis of studies estimating standardised mortality ratios (SMRs) in bipolar affective disorder (BPAD) for all-cause and cause-specific mortalities. Method Cause-specific mortality was grouped into natural and unnatural causes. These subgroups were further divided into circulatory, respiratory, neoplastic and infectious causes, and suicide and other violent deaths. Summary SMRs were calculated using random-effects meta-analysis. Heterogeneity was examined via subgroup analysis and meta-regression. Results Systematic searching found 31 studies meeting inclusion criteria. Summary SMR for all-cause mortality = 2.05 (95% CI 1.89– 2.23), but heterogeneity was high (I2 = 96.2%). This heterogeneity could not be accounted for by date of publication, cohort size, mid-decade of data collection, population type or geographical region. Unnatural death summary SMR = 7.42 (95% CI 6.43–8.55) and natural death = 1.64 (95% CI 1.47–1.83). Specifically, suicide SMR = 14.44 (95% CI 12.43–16.78), other violent death SMR = 3.68 (95% CI 2.77–4.90), deaths from circulatory disease = 1.73 (95% CI 1.54–1.94), respiratory disease = 2.92 (95% CI 2.00–4.23), infection = 2.25 (95% CI 1.70–3.00) and neoplasm = 1.14 (95% CI 1.10–1.21). Conclusion Despite considerable heterogeneity, all summary SMR estimates and a large majority of individual studies showed elevated mortality in BPAD compared to the general population. This was true for all causes of mortality studied. PMID:25735195

  3. 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

  4. Reducing maternal, newborn, and infant mortality globally: an integrated action agenda.

    PubMed

    Bhutta, Zulfiqar A; Cabral, Sergio; Chan, Chok-Wan; Keenan, William J

    2012-10-01

    There has been increasing awareness over recent years of the persisting burden of worldwide maternal, newborn, and child mortality. The majority of maternal deaths occur during labor, delivery, and the immediate postpartum period, with obstetric hemorrhage as the primary medical cause of death. Other causes of maternal mortality include hypertensive diseases, sepsis/infections, obstructed labor, and abortion-related complications. Recent estimates indicate that in 2009 an estimated 3.3 million babies died in the first month of life and that overall, 7.3 million children under 5 die each year. Recent data also suggest that sufficient evidence- and consensus-based interventions exist to address reproductive, maternal, newborn, and child health globally, and if implemented at scale, these have the potential to reduce morbidity and mortality. There is an urgent need to put elements in place to promote integrated interventions among healthcare professionals and their associations. What is needed is the political will and partnerships to implement evidence-based interventions at scale. PMID:22883919

  5. 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

  6. Frontal Lobe Activity and Affective Behavior of Infants of Mothers with Depressive Symptoms.

    ERIC Educational Resources Information Center

    Dawson, Geraldine; And Others

    1992-01-01

    In comparison to infants of mothers who had no symptoms of depression, infants of mothers with symptoms exhibited reduced left frontal lobe activity during play and failed to exhibit increased right frontal lobe activity during distress. Infants of symptomatic mothers showed less distress during maternal separation than infants of nonsymptomatic…

  7. Mortality and Long-Term Virologic Outcomes in Children and Infants Treated with Lopinavir/Ritonavir

    PubMed Central

    Estripeaut, Dora; Mosser, Jon; Doherty, Meg; Acosta, William; Shah, Harita; Castaño, Elizabeth; Luciani, Kathia; Pascale, Juan Miguel; Bollinger, Robert C.; Page, Kathleen R.

    2013-01-01

    Background There is scant data on young children receiving protease inhibitor (PI)-based therapy in real-life resource-limited settings and on the optimal timing of therapy among children who survive infancy. Our aim was to evaluate outcomes at the Hospital del Niño, Panama, where children have been routinely treated with lopinavir/ritonavir (LPV/r)-based therapy since 2002. Methods Retrospective cohort analysis of all HIV-infected children enrolled in care between January 1, 1991 and June 1, 2011. Kaplan-Meier method and Cox proportional hazards regression were used to evaluate death, virologic suppression, and virologic rebound. Results Of 399 children contributing 1,944 person-years of follow-up, 254 (63.7%) were treated with LPV/r and 94 (23.6%) were never treated with antiretrovirals (ARVs). Among infants, improved survival was associated with male gender (HRdeath 0.54, 95% CI 0.32–0.92) and treatment with highly active antiretroviral therapy (HAART) (HRdeath 0.32, 95% CI 0.12–0.83), while residence outside of Panama City was associated with poorer survival (HRdeath 1.72, 95% CI 1.01–2.94). Among children who survived to 1 year of age without exposure to ARVs, LPV/r-based therapy improved survival (HRdeath 0.07, 95% CI 0.01–0.33). Virologic suppression was achieved in 42.1%, 70.5%, and 85.1% by 12, 24 and 60 months of follow up among children treated with LPV/r. Virologic suppression was not associated with prior ARV exposure or age at initiation of therapy but was associated with residence outside of Panama City (HRsuppression 1.93, 95% CI 1.19–3.14). Patients with a baseline viral load > 100,000 copies/mL were less likely to achieve suppression (HRsuppression 0.37, 95% CI 0.21–0.66). No children who achieved virologic suppression after initiating LPV/r died. Conclusions LPV/r-based therapy improved survival not only in infants but also in children over 1 year of age. Age at initiation of LPV/r-based therapy or prior ARVs did not impact virologic

  8. Characteristics of Active Tuberculosis Patients Requiring Intensive Care Monitoring and Factors Affecting Mortality

    PubMed Central

    Levent, Dalar; Emel, Eryüksel; Pelin, Uysal; Turkay, Akbaş; Aybüke, Kekeçoğlu

    2016-01-01

    Background One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and PaO2/FIO2 levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate. PMID:27433176

  9. (Dr. P. C. Sen Award on rural health practice). Infant and early childhood mortality in some rural ICDS blocks of west Bengal.

    PubMed

    Biswas, A B; Basu, M; Das, K K; Biswas, R

    1993-01-01

    This one year prospective study was carried out to determine the CBR, CDR and different underfive mortality rates in some selected rural ICDS blocks of West Bengal and also to find out the common causes of infant and childhood mortality in these areas. It was revealed that most of the above mentioned indicators in ICDS blocks were considerably lower than that of National figures, but more or less similar to those of rural Bengal as recorded in routine Govt. reports. Compared to the picture of rural West Bengal, both still birth & perinatal mortality rates were found higher in all ICDS blocks. The causes of mortality trends among under fives' were found similar to that of rural India pattern i.e. prematurity, acute respiratory infections and diarrhoea being the leaders. Neonates, who contributed the largest share of infant mortality died mainly due to prematurity. So, observations like high perinatal mortality & still birth rates, huge proportion of neonatal death during infancy, same IMR but low 5MR, and death of neonates due to prematurity etc. claim the necessity of improving maternal component of ICDS services, their nutritional care in particular. PMID:8063374

  10. Rapid progression and mortality of lysosomal acid lipase deficiency presenting in infants

    PubMed Central

    Jones, Simon A.; Valayannopoulos, Vassili; Schneider, Eugene; Eckert, Stephen; Banikazemi, Maryam; Bialer, Martin; Cederbaum, Stephen; Chan, Alicia; Dhawan, Anil; Di Rocco, Maja; Domm, Jennifer; Enns, Gregory M.; Finegold, David; Gargus, J. Jay; Guardamagna, Ornella; Hendriksz, Christian; Mahmoud, Iman G.; Raiman, Julian; Selim, Laila A.; Whitley, Chester B.; Zaki, Osama; Quinn, Anthony G.

    2016-01-01

    Purpose: The purpose of this study was to enhance understanding of lysosomal acid lipase deficiency (LALD) in infancy. Genet Med 18 5, 452–458. Methods: Investigators reviewed medical records of infants with LALD and summarized data for the overall population and for patients with and without early growth failure (GF). Kaplan–Meier survival analyses were conducted for the overall population and for treated and untreated patients. Genet Med 18 5, 452–458. Results: Records for 35 patients, 26 with early GF, were analyzed. Prominent symptom manifestations included vomiting, diarrhea, and steatorrhea. Median age at death was 3.7 months; estimated probability of survival past age 12 months was 0.114 (95% confidence interval (CI): 0.009-0.220). Among patients with early GF, median age at death was 3.5 months; estimated probability of survival past age 12 months was 0.038 (95% CI: 0.000-0.112). Treated patients (hematopoietic stem cell transplant (HSCT), n = 9; HSCT and liver transplant, n = 1) in the overall population and the early GF subset survived longer than untreated patients, but survival was still poor (median age at death, 8.6 months). Genet Med 18 5, 452–458. Conclusions: These data confirm and expand earlier insights on the progression and course of LALD presenting in infancy. Despite variations in the nature, onset, and severity of clinical manifestations, and treatment attempts, clinical outcome was poor. Genet Med 18 5, 452–458. PMID:26312827

  11. Gaze behavior and affect at 6 months: predicting clinical outcomes and language development in typically developing infants and infants at risk for autism.

    PubMed

    Young, Gregory S; Merin, Noah; Rogers, Sally J; Ozonoff, Sally

    2009-09-01

    This paper presents follow-up longitudinal data to research that previously suggested the possibility of abnormal gaze behavior marked by decreased eye contact in a subgroup of 6-month-old infants at risk for autism (Merin, Young, Ozonoff & Rogers, 2007). Using eye-tracking data and behavioral data recorded during a live mother-infant interaction involving the still-face procedure, the predictive utility of gaze behavior and affective behaviors at 6 months was examined using diagnostic outcome data obtained longitudinally over the following 18 months. Results revealed that none of the infants previously identified as showing lower rates of eye contact had any signs of autism at outcome. In contrast, three infants who were diagnosed with autism demonstrated consistent gaze to the eye region and typical affective responses at 6 months. Individual differences in face scanning and affective responsivity during the live interaction were not related to any continuous measures of symptom frequency or symptom severity. In contrast, results of growth curve models for language development revealed significant relationships between face scanning and expressive language. Greater amounts of fixation to the mother's mouth during live interaction predicted higher levels of expressive language at outcome and greater rates of growth. These findings suggest that although gaze behavior at 6 months may not provide early markers for autism as initially conceived, gaze to the mouth in particular may be useful in predicting individual differences in language development. PMID:19702771

  12. Consequences of maternal mortality on infant and child survival: a 25-year longitudinal analysis in Butajira Ethiopia (1987-2011)

    PubMed Central

    2015-01-01

    Background Maternal mortality remains the leading cause of death and disability for reproductive-age women in resource-poor countries. The impact of a mother’s death on child outcomes is likely severe but has not been well quantified. This analysis examines survival outcomes for children whose mothers die during or shortly after childbirth in Butajira, Ethiopia. Methods This study uses data from the Butajira Health and Demographic Surveillance System (HDSS) site. Child outcomes were assessed using statistical tests to compare survival trajectories and age-specific mortality rates for children who did and did not experience a maternal death. The analyses leveraged the advantages of a large, long-term longitudinal dataset with a high frequency of data collection; but used a strict date-based method to code maternal deaths (as occurring within 42 or 365 days of childbirth), which may be subject to misclassification or recall bias. Results Between 1987 and 2011, there were 18189 live births to 5119 mothers; and 73 mothers of 78 children died within the first year of their child’s life, with 45% of these (n=30) classified as maternal deaths due to women dying within 42 days of childbirth. Among the maternal deaths, 81% of these infants also died. Children who experienced a maternal death within 42 days of their birth faced 46 times greater risk of dying within one month when compared to babies whose mothers survived (95% confidence interval 25.84-81.92; or adjusted ratio, 57.24 with confidence interval 25.31-129.49). Conclusions When a woman in this study population experienced a maternal death, her infant was much more likely to die than to survive—and the survival trajectory of these children is far worse than those of mothers who do not die postpartum. This highlights the importance of investigating how clinical care and socio-economic support programs can better address the needs of orphans, both throughout the intra- and post-partum periods as well as over

  13. 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. PMID:23638270

  14. Threshold Levels of Infant and Under-Five Mortality for Crossover between Life Expectancies at Ages Zero, One and Five in India: A Decomposition Analysis

    PubMed Central

    Dubey, Manisha

    2015-01-01

    Objectives Under the prevailing conditions of imbalanced life table and historic gender discrimination in India, our study examines crossover between life expectancies at ages zero, one and five years for India and quantifies the relative share of infant and under-five mortality towards this crossover. Methods We estimate threshold levels of infant and under-five mortality required for crossover using age specific death rates during 1981–2009 for 16 Indian states by sex (comprising of India’s 90% population in 2011). Kitagawa decomposition equations were used to analyse relative share of infant and under-five mortality towards crossover. Findings India experienced crossover between life expectancies at ages zero and five in 2004 for menand in 2009 for women; eleven and nine Indian states have experienced this crossover for men and women, respectively. Men usually experienced crossover four years earlier than the women. Improvements in mortality below ages five have mostly contributed towards this crossover. Life expectancy at age one exceeds that at age zero for both men and women in India except for Kerala (the only state to experience this crossover in 2000 for men and 1999 for women). Conclusions For India, using life expectancy at age zero and under-five mortality rate together may be more meaningful to measure overall health of its people until the crossover. Delayed crossover for women, despite higher life expectancy at birth than for men reiterates that Indian women are still disadvantaged and hence use of life expectancies at ages zero, one and five become important for India. Greater programmatic efforts to control leading causes of death during the first month and 1–59 months in high child mortality areas can help India to attain this crossover early. PMID:26683617

  15. 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. PMID:23659892

  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. Pride in Parenting: Training Curriculum for Lay Home Visitors. NIH-DC Initiative To Reduce Infant Mortality in Minority Populations.

    ERIC Educational Resources Information Center

    Diamond, Linda T., Ed.; Jarrett, Marion H., Ed.

    The Pride in Parenting (PIP) program was developed for mothers 18 years of age or older who had little or no prenatal care and their infants from birth to one year. The major goals of the program were to promote effective use of health services by mothers and their infants and to enhance infant development. The intervention program consisted of…

  18. 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. PMID:19636165

  19. Task-Oriented and Bottle Feeding Adversely Affect the Quality of Mother-Infant Interactions Following Abnormal Newborn Screens

    PubMed Central

    Tluczek, Audrey; Clark, Roseanne; McKechnie, Anne Chevalier; Orland, Kate Murphy; Brown, Roger L.

    2010-01-01

    Objective Examine effects of newborn screening (NBS) and neonatal diagnosis on the quality of mother-infant interactions in the context of feeding. Methods Study compared the quality of mother-infant feeding interactions among four groups of infants classified by severity of NBS and diagnostic results: cystic fibrosis (CF), congenital hypothyroidism, heterozygote CF carrier, and healthy with normal NBS. The Parent-Child Early Relational Assessment and a task-oriented item measured the quality of feeding interactions for 130 dyads, infant ages 3–19 weeks (M=9.19, SD=3.28). The Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory measured maternal depression and anxiety. Results Composite Indicator Structure Equation Modeling showed that infant diagnostic status and, to a lesser extent, maternal education predicted feeding method. Mothers of infants with CF were most likely to bottle feed, which was associated with more task-oriented maternal behavior than breastfeeding. Mothers with low task-oriented behavior showed more sensitivity and responsiveness to infant cues, as well as less negative affect and behavior in their interactions with their infants than mothers with high task-oriented scores. Mothers of infants with CF were significantly more likely to have clinically significant anxiety and depression than the other groups. However, maternal psychological profile did not predict feeding method or interaction quality. Conclusions Mothers in the CF group were the least likely to breastfeed. Research is needed to explicate long-term effects of feeding methods on quality of mother-child relationship and ways to promote continued breastfeeding following a neonatal CF diagnosis. PMID:20495477

  20. 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…

  1. 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...

  2. Role of Federal Food Assistance Programs in Strategies To Reduce Infant Mortality. Hearing before the Domestic Task Force of the Select Committee on Hunger. House of Representatives, One Hundredth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Hunger.

    This document presents oral and written testimony concerning the effectiveness of federal assistance programs in reducing infant mortality. In opening statements, members of the House Select Committee on Hunger voiced their concern over the persistence of high infant death rates among minorities, the rural poor, and urban populations, despite…

  3. 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. PMID:25243641

  4. 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…

  5. 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. PMID:26770047

  6. Infant Colic.

    PubMed

    Gelfand, Amy A

    2016-02-01

    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. Although infant colic is often assumed to have a gastrointestinal cause, several treatment trials aimed at gastrointestinal etiologies have been negative. Teaching parents how to respond best 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

  7. Experimental icing affects growth, mortality, and flowering in a high Arctic dwarf shrub.

    PubMed

    Milner, Jos M; Varpe, Øystein; van der Wal, René; Hansen, Brage Bremset

    2016-04-01

    Effects of climate change are predicted to be greatest at high latitudes, with more pronounced warming in winter than summer. Extreme mid-winter warm spells and heavy rain-on-snow events are already increasing in frequency in the Arctic, with implications for snow-pack and ground-ice formation. These may in turn affect key components of Arctic ecosystems. However, the fitness consequences of extreme winter weather events for tundra plants are not well understood, especially in the high Arctic. We simulated an extreme mid-winter rain-on-snow event at a field site in high Arctic Svalbard (78°N) by experimentally encasing tundra vegetation in ice. After the subsequent growing season, we measured the effects of icing on growth and fitness indices in the common tundra plant, Arctic bell-heather (Cassiope tetragona). The suitability of this species for retrospective growth analysis enabled us to compare shoot growth in pre and postmanipulation years in icing treatment and control plants, as well as shoot survival and flowering. Plants from icing treatment plots had higher shoot mortality and lower flowering success than controls. At the individual sample level, heavily flowering plants invested less in shoot growth than nonflowering plants, while shoot growth was positively related to the degree of shoot mortality. Therefore, contrary to expectation, undamaged shoots showed enhanced growth in ice treatment plants. This suggests that following damage, aboveground resources were allocated to the few remaining undamaged meristems. The enhanced shoot growth measured in our icing treatment plants has implications for climate studies based on retrospective analyses of Cassiope. As shoot growth in this species responds positively to summer warming, it also highlights a potentially complex interaction between summer and winter conditions. By documenting strong effects of icing on growth and reproduction of a widespread tundra plant, our study contributes to an understanding of

  8. Approval and Disapproval: Infant Responsiveness to Vocal Affect in Familiar and Unfamiliar Languages.

    ERIC Educational Resources Information Center

    Fernald, Anne

    1993-01-01

    Presented five-month olds in English-speaking families with approval and prohibition vocalizations in infant-directed (ID) and adult-directed (AD) English, and in ID German, Italian, Japanese, and nonsense English. Infants responded differently to ID approval and disapproval in all languages except Japanese. Differential responses to approval and…

  9. Father's Involvement and Affect to Infant: "More" May Not Be "Better."

    ERIC Educational Resources Information Center

    Bailey, William T.

    Both the popular and professional literatures commonly suggest that the more involvement by fathers in their infants' routine care the better. However, empirical support for this position is far from conclusive. Although several researchers have reported a positive relationship between father involvement and father-infant relations, others have…

  10. Infant diet differentially affects human electroencephalographic activities in the first year of life

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The influence of infant diet (milk-based formula [MF], soy-based formula [SF], and breast milk [BF]) on brain EEG activities was studied in infants (20 males and 20 females per group) at 3, 6, 9, and 12 months of age. Power spectra were calculated in five frequency bands for scalp EEG signals record...

  11. 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).…

  12. 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…

  13. 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…

  14. Has the Rate of Reduction in Infant Mortality Increased in India Since the Launch of National Rural Health Mission? Analysis of Time Trends 2000-2009 with Projection to 2015

    PubMed Central

    Narwal, Rajesh; Gram, Lu

    2013-01-01

    Objectives: National Rural Health Mission (NRHM) - India was launched in 2005 to tackle urban-rural health inequalities, especially in maternal and child health. We examined national and state level trends in Infant Mortality Rates (IMR) from 2000 through 2009 to: 1) assess whether the NRHM had increased the average annual reduction rate (AARR) of IMR 2) evaluate state-wise progress towards Millennium Development Goals (MDG4) and estimate required AARRs for ‘off track’ states. Methods: Log-linear regression models were applied to national and state IMR data collated from the Sample Registration System (SRS)-India to estimate average annual reduction rates and compare AAARs before and after introduction of NRHM. The log-linear trend of infant mortality rates was also projected forward to 2015. Results: The infant mortality rate in rural India declined from 74 to 55/1000 live births between 2000 and 2009, with AARR of 3.0% (95% CI=2.6%-3.4%) and the urban-rural gap in infant mortality narrowed (p =0.036). However there was no evidence (p=0.49) that AARR in rural India increased post NRHM (3.4%, 95% CI 2.0-4.7%) compared to pre NRHM (2.8%, 95% CI 2.1%-3.5%). States varied widely in rates of infant mortality reduction. Projections of infant mortality rates suggested that only eight states might be on track to help India achieve MDG4 by 2015. Conclusions and Public Health Implications: Despite a narrowing urban-rural gap and high AARRs in some states, there was no evidence that the rate of reduction in infant mortality has increased in rural India post NRHM introduction. India appears unlikely to achieve child survival-related NRHM and millennium development goals. Government should revisit the child survival related NRHM strategies and ensure equitable access to health services. More robust monitoring and evaluation mechanisms must be inbuilt for following years.

  15. The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis

    PubMed Central

    2013-01-01

    Background Previous studies have reported on adverse neonatal outcomes associated with parity and maternal age. Many of these studies have relied on cross-sectional data, from which drawing causal inference is complex. We explore the associations between parity/maternal age and adverse neonatal outcomes using data from cohort studies conducted in low- and middle-income countries (LMIC). Methods Data from 14 cohort studies were included. Parity (nulliparous, parity 1-2, parity ≥3) and maternal age (<18 years, 18-<35 years, ≥35 years) categories were matched with each other to create exposure categories, with those who are parity 1-2 and age 18-<35 years as the reference. Outcomes included small-for-gestational-age (SGA), preterm, neonatal and infant mortality. Adjusted odds ratios (aOR) were calculated per study and meta-analyzed. Results Nulliparous, age <18 year women, compared with women who were parity 1-2 and age 18-<35 years had the highest odds of SGA (pooled adjusted OR: 1.80), preterm (pooled aOR: 1.52), neonatal mortality (pooled aOR: 2.07), and infant mortality (pooled aOR: 1.49). Increased odds were also noted for SGA and neonatal mortality for nulliparous/age 18-<35 years, preterm, neonatal, and infant mortality for parity ≥3/age 18-<35 years, and preterm and neonatal mortality for parity ≥3/≥35 years. Conclusions Nulliparous women <18 years of age have the highest odds of adverse neonatal outcomes. Family planning has traditionally been the least successful in addressing young age as a risk factor; a renewed focus must be placed on finding effective interventions that delay age at first birth. Higher odds of adverse outcomes are also seen among parity ≥3 / age ≥35 mothers, suggesting that reproductive health interventions need to address the entirety of a woman’s reproductive period. Funding Funding was provided by the Bill & Melinda Gates Foundation (810-2054) by a grant to the US Fund for UNICEF to support the activities of the Child

  16. "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. PMID:22348314

  17. 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.

  18. 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…

  19. Intervention programs for premature infants. How and do they affect development?

    PubMed

    Feldman, R; Eidelman, A I

    1998-09-01

    Over the past 30 years, a variety of intervention programs for the enhancement of the neurodevelopmental status of premature infants have been implemented with confusing outcomes. In addition, diametrically different forms of therapy that rest on contrasting theories have led, paradoxically, to similar results. This article systematically examines and analyses the various modes of therapy and their underlying theoretical mechanisms. Skin-to-skin contact (kangaroo care) is suggested as the intervention that most logically meshes the premature infant's need to develop state regulation while facilitating sequential sensory development and promoting mother-infant attachment. PMID:9779337

  20. The effect of preterm birth on infant negative affect and maternal postpartum depressive symptoms: A preliminary examination in an underrepresented minority sample

    PubMed Central

    Barroso, Nicole; Hartley, Chelsey M.; Bagner, Daniel M.; Pettit, Jeremy W.

    2015-01-01

    Objective To examine the effect of preterm birth on maternal postpartum depressive symptoms and infant negative affect in an underrepresented minority sample. Method Participants were 102 mothers and their 3- to 10-month-old infants. Mothers completed the Edinburgh Postnatal Depression Scale and the Infant Behavior Questionnaire-Revised. Results Relative to normative samples, the current underrepresented minority sample of mostly Hispanics and Blacks displayed high rates of preterm birth (30%) and maternal postpartum depressive symptoms (17%). Preterm birth had a significant direct effect on postpartum depressive symptoms and infant negative affect. Additionally, there was an indirect effect of postpartum depressive symptoms on the relation between preterm birth and infant negative affect. Specifically, lower birth weight and gestational age predicted higher levels of depressive symptoms in the mother, and higher levels of depressive symptoms in the mother, in turn, predicted higher levels of infant negative affect. Conclusion Findings emphasize the importance of screening for postpartum depressive symptoms and infant negative affect among mothers and their preterm infants, especially among families from underrepresented minority backgrounds. PMID:25879520

  1. Molecular virus screening to detect novel viruses from turkey flocks affected by Poult Enteritis Mortality Syndrome

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Poult Enteritis Mortality Syndrome (PEMS) is an economically important, infectious enteric disease of young turkeys. The disease is characterized by decreased weight gain, increased morbidity and mortality, and increased production costs due to poor feed conversions. PEMS is considered to be a multi...

  2. 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

  3. Risk Factors Affecting School Readiness in Premature Infants With Respiratory Distress Syndrome

    PubMed Central

    Patrianakos-Hoobler, Athena I.; Msall, Michael E.; Marks, Jeremy D.; Huo, Dezheng; Schreiber, Michael D.

    2009-01-01

    OBJECTIVE Advances in neonatal care have resulted in children born pre-maturely with respiratory distress syndrome (RDS) successfully reaching school age. It is unknown how many will be ready for school and what factors affect school readiness in these children at high risk. Our objective was to assess readiness of children born prematurely with RDS in the last decade for entry into public school, and determine risk factors associated with lack of school readiness in this population. METHODS This was a single-center prospective cohort study. Follow-up data were collected for 135 of 167 (81%) surviving premature infants with RDS requiring surfactant-replacement therapy and mechanical ventilation. The children were seen between July 2005 and September 2006 (average age: 5.7 ± 1.0 years) and underwent standardized neurodevelopmental and health assessments and socioeconomic status classification. A 4-level school-readiness score was constructed by using each child’s standardized scores on assessments of basic concepts (Bracken School-Readiness Assessment), perceptual skills (Visual-Motor Integration Test), receptive vocabulary (Peabody Picture Vocabulary Test, Third Edition), daily living functional skills (Pediatric Functional Independence Measure), and presence of sensory impairments or autism. Proportional odds models were used to identify risk factors predicting lower school-readiness levels. RESULTS Of the children examined, the mean birth weight was 1016 ± 391 g, and the mean gestational age was 27.5 ± 2.6 weeks. Ninety-one (67%) children were school-ready. Using multivariate analysis, male gender, chronic lung disease, and severe intraventricular hemorrhage or periventricular leukomalacia were associated with lower school-readiness levels. However, the most powerful factor determining school-readiness level was low socioeconomic status. CONCLUSION Interventions targeting neonatal morbidities may be much less effective at improving overall performance at

  4. Why reduced-form regression models of health effects versus exposures should not replace QRA: livestock production and infant mortality as an example.

    PubMed

    Cox, Louis Anthony Tony

    2009-12-01

    Do pollution emissions from livestock operations increase infant mortality rate (IMR)? A recent regression analysis of changes in IMR against changes in aggregate "animal units" (a weighted sum of cattle, pig, and poultry numbers) over time, for counties throughout the United States, suggested the provocative conclusion that they do: "[A] doubling of production leads to a 7.4% increase in infant mortality." Yet, we find that regressing IMR changes against changes in specific components of "animal units" (cattle, pigs, and broilers) at the state level reveals statistically significant negative associations between changes in livestock production (especially, cattle production) and changes in IMR. We conclude that statistical associations between livestock variables and IMR variables are very sensitive to modeling choices (e.g., selection of explanatory variables, and use of specific animal types vs. aggregate "animal units). Such associations, whether positive or negative, do not warrant causal interpretation. We suggest that standard methods of quantitative risk assessment (QRA), including emissions release (source) models, fate and transport modeling, exposure assessment, and dose-response modeling, really are important-and indeed, perhaps, essential-for drawing valid causal inferences about health effects of exposures to guide sound, well-informed public health risk management policy. Reduced-form regression models, which skip most or all of these steps, can only quantify statistical associations (which may be due to model specification, variable selection, residual confounding, or other noncausal factors). Sound risk management requires the extra work needed to identify and model valid causal relations. PMID:19878487

  5. Relative trends in hospitalizations and mortality among infants by the number of vaccine doses and age, based on the Vaccine Adverse Event Reporting System (VAERS), 1990–2010

    PubMed Central

    Goldman, GS; Miller, NZ

    2012-01-01

    In this study, the Vaccine Adverse Event Reporting System (VAERS) database, 1990–2010, was investigated; cases that specified either hospitalization or death were identified among 38,801 reports of infants. Based on the types of vaccines reported, the actual number of vaccine doses administered, from 1 to 8, was summed for each case. Linear regression analysis of hospitalization rates as a function of (a) the number of reported vaccine doses and (b) patient age yielded a linear relationship with r 2 = 0.91 and r 2 = 0.95, respectively. The hospitalization rate increased linearly from 11.0% (107 of 969) for 2 doses to 23.5% (661 of 2817) for 8 doses and decreased linearly from 20.1% (154 of 765) for children aged <0.1 year to 10.7% (86 of 801) for children aged 0.9 year. The rate ratio (RR) of the mortality rate for 5–8 vaccine doses to 1–4 vaccine doses is 1.5 (95% confidence interval (CI), 1.4–1.7), indicating a statistically significant increase from 3.6% (95% CI, 3.2–3.9%) deaths associated with 1–4 vaccine doses to 5.5% (95% CI, 5.2–5.7%) associated with 5–8 vaccine doses. The male-to-female mortality RR was 1.4 (95% CI, 1.3–1.5). Our findings show a positive correlation between the number of vaccine doses administered and the percentage of hospitalizations and deaths. Since vaccines are given to millions of infants annually, it is imperative that health authorities have scientific data from synergistic toxicity studies on all combinations of vaccines that infants might receive. Finding ways to increase vaccine safety should be the highest priority. PMID:22531966

  6. Impact of pneumococcal conjugate vaccination of infants on pneumonia and influenza hospitalization and mortality in all age groups in the United States.

    PubMed

    Simonsen, Lone; Taylor, Robert J; Young-Xu, Yinong; Haber, Michael; May, Larissa; Klugman, Keith P

    2011-01-01

    A seven-valent pneumococcal conjugate vaccine (PCV7) introduced in the United States in 2000 has been shown to reduce invasive pneumococcal disease (IPD) in both vaccinated children and adults through induction of herd immunity. We assessed the impact of infant immunization on pneumococcal pneumonia hospitalizations and mortality in all age groups using Health Care Utilization Project State Inpatient Databases (SID) for 1996 to 2006 from 10 states; SID contain 100% samples of ICD9-coded hospitalization data for the selected states. Compared to a 1996-1997 through 1998-1999 baseline, by the 2005-2006 season, both IPD and pneumococcal pneumonia hospitalizations and deaths had decreased substantially in all age groups, including a 47% (95% confidence interval [CI], 38 to 54%) reduction in nonbacteremic pneumococcal pneumonia (ICD9 code 481 with no codes indicating IPD) in infants <2 years old and a 54% reduction (CI, 53 to 56%) in adults ≥65 years of age. A model developed to calculate the total burden of pneumococcal pneumonia prevented by infant PCV7 vaccination in the United States from 2000 to 2006 estimated a reduction of 788,838 (CI, 695,406 to 875,476) hospitalizations for pneumococcal pneumonia. Ninety percent of the reduction in model-attributed pneumococcal pneumonia hospitalizations occurred through herd immunity among adults 18 years old and older; similar proportions were found in pneumococcal disease mortality prevented by the vaccine. In the first seasons after PCV introduction, when there were substantial state differences in coverage among <5-year-olds, states with greater coverage had significantly fewer influenza-associated pneumonia hospitalizations among children, suggesting that PCV7 use also reduces influenza-attributable pneumonia hospitalizations. PMID:21264063

  7. 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

  8. Degrading phonetic information affects matching of audiovisual speech in adults, but not in infants

    PubMed Central

    Baart, Martijn; Vroomen, Jean; Shaw, Kathleen; Bortfeld, Heather

    2013-01-01

    Infants and adults are well able to match auditory and visual speech, but the cues on which they rely (viz. temporal, phonetic and energetic correspondence in the auditory and visual speech streams) may differ. Here we assessed the relative contribution of the different cues using sine-wave speech (SWS). Adults (N=52) and infants (N=34, age ranged in between 5 and 15 months) matched 2 trisyllabic speech sounds (‘kalisu’ and ‘mufapi’), either natural or SWS, with visual speech information. On each trial, adults saw two articulating faces and matched a sound to one of these, while infants were presented the same stimuli in a preferential looking paradigm. Adults’ performance was almost flawless with natural speech, but was significantly less accurate with SWS. In contrast, infants matched the sound to the articulating face equally well for natural speech and SWS. These results suggest that infants rely to a lesser extent on phonetic cues than adults do to match audio to visual speech. This is in line with the notion that the ability to extract phonetic information from the visual signal increases during development, and suggests that phonetic knowledge might not be the basis for early audiovisual correspondence detection in speech. PMID:24141035

  9. 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

  10. Exploring the relationship between weaning and infant mortality: an isotope case study from Aşıklı Höyük and Çayönü Tepesi.

    PubMed

    Pearson, J A; Hedges, R E M; Molleson, T I; Ozbek, M

    2010-11-01

    We measured stable nitrogen isotope ratios in bone collagen of 60 individuals from the early Neolithic (9th-8th millennium Cal. BC) sites of Çayönü Tepesi and Aşıklı Höyük. Our aim was to identify the duration of exclusive breastfeeding (EBF), compare this with juvenile mortality at each site, and assess whether there was a relationship between them. The isotope analysis suggests that weaning commenced at about 1 year at Aşıklı Höyük and around 2 years at Çayönü Tepesi. The mortality data show equal numbers of infant deaths up to 24 months; however, after 24 months, the mortality rate increases at Çayönü Tepesi, and a Student's t-test confirms a significant difference in infant mortality between the sites. Weaning foods prepared in the early Neolithic from agricultural crops would have had low-iron content, poor nutritional value, and would have been prepared in nonsterilized containers. Therefore, later weaned infants in early Neolithic farming settlements, although capable of some immunological response, were probably undernourished putting them at a disadvantage when encountering bacteria in their weaning food. Our results suggest that infant feeding regimes that introduced infants to weaning foods in the first year of life may have had a positive effect on their survival. PMID:20623678

  11. 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. PMID:26428839

  12. Maternal HIV status affects the infant hemoglobin level: A comparative cross-sectional study.

    PubMed

    Feleke, Berhanu Elfu

    2016-08-01

    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

  13. Mortality affects adaptive allocation to growth and reproduction: field evidence from a guild of body snatchers

    PubMed Central

    2010-01-01

    Background The probability of being killed by external factors (extrinsic mortality) should influence how individuals allocate limited resources to the competing processes of growth and reproduction. Increased extrinsic mortality should select for decreased allocation to growth and for increased reproductive effort. This study presents perhaps the first clear cross-species test of this hypothesis, capitalizing on the unique properties offered by a diverse guild of parasitic castrators (body snatchers). I quantify growth, reproductive effort, and expected extrinsic mortality for several species that, despite being different species, use the same species' phenotype for growth and survival. These are eight trematode parasitic castrators—the individuals of which infect and take over the bodies of the same host species—and their uninfected host, the California horn snail. Results As predicted, across species, growth decreased with increased extrinsic mortality, while reproductive effort increased with increased extrinsic mortality. The trematode parasitic castrator species (operating stolen host bodies) that were more likely to be killed by dominant species allocated less to growth and relatively more to current reproduction than did species with greater life expectancies. Both genders of uninfected snails fit into the patterns observed for the parasitic castrator species, allocating as much to growth and to current reproduction as expected given their probability of reproductive death (castration by trematode parasites). Additionally, species differences appeared to represent species-specific adaptations, not general plastic responses to local mortality risk. Conclusions Broadly, this research illustrates that parasitic castrator guilds can allow unique comparative tests discerning the forces promoting adaptive evolution. The specific findings of this study support the hypothesis that extrinsic mortality influences species differences in growth and reproduction

  14. Changing the Tune: The Structure of the Input Affects Infants' Use of Absolute and Relative Pitch

    ERIC Educational Resources Information Center

    Saffran, Jenny R.; Reeck, Karelyn; Niebuhr, Aimee; Wilson, Diana

    2005-01-01

    Sequences of notes contain several different types of pitch cues, including both absolute and relative pitch information. What factors determine which of these cues are used when learning about tone sequences? Previous research suggests that infants tend to preferentially process absolute pitch patterns in continuous tone sequences, while other…

  15. 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…

  16. 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…

  17. 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.

  18. A Comparison of Community and Clinic Baby Showers to Promote Safe Sleep for Populations at High Risk for Infant Mortality

    PubMed Central

    Ahlers-Schmidt, Carolyn R.; Schunn, Christy; Lopez, Venessa; Kraus, Stacey; Blackmon, Sheila; Dempsey, Millicent; Sollo, Natalie

    2016-01-01

    Community baby showers have provided education and free portable cribs to promote safe sleep for high-risk infants. We evaluated knowledge gained at these showers and the effectiveness of holding baby showers at a primary care clinic as an alternative to traditional community venues. Participants at the community venue were more likely to exhibit risk factors associated with unsafe sleep and to report an unsafe sleep location for their infant without the provided portable crib. Following the showers, both groups showed improvement in knowledge and intentions regarding safe sleep. However, to connect with the highest risk groups, showers held at community venues appeared to be preferable to those held at high-risk clinics. PMID:27335991

  19. A Comparison of Community and Clinic Baby Showers to Promote Safe Sleep for Populations at High Risk for Infant Mortality.

    PubMed

    Ahlers-Schmidt, Carolyn R; Schunn, Christy; Lopez, Venessa; Kraus, Stacey; Blackmon, Sheila; Dempsey, Millicent; Sollo, Natalie

    2016-01-01

    Community baby showers have provided education and free portable cribs to promote safe sleep for high-risk infants. We evaluated knowledge gained at these showers and the effectiveness of holding baby showers at a primary care clinic as an alternative to traditional community venues. Participants at the community venue were more likely to exhibit risk factors associated with unsafe sleep and to report an unsafe sleep location for their infant without the provided portable crib. Following the showers, both groups showed improvement in knowledge and intentions regarding safe sleep. However, to connect with the highest risk groups, showers held at community venues appeared to be preferable to those held at high-risk clinics. PMID:27335991

  20. 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. PMID:7269553

  1. 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

  2. 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…

  3. The Continuing Infant Mortality Crisis in Illinois. Part 1. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundredth Congress, First Session (Springfield, 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) difficulties and successes in obtaining private and public medical services experienced by Illinois citizens with health problems during pregancy; (2) Illinois' efforts to deal with high infant mortality, including descriptions of intervention programs, excerpts from the data report of Illinois' 1988 Human Services Plan,…

  4. 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)…

  5. Solid-Stemmed Wheat Does Not Affect Overwintering Mortality of the Wheat Stem Sawfly, Cephus cinctus

    PubMed Central

    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. PMID:22235942

  6. 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. PMID:26473698

  7. Specific characteristics of the aviary housing system affect plumage condition, mortality and production in laying hens.

    PubMed

    Heerkens, Jasper L T; Delezie, Evelyne; Kempen, Ine; Zoons, Johan; Ampe, Bart; Rodenburg, T Bas; Tuyttens, Frank A M

    2015-09-01

    Feather pecking and high mortality levels are significant welfare problems in non-cage housing systems for laying hens. The aim of this study was to identify husbandry-related risk factors for feather damage, mortality, and egg laying performance in laying hens housed in the multi-tier non-cage housing systems known as aviaries. Factors tested included type of system flooring, degree of red mite infestation, and access to free-range areas. Information on housing characteristics, management, and performance in Belgian aviaries (N=47 flocks) were obtained from a questionnaire, farm records, and farm visits. Plumage condition and pecking wounds were scored in 50 randomly selected 60-week-old hens per flock. Associations between plumage condition, wounds, performance, mortality, and possible risk factors were investigated using a linear model with a stepwise model selection procedure. Many flocks exhibited a poor plumage condition and a high prevalence of wounds, with considerable variation between flocks. Better plumage condition was found in wire mesh aviaries (P<0.001), in aviaries with no red mite infestation (P=0.004), and in free-range systems (P=0.011) compared to plastic slatted aviaries, in houses with red mite infestations, and those without a free-range area. Furthermore, hens in aviaries with wire mesh flooring had fewer wounds on the back (P=0.006) and vent (P=0.009), reduced mortality (P=0.003), and a better laying performance (P=0.013) as compared to hens in aviaries with plastic slatted flooring. Flocks with better feather cover had lower levels of mortality (P<0.001). Red mite infestations were more common in plastic slatted aviaries (P=0.043). Other risk factors associated with plumage condition were genotype, number of diet changes, and the presence of nest perches. Wire mesh flooring in particular seems to have several health, welfare, and performance benefits in comparison to plastic slats, possibly related to decreased feather pecking, better

  8. 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…

  9. 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. PMID:22893477

  10. 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

  11. Evaluation of factors affecting mortality in Fournier’s Gangrene: Retrospective clinical study of sixteen cases

    PubMed Central

    Oymacı, Erkan; Coşkun, Ali; Yakan, Savaş; Erkan, Nazif; Uçar, Ahmet Deniz; Yıldırım, Mehmet

    2014-01-01

    Objective: Fournier’s gangrene is a progressive, necrotizing fasciitis due to synergistic infection of the perineum and external genitalia that is associated with high mortality and morbidity. The purpose of this study is to review the diagnostic and treatment methods that effect mortality in Fournier’s gangrene. Material and Methods: Sixteen patients who were diagnosed and treated at our clinic between 2011 and 2013 due to Fournier’s gangrene were retrospectively analyzed. The surviving and non-surviving patient groups were compared in terms of age, sex, onset time of symptoms, isolated microorganisms, concomitant diseases, Fournier’s gangrene severity index (FGSI), and length of hospital stay. Results: Ten of our cases (62.5%) were male and six (37.5%) were female, with a mean age of 61.2±12.3 (42–73) years. The mortality rate was 18.8% (3 cases). The mean duration of symptoms before admission was 4.31±1.81 (2–8) days. This period was 6.67±1.52 days in patients who succumbed to death, and 3.77±1.42 days in patients who survived (p=0.007). Ten cases (62.5%) had concomitant diabetes mellitus. The most common organism isolated in wound cultures was Escherichia coli (68.7%), and Acinetobacter baumannii, Proteus mirabilis, methicillin-resistant Staphylococcus aureus and Enterococcus spp. in the remaining patients. The mean FGSI of surviving patients was 3.84±1.77, and 7.66±0.57 in fatal cases (p=0.003). The mean length of hospital stay was 25.5 days (2–57) and duration of hospitalization was significantly longer in survivors (p<0.05). Conclusion: The delay in diagnosis and higher FGSI may be responsible for worsening of prognosis and mortality in Fournier’s gangrene. Early diagnosis and determination of the severity of the disease, aggressive surgical debridement and appropriate antimicrobial therapy may improve prognosis. PMID:25931901

  12. Gaze Behavior and Affect at 6 Months: Predicting Clinical Outcomes and Language Development in Typically Developing Infants and Infants at Risk for Autism

    ERIC Educational Resources Information Center

    Young, Gregory S.; Merin, Noah; Rogers, Sally J.; Ozonoff, Sally

    2009-01-01

    This paper presents follow-up longitudinal data to research that previously suggested the possibility of abnormal gaze behavior marked by decreased eye contact in a subgroup of 6-month-old infants at risk for autism (Merin, Young, Ozonoff & Rogers, 2007). Using eye-tracking data and behavioral data recorded during a live mother-infant interaction…

  13. 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

  14. Zinc absorption from micronutrient powder is low but is not affected by iron in Kenyan infants.

    PubMed

    Esamai, Fabian; Liechty, Edward; Ikemeri, Justus; Westcott, Jamie; Kemp, Jennifer; Culbertson, Diana; Miller, Leland V; Hambidge, K Michael; Krebs, Nancy F

    2014-12-01

    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

  15. 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. PMID:12076005

  16. Factors affecting mortality of pediatric trauma patients encountered in Kandahar, Afghanistan

    PubMed Central

    Pannell, Capt Dylan; Poynter, Jeffery; Wales, Paul W.; Tien, Col Homer; Nathens, Avery B.; Shellington, David

    2015-01-01

    Background The North Atlantic Treaty Organization (NATO) Role 3 Multinational Medical Unit (R3-MMU) is a tertiary care trauma facility that receives casualties, both coalition and civilian, and provides humanitarian medical assistance when able to the Kandahar province in southern Afghanistan. We examined the cohort of pediatric patients evaluated at the facility during a 16-month period to determine the characteristics and care requirements of this unique patient population. Methods A database of Afghan patients younger than 18 years of age admitted to the NATO R3-MMU between January 2010 and April 2011 was developed from the Joint Theatre Trauma Registry. This patient cohort was analyzed to determine demographics, injury mechanism, injury severity, resource utilization and factors associated with mortality. Results A total of 263 children were admitted to the NATO R3-MMU during the study period, representing 12% of all trauma admissions during this time period. The median age was 9 years (range 3 mo–17 yr) with a predominance of male patients (82%). Battle-related trauma was responsible for 62% of admissions, with explosive blast injury constituting the predominant mechanism (42%). The average injury severity score was 12.3 ± 9.3. Overall mortality was 8%. Factors associated with increased risk of death included admission acidosis, coagulopathy, hypothermia and female sex. Conclusion Children represent a significant proportion of traumatic injuries encountered in a modern war zone; many of them are critically injured. Organizations that provide health care in such environments should be prepared to care for this patient population where their mandates and facilities allow for it. PMID:26100774

  17. Infant mortality and intra-household competition in the Northern Islands of Orkney, Scotland, 1855-2001.

    PubMed

    Sparks, Corey S; Wood, James W; Johnson, Patricia L

    2013-06-01

    This study applies principles from the theory of household life cycles to the study of early childhood mortality in the population of the Northern Orkney Islands, Scotland. The primary hypothesis is that unfavorable household economic conditions resulting from changes in household demographic composition increase the risk of death for children under the age of 5 years because of limited resources and intra-household competition. We apply Cox proportional hazards models to nearly 5,000 linked birth and death records from the Northern Orkney Islands, Scotland, from the period 1855 to 2001. The dependent variable is the child's risk of death before age 5. Findings suggest that children in households with unfavorable age compositions face higher risk of death. This elevated risk of death continues once heterogeneity among children, islands, and households is controlled. Results also show differential risk of death for male children, children of higher birth orders, and twin births. The analyses present evidence for intra-household competition in this historic setting. The most convincing evidence of competition is found in the effects of household consumer/producer ratios and twinning on child mortality risks. PMID:23580417

  18. Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia: A 14-Year Nationwide Cohort Study in Taiwan.

    PubMed

    Lee, Min; Chen, Solomon Chih-Cheng; Yang, Hsin-Yi; Huang, Jui-Hua; Yeung, Chun-Yan; Lee, Hung-Chang

    2016-03-01

    Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes.This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death.Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997-2004) to 4.9 to 5.3/case in the later cohort (2005-2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10-1.18) and death (HR = 1.05, 95% CI = 1.01-1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82-6.73) and death (aOR = 1.75, 95% CI = 1.17-2.62).The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the hospitalization rate and final

  19. Management factors affecting mortality, feed intake and feed conversion ratio of grow-finishing pigs.

    PubMed

    Agostini, P S; Fahey, A G; Manzanilla, E G; O'Doherty, J V; de Blas, C; Gasa, J

    2014-08-01

    The aim of this study was to determine the effect of animal management and farm facilities on total feed intake (TFI), feed conversion ratio (FCR) and mortality rate (MORT) of grower-finishing pigs. In total, 310 batches from 244 grower-finishing farms, consisting of 454 855 Pietrain sired pigs in six Spanish pig companies were used. Data collection consisted of a survey on management practices (season of placement, split-sex by pens, number of pig origins, water source in the farm, initial or final BW) and facilities (floor, feeder, ventilation or number of animals placed) during 2008 and 2009. Results indicated that batches of pigs placed between January and March had higher TFI (P=0.006), FCR (P=0.005) and MORT (P=0.03) than those placed between July and September. Moreover, batches of pigs placed between April and June had lower MORT (P=0.003) than those placed between January and March. Batches which had split-sex pens had lower TFI (P=0.001) and better FCR (P<0.001) than those with mixed-sex in pens; pigs fed with a single-space feeder with incorporated drinker also had the lowest TFI (P<0.001) and best FCR (P<0.001) in comparison to single and multi-space feeders without a drinker. Pigs placed in pens with <50% slatted floors presented an improvement in FCR (P<0.05) than pens with 50% or more slatted floors. Batches filled with pigs from multiple origins had higher MORT (P<0.001) than those from a single origin. Pigs housed in barns that performed manual ventilation control presented higher MORT (P<0.001) in comparison to automatic ventilation. The regression analysis also indicated that pigs which entered to grower-finisher facilities with higher initial BW had lower MORT (P<0.05) and finally pigs which were sent to slaughterhouse with a higher final BW presented higher TFI (P<0.001). The variables selected for each dependent variable explained 61.9%, 24.8% and 20.4% of the total variability for TFI, FCR and MORT, respectively. This study indicates that

  20. 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. ...

  1. 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…

  2. Ljungan virus: a commentary on its association with fetal and infant morbidity and mortality in animals and humans.

    PubMed

    Krous, Henry F; Langlois, Neil E

    2010-11-01

    Epidemiologic and experimental data support the notion that Ljungan virus (LV), endemic in some rodent populations in Sweden, Denmark, and the United States, can cause morbidity and mortality in animals and humans. LV infection can cause type I diabetes mellitus, myocarditis, and encephalitis in bank voles and experimental mice, and lemmings. Mouse dams infected with LV experience high rates of stillbirth that may persist across generations, and their fetuses may develop cranial, brain, and limb malformations. In humans, epidemiologic and serologic data suggest that LV infection correlates with intrauterine fetal death, malformations, placental inflammation, myocarditis, encephalitis, and Guillain-Barré syndrome. The proposed role of LV infection in SIDS is unconvincing. Further research is necessary to clarify the role of LV infection in animal and human disease. PMID:20890937

  3. 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...

  4. Infant Negative Affect and Maternal Interactive Behavior During the Still-Face Procedure: The Moderating Role of Adult Attachment States of Mind

    PubMed Central

    Haltigan, John D.; Leerkes, Esther M.; Supple, Andrew J.; Calkins, Susan D.

    2013-01-01

    The current study examined associations between attachment state of mind measured prenatally (N = 259) and maternal behavior in the reunion episode of the still-face procedure when infants were six months of age both as a main effect and in conjunction with infant negative affect. Using a dimensional approach to adult attachment measurement, dismissing and preoccupied states of mind were negatively associated with maternal sensitivity, and each correlated with distinct parenting behaviors. Positive associations were found between dismissing states of mind and maternal monitoring and preoccupied states of mind and maternal withdraw. Maternal preoccupation moderated associations between infant negative affect and maternal intrusive, withdrawn, and monitoring behaviors, supporting the notion that maternal attachment influences parenting behavior via a modulatory process in which infant distress cues are selectively filtered and responded to. Analyses using a traditional AAI scale and classification approach also provided evidence for distinct parenting behavior correlates of insecure adult attachment representations. The importance of measuring global and stylistic differences in maternal behavior in contexts which allow for the activation of the entire range of infant affective states is discussed. PMID:24329015

  5. Two methods of assessing the mortality factors affecting the larvae and pupae of Cameraria ohridella in the leaves of Aesculus hippocastanum in Switzerland and Bulgaria.

    PubMed

    Girardoz, S; Tomov, R; Eschen, R; Quicke, D L J; Kenis, M

    2007-10-01

    The horse-chestnut leaf miner, Cameraria ohridella, is an invasive alien species defoliating horse-chestnut, a popular ornamental tree in Europe. This paper presents quantitative data on mortality factors affecting larvae and pupae of the leaf miner in Switzerland and Bulgaria, both in urban and forest environments. Two sampling methods were used and compared: a cohort method, consisting of the surveying of pre-selected mines throughout their development, and a grab sampling method, consisting of single sets of leaves collected and dissected at regular intervals. The total mortality per generation varied between 14 and 99%. Mortality was caused by a variety of factors, including parasitism, host feeding, predation by birds and arthropods, plant defence reaction, leaf senescence, intra-specific competition and inter-specific competition with a fungal disease. Significant interactions were found between mortality factors and sampling methods, countries, environments and generation. No mortality factor was dominant throughout the sites, generations and methods tested. Plant defence reactions constituted the main mortality factor for the first two larval stages, whereas predation by birds and arthropods and parasitism were more important in older larvae and pupae. Mortality caused by leaf senescence was often the dominant mortality factor in the last annual generation. The cohort method detected higher mortality rates than the grab sampling method. In particular, mortality by plant defence reaction and leaf senescence were better assessed using the cohort method, which is, therefore, recommended for life table studies on leaf miners. PMID:17916263

  6. Child acute malnutrition and mortality in populations affected by displacement in the Horn of Africa, 1997-2009.

    PubMed

    Mason, John B; White, Jessica M; Heron, Linda; Carter, Jennifer; Wilkinson, Caroline; Spiegel, Paul

    2012-03-01

    Drought and conflict in the Horn of Africa are causing population displacement, increasing risks of child mortality and malnutrition. Humanitarian agencies are trying to mitigate the impact, with limited resources. Data from previous years may help guide decisions. Trends in different populations affected by displacement (1997-2009) were analyzed to investigate: (1) how elevated malnutrition and mortality were among displaced compared to host populations; (2) whether the mortality/malnutrition relation changed through time; and (3) how useful is malnutrition in identifying high mortality situations. Under-five mortality rates (usually from 90-day recall, as deaths/10,000/day: U5MR) and global acute malnutrition (wasting prevalences, < -2SDs of references plus edema: GAM) were extracted from reports of 1,175 surveys carried out between 1997-2009 in the Horn of Africa; these outcome indicators were analyzed by livelihood (pastoral, agricultural) and by displacement status (refugee/internally displaced, local resident/host population, mixed); associations between these indicators were examined, stratifying by status. Patterns of GAM and U5MR plotted over time by country and livelihood clarified trends and showed substantial correspondence. Over the period GAM was steady but U5MR generally fell by nearly half. Average U5MR was similar overall between displaced and local residents. GAM was double on average for pastoralists compared with agriculturalists (17% vs. 8%), but was not different between displaced and local populations. Agricultural populations showed increased U5MR when displaced, in contrast to pastoralist. U5MR rose sharply with increasing GAM, at different GAM thresholds depending on livelihood. Higher GAM cut-points for pastoralists than agriculturalists would better predict elevated U5MR (1/10,000/day) or emergency levels (2/10,000/day) in the Horn of Africa; cut-points of 20-25% GAM in pastoral populations and 10-15% GAM in agriculturalists are

  7. 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...

  8. Impact of smoke-free legislation on perinatal and infant mortality: a national quasi-experimental study

    PubMed Central

    Been, Jasper V; Mackay, Daniel F; Millett, Christopher; Pell, Jill P; van Schayck, Onno CP; Sheikh, Aziz

    2015-01-01

    Smoke-free legislation is associated with improved early-life outcomes; however its impact on perinatal survival is unclear. We linked individual-level data with death certificates for all registered singletons births in England (1995–2011). We used interrupted time series logistic regression analysis to study changes in key adverse perinatal events following the July 2007 national, comprehensive smoke-free legislation. We studied 52,163 stillbirths and 10,238,950 live-births. Smoke-free legislation was associated with an immediate 7.8% (95%CI 3.5–11.8; p < 0.001) reduction in stillbirth, a 3.9% (95%CI 2.6–5.1; p < 0.001) reduction in low birth weight, and a 7.6% (95%CI 3.4–11.7; p = 0.001) reduction in neonatal mortality. No significant impact on SIDS was observed. Using a counterfactual scenario, we estimated that in the first four years following smoke-free legislation, 991 stillbirths, 5,470 cases of low birth weight, and 430 neonatal deaths were prevented. In conclusion, smoke-free legislation in England was associated with clinically important reductions in severe adverse perinatal outcomes. PMID:26268789

  9. 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

  10. Bifidobacteria isolated from infants and cultured on human milk oligosaccharides affect intestinal epithelial function

    PubMed Central

    Chichlowski, Maciej; De Lartigue, Guillaume; German, J. Bruce; Raybould, Helen E.; Mills, David A.

    2012-01-01

    Objectives Human milk oligosaccharides (HMO) are the third most abundant component of breast milk. Our laboratory has previously revealed gene clusters specifically linked to HMO metabolism in select bifidobacteria isolated from fecal samples of infants. Our objective was to test the hypothesis that growth of select bifidobacteria on HMO stimulates the intestinal epithelium. Methods Caco-2 and HT-29 cells were incubated with lactose (LAC) or HMO-grown Bifidobacterium longum subsp. infantis (B. infantis) or B. bifidum. Bacterial adhesion and translocation was measured by real-time quantitative PCR. Expression of pro- and anti-inflammatory cytokines and tight junction proteins was analyzed by real time reverse transcriptase. Distribution of tight junction proteins was measured using immunofluorescent microscopy. Results We showed that HMO-grown B. infantis had significantly higher rate of adhesion to HT-29 cells compared to B. bifidum. B. infantis also induced expression of a cell membrane glycoprotein, P-selectin glycoprotein ligand -1. Both B. infantis and B. bifidum grown on HMO caused less occludin relocalization and higher expression of anti-inflammatory cytokine, interleukin (IL)-10 compared to LAC-grown bacteria in Caco-2 cells. B. bifidum grown on HMO showed higher expression of junctional adhesion molecule and occludin in Caco-2 cell and HT-29 cells. There were no significant differences between LAC or HMO treatments in bacterial translocation. Conclusions This study provides evidence for the specific relationship between HMO-grown bifidobacteria and intestinal epithelial cells. To our knowledge, this is the first study describing HMO-induced changes in the bifidobacteria-intestinal cells interaction. PMID:22383026

  11. 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. PMID:19775921

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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. PMID:15768774

  17. 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

  18. 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.

  19. 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.

  20. From infant affect expression to symbolic play: the coherence of development in Down syndrome children.

    PubMed

    Motti, F; Cicchetti, D; Sroufe, L A

    1983-10-01

    To examine further the coherence of development of a sample of Down syndrome children, assessments were made of the quality and level of play at age 3-5 years. It was found that, with corrections for mental age, the play of these children was similar to that of nonhandicapped children. Moreover, individual differences in the level and quality of play were strongly predicted from Bayley DQ scores obtained at age 2 and by several indexes of affective expressiveness including 1 obtained in the first year of life. This was despite limitations on the performance range represented in the subsample included in this follow-up study. Finally, the various aspects of play, as indexed by 5 separate scales, intercorrelated strongly, suggesting consistent individual differences in the play session itself. All of these findings point to the coherence of development of these children. In addition, it is suggested that early affective assessments are strong predictors of the later functioning of Down syndrome. PMID:6194942

  1. [Prognostic factors of hospital mortality from diarrhea or pneumonia in infants younger than 1 year old. A case-control study].

    PubMed

    Post, C L; Victora, C G; Valente, J G; Leal, M do C; Niobey, F M; Sabroza, P C

    1992-12-01

    Diarrhea and pneumonia are common diseases in children aged under one year, for which there are simple therapeutic measures. However, infant mortality due to these diseases is still very high, varying markedly according to socio-economic status. The characteristics of children who died (cases) and of those who were hospitalized with diarrhea or pneumonia, but survived (controls), were studied. The following groups of variables were studied: socio-economic, environmental and biological conditions, nutritional status and breast-feeding. Information on cases and controls was collected from hospital records and through home interviews. Important losses occurred in the latter: 40% of cases and 50% of controls were not interviewed. There were no significant differences between cases who were included and those who were not, in terms of age, sex or place of residence. To estimate relative risks of prognostic factors unconditional Logistic Regression was used to calculate the odds ratios and their 95% confidence intervals. Prematurity, low birth weight, weight/age deficit, presence of edema and poor general status at hospital admission were prognostic factors for hospital case-fatality. In relation to the anthropometric variables, it was not possible to conclude for certain whether the increased case-fatality was linearly or non-linearly (threshold) associated with nutritional deficit. The duration of breast-feeding was only associated with case-fatality for pneumonia. Socio-economic factors were not important for the prognosis of children admitted to hospital with diarrhea or pneumonia. Some of the expected risk factor associations were not detected, maybe due to the small sample size (resulting from the high losses) which was insufficient to show small differences. In this study the biological conditions of children with diarrhea or pneumonia appeared to be the important prognostic factors for hospital case-fatality. PMID:1342527

  2. The Relationship between Affect and Cognition in Maltreated Infants: Quality of Attachment and the Development of Visual Self-Recognition.

    ERIC Educational Resources Information Center

    Schneider-Rosen, Karen; and Cicchetti, Dante

    1984-01-01

    Compares 18 maltreated and 19 matched 19-month-old lower class infants in Ainsworth and Wittig's Strange Situation and in the standard mirror-and-rouge paradigm. Finds that a greater proportion of maltreated infants showed insecure attachments to their mothers and, when rouge-marked, responded negatively and did not recognize themselves. (CB)

  3. Do social disadvantage and early family adversity affect the diurnal cortisol rhythm in infants? The Generation R Study.

    PubMed

    Saridjan, Nathalie S; Huizink, Anja C; Koetsier, Jitske A; Jaddoe, Vincent W; Mackenbach, Johan P; Hofman, Albert; Kirschbaum, Clemens; Verhulst, Frank C; Tiemeier, Henning

    2010-02-01

    Dysregulation of diurnal cortisol secretion patterns may explain the link between adversities early in life and later mental health problems. However, few studies have investigated the influence of social disadvantage and family adversity on the hypothalamic-pituitary-adrenal (HPA) axis early in life. In 366 infants aged 12-20 months from the Generation R Study, a population-based cohort from fetal life onwards, parents collected saliva samples from their infant at 5 moments over the course of 1 day. The area under the curve (AUC), the cortisol awakening response (CAR) and the diurnal cortisol slope were calculated as different composite measures of the diurnal cortisol rhythm. Information about social disadvantage and early adversity was collected using prenatal and postnatal questionnaires. We found that older infants showed lower AUC levels; moreover, infants with a positive CAR were significantly older. Both the AUC and the CAR were related to indicators of social disadvantage and early adversity. Infants of low income families, in comparison to high income families, showed higher AUC levels and a positive CAR. Infants of mothers who smoked during pregnancy were also significantly more likely to show a positive CAR. Furthermore, infants of mothers experiencing parenting stress showed higher AUC levels. The results of our study show that effects of social disadvantage and early adversity on the diurnal cortisol rhythm are already observable in infants. This may reflect the influence of early negative life events on early maturation of the HPA axis. PMID:20006614

  4. 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

  5. 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. PMID:15671809

  6. 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...

  7. Top-down modulation in the infant brain: Learning-induced expectations rapidly affect the sensory cortex at 6 months.

    PubMed

    Emberson, Lauren L; Richards, John E; Aslin, Richard N

    2015-08-01

    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

  8. Welfare reform, time limits, and infant health.

    PubMed

    Leonard, Jonathan; Mas, Alexandre

    2008-12-01

    This paper offers evidence that welfare time limits contributed to a deterioration of infant health. We use the fact that the dates at which TANF recipients were first subject to timing out varied by state. We show that by 2000 there was a marked difference in TANF duration spells depending on whether the state employed the 60-month Federally imposed time limit, or a shorter limit, differences that were not present under AFDC. There were significant increases in infant mortality when time limits became binding in a state. These increases occurred primarily among mothers who could have plausibly timed-out of TANF: poorly educated and unmarried women with at least one previous live-birth. There is some evidence that the population of mothers affected by time limits were less likely to seek prenatal care in the first trimester, suggesting a possible role for reduced medical care in explaining the deterioration in infant health. PMID:18947892

  9. Clinical Significance of National Patients Sample Analysis: Factors Affecting Mortality and Length of Stay of Organophosphate and Carbamate Poisoned Patients

    PubMed Central

    Kim, Kyoung-Ho; Lee, Jun Yeob; Yeo, Woon Hyung; Park, Ha Young; Park, Kyung Hye; Cho, Junho; Kim, Hyunjong; Kim, Gun Bea; Park, Deuk Hyun; Yoon, Yoo Sang; Kim, Yang Weon

    2013-01-01

    Objectives This study considered whether there could be a change of mortality and length of stay as a result of inter-hospital transfer, clinical department, and size of hospital for patients with organophosphates and carbamates poisoning via National Patients Sample data of the year 2009, which was obtained from Health Insurance Review and Assessment Services (HIRA). The utility and representativeness of the HIRA data as the source of prognosis analysis in poisoned patients were also evaluated. Methods Organophosphate and carbamate poisoned patients' mortality and length of stay were analyzed in relation to the initial and final treating hospitals and departments, as well as the presence of inter-hospital transfers. Results Among a total of 146 cases, there were 17 mortality cases, and the mean age was 56.8 ± 19.2 years. The median length of stay was 6 days. There was no inter-hospital or inter-departmental difference in length of stay. However, it significantly increased when inter-hospital transfer occurred (transferred 11 days vs. non-transferred 6 days; p = 0.037). Overall mortality rate was 11.6%. The mortality rate significantly increased when inter-hospital transfer occurred (transferred 23.5% vs. non-transferred 7.0%; p = 0.047), but there was no statistical difference in mortality on inter-hospital and inter-department comparison at the initial treating facility. However, at the final treating facility, there was a significant difference between tertiary and general hospitals (5.1% for tertiary hospitals and 17.3% for general hospitals; p = 0.024), although there was no significant inter-departmental difference. Conclusions We demonstrated that hospital, clinical department, length of stay, and mortality could be analyzed using insurance claim data of a specific disease group. Our results also indicated that length of stay and mortality according to inter-hospital transfer could be analyzed, which was previously unknown. PMID:24523992

  10. ICMR Task Force National Collaborative Study on Identification of High Risk Families, Mothers and Outcome of their Off-springs with particular reference to the problem of maternal nutrition, low birth weight, perinatal and infant morbidity and mortality in rural and urban slum communities. Summary, conclusions and recommendations.

    PubMed

    Bhargava, S K; Singh, K K; Saxena, B N

    1991-12-01

    The objectives was to assess the determinants of and rates of abortion, stillbirth, and infant mortality for a cohort of pregnant women from slums in New Delhi, Calcutta, and Madras, India and rural slums in Hyderabad, Varanasi, and Chandigarh, India in 1981. The relationship of low birthweight (LBW) and high risk pregnancies to social, environmental, nutritional, cultural, and biological factors was of interest. The results showed variation both between and within urban and rural areas. Rural pregnancy outcome showed fewer LBWs and perinatal and neonatal mortality. Perinatal, neonatal, and infant mortality rates were consistent with prior findings. There was a demonstrated need for prenatal care and referral due to the 10-12% with a poor obstetric history and the significant number with anemia, bleeding, hypertension, toxemia, and urinary tract infections during this pregnancy. Many women were malnourished (body weight 40 kg, height 145 cm, and midarm circumference of 22.5 cm. These women can be identified as high risk. Other risk factors identified were women with disadvantageous personal habits: smoking, alcohol use, tobacco chewing, and working. 10-25% of pregnancies were not registered even though the prenatal clinic was accessible and outreach was provided. 20% completed the recommended number of prenatal visits. 75-85% visited at least once and sometimes more often. Screening for high risk must be done at the 1st visit. Women had strong feelings about the preference for a Dai during delivery and for place of delivery. Poor training of health workers was reflected in the lack of adequate sanitation during the birthing process. Neonatal units were lacking and primary care absent. 10-14% of births were preterm of which 50% occurred at 36 weeks. Multiple regression identified risk factors for fetal and neonatal mortality and LBW as maternal age, preterm birth, maternal anemia, previous preterm or LBW, birth interval, and previous fetal and neonatal mortality

  11. 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. PMID:20568002

  12. 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.

  13. CPR - infant

    MedlinePlus

    ... breathing and chest compressions - infant; Resuscitation - cardiopulmonary - infant; Cardiopulmonary resuscitation - infant ... CPR is best done by someone trained in an accredited CPR course. The newest techniques emphasize compression ...

  14. 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. PMID:26072908

  15. Neonatal mortality in Meerut district.

    PubMed

    Garg, S K; Mishra, V N; Singh, J V; Bhatnagar, M; Chopra, H; Singh, R B

    1993-09-01

    A study of neonatal mortality in Meerut district revealed an infant mortality rate of 50.1 per 1000 live births. Neonatal mortality accounted for 37.8% of infant mortality with a neonatal mortality rate of 19.0 per 1000 live births. 90.5% of these neonates were delivered at home largely by untrained personnel (57.2%). Only 28.6% of these neonates were treated by qualified doctors and only 30.9% of their mothers were fully immunized against tetanus. At least 2/3rd of neonatal mortality was due to exogenous factors with tetanus neonatorum and septicaemia being the principal causes of mortality each accounting for a mortality rate of 4.7 per 1000 live births. PMID:8112786

  16. 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,…

  17. 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…

  18. Forced migration and mortality in the very long term: did perestroika affect death rates also in Finland?

    PubMed

    Saarela, Jan; Finnäs, Fjalar

    2009-08-01

    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

  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. 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

  1. Clinical and Echocardiographic Factors Associated With In-Hospital Mortality in Patients With Infective Endocarditis Affecting the Native Tricuspid Valve.

    PubMed

    Mi, Michael Y; Nelson, Sandra B; Weiner, Rory B

    2016-09-01

    Infective endocarditis (IE) is a highly morbid disease, for which most outcomes data come from patients with left-sided valvular lesions. Echocardiographic findings such as vegetation size and prosthetic valve involvement have been identified as important predictors of mortality in left-sided IE, but predictors of outcomes in right-sided IE are less well characterized. Therefore, the aim of this study was to identify clinical and echocardiographic findings predictive of mortality in tricuspid valve (TV) IE. We retrospectively reviewed all echocardiograms showing TV vegetations that were performed at the Massachusetts General Hospital from January 1, 2003, to December 31, 2013. We identified 105 patients who had echocardiographic evidence of TV vegetations and a definite clinical diagnosis of IE based on the modified Duke's criteria but did not have intracardiac device-associated vegetations. Of the 105 patients, 88 survived until discharge. Clinical and echocardiographic factors that positively correlated with in-hospital mortality included age (p = 0.002), immunosuppression status (p = 0.016), blood urea nitrogen level (p = 0.029), Candida causative organism (p = 0.025), left ventricular ejection fraction <40% (p = 0.027), right ventricular (RV) systolic dysfunction (p = 0.009), and estimated RV systolic pressure >40 mm Hg (p = 0.040). Of these factors, immunosuppression status, blood urea nitrogen level, and RV systolic dysfunction were independently associated with increased in-hospital mortality. In conclusion, RV systolic dysfunction may serve as an echocardiographic marker to aid clinicians in identifying high-risk patients with right-sided IE for more aggressive therapy. PMID:27392511

  2. Reproductive justice and the pace of change: socioeconomic trends in US infant death rates by legal status of abortion, 1960-1980.

    PubMed

    Krieger, Nancy; Gruskin, Sofia; Singh, Nakul; Kiang, Mathew V; Chen, Jarvis T; Waterman, Pamela D; Gottlieb, Jillian; Beckfield, Jason; Coull, Brent A

    2015-04-01

    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

  3. 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

  4. 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

  5. Type-I interferon response affects an inoculation dose-independent mortality in mice following Japanese encephalitis virus infection

    PubMed Central

    2014-01-01

    Background The laboratory mouse model is commonly employed to study the pathogenesis of encephalitic flaviviruses such as Japanese encephalitis virus (JEV). However, it is known that some strains of these viruses do not elicit a typical mortality dose response curve from this organism after peripheral infection and the reason for it has not yet been fully understood. It is suggested that induction of more vigorous Type-I IFN (IFN-I) response might control early virus dissemination following increasing infectious challenge doses of the virus. Thus, the objective of this study was to examine this suggested role of IFN-I in the mortality of mice infected with various doses of JEV. Methods Inbred 129 mice and their IFNAR KO (A129) mice were subcutaneously inoculated with 100, 102, 104 or 106 pfu of JaOArS982 strain of JEV. Mice were weighed daily and observed for clinical signs. Virus titers in the brains and spleens of JEV-infected mice were determined by plaque forming assays. The upregulated mRNA levels of genes related to IFN-I response of mice were examined by real-time PCR. Results The mortality rates of 129 mice infected with JaOArS982 did not significantly increase despite the increase in inoculation dose and no significant difference of viral loads was observed between their brains. However, there was clear elevation of the mRNA levels of interferon regulatory factor (IRF)3, IRF7, IRF9, MDA5 and RIG-I at 24 hours post-infection depending on the inoculation dose. In A129 mice, length of survival days and the viral loads of spleen and brain were observed to be inoculation dose-dependent. Conclusions From these results, it is suggested that early IFN-I response elicited by high inoculation doses of JEV provides an anti-viral effect during the early phase of infection. Accordingly, virus replication is counteracted by IFN-I response at each increasing inoculation dose resulting in the interference of impending severe disease course or fatal outcome; hence, this

  6. 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

  7. NATIONAL MATERNAL AND INFANT HEALTH SURVEY (NMIHS)

    EPA Science Inventory

    The National Maternal and Infant Health Survey (NMIHS) provides data on maternal and infant health, including prenatal care, birth weight, fetal loss, and infant mortality. The objective of the NMIHS is to collect data needed by Federal, State, and private researchers to study fa...

  8. Statin drugs mitigate cellular inflammatory response after ST elevation myocardial infarction, but do not affect in-hospital mortality

    PubMed Central

    Pourafkari, Leili; Visnjevac, Ognjen; Ghaffari, Samad; Nader, Nader D.

    2016-01-01

    Introduction: The objective was to examine the role of statins in modulating post-STEMI inflammation and related mortality. Methods: A total of 404 patients with STEMI were reviewed. Demographics, comorbidities, laboratory values, and outcomes were collected. The patients were grouped as STATIN and NOSTAT based on the use of statin drugs at the time of admission. Ninety-seven patients were receiving statin drugs. Results: The patients in the STATIN group were more likely to be hypertensive (53.6%), diabetic (37.1%) and to have previous coronary revascularization (9.3%). Following propensity matching of 89 patients in STATIN group to an equal number of patients in NOSTAT controls had lower neutrophil count 7.8 (6.8-8.4) compared to those in the NOSTAT group 9.1 (7.9-10.1). Although there was no difference in-hospital mortality between the two groups, the incidence of pump failure was lower in the STATIN group (5.6% vs. 15.7%; P < 0.01). Conclusion: Statin treatment prior to STEMI mitigates the cellular inflammatory response after the myocardial infarction, as evidenced by lower leukocyte and neutrophil cell counts in the STATIN group. PMID:27069565

  9. Infant Mortality. A Report Prepared by the Congressional Research Service for the Use of the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, U.S. House of Representatives, 98th Congress, Committee Print 98-J.

    ERIC Educational Resources Information Center

    Library of Congress, Washington, DC. Congressional Research Service.

    Recently, reports have indicated that, after years of steady decline, infant mortality has begun to increase in a number of communities throughout the United States. Many of these reports come from areas experiencing high levels of unemployment. While the dimensions and causes of this problem are not entirely understood, strong indications exist…

  10. Infant Mortality Rates: Failure to Close the Black-White Gap. Hearing before the Subcommittee on Oversight and Investigations and the Subcommittee on Health and the Environment of the Committee on Energy and Commerce. House of Representatives, Ninety-Eighth Congress, Second Session (March 16, 1984).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Energy and Commerce.

    This hearing was held in response to a request from the Congressional Black Caucus, which asked the subcommittees to find out if the Department of Health and Human Services (HHS) was doing everything possible to reduce infant mortality, especially the high death rate experienced by Blacks. The hearing opened with statements by both subcommittee…

  11. 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

  12. Mortality salience and positive affect influence adolescents' attitudes toward peers with physical disabilities: terror management and broaden and build theories.

    PubMed

    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 either a picture depicting an adolescent sitting on a regular chair or in a wheelchair and were asked to assess the characteristics of the person in the picture and their willingness to be in his or her company. The findings suggest that both types of manipulations enhanced the personality assessment and social acceptance of adolescents with disabilities compared to adolescents without disabilities and compared to the control condition. Girls reported more favorable attitudes toward another adolescent than boys did. The study indicates that seemingly contradictory manipulations may lead to social acceptance of adolescents with disabilities. PMID:24501847

  13. Dietary amino acid levels and feed restriction affect small intestinal development, mortality, and weight gain of male broilers.

    PubMed

    Wijtten, P J A; Hangoor, E; Sparla, J K W M; Verstegen, M W A

    2010-07-01

    This study investigated the effect of 2 different dietary amino acid treatments and feed restriction in early life versus a control treatment on development of the small intestine segments (weights), mortality, and broiler performance. Each treatment was applied to 6 cages with Ross 308 male broilers and to 6 cages with Cobb 500 male broilers with 24 birds per cage. A control treatment (100% ideal protein) was compared with a treatment with 30% extra ideal protein, a treatment with daily adjustment of the dietary amino acid level and profile, and a feed restriction treatment. The protein treatments were applied from 0 to 14 d of age. The feed restriction was applied from 4 to 21 d of age. Restriction was 15% from d 4 to 14 of age and diminished with equal daily steps thereafter to 5% at 21 d of age. Birds were weighed and dissected for evaluation of small intestine weights at 6, 9, 14, and 36 d of age. Feed intake restriction reduced leg problems in Ross and Cobb broilers. Extra dietary protein reduced leg problems in Ross broilers only. The present experiment does not show that small intestinal weight development is related to mortality. Thirty percent extra dietary ideal protein increased duodenum weight between 6 and 9 d of age. This was not further increased by the daily optimization of the dietary amino acid level and profile. The increased duodenum weights coincided with an improved BW gain. This indicates that duodenum weight may be important in facilitating BW gain in young broilers. Thus, it may be worthwhile to pay more attention to the relation between nutrition and duodenum weight and duodenum function in further studies. PMID:20548070

  14. 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.

  15. 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.

  16. Premature infant

    MedlinePlus

    Preterm infant; Preemie; Premie ... The infant may have trouble breathing and keeping a constant body temperature. ... A premature infant may have signs of the following problems: Anemia Bleeding into the brain or damage to the brain's white ...

  17. How are older maternal age and grand multiparity related to infant health?

    PubMed

    Haaga, J G

    1989-12-01

    Most of the studies that have shown excess risks of morbidity and mortality for infants born to older mothers or those at very high parity have used data from countries with low infant mortality rates, mainly in Europe and North America. In these countries, increasing numbers of women are delaying childbearing into their thirties and early forties, making the consequences of older maternal age for the infant an important public health concern. Grand multiparity, by contrast, is now exceedingly rare in those countries. In many developing countries, however, childbearing typically continues, even if it does not start, at older maternal ages, and grand multiparity is not at all uncommon, It is thus important for the design and targeting of maternal and child health and family planning programs to distinguish the effects of infant health of high parity from those of older maternal age, and of maternal age as such from those of primiparity at older ages. This review uses data from countries that now have low fertility and infant mortality rates as well as from countries where both rates are higher to assess the evidence for different mechanisms through which maternal age and parity affect infant health. PMID:12283074

  18. 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…

  19. 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 ...

  20. Face Orientation and Motion Differently Affect the Deployment of Visual Attention in Newborns and 4-Month-Old Infants.

    PubMed

    Valenza, Eloisa; Otsuka, Yumiko; Bulf, Hermann; Ichikawa, Hiroko; Kanazawa, So; Yamaguchi, Masami K

    2015-01-01

    Orienting visual attention allows us to properly select relevant visual information from a noisy environment. Despite extensive investigation of the orienting of visual attention in infancy, it is unknown whether and how stimulus characteristics modulate the deployment of attention from birth to 4 months of age, a period in which the efficiency in orienting of attention improves dramatically. The aim of the present study was to compare 4-month-old infants' and newborns' ability to orient attention from central to peripheral stimuli that have the same or different attributes. In Experiment 1, all the stimuli were dynamic and the only attribute of the central and peripheral stimuli to be manipulated was face orientation. In Experiment 2, both face orientation and motion of the central and peripheral stimuli were contrasted. The number of valid trials and saccadic latency were measured at both ages. Our results demonstrated that the deployment of attention is mainly influenced by motion at birth, while it is also influenced by face orientation at 4-month of age. These findings provide insight into the development of the orienting visual attention in the first few months of life and suggest that maturation may be not the only factor that determines the developmental change in orienting visual attention from birth to 4 months. PMID:26367122

  1. 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…

  2. [Geographic aspects of mortality in French Polynesia].

    PubMed

    Vigneron, E

    1993-05-01

    The fast pace of social and economic changes which have occurred in French Polynesia over the last 30 years, have made this territory a choice ground for studying trends in mortality by revealing a fast and outstanding epidemiological transition. However, the breakdown of the population in small scattered human groups raises the statistical problem of measuring mortality. The crude mortality rate has decreased steadily from 17.5/1000 in 1945-1949 to 5.3/1000 over the last five years. However, the various infant mortality rate, in spite of their decline, is still exceeding those of Metropolitan France. The contrasted trends in the causes of mortality provides a means to classify French Polynesia in the group of small fast developing countries but still ranks it far behind its 'reference models' such as Metropolitan France or the developed countries in the South Pacific, Australia and New Zealand. Moreover, there are significant regional disparities which still exist between Tahiti and the outlying archipelagoes, mainly among causes of death. As a whole, distant islands remain significantly more affected by deaths resulting from infectious and parasitic diseases, in line with the model of epidemiological transition, where as the islands of Tahiti with 70% of the total population appears as a place of cumulation of infectious and degenerative diseases, in particular of overloading and cultural problems. The centre/periphery opposition between a metropolitan country and an overseas territory repeats itself at the local level between urban and rural environments. PMID:8511621

  3. 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

  4. Total parenteral nutrition - infants

    MedlinePlus

    IV fluids - infants; TPN - infants; Intravenous fluids - infants; Hyperalimentation - infants ... vitamins, minerals, and often lipids (fats) into an infant's vein. TPN can be lifesaving for very small ...

  5. 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

  6. Fish oil supplementation from 9 to 18 months of age affects the insulin-like growth factor axis in a sex-specific manner in Danish infants.

    PubMed

    Damsgaard, Camilla T; Harsløf, Laurine B S; Andersen, Anders D; Hellgren, Lars I; Michaelsen, Kim F; Lauritzen, Lotte

    2016-03-14

    Several studies have investigated the effects of fish oil (FO) on infant growth, but little is known about the effects of FO and sex on insulin-like growth factor-1 (IGF-1), the main regulator of growth in childhood. We explored whether FO v. sunflower oil (SO) supplementation from 9 to 18 months of age affected IGF-1 and its binding protein-3 (IGFBP-3) and whether the potential effects were sex specific. Danish infants (n 115) were randomly allocated to 5 ml/d FO (1·2 g/d n-3 long-chain PUFA (n-3 LCPUFA)) or SO. We measured growth, IGF-1, IGFBP-3 and erythrocyte EPA, a biomarker of n-3 LCPUFA intake and status, at 9 and 18 months. Erythrocyte EPA increased strongly with FO compared with SO (P<0·001). There were no effects of FO compared with SO on IGF-1 in the total population, but a sex × group interaction (P=0·02). Baseline-adjusted IGF-1 at 18 months was 11·1 µg/l (95% CI 0·4, 21·8; P=0·04) higher after FO compared with SO supplementation among boys only. The sex × group interaction was borderline significant in the model of IGFBP-3 (P=0·09), with lower IGFBP-3 with FO compared with SO among girls only (P=0·03). The results were supported by sex-specific dose-response associations between changes in erythrocyte EPA and changes in IGF-1 and IGFBP-3 (both P<0·03). Moreover, IGF-1 was sex specifically associated with BMI and length. In conclusion, FO compared with SO resulted in higher IGF-1 among boys and lower IGFBP-3 among girls. The potential long-term implications for growth and body composition should be investigated further. PMID:26758502

  7. [Mortality. The behavior of mortality through 1987].

    PubMed

    Jimenez, R

    1988-01-01

    Mexico's crude death rate has declined from 33/1000 in the early 20th century to about 6/1000 in 1985-87. Mortality declined sharply from 1640-60. more slowly from 1960-77, and rapidly again beginning around 1980. The explanation for the mortality decline lies both in advances in medical and health care and in economic growth of the country. The mortality declines in the late 1970s and early 1980s probably resulted primarily from extension of primary health care programs in rural areas. The infant mortality rate has declined from 288.6/1000 live births in 1900 to 73.8 in 1960 and 42 in 1986-87. At present 30% of deaths in Mexico are to children under 5, but little is known of the impact of the country's economic crisis on mortality in this age group. The strong mortality decline between 1950-70 was in the economically active age group of 15-64 years. Excess male mortality in this group reached a maximum in 1980: for each death of woman there were 150 male deaths. Between 1960-80 the rate of deaths due to infection, parasfitism, and respiratory disease declined by 5%, the rate of death from cancer remained almost unchanged, and the rate of death from cardiovascular diseases increased by 9%. Deaths from accidents, homicide, suicide, and other violence increased by 38%. Male general mortality rates were 25% higher than female in 1980. Mexican life expectancy increased from 49.6 years in 195 to 67 in 1987. Life expectancy was 65.6 for males and 71.7 for females. Average life expectancy was 69 for the more privileged social sectors and 56.7 for agricultural workers in 1965-79. The life expectancy of urban women was 3 years longer than that of rural women and 10.4 years longer than that of rural men. PMID:12158030

  8. Mortality in Asia.

    PubMed

    1981-01-01

    Although the general trend in mortality between 1950 and 1975 in South and East Asia has been downward, there is considerable country-to-country variation in the rate of decline. In countries where combined economic, social, and political circumstances resulted in controlling the disease spectrum (e.g., China, Malaysia, Sri Lanka), mortality levels declined to those seen in low-mortality countries. In most of the large countries of the region however, mortality declined at a slower rate, even slowing down considerably in the 1970's while the death rates remained high (e.g., India, Bangladesh, Thailand, Philippines); this slowing down of mortality level is attributed essentially to the poverty-stricken masses of society which were not able to take advantage of social, technological, and health-promoting behavioral changes conducive to mortality decline. Infant mortality levels, although declining since 1950, followed the same dismal pattern of the general mortality level. The rate varies from less than 10/1000 live births (Japan) to more than 140/1000 (Bangladesh, Laos, Nepal). Generally, rural areas exhibited higher infant mortality than urban areas. The level of child mortality declines with increases in the mother's educational level in Bangladesh, India, Indonesia, Sri Lanka, and Thailand. The largest decline in child mortality occurs when at least 1 parent has secondary education. The premature retardation of mortality decline is caused by several factors: economic development, nutrition and food supply, provision and adequacy of health services, and demographic trends. The outlook for the year 2000 for most of Asia's countries will depend heavily on significant population increases. In most countries, particularly in South Asia, population is expected to increase by 75%, much of it in rural areas and among poorer socioeconomic groups. In view of this, Asia's health planners and policymakers will have to develop health policies which will strike a balance

  9. Determinants of neonatal mortality in rural India, 2007–2008

    PubMed Central

    Kumar, Abhishek; Kumar, Amit

    2013-01-01

    Background. Despite the growing share of neonatal mortality in under-5 mortality in the recent decades in India, most studies have focused on infant and child mortality putting neonatal mortality on the back seat. The development of focused and evidence-based health interventions to reduce neonatal mortality warrants an examination of factors affecting it. Therefore, this study attempt to examine individual, household, and community level factors affecting neonatal mortality in rural India. Data and methods. We analysed information on 171,529 singleton live births using the data from the most recent round of the District Level Household Survey conducted in 2007–08. Principal component analysis was used to create an asset index. Two-level logistic regression was performed to analyse the factors associated with neonatal deaths in rural India. Results. The odds of neonatal death were lower for neonates born to mothers with secondary level education (O R = 0.60, p = 0.01) compared to those born to illiterate mothers. A progressive reduction in the odds occurred as the level of fathers’ education increased. The odds of neonatal death were lower for infants born to unemployed mothers (O R = 0.89, p = 0.00) compared to those who worked as agricultural worker/farmer/laborer. The odds decreased if neonates belonged to Scheduled Tribes (O R = 0.72, p = 0.00) or ‘Others’ caste group (O R = 0.87, p = 0.04) and to the households with access to improved sanitation (O R = 0.87, p = 0.02), pucca house (O R = 0.87, p = 0.03) and electricity (O R = 0.84, p = 0.00). The odds were higher for male infants (O R = 1.21, p = 0.00) and whose mother experienced delivery complications (O R = 1.20, p = 0.00). Infants whose mothers received two tetanus toxoid injections (O R = 0.65, p = 0.00) were less likely to die in the neonatal period. Children of higher birth order were less likely to die compared to first birth order. Conclusion. Ensuring the consumption of an adequate quantity

  10. Infants' Vagal Regulation in the Still-Face Paradigm Is Related to Dyadic Coordination of Mother-Infant Interaction

    ERIC Educational Resources Information Center

    Moore, Ginger A.; Calkins, Susan D.

    2004-01-01

    The authors investigated relations between mother-infant dyadic coordination and infants' physiological responses. Mothers (N=73) and 3-month-old male and female infants were observed in the still-face paradigm, and mothers' and infants' affective states were coded at 1-s intervals. Synchrony and levels of matching between mother-infant affective…

  11. Mortality rates above emergency threshold in population affected by conflict in North Kivu, Democratic Republic of Congo, July 2012-April 2013.

    PubMed

    Carrión Martín, Antonio Isidro; Bil, Karla; Salumu, Papy; Baabo, Dominique; Singh, Jatinder; Kik, Corry; Lenglet, Annick

    2014-09-01

    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

  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. Premature infant

    MedlinePlus

    ... infant. Common signs of prematurity include: Abnormal breathing patterns (shallow, irregular pauses in breathing called apnea) Body hair (lanugo) Enlarged clitoris (in female infants) Less body fat Lower muscle tone and ...

  15. Infant botulism

    MedlinePlus

    ... certain foods (such as honey and some corn syrups). Infant botulism occurs mostly in young infants between ... Clostridium spores are found in honey and corn syrup. These foods should not should not be fed ...

  16. Maternal mortality in Sirur.

    PubMed

    Shrotri, A; Pratinidhi, A; Shah, U

    1990-01-01

    hospital death rate was 5.7/1000 and the district referral hospital death rate was 13.9/1000. The home delivery death rate was 1.2/1000. 5 (33.3%) who died had preterm deliveries. 5 infants died perinatally, 5 died neonatally, and 1 died postneonatally. Infant mortality was 6 times greater among mothers who died. PMID:12319232

  17. Infant memory for musical experiences.

    PubMed

    Saffran, J R; Loman, M M; Robertson, R R

    2000-10-16

    Recent findings suggest that infants can remember words from stories over 2 week delays (Jusczyk, P. W., & Hohne, E. A. (1997). Infants' memory for spoken words. Science, 277, 1984-1986). Because music, like language, presents infants with a massively complex auditory learning task, it is possible that infant memory for musical stimuli is equally powerful. Seven-month-old infants heard two Mozart sonata movements daily for 2 weeks. Following a 2 week retention interval, the infants were tested on passages of the familiarized music, and passages taken from similar but novel music. Results from two experiments suggest that the infants retained the familiarized music in long-term memory, and that their listening preferences were affected by the extent to which familiar passages were removed from the musical contexts within which they were originally learned. PMID:10980255

  18. 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…

  19. 78 FR 61383 - Certain Thermal Support Devices For Infants, Infant Incubators, Infant Warmers, and Components...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... COMMISSION Certain Thermal Support Devices For Infants, Infant Incubators, Infant Warmers, and Components... United States after importation of certain thermal support devices for infants, infant incubators, infant... certain thermal support devices for infants, infant incubators, infant warmers, and components thereof...

  20. Child Mortality Rate in Ethiopia

    PubMed Central

    Susuman, A Sathiya

    2012-01-01

    Ethiopia’s childhood mortality has continued to decline although at a swift pace. The drop in urban childhood mortality decline, duration of breastfeeding is the principle reason for the overall decline in mortality trends in Ethiopia. Data from the Ethiopian Demographic and Health Surveys 2000 and 2005 were used. Indirect estimation of Brass and Trussell’s methods were adopted. Selected demographic and socio-economic variables were included in the analysis with statistically significant effects. Findings clearly show neonatal and post neonatal mortality decline gradually. Even though, Ethiopia’s childhood mortality rates are still high. The result shows less than 2 years birth interval have higher infant mortality rates than higher birth interval (113 deaths per 1000). The proper spacing of births allows more time for childcare to make more maternal resources available for the care of the child and mother. Therefore, further research is urgent for regional level and national level investigation. PMID:23113145

  1. Mortality rates decline in Malaysia.

    PubMed

    1991-11-01

    Experiencing remarkable decreases in mortality rates over the past 3 decades, Malaysia currently has one of the lowest mortality rates among developing countries, a rate that compares favorably with those of developed countries. Between 1957 and 1989, the crude death rate dropped from 12.4/1000 population to 4.6. Over the same period, Malaysia recorded even greater decreases in the infant mortality rate, from 75.5/1000 births to 15.2. The Maternal mortality rate also declined from 1.48 in 1970 to 0.24 in 1988. The data indicates that mortality rates vary from state to state, and that rural areas have a higher mortality than urban areas. According to a study by the National Population and Family Development Board, the use of maternal and child health services has played an important role in reducing neonatal, perinatal, infant, child, and maternal mortality rates. Nearly all women in Malaysia receive antenatal services. While the country has achieved great gains on mortality rates, programs focusing on specific age and socioeconomic groups could lead to even greater reductions. The Minister for National Unity and Social Development, Dato Napsiah Omar, has called for the development of programs designed to improve the population's quality of life. PMID:12284509

  2. Birth Defects Prevalence and Mortality

    EPA Science Inventory

    This indicator describes the prevalence of birth defects present at birth and mortality rates among infants in the United States between from 1999-2008 and 1979-2007, respectively. Some scientific studies have linked birth defects with environmental exposures. This indicator p...

  3. Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia

    PubMed Central

    Wang, Shwu-Meei; Lung, Hou-Ling; Chang, Jui-Hsing; Hsu, Chyong-Hsin; Jim, Wai-Tim; Lee, Ching-Hsiao; Hung, Hsiao-Fang

    2015-01-01

    Background Neonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants. Study Design This retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW) preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5–37.5°C), mild hypothermia (36.0–36.4°C), moderate hypothermia (32.0–35.9°C), and severe hypothermia (< 32°C). We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups. Results We studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02) and smaller birth weight (1004 g vs. 1187 g, P < .001) compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001), respiratory distress syndrome (RDS) (58.0% vs. 39.2%, P = .006), and mortality (18.5% vs. 5.1%, P = .005). Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years’ corrected age. Mild hypothermia had no effect on short-term or long-term outcomes. Conclusions Admission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment. PMID:26193370

  4. Maternal HIV infection influences the microbiome of HIV-uninfected infants.

    PubMed

    Bender, Jeffrey M; Li, Fan; Martelly, Shoria; Byrt, Erin; Rouzier, Vanessa; Leo, Marguerite; Tobin, Nicole; Pannaraj, Pia S; Adisetiyo, Helty; Rollie, Adrienne; Santiskulvong, Chintda; Wang, Shaun; Autran, Chloe; Bode, Lars; Fitzgerald, Daniel; Kuhn, Louise; Aldrovandi, Grace M

    2016-07-27

    More than 1 million HIV-exposed, uninfected infants are born annually to HIV-positive mothers worldwide. This growing population of infants experiences twice the mortality of HIV-unexposed infants. We found that although there were very few differences seen in the microbiomes of mothers with and without HIV infection, maternal HIV infection was associated with changes in the microbiome of HIV-exposed, uninfected infants. Furthermore, we observed that human breast milk oligosaccharides were associated with bacterial species in the infant microbiome. The disruption of the infant's microbiome associated with maternal HIV infection may contribute to the increased morbidity and mortality of HIV-exposed, uninfected infants. PMID:27464748

  5. Whooping cough and unrecognised postperinatal mortality.

    PubMed Central

    Nicoll, A; Gardner, A

    1988-01-01

    Trends in postperinatal infant mortality from respiratory causes and the sudden infant death syndrome in England and Wales for 1968 to 1984 were examined. These were compared by time series analysis with changes in the incidence of specific infective diseases and organisms for the same period. Discontinuity was found in association with the occurrence of whooping cough between 1977 and 1982. Associations with the general incidence of respiratory infections and other specific organisms were less evident. An estimate of excess mortality is 460 to 700 deaths, a substantial increase over the certified mortality from whooping cough. PMID:3126714

  6. Height, infant-feeding practices and cardiovascular functioning among 3 or 4 year old children in three ethnic groups.

    PubMed

    Baranowski, T; Bryan, G T; Harrison, J A; Rassin, D K; Greaves, K A; Baranowski, J H

    1992-05-01

    Barker recently hypothesized that factors affecting prenatal and infant growth are related to adult blood pressure and CVD mortality. Predictions from Barker's hypothesis in regard to infant feeding were tested among a sample of 3 or 4 year old children. The relationship of infant-feeding characteristics (duration of breast-feeding, times of introduction of high fat, high carbohydrate, high potassium foods and table salt) to indicators of cardiovascular functioning (resting blood pressures and heart rates, and heart rate response to graded activity) while controlling for anthropometric (height, sum of seven skinfolds, BMI) and demographic (ethnicity, gender, social status) characteristics revealed that infant-feeding practices were not related to CV functioning in the predicted directions among this sample of 3 or 4 year old children. Furthermore, the positive relationship between height and systolic blood pressure was inconsistent with the Barker hypothesis. PMID:1588357

  7. Infant Care and Infant Health

    MedlinePlus

    ... Meetings, Conferences & Events Partnering & Donating to the NICHD Staff ... Overview Skip sharing on social media links Share this: Page Content Since the NICHD's founding in 1962, infant death ...

  8. Infant Stimulation.

    ERIC Educational Resources Information Center

    International Children's Centre, Paris (France).

    This set of documents consists of English, French, and Spanish translations of four pamphlets on infant stimulation. The pamphlets provide information designed for lay persons, educators and primary care personnel, academics and professionals, and for health administrators and family-planning organizations. The contents cover infant needs; infant…

  9. Postpartum Depression: Is It a Condition Affecting the Mother-Infant Interaction and the Development of the Child across the First Year of Life?

    ERIC Educational Resources Information Center

    Figueiredo, B.

    Noting that maternal depression is common during a baby's first year, this study examined the interaction of depressed and non-depressed mother-child dyads. A sample of 26 first-time mothers with postpartum depression at the third month after birth and their 3-month-old infants was compared to a sample of 25 first-time mothers with no postpartum…

  10. Maternal and perinatal mortality.

    PubMed

    Krishna Menon, M K

    1972-01-01

    A brief analysis of data from the records of the Government Hospital for Women and Children in Madras for a 36-year period (1929-1964) is presented. India with a population of over 550 million has only 1 doctor for each 6000 population. For the 80% of the population which is rural, the doctor ratio is only 88/1 million. There is also a shortage of paramedical personnel. During the earlier years of this study period, abortions, puerperal infections; hemorrhage, and toxemia accounted for nearly 75% of all meternal deaths, while in later years deaths from these causes were 40%. Among associated factors in maternal mortality, anemia was the most frequent, it still accounts for 20% and is a contributory factor in another 20%. The mortality from postpartum hemorrhage was 9.3% but has now decreased to 2.8%. Eclampsia is a preventable disease and a marked reduction in maternal and perinatal mortality from this cause has been achieved. Maternal deaths from puerperal infections have dropped from 25% of all maternal deaths to 7%. Uterine rupture has been reduced from 75% to 9.3% due to modern facilities. Operative deliveries still have an incidence of 2.1% and a mortality rate of 1.4% of all deliveries. These rates would be further reduced by more efficient antenatal and intranatal care. Reported perinatal mortality of infants has been reduced from 182/1000 births to an average of 78/1000 in all areas, but is 60.6/1000 in the city of Madras. Socioeconomic standards play an important role in perinatal mortality, 70% of such deaths occurring in the lowest economic groups. Improvement has been noted in the past 25 years but in rural areas little progress has been made. Prematurity and low birth weights are still larger factors in India than in other countries, with acute infectious diseases, anemia, and general malnutrition among mothers the frequent causes. Problems requiring further efforts to reduce maternal and infant mortality are correct vital statistics, improved

  11. Are IgM-enriched immunoglobulins an effective adjuvant in septic VLBW infants?

    PubMed Central

    2013-01-01

    Aim To investigate the effectiveness of IgM-enriched immunoglobulins (IgM-eIVIG) in reducing short-term mortality of neonates with proven late-onset sepsis. Methods All VLBW infants from January 2008 to December 2012 with positive blood culture beyond 72 hours of life were enrolled in a retrospective cohort study. Newborns born after June 2010 were treated with IgM-eIVIG, 250 mg/kg/day iv for three days in addition to standard antibiotic regimen and compared to an historical cohort born before June 2010, receiving antimicrobial regimen alone. Short-term mortality (i.e. death within 7 and 21 days from treatment) was the primary outcome. Secondary outcomes were: total mortality, intraventricular hemorrhage, necrotizing enterocolitis, periventricular leukomalacia, bronchopulmonary dysplasia at discharge. Results 79 neonates (40 cases) were enrolled. No difference in birth weight, gestational age or SNAP II score (disease severity score) were found. Significantly reduced short-term mortality was found in treated infants (22% vs 46%; p = 0.005) considering all microbial aetiologies and the subgroup affected by Candida spp. Secondary outcomes were not different between groups. Conclusion This hypothesis-generator study shows that IgM-eIVIG is an effective adjuvant therapy in VLBW infants with proven sepsis. Randomized controlled trials are warranted to confirm this pilot observation. PMID:24098953

  12. Outcomes for extremely premature infants.

    PubMed

    Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

    2015-06-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (<1000 g) remain at high risk for death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address

  13. Avoidable mortality in Lithuania.

    PubMed Central

    Gaizauskiene, A; Gurevicius, R

    1995-01-01

    STUDY OBJECTIVE--The study aimed to analyse avoidable mortality in Lithuania as an index of the quality of health care and to assess trends in avoidable mortality from 1970-90. SETTING AND PARTICIPANTS--All deaths of Lithuanian residents aged between 0 and 64 years between 1970 and 1990 were analysed. MEASUREMENTS AND MAIN RESULTS--Twenty seven per cent of all deaths in this age group were avoidable. Avoidable deaths were grouped into preventable and treatable ones. Treatable causes of death accounted for 54%, and preventable, 46% of avoidable mortality. Time trends showed that general mortality and mortality from avoidable causes of death in this age group were almost stable between 1970 and 1990. Mortality from treatable causes of death fell, while deaths from preventable causes increased. The results in the preventable group were greatly affected by deaths from malignant neoplasms of trachea, bronchus, and lungs. Differences were noted between the sexes in total mortality as well as in avoidable mortality. CONCLUSIONS--Avoidable causes of death are relatively common and, consequently, they are of practical importance for public health and studies of the health care quality in Lithuania. Reorganisation of health care is to be carried out and considerable emphasis will be placed on health education, promotion, and prevention, as primary prevention measures have not been effective thus far. PMID:7629464

  14. Sex of Infant Differences in Mother-Infant Interaction: A Reinterpretation of Past Findings.

    ERIC Educational Resources Information Center

    Grant, Valerie J.

    1994-01-01

    Describes the nature and consistency differences in mother-infant interaction affected by sex of infant, and reviews past interpretations. Offers an alternative interpretation, drawing on evidence from animal studies, studies of pregnant women, and work by epidemiologists and ethologists on sex ratio data that suggests mothers of male infants may…

  15. Mode of oral iron administration and the amount of iron habitually consumed do not affect iron absorption, systemic iron utilisation or zinc absorption in iron-sufficient infants: a randomised trial.

    PubMed

    Szymlek-Gay, Ewa A; Domellöf, Magnus; Hernell, Olle; Hurrell, Richard F; Lind, Torbjörn; Lönnerdal, Bo; Zeder, Christophe; Egli, Ines M

    2016-09-01

    Different metabolic pathways of supplemental and fortification Fe, or inhibition of Zn absorption by Fe, may explain adverse effects of supplemental Fe in Fe-sufficient infants. We determined whether the mode of oral Fe administration or the amount habitually consumed affects Fe absorption and systemic Fe utilisation in infants, and assessed the effects of these interventions on Zn absorption, Fe and Zn status, and growth. Fe-sufficient 6-month-old infants (n 72) were randomly assigned to receive 6·6 mg Fe/d from a high-Fe formula, 1·3 mg Fe/d from a low-Fe formula or 6·6 mg Fe/d from Fe drops and a formula with no added Fe for 45 d. Fractional Fe absorption, Fe utilisation and fractional Zn absorption were measured with oral (57Fe and 67Zn) and intravenous (58Fe and 70Zn) isotopes. Fe and Zn status, infection and growth were measured. At 45 d, Hb was 6·3 g/l higher in the high-Fe formula group compared with the Fe drops group, whereas serum ferritin was 34 and 35 % higher, respectively, and serum transferrin 0·1 g/l lower in the high-Fe formula and Fe drops groups compared with the low-Fe formula group (all P<0·05). No intervention effects were observed on Fe absorption, Fe utilisation, Zn absorption, other Fe status indices, plasma Zn or growth. We concluded that neither supplemental or fortification Fe nor the amount of Fe habitually consumed altered Fe absorption, Fe utilisation, Zn absorption, Zn status or growth in Fe-sufficient infants. Consumption of low-Fe formula as the only source of Fe was insufficient to maintain Fe stores. PMID:27546308

  16. Household Air Pollution and Under-Five Mortality in Bangladesh (2004–2011)

    PubMed Central

    Naz, Sabrina; Page, Andrew; Agho, Kingsley Emwinyore

    2015-01-01

    Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among children under five years in Bangladesh. This study investigates the association between HAP from cooking fuel and under-five mortality using Bangladesh Demographic and Health Survey (BDHS) datasets over the period 2004–2011 (n = 18,308 children), and the extent to which this association differed by environmental and behavioral factors affecting level of exposure. The association between HAP and neonatal (age between 0–28 days), infant (age between 0 and 11 months) and under–five (age between 0 and 59 months) mortality was examined using multilevel logistic regression models. HAP was not strongly associated with overall neonatal (OR = 1.49, 95% CI = 1.01–2.22, p = 0.043), infant (OR = 1.27, 95% CI = 0.91–1.77, p = 0.157) or under-five mortality (OR = 1.14, 95% CI = 0.83–1.55, p = 0.422) in the context of overall decreasing trends in under-five mortality. The association was stronger for households with an indoor kitchen using polluting fuels, and in women who had never breastfed. Reductions in exposure to pollution from cooking fuel, given it is a ubiquitous and modifiable risk factor, can result in further declines in under-five mortality with household design and behavioural interventions. PMID:26501296

  17. CPR - infant

    MedlinePlus

    ... small or loose parts, sharp edges, points, loose batteries, and other hazards. Create a safe environment. Watch ... infants and small children cannot reach buttons, watch batteries, popcorn, coins, grapes, or nuts. Sit with an ...

  18. Neutropenia - infants

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007230.htm Neutropenia - infants To use the sharing features on this page, please enable JavaScript. Neutropenia is an abnormally low number of white blood ...

  19. Infant reflexes

    MedlinePlus

    ... or her hips toward the touch in a dancing movement. Grasp reflex . This reflex occurs if you ... reflex occurs in slightly older infants when the child is held upright and the baby’s body is ...

  20. Infant reflexes

    MedlinePlus

    ... neck reflex; Galant reflex; Truncal incurvation; Rooting reflex; Parachute reflex; Grasp reflex ... was stroked and begin to make sucking motions. PARACHUTE REFLEX This reflex occurs in slightly older infants ...

  1. Macro-economic conditions and infant health: a changing relationship for black and white infants in the United States.

    PubMed

    Orsini, Chiara; Avendano, Mauricio

    2015-01-01

    We study whether the relationship between the state unemployment rate at the time of conception and infant health, infant mortality and maternal characteristics in the United States has changed over the years 1980-2004. We use microdata on births and deaths for years 1980-2004 and find that the relationship between the state unemployment rate at the time of conception and infant mortality and birthweight changes over time and is stronger for blacks than whites. For years 1980-1989 increases in the state unemployment rate are associated with a decline in infant mortality among blacks, an effect driven by mortality from gestational development and birth weight, and complications of placenta while in utero. In contrast, state economic conditions are unrelated to black infant mortality in years 1990-2004 and white infant mortality in any period, although effects vary by cause of death. We explore potential mechanisms for our findings and, including mothers younger than 18 in the analysis, uncover evidence of age-related maternal selection in response to the business cycle. In particular, in years 1980-1989 an increase in the unemployment rate at the time of conception is associated with fewer babies born to young mothers. The magnitude and direction of the relationship between business cycles and infant mortality differs by race and period. Age-related selection into motherhood in response to the business cycle is a possible explanation for this changing relationship. PMID:25974070

  2. Cefepime and Ceftazidime Safety in Hospitalized Infants

    PubMed Central

    Arnold, Christopher J.; Ericson, Jessica; Cho, Nathan; Tian, James; Wilson, Shelby; Chu, Vivian H.; Hornik, Christoph P.; Clark, Reese H.; Benjamin, Daniel K.; Smith, P. Brian

    2015-01-01

    Background Cefepime and ceftazidime are cephalosporins used for the treatment of serious gram-negative infections. These cephalosporins are used off-label in the setting of minimal safety data for young infants. Methods We identified all infants discharged from 348 neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2012 who were exposed to either cefepime or ceftazidime in the first 120 days of life. We reported clinical and laboratory adverse events occurring in infants exposed to cefepime or ceftazidime and used multivariable logistic regression to compare the odds of seizures and death between the 2 groups. Results A total of 1761 infants received 13,293 days of ceftazidime, and 594 infants received 4628 days of cefepime. Laboratory adverse events occurred more frequently on days of therapy with ceftazidime compared with cefepime (373 vs. 341 per 1000 infant days, p<0.001). Seizure was the most commonly observed clinical adverse event, occurring in 3% of ceftazidime-treated infants and 4% of cefepime-treated infants (p=0.52). Mortality was similar between the ceftazidime and cefepime groups (5% vs. 3%, p=0.07). There was no difference in the adjusted odds of seizure (odds ratio [OR] = 0.96 [95% confidence interval, 0.89–1.03]) or the combined outcome of mortality or seizures (OR = 1.00 [0.96–1.04]) in infants exposed to ceftazidime vs. those exposed to cefepime. Conclusions In this cohort of infants, cefepime was associated with fewer laboratory adverse events than ceftazidime, although this may have been due to a significant difference in clinical exposures and severity of illness between the 2 groups. There was no difference in seizure risk or mortality between the 2 drugs. PMID:26376308

  3. Transdermal estradiol treatment during breastfeeding: maternal and infant serum concentrations.

    PubMed

    Pinheiro, Emily; Bogen, Debra L; Hoxha, Denada; Wisner, Katherine L

    2016-04-01

    We examined estradiol (E2) and estrone (E1) concentrations in breastfeeding mother-infant dyads. The mothers had postpartum depression and were participants in a randomized clinical trial with three treatments (transdermal E2, sertraline, and placebo). Neither infant E1 and E2 concentrations nor infant growth differed across the treatments. Transdermal E2 administration of 50 to 200 mcg/day for breastfeeding women did not affect infant E1 or E2 concentrations or infant growth. PMID:25956588

  4. Infant-directed prosody helps infants map sounds to meanings

    PubMed Central

    Estes, Katharine Graf; Hurley, Karinna

    2012-01-01

    Adults typically use an exaggerated, distinctive speaking style when addressing infants. However, the effects of infant-directed (ID) speech on infants’ learning is not yet well understood. This research investigates how ID speech affects how infants perform a key function in language acquisition, associating the sounds of words with their meanings. Seventeen-month-old infants were presented with two label-object pairs in a habituation-based word learning task. In Experiment 1, the labels were produced in adult-directed (AD) speech. In Experiment 2, the labels were produced in ID prosody; they had higher pitch, greater pitch variation, and longer durations than the AD labels. We found that infants failed to learn the labels in AD speech, but succeeded in learning the same labels when they were produced in ID speech. Experiment 3 investigated the role of variability in learning from ID speech. When the labels were presented in ID prosody with no variation across tokens, infants failed to learn them. Our findings indicate that ID prosody can affect how readily infants map sounds to meanings and that the variability in prosody that is characteristic of ID speech may play a key role in its effect on learning new words. PMID:24244106

  5. Young Infants Match Facial and Vocal Emotional Expressions of Other Infants

    PubMed Central

    Vaillant-Molina, Mariana; Bahrick, Lorraine E.; Flom, Ross

    2013-01-01

    Research has demonstrated that infants recognize emotional expressions of adults in the first half-year of life. We extended this research to a new domain, infant perception of the expressions of other infants. In an intermodal matching procedure, 3.5- and 5-month-old infants heard a series of infant vocal expressions (positive and negative affect) along with side-by-side dynamic videos in which one infant conveyed positive facial affect and another infant conveyed negative facial affect. Results demonstrated that 5-month-olds matched the vocal expressions with the affectively congruent facial expressions, whereas 3.5-month-olds showed no evidence of matching. These findings indicate that by 5 months of age, infants detect, discriminate, and match the facial and vocal affective displays of other infants. Further, because the facial and vocal expressions were portrayed by different infants and shared no face-voice synchrony, temporal or intensity patterning, matching was likely based on detection of a more general affective valence common to the face and voice. PMID:24302853

  6. THE EFFECT OF PREGNANCY SPACING ON FETAL SURVIVAL AND NEONATAL MORTALITY IN RWANDA: A HECKMAN SELECTION ANALYSIS.

    PubMed

    Habimana-Kabano, Ignace; Broekhuis, Annelet; Hooimeijer, Pieter

    2016-05-01

    Most studies on birth intervals and infant mortality ignore pregnancies that do not result in live births. Yet, fetal deaths are important in infant mortality analyses for three reasons: ignoring fetal deaths between two live births lengthens the measured interval between births, implying that short intervals are underestimated; the recommended inter-pregnancy interval (IPI) after a fetal loss is shorter (6 months) than after a live birth (24 months), as the effect of IPI on outcomes might differ according to the previous type of pregnancy outcome; fetal death will selectively reduce the population at risk of neonatal mortality, leading to biased results. This study uses the Heckman selection model to simultaneously estimate the combined effect of IPI duration and the type of pregnancy outcome at the start of the interval on pregnancy survival and neonatal mortality. The analysis is based on retrospective data from the Rwanda Demographic Health Surveys of 2000, 2005 and 2010. The results show a significant selection effect. After controlling for the selection bias, short (60 months) intervals after a fetal death reduce the chances of pregnancy survival, but no longer have an effect on neonatal mortality. For intervals starting with a live birth, the reverse is true. Short intervals (<24 months) do not affect pregnancy survival but increase the odds of neonatal mortality. If the previous child died in infancy, the highest odds are found for neonatal death regardless of the IPI duration. PMID:26166680

  7. Serotonin’s role in piglet mortality and thriftiness

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Improving piglet survivability rates is of high priority for swine production as well as for piglet well-being. Dysfunction in the serotonin system has been associated with growth deficiencies, infant mortalities or failure to thrive in human infants. The aim of this research was to determine if a r...

  8. A role for serotonin in piglet preweaning mortality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Improving piglet survivability rate is of high priority for swine production as well as for piglet well-being. Dysfunction in the serotonin system has been associated with growth deficiencies, infant mortality or failure to thrive (FTT) in human infants. The aim of this study was to examine the role...

  9. Infant Cries Rattle Adult Cognition.

    PubMed

    Dudek, Joanna; Faress, Ahmed; Bornstein, Marc H; Haley, David W

    2016-01-01

    The attention-grabbing quality of the infant cry is well recognized, but how the emotional valence of infant vocal signals affects adult cognition and cortical activity has heretofore been unknown. We examined the effects of two contrasting infant vocalizations (cries vs. laughs) on adult performance on a Stroop task using a cross-modal distraction paradigm in which infant distractors were vocal and targets were visual. Infant vocalizations were presented before (Experiment 1) or during each Stroop trial (Experiment 2). To evaluate the influence of infant vocalizations on cognitive control, neural responses to the Stroop task were obtained by measuring electroencephalography (EEG) and event-related potentials (ERPs) in Experiment 1. Based on the previously demonstrated existence of negative arousal bias, we hypothesized that cry vocalizations would be more distracting and invoke greater conflict processing than laugh vocalizations. Similarly, we expected participants to have greater difficulty shifting attention from the vocal distractors to the target task after hearing cries vs. after hearing laughs. Behavioral results from both experiments showed a cry interference effect, in wh