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Sample records for large national birth

  1. Men with severe hemophilia in the United States: birth cohort analysis of a large national database

    PubMed Central

    Mazepa, Marshall A.; Baker, Judith R.; Riske, Brenda K.; Soucie, J. Michael

    2016-01-01

    The availability of longitudinal data collected prospectively from 1998 to 2011 at federally funded US hemophilia treatment centers provided an opportunity to construct a descriptive analysis of how outcomes of men with severe hemophilia have been altered by the incremental advances and setbacks in hemophilia care in the last 50 years in the United States. This surveillance collaboration with the US Centers for Disease Control and Prevention assembled the largest uniformly examined population with severe hemophilia (n = 4899 men with severe factor VIII and IX deficiency). To address the heterogeneity of this population, 4 successive birth cohorts, differentially affected by eras of hemophilia care, were examined separately in regard to demographics, complications of hemophilia and its treatment, and mortality. Severely affected men in each birth cohort were compared also with the corresponding mild hemophilia birth cohorts (n = 2587 men total) to control for outcomes that might be attributable to aging and environment independent of severely defective hemostasis. The analysis demonstrates improving access to standard of care therapy, correlating the proportion of men on prophylactic factor replacement and reduced bleeding frequency for the youngest men. Frequent bleeding persisted in one third to one half of men across all ages, however, and the disability gap between severe and mild hemophilia did not narrow. The greatest cause of death was liver failure, but attempted anti–hepatitis C virus therapy and cure were low. The study suggests a continued need for national surveillance to monitor and inform hemophilia interventions and outcomes. PMID:26983851

  2. School Readiness among Children of Immigrants in the US: Evidence from a Large National Birth Cohort Study

    PubMed Central

    Han, Wen-Jui; Lee, RaeHyuck; Waldfogel, Jane

    2012-01-01

    Using the Early Childhood Longitudinal Study-Birth Cohort (n ≈ 6,800), we examined the factors explaining variation in school readiness in a large and nationally representative sample of children in immigrant and non-immigrant families. In OLS regression models with rich controls to account for selection, we found that language background was a key factor in explaining children of immigrants’ expressive language and early reading at kindergarten, whereas both socioeconomic status and language background helped explain their performance in math. PMID:22711952

  3. Birth in Brazil: national survey into labour and birth

    PubMed Central

    2012-01-01

    Background Caesarean section rates in Brazil have been steadily increasing. In 2009, for the first time, the number of children born by this type of procedure was greater than the number of vaginal births. Caesarean section is associated with a series of adverse effects on the women and newborn, and recent evidence suggests that the increasing rates of prematurity and low birth weight in Brazil are associated to the increasing rates of Caesarean section and labour induction. Methods Nationwide hospital-based cohort study of postnatal women and their offspring with follow-up at 45 to 60 days after birth. The sample was stratified by geographic macro-region, type of the municipality and by type of hospital governance. The number of postnatal women sampled was 23,940, distributed in 191 municipalities throughout Brazil. Two electronic questionnaires were applied to the postnatal women, one baseline face-to-face and one follow-up telephone interview. Two other questionnaires were filled with information on patients’ medical records and to assess hospital facilities. The primary outcome was the percentage of Caesarean sections (total, elective and according to Robson’s groups). Secondary outcomes were: post-partum pain; breastfeeding initiation; severe/near miss maternal morbidity; reasons for maternal mortality; prematurity; low birth weight; use of oxygen use after birth and mechanical ventilation; admission to neonatal ICU; stillbirths; neonatal mortality; readmission in hospital; use of surfactant; asphyxia; severe/near miss neonatal morbidity. The association between variables were investigated using bivariate, stratified and multivariate model analyses. Statistical tests were applied according to data distribution and homogeneity of variances of groups to be compared. All analyses were taken into consideration for the complex sample design. Discussion This study, for the first time, depicts a national panorama of labour and birth outcomes in Brazil

  4. Birth in Brazil: national survey into labour and birth.

    PubMed

    do Carmo Leal, Maria; da Silva, Antônio Augusto Moura; Dias, Marcos Augusto Bastos; da Gama, Silvana Granado Nogueira; Rattner, Daphne; Moreira, Maria Elizabeth; Filha, Mariza Miranda Theme; Domingues, Rosa Maria Soares Madeira; Pereira, Ana Paula Esteves; Torres, Jacqueline Alves; Bittencourt, Sonia Duarte Azevedo; D'orsi, Eleonora; Cunha, Antonio Jla; Leite, Alvaro Jorge Madeiro; Cavalcante, Rejane Silva; Lansky, Sonia; Diniz, Carmem Simone Grilo; Szwarcwald, Célia Landmann

    2012-08-22

    Caesarean section rates in Brazil have been steadily increasing. In 2009, for the first time, the number of children born by this type of procedure was greater than the number of vaginal births. Caesarean section is associated with a series of adverse effects on the women and newborn, and recent evidence suggests that the increasing rates of prematurity and low birth weight in Brazil are associated to the increasing rates of Caesarean section and labour induction. Nationwide hospital-based cohort study of postnatal women and their offspring with follow-up at 45 to 60 days after birth. The sample was stratified by geographic macro-region, type of the municipality and by type of hospital governance. The number of postnatal women sampled was 23,940, distributed in 191 municipalities throughout Brazil. Two electronic questionnaires were applied to the postnatal women, one baseline face-to-face and one follow-up telephone interview. Two other questionnaires were filled with information on patients' medical records and to assess hospital facilities. The primary outcome was the percentage of Caesarean sections (total, elective and according to Robson's groups). Secondary outcomes were: post-partum pain; breastfeeding initiation; severe/near miss maternal morbidity; reasons for maternal mortality; prematurity; low birth weight; use of oxygen use after birth and mechanical ventilation; admission to neonatal ICU; stillbirths; neonatal mortality; readmission in hospital; use of surfactant; asphyxia; severe/near miss neonatal morbidity. The association between variables were investigated using bivariate, stratified and multivariate model analyses. Statistical tests were applied according to data distribution and homogeneity of variances of groups to be compared. All analyses were taken into consideration for the complex sample design. This study, for the first time, depicts a national panorama of labour and birth outcomes in Brazil. Regardless of the socioeconomic level

  5. The Danish National Quality Database for Births

    PubMed Central

    Andersson, Charlotte Brix; Flems, Christina; Kesmodel, Ulrik Schiøler

    2016-01-01

    Aim of the database The aim of the Danish National Quality Database for Births (DNQDB) is to measure the quality of the care provided during birth through specific indicators. Study population The database includes all hospital births in Denmark. Main variables Anesthesia/pain relief, continuous support for women in the delivery room, lacerations (third and fourth degree), cesarean section, postpartum hemorrhage, establishment of skin-to-skin contact between the mother and the newborn infant, severe fetal hypoxia (proportion of live-born children with neonatal hypoxia), delivery of a healthy child after an uncomplicated birth, and anesthesia in case of cesarean section. Descriptive data Data have been collected since 2010. As of August 2015, data on women and children representing 269,597 births and 274,153 children have been collected. All data for the DNQDB is collected from the Danish Medical Birth Registry. Registration to the Danish Medical Birth Registry is mandatory for all maternity units in Denmark. During the 5 years, performance has improved in the areas covered by the process indicators and for some of the outcome indicators. Conclusion Measuring quality of care during childbirth has inspired and enabled staff to attend to the quality of the care they provide and has led to improvements in most of the areas covered. PMID:27822105

  6. Laterality defects in the national birth defects prevention study 1998-2007 birth prevalence and descriptive epidemiology

    USDA-ARS?s Scientific Manuscript database

    Little is known epidemiologically about laterality defects. Using data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, we analyzed prevalence and selected characteristics in children born with laterality defects born from 1998 to 2007...

  7. Childhood cancer mortality and birth characteristics in Korea: a national population-based birth cohort study.

    PubMed

    Cha, Eun Shil; Kong, Kyoung Ae; Moon, Eun Kyeong; Khang, Young-Ho; Lee, Won Jin

    2011-03-01

    To examine the relationship between birth characteristics and childhood cancer mortality, a retrospective cohort study of Korean children was conducted using data collected by the national birth register between 1995 and 2006, which were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until their death or until December 31, 2006. Poisson regression analyses were used to calculate rate ratios of childhood cancer deaths according to birth characteristics. A total of 1,469 cancer deaths were noted and the childhood cancer mortality rate was found to be 3.43 per 100,000 person-years in Korea during the period of 1995-2006. The birth characteristics examined in this study (i.e. , birth weight, gestational age, multiple births, parental ages, and number of siblings) were generally found to be not significantly associated with childhood cancer mortality, and the associations did not vary meaningfully with gender nor with cancer sites. However, among children aged 5-11 yr, higher birth weight was associated with elevated childhood cancer mortality (rate ratio = 1.28, 95% confidence interval 1.04-1.58). Our results offer no overall associations between childhood cancer mortality and birth characteristics, but suggest that the association may be specific to age group.

  8. North-South Gradients in Adverse Birth Outcomes for First Nations and Others in Manitoba, Canada.

    PubMed

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

    2010-01-01

    OBJECTIVE: to determine the relationship of north-south place of residence to adverse birth outcomes among First Nations and non-First Nations in Manitoba, Canada, a setting with universal health insurance. STUDY DESIGN: Live birth records (n=151,472) for the province of Manitoba, Canada 1991-2000 were analyzed, including 25,743 First Nations and 125,729 non-First Nations infants. North-south and rural-urban residence was determined for each birth through geocoding. RESULTS: Comparing First Nations to non-First Nations, crude rates in North (and South) were: 7.0% versus 8.4% (9.3% versus 7.5%) for preterm birth; 6.1% versus 8.4% (8.7% versus 10.0%) for small-for-gestational-age birth, 4.2% versus 6.5% (6.2% versus 5.7%) for low birth weight, and 20.6% versus 13.7% (17.0% versus 11.0%) for large-for-gestational-age birth; and mortality per 1000 - neonatal 3.2 versus 6.2 (3.8 versus 3.3), post-neonatal 6.4 versus 6.4 (5.8 versus 1.5), and infant 9.5 versus 12.6 (9.6 versus 4.8). Adjusting for observed maternal and infant characteristics and rural versus urban residence, the North was high risk for large-for-gestational-age birth for both First Nations and non-First Nations. First Nations' risk of preterm, small-for-gestational-age and low birth weight was lowest in the North, but for non-First Nations, the North was lower only for small-for-gestational-age. First Nations mortality indicators were similar North to South, but for non-First Nations, the North was high risk. CONCLUSION: North-South place of residence does matter for adverse birth outcomes, but the effects may differ by ethnicity and could require different intervention strategies.

  9. North-South Gradients in Adverse Birth Outcomes for First Nations and Others in Manitoba, Canada

    PubMed Central

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

    2012-01-01

    Objective to determine the relationship of north-south place of residence to adverse birth outcomes among First Nations and non-First Nations in Manitoba, Canada, a setting with universal health insurance. Study Design Live birth records (n=151,472) for the province of Manitoba, Canada 1991–2000 were analyzed, including 25,743 First Nations and 125,729 non-First Nations infants. North-south and rural-urban residence was determined for each birth through geocoding. Results Comparing First Nations to non-First Nations, crude rates in North (and South) were: 7.0% versus 8.4% (9.3% versus 7.5%) for preterm birth; 6.1% versus 8.4% (8.7% versus 10.0%) for small-for-gestational-age birth, 4.2% versus 6.5% (6.2% versus 5.7%) for low birth weight, and 20.6% versus 13.7% (17.0% versus 11.0%) for large-for-gestational-age birth; and mortality per 1000 - neonatal 3.2 versus 6.2 (3.8 versus 3.3), post-neonatal 6.4 versus 6.4 (5.8 versus 1.5), and infant 9.5 versus 12.6 (9.6 versus 4.8). Adjusting for observed maternal and infant characteristics and rural versus urban residence, the North was high risk for large-for-gestational-age birth for both First Nations and non-First Nations. First Nations’ risk of preterm, small-for-gestational-age and low birth weight was lowest in the North, but for non-First Nations, the North was lower only for small-for-gestational-age. First Nations mortality indicators were similar North to South, but for non-First Nations, the North was high risk. Conclusion North-South place of residence does matter for adverse birth outcomes, but the effects may differ by ethnicity and could require different intervention strategies. PMID:22523523

  10. Application of data screening to drug exposure in large risk factor studies of birth defects.

    PubMed

    Louik, Carol; Werler, Martha; Anderka, Marlene; Mitchell, Allen A

    2015-08-01

    Birth defects are the leading cause of infant death. While causes of most are unknown, those that might be due to medication use are among the most preventable. This study describes an approach to identifying those medications that most warrant attention by using a "screen" program that calculates odds ratios for pairs of exposures and specific birth defects. We discuss the development of this tool and illustrate its application to two large risk factor studies, the Slone Epidemiology Center's Birth Defects Study and the Centers for Disease Control and Prevention's National Birth Defects Prevention Study, ideal settings for the systematic study of risks and relative safety of drugs in relation to birth defects while recognizing the inherent limitations of such an approach. Suggestions for establishing criteria for exposures and outcomes that balance the need for specific details with the practical considerations of sample size and volume of output are presented. Selection of appropriate exposure reference categories and control groups is also discussed, as well as the need to address potential confounding. An example that motivated a detailed investigation of possible associations between a medication (butalbital) and selected specific birth defects is provided. While screening programs such as the one described can be a valuable tool for exploring potential associations in large data bases, they must be applied with caution. The issue of multiple testing and chance findings is a major concern. While statistics are a necessary component, human judgment must be an integral part of the process. © 2015 Wiley Periodicals, Inc.

  11. Maternal autoimmune disease and birth defects in the National Birth Defects Prevention Study.

    PubMed

    Howley, Meredith M; Browne, Marilyn L; Van Zutphen, Alissa R; Richardson, Sandra D; Blossom, Sarah J; Broussard, Cheryl S; Carmichael, Suzan L; Druschel, Charlotte M

    2016-11-01

    Little is known about the association between maternal autoimmune disease or its treatment and the risk of birth defects. We examined these associations using data from the National Birth Defects Prevention Study, a multi-site, population-based, case-control study. Analyses included 25,116 case and 9897 unaffected control infants with estimated delivery dates between 1997 and 2009. Information on autoimmune disease, medication use, and other pregnancy exposures was collected by means of telephone interview. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for birth defects with five or more exposed cases; crude ORs and exact 95% CIs were estimated for birth defects with three to four exposed cases. Autoimmune disease was reported by 373 mothers (279 case and 94 control mothers). The majority of birth defects evaluated were not associated with autoimmune disease; however, a statistically significant association between maternal autoimmune disease and encephalocele was observed (OR, 4.64; 95% CI, 1.95-11.04). Eighty-two mothers with autoimmune disease used an immune modifying/suppressing medication during pregnancy; this was associated with encephalocele (OR, 7.26; 95% CI, 1.37-24.61) and atrial septal defects (OR, 3.01; 95% CI, 1.16-7.80). Our findings suggest maternal autoimmune disease and treatment are not associated with the majority of birth defects, but may be associated with some defects, particularly encephalocele. Given the low prevalence of individual autoimmune diseases and the rare use of specific medications, we were unable to examine associations of specific autoimmune diseases and medications with birth defects. Other studies are needed to confirm these findings. Birth Defects Research (Part A) 106:950-962, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

    PubMed

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

    2017-05-01

    The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. D. W. Griffith's Controversial Film, "The Birth of a Nation."

    ERIC Educational Resources Information Center

    Pitcher, Conrad

    1999-01-01

    Presents a lesson plan that enables students to investigate race relations during the Progressive Era by analyzing D. W. Griffith's "The Birth of a Nation" and the controversy surrounding the release of the film. Explores the pros and cons of using motion pictures as teaching tool. Includes two student handouts. (CMK)

  14. D. W. Griffith's Controversial Film, "The Birth of a Nation."

    ERIC Educational Resources Information Center

    Pitcher, Conrad

    1999-01-01

    Presents a lesson plan that enables students to investigate race relations during the Progressive Era by analyzing D. W. Griffith's "The Birth of a Nation" and the controversy surrounding the release of the film. Explores the pros and cons of using motion pictures as teaching tool. Includes two student handouts. (CMK)

  15. Paternal occupation and birth defects: findings from the National Birth Defects Prevention Study

    PubMed Central

    Desrosiers, Tania A.; Herring, Amy H.; Shapira, Stuart K.; Hooiveld, Mariette; Luben, Tom J.; Herdt-Losavio, Michele L.; Lin, Shao; Olshan, Andrew F.

    2013-01-01

    Objectives Several epidemiologic studies have suggested that certain paternal occupations may be associated with an increased prevalence of birth defects in offspring. Using data from the National Birth Defects Prevention Study, we investigated the association between paternal occupation and birth defects in a case-control study of cases comprising over 60 different types of birth defects (n = 9998) and non-malformed controls (n = 4066) with dates of delivery between 1997 and 2004. Methods Using paternal occupational histories reported by mothers via telephone interview, jobs were systematically classified into 63 groups based on shared exposure profiles within occupation and industry. Data were analyzed using Bayesian logistic regression with a hierarchical prior for dependent shrinkage to stabilize estimation with sparse data. Results Several occupations were associated with an increased prevalence of various birth defect categories, including: mathematical, physical and computer scientists; artists; photographers and photo processors; food service workers; landscapers and groundskeepers; hairdressers and cosmetologists; office and administrative support workers; sawmill workers; petroleum and gas workers; chemical workers; printers; material moving equipment operators; and motor vehicle operators. Conclusions Findings from this study might be used to identify specific occupations worthy of further investigation, and to generate hypotheses about chemical or physical exposures common to such occupations. PMID:22782864

  16. Paternal occupation and birth defects: findings from the National Birth Defects Prevention Study.

    PubMed

    Desrosiers, Tania A; Herring, Amy H; Shapira, Stuart K; Hooiveld, Mariëtte; Luben, Tom J; Herdt-Losavio, Michele L; Lin, Shao; Olshan, Andrew F

    2012-08-01

    Several epidemiological studies have suggested that certain paternal occupations may be associated with an increased prevalence of birth defects in offspring. Using data from the National Birth Defects Prevention Study, the authors investigated the association between paternal occupation and birth defects in a case-control study of cases comprising over 60 different types of birth defects (n=9998) and non-malformed controls (n=4066) with dates of delivery between 1997 and 2004. Using paternal occupational histories reported by mothers via telephone interview, jobs were systematically classified into 63 groups based on shared exposure profiles within occupation and industry. Data were analysed using bayesian logistic regression with a hierarchical prior for dependent shrinkage to stabilise estimation with sparse data. Several occupations were associated with an increased prevalence of various birth defect categories, including mathematical, physical and computer scientists; artists; photographers and photo processors; food service workers; landscapers and groundskeepers; hairdressers and cosmetologists; office and administrative support workers; sawmill workers; petroleum and gas workers; chemical workers; printers; material moving equipment operators; and motor vehicle operators. Findings from this study might be used to identify specific occupations worthy of further investigation and to generate hypotheses about chemical or physical exposures common to such occupations.

  17. Occupational Lifting, Fetal Death and Preterm Birth: Findings from the Danish National Birth Cohort Using a Job Exposure Matrix

    PubMed Central

    Mocevic, Emina; Svendsen, Susanne Wulff; Jørgensen, Kristian Tore; Frost, Poul; Bonde, Jens Peter

    2014-01-01

    Objective We examined the association between occupational lifting during pregnancy and risk of fetal death and preterm birth using a job exposure matrix (JEM). Methods For 68,086 occupationally active women in the Danish National Birth Cohort, interview information on occupational lifting was collected around gestational week 16. We established a JEM based on information from women, who were still pregnant when interviewed. The JEM provided mean total loads lifted per day within homogeneous exposure groups as informed by job and industry codes. All women were assigned an exposure estimate from the JEM. We used Cox regression models with gestational age as underlying time variable and adjustment for covariates. Results We observed 2,717 fetal deaths and 3,128 preterm births within the study cohort. No exposure-response relation was observed for fetal death, but for women with a prior fetal death, we found a hazard ratio (HR) of 2.87 (95% CI 1.37, 6.01) for stillbirth (fetal death ≥22 completed gestational weeks) among those who lifted >200 kg/day. For preterm birth, we found an exposure-response relation for primigravid women, reaching a HR of 1.43 (95% CI 1.13, 1.80) for total loads >200 kg per day. These findings correspond to an excess fraction of 11% for stillbirth and 10% for preterm birth. Conclusion We found an increased risk of stillbirth among women with a prior fetal death, who lifted >200 kg/day, and an exposure-response relationship between occupational lifting and preterm birth among primigravid women. The study adds to a large body of prospective studies on occupational lifting and adverse pregnancy outcomes by refined exposure assessment. PMID:24614129

  18. Occupational lifting, fetal death and preterm birth: findings from the Danish National Birth Cohort using a job exposure matrix.

    PubMed

    Mocevic, Emina; Svendsen, Susanne Wulff; Jørgensen, Kristian Tore; Frost, Poul; Bonde, Jens Peter

    2014-01-01

    We examined the association between occupational lifting during pregnancy and risk of fetal death and preterm birth using a job exposure matrix (JEM). For 68,086 occupationally active women in the Danish National Birth Cohort, interview information on occupational lifting was collected around gestational week 16. We established a JEM based on information from women, who were still pregnant when interviewed. The JEM provided mean total loads lifted per day within homogeneous exposure groups as informed by job and industry codes. All women were assigned an exposure estimate from the JEM. We used Cox regression models with gestational age as underlying time variable and adjustment for covariates. We observed 2,717 fetal deaths and 3,128 preterm births within the study cohort. No exposure-response relation was observed for fetal death, but for women with a prior fetal death, we found a hazard ratio (HR) of 2.87 (95% CI 1.37, 6.01) for stillbirth (fetal death ≥22 completed gestational weeks) among those who lifted >200 kg/day. For preterm birth, we found an exposure-response relation for primigravid women, reaching a HR of 1.43 (95% CI 1.13, 1.80) for total loads >200 kg per day. These findings correspond to an excess fraction of 11% for stillbirth and 10% for preterm birth. We found an increased risk of stillbirth among women with a prior fetal death, who lifted >200 kg/day, and an exposure-response relationship between occupational lifting and preterm birth among primigravid women. The study adds to a large body of prospective studies on occupational lifting and adverse pregnancy outcomes by refined exposure assessment.

  19. Birth defects, causal attributions, and ethnicity in the national birth defects prevention study.

    PubMed

    Case, Amy P; Royle, Marjorie; Scheuerle, Angela E; Carmichael, Suzan L; Moffitt, Karen; Ramadhani, Tunu

    2014-10-01

    In order to translate research findings into effective prevention strategies, it is important to understand people's beliefs about the causes of poor health outcomes. However, with the exception of knowledge and beliefs about folic acid supplementation, little is known regarding women's causal attributions women regarding birth defects. We employed Attribution Theory constructs to analyze open-text interview responses from 2,672 control mothers in the National Birth Defects Prevention Study who gave birth in 1997-2005. Common themes included use of alcohol, tobacco, illicit drugs, and medications during pregnancy. Stress and emotional upset were also suggested as possible causes of birth defects. Genetic- and heredity-related responses were more likely to be mentioned by Asian/Pacific Islander women compared to non-Hispanic Whites. Hispanic women were less likely to suggest several specific possible teratogens, such as paint, pesticides, or other chemicals, but were more likely to suggest events occurring during childbirth. Differences also emerged among ethnic groups for theoretical constructs, although most responses were categorized as controllable, changeable over time, and with an internal locus of causality.

  20. Maternal intake of vitamin E and birth defects, National Birth Defects Prevention Study, 1997–2005

    PubMed Central

    Gilboa, Suzanne M.; Lee, Kyung A.; Cogswell, Mary E.; Traven, Flavia K.; Botto, Lorenzo D.; Riehle-Colarusso, Tiffany; Correa, Adolfo; Boyle, Coleen A.

    2015-01-01

    Background In a recent study, high maternal periconceptional intake of vitamin E was found to be associated with risk of congenital heart defects (CHDs). To explore this association further, we investigated the association between total daily vitamin E intake and selected birth defects. Methods We analyzed data from 4,525 controls and 8,665 cases from the 1997–2005 National Birth Defects Prevention Study. We categorized estimated periconceptional energy-adjusted total daily vitamin E intake from diet and supplements into quartiles (referent, lowest quartile). Associations between quartiles of energy-adjusted vitamin E intake and selected birth defects were adjusted for demographic, lifestyle, and nutritional factors. Results We observed a statistically significant association with the third quartile of vitamin E intake (OR 1.17; 95% CI 1.01 – 1.35) and all CHDs combined. Among CHD sub-types, we observed associations with left ventricular outflow tract obstruction defects, and its sub-type, coarctation of the aorta and the third quartile of vitamin E intake. Among defects other than CHDs, we observed associations between anorectal atresia and the third quartile of vitamin E intake (OR 1.66; 95% CI 1.01 – 2.72) and hypospadias and the fourth quartile of vitamin E intake (OR 1.42; 95% CI 1.09 – 1.87). Conclusions Selected quartiles of energy-adjusted estimated total daily vitamin E intake were associated with selected birth defects. However, because these few associations did not exhibit exposure-response patterns consistent with increasing risk associated with increasing intake of vitamin E, further studies are warranted to corroborate our findings. PMID:24740457

  1. Laterality Defects in the National Birth Defects Prevention Study (1998–2007): Birth Prevalence and Descriptive Epidemiology

    PubMed Central

    Lin, Angela E.; Krikov, Sergey; Riehle-Colarusso, Tiffany; Frías, Jaime L.; Belmont, John; Anderka, Marlene; Geva, Tal; Getz, Kelly D.; Botto, Lorenzo D.

    2015-01-01

    Little is known epidemiologically about laterality defects. Using data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, we analyzed prevalence and selected characteristics in children born with laterality defects born from 1998 to 2007. We identified 517 nonsyndromic cases (378 heterotaxy, 73.1%; 139 situs inversus totalis [SIT], 26.9%) resulting in an estimated birth prevalence of 1.1 per 10,000 live births (95% confidence interval 1.0–1.2). Prevalence did not differ significantly across sites, over time, or by inclusion of pregnancy termination. Laterality defects were more common among preterm cases compared to term cases, and in children born to mothers who were non-white or younger than 20 years compared to white mothers or those age 25–29 years. The distribution of associated cardiac and extracardiac defects, excluding the expected heterotaxy anomalies, varied by type of laterality defect. Cases with heterotaxy were significantly more likely than those with SIT to have double outlet right ventricle, atrioventricular canal defects, pulmonary stenosis, non-tetralogy of Fallot pulmonary atresia with ventricular septal defect, totally and partially anomalous pulmonary venous return; also more likely to have orofacial clefts, esophageal atresia, bowel atresias, and omphalocele, though not reaching statistical significance. Relatively more common among cases with SIT were Dandy-Walker malformation, anotia/microtia, and limb deficiency. The similarity in the demographic characteristics of heterotaxy and SIT supports the hypothesis that they are part of a continuum of abnormal left-right axis patterning. These findings on laterality defects may help guide clinical care, future research, and prevention strategies. PMID:25099286

  2. Maternal caffeine intake and risk of selected birth defects in the National Birth Defects Prevention Study.

    PubMed

    Browne, Marilyn L; Hoyt, Adrienne T; Feldkamp, Marcia L; Rasmussen, Sonja A; Marshall, Elizabeth G; Druschel, Charlotte M; Romitti, Paul A

    2011-02-01

    Caffeine intake is common during pregnancy, yet few epidemiologic studies have examined the association between maternal caffeine consumption and birth defects. Using data from the National Birth Defects Prevention Study (NBDPS), we examined the association between maternal caffeine consumption and anotia/microtia, esophageal atresia, small intestinal atresia, craniosynostosis, diaphragmatic hernia, omphalocele, and gastroschisis. The NBDPS is a multi-site population-based case-control study. The present analysis included 3,346 case infants and 6,642 control infants born from October 1997 through December 2005. Maternal telephone interview reports of demographic characteristics and conditions and exposures before and during pregnancy were collected. Odds ratios and 95% confidence intervals, adjusted for relevant covariates, were calculated to estimate the associations between maternal dietary caffeine intake (coffee, tea, soda, and chocolate) and maternal use of caffeine-containing medications and each defect. We observed small, statistically significant elevations in adjusted odds ratios ranging from 1.3 to 1.8 for total maternal dietary caffeine intake or specific types of caffeinated beverages and anotia/microtia, esophageal atresia, small intestinal atresia, and craniosynostosis; however, dose-response patterns were absent. Periconceptional use of caffeine-containing medications was infrequent and estimates were imprecise. We did not find convincing evidence of an association between maternal caffeine intake and the birth defects included in this study. The increasing popularity of caffeine-containing energy drinks and other caffeinated products may result in higher caffeine intake among women of childbearing age. Future studies should consider more detailed evaluation of such products. Copyright © 2010 Wiley-Liss, Inc.

  3. Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey.

    PubMed

    Fleming, Susan E; Donovan-Batson, Colleen; Burduli, Ekaterina; Barbosa-Leiker, Celestina; Hollins Martin, Caroline J; Martin, Colin R

    2016-10-01

    to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R). a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected using electronic linkages (Qualtrics(™)). a convenience sample of childbearing women (n=2229) who had planned to birth in their home or birth center from the US (United States) participated. Participants were recruited via professional and personal contacts, primarily their midwives. the total 30-item BSS score mean was 128.98 (SD 16.92) and the 10-item BSS-R mean score was 31.94 (SD 6.75). Sub-scale mean scores quantified the quality of care provision, women's personal attributes, and stress experienced during labour. Satisfaction was higher for women with vaginal births compared with caesareans deliveries. In addition, satisfaction was higher for women who had both planned to deliver in a home or a birth centre, and who had actually delivered in a home or a birth center. total and subscale birth satisfaction scores were positive and high for the overall sample IMPLICATIONS FOR PRACTICE: the BSS and the BSS-R provide a robust tool to quantify women's experiences of childbirth between variables such as birth types, birth settings and providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. The National Birth Defects Prevention Study: A review of the methods.

    PubMed

    Reefhuis, Jennita; Gilboa, Suzanne M; Anderka, Marlene; Browne, Marilyn L; Feldkamp, Marcia L; Hobbs, Charlotte A; Jenkins, Mary M; Langlois, Peter H; Newsome, Kimberly B; Olshan, Andrew F; Romitti, Paul A; Shapira, Stuart K; Shaw, Gary M; Tinker, Sarah C; Honein, Margaret A

    2015-08-01

    The National Birth Defects Prevention Study (NBDPS) is a large population-based multicenter case-control study of major birth defects in the United States. Data collection took place from 1998 through 2013 on pregnancies ending between October 1997 and December 2011. Cases could be live born, stillborn, or induced terminations, and were identified from birth defects surveillance programs in Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas, and Utah. Controls were live born infants without major birth defects identified from the same geographical regions and time periods as cases by means of either vital records or birth hospitals. Computer-assisted telephone interviews were completed with women between 6 weeks and 24 months after the estimated date of delivery. After completion of interviews, families received buccal cell collection kits for the mother, father, and infant (if living). There were 47,832 eligible cases and 18,272 eligible controls. Among these, 32,187 (67%) and 11,814 (65%), respectively, provided interview information about their pregnancies. Buccal cell collection kits with a cytobrush for at least one family member were returned by 19,065 case and 6,211 control families (65% and 59% of those who were sent a kit). More than 500 projects have been proposed by the collaborators and over 200 manuscripts published using data from the NBDPS through December 2014. The NBDPS has made substantial contributions to the field of birth defects epidemiology through its rigorous design, including case classification, detailed questionnaire and specimen collection, large study population, and collaborative activities across Centers. © 2015 Wiley Periodicals, Inc.

  5. The National Birth Defects Prevention Study: a review of the methods

    PubMed Central

    Reefhuis, Jennita; Gilboa, Suzanne M.; Anderka, Marlene; Browne, Marilyn L.; Feldkamp, Marcia L.; Hobbs, Charlotte A.; Jenkins, Mary M.; Langlois, Peter H.; Newsome, Kimberly B.; Olshan, Andrew F.; Romitti, Paul A.; Shapira, Stuart K.; Shaw, Gary M.; Tinker, Sarah C.; Honein, Margaret A.

    2015-01-01

    Background The National Birth Defects Prevention Study (NBDPS) is a large population-based multi-center case-control study of major birth defects in the United States. Methods Data collection took place from 1998 through 2013 on pregnancies ending between October 1997 and December 2011. Cases could be live born, stillborn or induced terminations, and were identified from birth defects surveillance programs in Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas and Utah. Controls were live born infants without major birth defects identified from the same geographical regions and time periods as cases via either vital records or birth hospitals. Computer-assisted telephone interviews were completed with women between 6 weeks and 24 months after the estimated date of delivery. After completion of interviews, families received buccal cell collection kits for the mother, father and infant (if living). Results There were 47,832 eligible cases and 18,272 eligible controls. Among these, 32,187 (67%) and 11,814 (65%) respectively, provided interview information about their pregnancies. Buccal cell collection kits with a cytobrush for at least one family member were returned by 19,065 case and 6,211 control families (65% and 59% of those who were sent a kit). More than 500 projects have been proposed by the collaborators and over 200 manuscripts published using data from the NBDPS through December 2014. Conclusion The NBDPS has made substantial contributions to the field of birth defects epidemiology through its rigorous design, including case classification, detailed questionnaire and specimen collection, large study population, and collaborative activities across Centers. PMID:26033852

  6. Birth of a nation: family planning in Albania.

    PubMed

    Geary, J

    1994-01-01

    Albania's entrance into the world community has exposed some of the consequences of a pronatalist policy of 40 years; high infant and maternal mortality, illegal clandestine abortions leading to morbidity and death, and high fertility at 3.3 children per woman in 1990. The crude birth rate was 25.2 per 1000. The communist dictator Enver Hohxa used extreme measures with his secret police to enforce repressive policies. Birth control was forbidden to be even discussed, and sex was absent from medical literature. The current population of Albania is 3.3 million, with 66% living in remote mountain villages. A national family planning program is currently underway. The goals are to reduce mortality, reduce premature births by 20%, and achieve contraceptive usage among 10% of the reproductive age populations. Medical personnel will be trained in family planning, and family planning will be introduced in the entire health education program. Reliance will be placed on the existing extensive system of primary health care (PHC) facilities. The outreach effort to the 700,000 women of reproductive age will involve all health care professionals. Information, education, and communication will be the main thrust of the program. A model family planning clinic will be established at the Maternity Hospital at Tirana, which already has a teaching capacity for training of medical students, midwives, and nurses. Although a PHC system is in place, buildings and equipment are out of data. The health personnel of the program are excited by the challenge of providing reproductive health care for an woman's entire reproductive life. A new family planning clinic has already been established in Elbasan, a remote village south of Tirana, but public response has been mixed. Another clinic north of tirana has a population that is enthusiastic about family planning, even with a clinic not as well equipped as in Elbasan. The educational outreach must include doctors as well, who have only read

  7. Variations in Teenage Birth Rates, 1991-98: National and State Trends.

    ERIC Educational Resources Information Center

    Ventura, Stephanie J.; Curtin, Sally C.; Mathews, T. J.

    2000-01-01

    This report presents national birth rates for teenagers for 1991-1998 and the percent change from 1991 to 1998. State-specific teenage birth rates by age, race, and Hispanic origin for 1991 and 1998, and the percent change, 1991 to 1998, are also presented. Tabular and graphical descriptions of the trends in teenage birth rates for the United…

  8. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort

    PubMed Central

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten; Bille, Camilla; Olsen, Jørn

    2006-01-01

    Objectives To examine whether infertile couples (with a time to pregnancy of > 12 months), who conceive naturally or after treatment, give birth to children with an increased prevalence of congenital malformations. Design Longitudinal study. Setting Danish national birth cohort. Participants Three groups of liveborn children and their mothers: 50 897 singletons and 1366 twins born of fertile couples (time to pregnancy ≤ 12 months), 5764 singletons and 100 twins born of infertile couples who conceived naturally (time to pregnancy > 12 months), and 4588 singletons and 1690 twins born after infertility treatment. Main outcome measures Prevalence of congenital malformations determined from hospital discharge diagnoses. Results Compared with singletons born of fertile couples, singletons born of infertile couples who conceived naturally or after treatment had a higher prevalence of congenital malformations—hazard ratios 1.20 (95% confidence interval 1.07 to 1.35) and 1.39 (1.23 to 1.57). The overall prevalence of congenital malformations increased with increasing time to pregnancy. When the analysis was restricted to singletons born of infertile couples, babies born after treatment had an increased prevalence of genital organ malformations (hazard ratio 2.32, 1.24 to 4.35) compared with babies conceived naturally. No significant differences existed in the overall prevalence of congenital malformations among twins. Conclusions Hormonal treatment for infertility may be related to the occurrence of malformations of genital organs, but our results suggest that the reported increased prevalence of congenital malformations seen in singletons born after assisted reproductive technology is partly due to the underlying infertility or its determinants. The association between untreated infertility and congenital malformations warrants further examination. PMID:16893903

  9. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort.

    PubMed

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten; Bille, Camilla; Olsen, Jørn

    2006-09-30

    To examine whether infertile couples (with a time to pregnancy of > 12 months), who conceive naturally or after treatment, give birth to children with an increased prevalence of congenital malformations. Longitudinal study. Danish national birth cohort. Three groups of liveborn children and their mothers: 50,897 singletons and 1366 twins born of fertile couples (time to pregnancy < or = 12 months), 5764 singletons and 100 twins born of infertile couples who conceived naturally (time to pregnancy > 12 months), and 4588 singletons and 1690 twins born after infertility treatment. Prevalence of congenital malformations determined from hospital discharge diagnoses. Compared with singletons born of fertile couples, singletons born of infertile couples who conceived naturally or after treatment had a higher prevalence of congenital malformations-hazard ratios 1.20 (95% confidence interval 1.07 to 1.35) and 1.39 (1.23 to 1.57). The overall prevalence of congenital malformations increased with increasing time to pregnancy. When the analysis was restricted to singletons born of infertile couples, babies born after treatment had an increased prevalence of genital organ malformations (hazard ratio 2.32, 1.24 to 4.35) compared with babies conceived naturally. No significant differences existed in the overall prevalence of congenital malformations among twins. Hormonal treatment for infertility may be related to the occurrence of malformations of genital organs, but our results suggest that the reported increased prevalence of congenital malformations seen in singletons born after assisted reproductive technology is partly due to the underlying infertility or its determinants. The association between untreated infertility and congenital malformations warrants further examination.

  10. Invited commentary: two studies of genetic control of birth weight where large data sets were available.

    PubMed

    Beaty, T H

    2007-04-01

    Physical size at birth (primarily birth weight) is a key predictor of infant mortality and morbidity and may serve as a predictor of risk to chronic disease in adulthood. By use of birth records, it is sometimes possible to accumulate large, even massive, data sets that can permit analyses to separate genetic and environmental factors controlling variation in the complex phenotype, birth weight. Two studies of birth records, one from Norway and one from Lebanon, demonstrate how hospital- or registry-based data sets can be used to address fundamental questions about genetic control. The Medical Birth Registry of Norway has birth certificate data dating back to 1967 and allowed nuclear families to be reconstructed by linking children and their parents. Path models were used to estimate heritability of head circumference, along with birth weight and length for over 100,000 reconstructed families. A hospital-based study of birth records in Beirut, Lebanon, collected information on over 10,000 births, including sufficient numbers of marriages between first and second cousins to estimate inbreeding effects. Both of these studies confirm that birth weight is not simply due to the direct effects of the baby's genes but is a complex phenotype reflecting the effects of maternal genes and environments.

  11. Maternal occupation and the risk of birth defects: an overview from the National Birth Defects Prevention Study.

    PubMed

    Herdt-Losavio, M L; Lin, S; Chapman, B R; Hooiveld, M; Olshan, A; Liu, X; DePersis, R D; Zhu, J; Druschel, C M

    2010-01-01

    To examine the association between a spectrum of 24 maternal occupations and 45 birth defects for hypothesis generating purposes. Cases of isolated and multiple birth defects (n = 8977) and all non-malformed live-born control births (n = 3833) included in the National Birth Defects Prevention Study (NBDPS) with estimated dates of delivery from 1 October 1997 through 31 December 2003 were included. A computer-assisted telephone interview with mothers was conducted. Occupational coding using the 2000 Standard Occupational Classification System and the 1997 North American Industry Classification System was completed for all jobs held by mothers. Jobs held from 1 month before pregnancy to the end of the third pregnancy month were considered exposures. Logistic regression models were run, adjusted for potential confounders. We also used a Bayesian approach to logistic regression. Approximately 72% of case mothers and 72% of control mothers in the NBDPS were employed. Several occupational groups were positively associated with one or more birth defects, including janitors/cleaners, scientists and electronic equipment operators. Using standard logistic regression, we found 42 (26 for Bayesian) significantly elevated risks of birth defects in offspring of working mothers. In addition, several other occupational groups were found to be negatively associated with one or more birth defects, including teachers and healthcare workers. Using standard logistic regression, we found 12 (11 for Bayesian) significantly reduced risks of birth defects among offspring of working women. Results from these analyses can be used for hypothesis generating purposes and guiding future investigations of occupational exposures and birth defects.

  12. Elevated maternal C-reactive protein and increased risk of schizophrenia in a national birth cohort.

    PubMed

    Canetta, Sarah; Sourander, Andre; Surcel, Heljä-Marja; Hinkka-Yli-Salomäki, Susanna; Leiviskä, Jaana; Kellendonk, Christoph; McKeague, Ian W; Brown, Alan S

    2014-09-01

    The objective of the present study was to investigate an association between early gestational C-reactive protein, an established inflammatory biomarker, prospectively assayed in maternal sera, and schizophrenia in a large, national birth cohort with an extensive serum biobank. A nested case-control design from the Finnish Prenatal Study of Schizophrenia cohort was utilized. A total of 777 schizophrenia cases (schizophrenia, N=630; schizoaffective disorder, N=147) with maternal sera available for C-reactive protein testing were identified and matched to 777 control subjects in the analysis. Maternal C-reactive protein levels were assessed using a latex immunoassay from archived maternal serum specimens. Increasing maternal C-reactive protein levels, classified as a continuous variable, were significantly associated with schizophrenia in offspring (adjusted odds ratio=1.31, 95% confidence interval=1.10-1.56). This finding remained significant after adjusting for potential confounders, including maternal and parental history of psychiatric disorders, twin/singleton birth, urbanicity, province of birth, and maternal socioeconomic status. This finding provides the most robust evidence to date that maternal inflammation may play a significant role in schizophrenia, with possible implications for identifying preventive strategies and pathogenic mechanisms in schizophrenia and other neurodevelopmental disorders.

  13. Pre-Pregnancy Dating Violence and Birth Outcomes Among Adolescent Mothers in a National Sample.

    PubMed

    Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W

    2014-07-01

    Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birth weight and gestational age of infants born to adolescent mothers. Data from the National Longitudinal Study of Adolescent Health Waves I (1995/1996), II (1996), and IV (2007/2008) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (N = 558) self-reported infants' birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age, parent education, age at pregnancy, time between reporting abuse and birth, and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black).On average, births occurred 2 years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birth weight and prevalence of verbal dating violence victimization were significantly lower in Black compared with non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birth weight (p< .001) and 4.72 fewer weeks gestational age (p< .01) for Black mothers who gave birth 2 years post-reporting abuse. Physical dating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers. Reducing physical dating violence in adolescent relationships prior to

  14. Sex-specific associations between birth weight and adult primary liver cancer in a large cohort of Danish children.

    PubMed

    Zimmermann, Esther; Berentzen, Tina L; Gamborg, Michael; Sørensen, Thorkild I A; Baker, Jennifer L

    2016-03-15

    Whether the prenatal period is critical for the development of adult primary liver cancer (PLC) is sparsely investigated. Recently, attention has been drawn to potential sex-differences in the early origins of adult disease. The association between birth weight and adult PLC, separately in men and women was investigated, using a large cohort of 217,227 children (51% boys), born from 1936 to 1980, from the Copenhagen School Health Records Register, and followed them until 2010 in national registers. Hazard ratios (95% confidence intervals) of PLC (30 years or older) were estimated by Cox regression models stratified by birth cohort. During 5.1 million person-years of follow-up, 185 men and 65 women developed PLC. Sex modified the association between birth weight and adult PLC (p values for interaction = 0.0005). Compared with a sex-specific reference group of birth weights between 3.25 and 3.75 kg, men with birth weights between 2.00 and 3.25 kg and 3.75-5.50 kg, had HRs of 1.48 (1.06-2.05) and 0.85 (0.56-1.28), respectively. Among women the corresponding HRs were 1.71 (0.90-3.29) and 3.43 (1.73-6.82). Associations were similar for hepatocellular carcinoma only, across year of birth, and after accounting for diagnoses of alcohol-related disorders, viral hepatitis and biliary cirrhosis. Prenatal exposures influenced the risk of adult PLC, and the effects at the high birth weight levels appeared to be sex-specific. These findings underscore the importance of considering sex-specific mechanisms in the early origins of adult PLC. © 2015 UICC.

  15. The Association Between Reported Venlafaxine Use in Early Pregnancy and Birth Defects, National Birth Defects Prevention Study, 1997–2007

    PubMed Central

    Polen, Kara ND; Rasmussen, Sonja A; Riehle-Colarusso, Tiffany; Reefhuis, Jennita

    2015-01-01

    Background Few epidemiologic studies have investigated the use of venlafaxine (Effexor®), an antidepressant used to treat major depression and anxiety disorders in adults, during pregnancy. Our objective was to determine whether use of venlafaxine during pregnancy is associated with specific birth defects. Methods We used data from the National Birth Defects Prevention Study (NBDPS), a population-based, case-control study in the United States. Our analysis included mothers with pregnancies affected by one of 30 selected birth defects (cases) and babies without birth defects (controls) with estimated dates of delivery between 1997–2007. Exposure was any reported use of venlafaxine from one month preconception through the third month of pregnancy. We calculated adjusted odds ratios (aORs) and 95% Fisher’s Exact confidence intervals (CIs) for 24 birth defect groups for which at least 400 case mothers were interviewed. Our adjusted analyses controlled for maternal age and race-ethnicity. Results Among the 27,045 NBDPS participants who met inclusion criteria, 0.17% (14/8,002) of control mothers and 0.40% (77/19,043) of case mothers reported any use of venlafaxine from one month preconception through the third month of pregnancy. Statistically significant associations were found for anencephaly, atrial septal defect (ASD) secundum or ASD not otherwise specified, coarctation of the aorta, cleft palate, and gastroschisis. Conclusions Our data suggest associations between periconceptional use of venlafaxine and some birth defects. However, sample sizes were small, confidence intervals were wide, and additional studies are needed to confirm these results. PMID:23281074

  16. Association between reported venlafaxine use in early pregnancy and birth defects, national birth defects prevention study, 1997-2007.

    PubMed

    Polen, Kara N D; Rasmussen, Sonja A; Riehle-Colarusso, Tiffany; Reefhuis, Jennita

    2013-01-01

    Few epidemiologic studies have investigated the use of venlafaxine (Effexor XR capsules, Product Monograph, Wyeth, Montreal, Canada), an antidepressant used to treat major depression and anxiety disorders in adults, during pregnancy. Our objective was to determine whether use of venlafaxine during pregnancy is associated with specific birth defects. We used data from the National Birth Defects Prevention Study (NBDPS), a population-based, case-control study in the United States. Our analysis included mothers with pregnancies affected by one of 30 selected birth defects (cases) and babies without birth defects (controls) with estimated dates of delivery between 1997 and 2007. Exposure was any reported use of venlafaxine from 1 month preconception through the third month of pregnancy. We calculated adjusted odds ratios (aORs) and 95% Fisher Exact confidence intervals (CIs) for 24 birth defect groups for which at least 400 case mothers were interviewed. Our adjusted analyses controlled for maternal age and race/ethnicity. Among the 27,045 NBDPS participants who met inclusion criteria, 0.17% (14/8002) of control mothers and 0.40% (77/19,043) of case mothers reported any use of venlafaxine from 1 month preconception through the third month of pregnancy. Statistically significant associations were found for anencephaly, atrial septal defect (ASD) secundum, or ASD not otherwise specified, coarctation of the aorta, cleft palate, and gastroschisis. Our data suggest associations between periconceptional use of venlafaxine and some birth defects. However, sample sizes were small, CIs were wide, and additional studies are needed to confirm these results. Copyright © 2012 Wiley Periodicals, Inc.

  17. Hypothyroxinemia During Gestation and Offspring Schizophrenia in a National Birth Cohort.

    PubMed

    Gyllenberg, David; Sourander, Andre; Surcel, Heljä-Marja; Hinkka-Yli-Salomäki, Susanna; McKeague, Ian W; Brown, Alan S

    2016-06-15

    Evidence from animal and human studies indicates that thyroid hormone deficiency during early gestation alters brain development. As schizophrenia is associated with prenatal brain insults and premorbid cognitive deficits, we tested the a priori hypothesis that serologically defined maternal thyroid deficiency during early gestation to mid-gestation is associated with schizophrenia in offspring. The investigation is based on the Finnish Prenatal Study of Schizophrenia, a nested case-control study that included archived maternal sera from virtually all pregnancies since 1983 (N = >1 million). We identified all offspring in the cohort with a diagnosis of schizophrenia based on the national inpatient and outpatient register and matched them on sex, date of birth, and residence in Finland at time of onset of the case to comparison subjects (1:1) from the cohort. Maternal sera of 1010 case-control pairs were assessed for free thyroxine, and sera of 948 case-control pairs were assessed for thyroid-stimulating hormone. Maternal hypothyroxinemia (free thyroxine ≤10th percentile, normal thyroid-stimulating hormone) was associated with an increased odds of schizophrenia (odds ratio = 1.75, 95% confidence interval = 1.22-2.50, p = .002). When adjusted for maternal psychiatric history, province of birth, and maternal smoking during pregnancy, the association remained significant (odds ratio = 1.70, 95% confidence interval = 1.13-2.55, p = .010). In a large, national birth cohort, prospectively documented hypothyroxinemia during early gestation to mid-gestation was associated with increased odds of schizophrenia in offspring. This information can inform translational studies of maternal hypothyroxinemia examining molecular and cellular deviations relevant to schizophrenia. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2010-01-01

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

  19. Birth of a Large Iceberg in Pine Island Bay, Antarctica

    NASA Image and Video Library

    2001-11-14

    A large tabular iceberg (42 kilometers x 17 kilometers) broke off Pine Island Glacier, West Antarctica (75ºS latitude, 102ºW longitude) sometime between November 4 and 12, 2001. Images of the glacier were acquired by the Multi-angle Imaging SpectroRadiometer (MISR) instrument aboard NASA's Terra spacecraft. This event was preceded by the formation of a large crack across the glacier in mid 2000. Data gathered by other imaging instruments revealed the crack to be propagating through the shelf ice at a rate averaging 15 meters per day, accompanied by a slight rotation of about one percent per year at the seaward margin of the rift. The image set shows three views of Pine Island Glacier acquired by MISR's vertical-viewing (nadir) camera. The first was captured in late 2000, early in the development of the crack. The second and third views were acquired in November 2001, just before and just after the new iceberg broke off. The existence of the crack took the glaciological community by surprise, and the rapid rate at which the crack propagated was also not anticipated. Glaciologists predicted that the rift would reach the other side of the glacier sometime in 2002. However, the iceberg detached much sooner than anticipated, and the last 10-kilometer segment that was still attached to the ice shelf snapped off in a matter of days. http://photojournal.jpl.nasa.gov/catalog/PIA03431

  20. Evidence of economic deprivation and female foeticide in a United Nations global births by gender data set.

    PubMed

    Grech, Victor

    2015-12-01

    The male-to-female ratio of live births is expressed as the ratio of male births divided by total births (M/F). Males are produced approximately 3% in excess. A large number of factors have been found to influence M/F. Stress and privation reduces M/F. Gender preference (which almost invariably favours males) with selective female foetal abortion increases M/F. This study was carried out in order to assess a United Nations data set for evidence of global trends in M/F in relation to broad socioeconomic conditions and male preference. Data (M/F and total births, 1955-2009) was obtained from the United Nations (UN) Department of Economic and Social Affairs, Population Division, Population Estimates and Projection Section. The following regions were analysed: more developed countries, less developed countries and least developed countries (as defined by the UN General Assembly). More developed countries: M/F was initially stable at 0.53 up to 1979 then fell to 0.525. Less developed countries: M/F was initially stable at 0.53 then rose after 1984 to 0.545 with a rise in male births and a fall in female births (estimated female birth deficit=48734993). Least developed countries: exhibited a stable M/F of 0.52 (all p<0.001). This study has confirmed, on a global scale, that least developed countries have the lowest M/F. The rise in M/F in developed countries (which includes Asia) confirms widespread selective female foeticide due to cultural male preference. The declining trend in M/F in developed countries has been previously noted and remains unexplained. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Birth of a Large Iceberg in Pine Island Bay, Antarctica

    NASA Technical Reports Server (NTRS)

    2001-01-01

    A large tabular iceberg (42 kilometers x 17 kilometers) broke off Pine Island Glacier, West Antarctica (75oS latitude, 102oW longitude) sometime between November 4 and 12, 2001. Images of the glacier were acquired by the Multi-angle Imaging SpectroRadiometer (MISR) instrument aboard NASA's Terra spacecraft. This event was preceded by the formation of a large crack across the glacier in mid 2000. Data gathered by other imaging instruments revealed the crack to be propagating through the shelf ice at a rate averaging 15 meters per day, accompanied by a slight rotation of about one percent per year at the seaward margin of the rift.

    The image set shows three views of Pine Island Glacier acquired by MISR's vertical-viewing (nadir) camera. The first was captured in late 2000, early in the development of the crack. The second and third views were acquired in November 2001, just before and just after the new iceberg broke off. The existence of the crack took the glaciological community by surprise, and the rapid rate at which the crack propagated was also not anticipated. Glaciologists predicted that the rift would reach the other side of the glacier sometime in 2002. However, the iceberg detached much sooner than anticipated, and the last 10-kilometer segment that was still attached to the ice shelf snapped off in a matter of days.

    The animated sequence consists of 11 snapshots acquired by MISR's nadir camera between September 16, 2000 and November 12, 2001. Due to frequent cloud cover, the time interval between successive frames is not uniform. The flow of the glacier, widening of the rift, and subsequent break-off of the iceberg are evident. A 'jump' in the position of the rift near the middle of the sequence is due to a gap in image acquisition during Antarctic winter, when the glacier was in continuous darkness.

    Pine Island Glacier is the largest discharger of ice in Antarctica and the continent's fastest moving glacier. This area of the West

  2. Birth of a Large Iceberg in Pine Island Bay, Antarctica

    NASA Technical Reports Server (NTRS)

    2001-01-01

    A large tabular iceberg (42 kilometers x 17 kilometers) broke off Pine Island Glacier, West Antarctica (75oS latitude, 102oW longitude) sometime between November 4 and 12, 2001. Images of the glacier were acquired by the Multi-angle Imaging SpectroRadiometer (MISR) instrument aboard NASA's Terra spacecraft. This event was preceded by the formation of a large crack across the glacier in mid 2000. Data gathered by other imaging instruments revealed the crack to be propagating through the shelf ice at a rate averaging 15 meters per day, accompanied by a slight rotation of about one percent per year at the seaward margin of the rift.

    The image set shows three views of Pine Island Glacier acquired by MISR's vertical-viewing (nadir) camera. The first was captured in late 2000, early in the development of the crack. The second and third views were acquired in November 2001, just before and just after the new iceberg broke off. The existence of the crack took the glaciological community by surprise, and the rapid rate at which the crack propagated was also not anticipated. Glaciologists predicted that the rift would reach the other side of the glacier sometime in 2002. However, the iceberg detached much sooner than anticipated, and the last 10-kilometer segment that was still attached to the ice shelf snapped off in a matter of days.

    The animated sequence consists of 11 snapshots acquired by MISR's nadir camera between September 16, 2000 and November 12, 2001. Due to frequent cloud cover, the time interval between successive frames is not uniform. The flow of the glacier, widening of the rift, and subsequent break-off of the iceberg are evident. A 'jump' in the position of the rift near the middle of the sequence is due to a gap in image acquisition during Antarctic winter, when the glacier was in continuous darkness.

    Pine Island Glacier is the largest discharger of ice in Antarctica and the continent's fastest moving glacier. This area of the West

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

    PubMed Central

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

    2011-01-01

    Objective We assessed individual- and community-level disparities and trends in birth outcomes and infant mortality among First Nations (North American Indians) and Inuit versus other populations in Quebec, Canada. Methods A retrospective birth cohort study of all births to Quebec residents, 1991–2000. At the individual level, we examined outcomes comparing births to First Nations and Inuit versus other mother tongue women. At the community level, we compared outcomes among First Nations and Inuit communities versus other communities. Results First Nations and Inuit births were much less likely to be small-for-gestational-age but much more likely to be large-for-gestational-age compared to other births at the individual or community level, especially for First Nations. At both levels, Inuit births were 1.5 times as likely to be preterm. At the individual level, total fetal and infant mortality rates were 2 times as high for First Nations, and 3 times as high for Inuit. Infant mortality rates were 2 times as high for First Nations, and 4 times as high for Inuit. There were no reductions in these disparities between 1991–1995 and 1996–2000. Modestly smaller disparities in total fetal and infant mortality were observed for First Nations at the community level (risk ratio=1.6), but for Inuit there were similar disparities at both levels. These disparities remained substantial after adjusting for maternal characteristics. Conclusion There were large and persistent disparities in fetal and infant mortality among First Nations and Inuit versus other populations in Quebec based on individual- or community-level assessments, indicating a need to improve socioeconomic conditions as well as perinatal and infant care for Aboriginal peoples. PMID:22282716

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

    PubMed

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

    2010-01-01

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

  5. References of birth weights for gestational age and sex from a large cohort of singleton births in cameroon.

    PubMed

    Kemfang Ngowa, Jean Dupont; Domkam, Irénée; Ngassam, Anny; Nguefack-Tsague, Georges; Dobgima Pisoh, Walter; Noa, Cyrille; Kasia, Jean Marie

    2014-01-01

    Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

  6. Elevated maternal C-reactive protein and autism in a national birth cohort.

    PubMed

    Brown, A S; Sourander, A; Hinkka-Yli-Salomäki, S; McKeague, I W; Sundvall, J; Surcel, H-M

    2014-02-01

    Autism is a complex neuropsychiatric syndrome with a largely unknown etiology. Inflammation during pregnancy may represent a common pathway by which infections and other insults increase risk for the disorder. Hence, we investigated the association between early gestational C-reactive protein (CRP), an established inflammatory biomarker, prospectively assayed in maternal sera, and childhood autism in a large national birth cohort with an extensive serum biobank. Other strengths of the cohort included nearly complete ascertainment of pregnancies in Finland (N=1.2 million) over the study period and national psychiatric registries consisting of virtually all treated autism cases in the population. Increasing maternal CRP levels, classified as a continuous variable, were significantly associated with autism in offspring. For maternal CRP levels in the highest quintile, compared with the lowest quintile, there was a significant, 43% elevated risk. This finding suggests that maternal inflammation may have a significant role in autism, with possible implications for identifying preventive strategies and pathogenic mechanisms in autism and other neurodevelopmental disorders.

  7. Elevated Maternal C-Reactive Protein and Autism in a National Birth Cohort

    PubMed Central

    Brown, Alan S.; Sourander, Andre; Hinkka-Yli-Salomäki, Susanna; McKeague, Ian W.; Sundvall, Jouko; Surcel, Helja-Marja

    2012-01-01

    Autism is a complex neuropsychiatric syndrome with a largely unknown etiology. Inflammation during pregnancy may represent a common pathway by which infections and other insults increase risk for the disorder. Hence, we investigated the association between early gestational C-reactive protein (CRP), an established inflammatory biomarker, prospectively assayed in maternal sera, and childhood autism in a large national birth cohort with an extensive serum biobank. Other strengths of the cohort included nearly complete ascertainment of pregnancies in Finland (N=1.2 million) over the study period and national psychiatric registries consisting of virtually all treated autism cases in the population. Increasing maternal CRP levels, classified as a continuous variable, were significantly associated with autism in offspring. For maternal CRP levels in the highest quintile, compared to the lowest quintile, there was a significant, 43% elevated risk. This finding suggests that maternal inflammation may play a significant role in autism, with possible implications for identifying preventive strategies and pathogenic mechanisms in autism and other neurodevelopmental disorders. PMID:23337946

  8. British National Formulary: its birth, death, and rebirth.

    PubMed Central

    Wade, O L

    1993-01-01

    The British National Formulary is a direct descendant of the National War Formulary, in which the titles of the preparations were in Latin and the doses in minims and grains. The British National Formulary was born in 1948, did a good job for about 20 years, but sickened and died in 1976. It was reborn in 1981. Parturition was painful with a very hostile reception from the media and the drug industry, but it survived and has grown in stature. The 25th edition was published in February. Wish it well for the next 25 issues! Images p1052-a p1053-a PMID:8490505

  9. Premature Birth and Large for Gestational Age Are Associated with Risk of Barrett's Esophagus in Adults.

    PubMed

    Shiota, Seiji; El-Serag, Hashem B; Thrift, Aaron P

    2016-04-01

    Birth characteristics, including weight and gestational age, may be associated with risk of Barrett's esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited. To examine associations between various birth characteristics and BE, and whether these associations are mediated by known risk factors for BE. Data were obtained from a cross-sectional study among eligible Veterans Affairs patients scheduled for an upper endoscopy, and a sample identified from primary care clinics. Participants underwent an esophagogastroduodenoscopy and completed a survey that captured information on sociodemographic and clinical factors, as well as birth information. We compared 263 patients with histologically confirmed BE to 1416 controls without BE on endoscopy. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using multivariate logistic regression. Premature birth was independently associated with risk of BE after adjusted by age, sex, race, and other birth characteristics (OR 3.28, 95 % CI 1.22-8.79). On the other hand, large for gestational age was inversely associated with risk of BE (OR 0.46, 95 % CI 0.21-0.98). These effects were stronger for patients with long-segment BE than with short-segment BE. The associations were not mediated by gastroesophageal reflux disease symptoms, use of proton pump inhibitors, Helicobacter Pylori infection, waist-hip-ratio, height or the presence of hiatus hernia. Premature birth and large for gestational age may be associated with risk of BE in adults. These associations do not appear to be mediated through known risk factors for BE; however, additional studies are required to confirm our findings.

  10. Large prospective birth cohort studies on environmental contaminants and child health - goals, challenges, limitations and needs.

    PubMed

    Luo, Zhong-Cheng; Liu, Jian-Meng; Fraser, William D

    2010-02-01

    The adverse health effects of environmental contaminants (ECs) are a rising public health concern, and a major threat to sustainable socioeconomic development. The developing fetuses and growing children are particularly vulnerable to the adverse effects of ECs. However, assessing the health impact of ECs presents a major challenge, given that multiple outcomes may arise from one exposure, multiple exposures may result in one outcome, and the complex interactions between ECs, and between ECs, nutrients and genetic factors, and the dynamic temporal changes in EC exposures during the life course. Large-scale prospective birth cohort studies collecting extensive data and specimen starting from the prenatal or pre-conception period, although costly, hold promise as a means to more clearly quantify the health effects of ECs, and to unravel the complex interactions between ECs, nutrients and genotypes. A number of such large-scale studies have been launched in some developed counties. We present an overview of "why", "what" and "how" behind these efforts with an objective to uncover major unidentified limitations and needs. Three major limitations were identified: (1) limited data and bio-specimens regarding early life EC exposure assessments in some birth cohort studies; (2) heavy participant burdens in some birth cohort studies may bias participant recruitment, and risk substantial loss to follow-up, protocol deviations limiting the quality of data and specimens collection, with an overall potential bias towards the null effect; (3) lack of concerted efforts in building comparable birth cohorts across countries to take advantage of natural "experiments" (large EC exposure level differences between countries) for more in-depth assessments of dose-response relationships, threshold exposure levels, and positive and negative effect modifiers. Addressing these concerns in current or future large-scale birth cohort studies may help to produce better evidence on the health

  11. Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study

    PubMed Central

    2014-01-01

    Background Maternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers. Methods Data from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents’ grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures. Results Among Black adolescents, those who ever skipped a grade had higher offspring’s birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring’s birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations. Conclusions Some indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers. PMID:24422664

  12. Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study.

    PubMed

    Xie, Yiqiong; Harville, Emily Wheeler; Madkour, Aubrey Spriggs

    2014-01-15

    Maternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers. Data from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents' grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures. Among Black adolescents, those who ever skipped a grade had higher offspring's birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring's birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations. Some indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers.

  13. Occupational lifting during pregnancy and child's birth size in a large cohort study.

    PubMed

    Juhl, Mette; Larsen, Pernille Stemann; Andersen, Per Kragh; Svendsen, Susanne Wulff; Bonde, Jens Peter; Nybo Andersen, Anne-Marie; Strandberg-Larsen, Katrine

    2014-07-01

    It has been suggested that the handling of heavy loads during pregnancy is associated with impaired fetal growth. We examined the association between quantity and frequency of maternal occupational lifting and the child's size at birth, measured by weight, length, ponderal index, small-for-gestational-age (SGA), abdominal circumference, head circumference, and placental weight. We analyzed birth size from the Danish Medical Birth Registry of 66 693 live-born children in the Danish National Birth Cohort according to the mother's self-reported information on occupational lifting from telephone interviews around gestational week 16. Data were collected in the period 1996-2002. We used linear and logistic regression models and adjusted for confounders. In the fully adjusted models, most of the mean differences in birth size measures had values indicating a smaller size of offspring among women with occupational lifting versus women with no lifting, but the differences were very small, and there was a statistically significant trend only for placental weight showing lighter weight with increasing number of kilos lifted per day. In jobs likely to include person-lifting, we found increased odds of SGA among children of women who lifted 501-1000 kilos per day [odds ratio (OR) 1.34, 95% confidence interval (95% CI) 0.98-1.83] and >1000 kilos per day (OR 1.51, 95% CI 0.83-2.76) compared to no lifting. In jobs with no person-lifting, occupational lifting was not associated with SGA. Overall, we observed no strong support for an association between maternal occupational lifting and impaired size at birth. Our data indicated a potential association between lifting and SGA among offspring of women in occupations that are likely to include person-lifting. These results should, however, be interpreted with caution due to limited statistical power, and we suggest that future studies include detailed, individual information on job functions and ergonomic routines of lifting

  14. History, Hypermedia and the Birth of a Nation.

    ERIC Educational Resources Information Center

    Messing, J.; McLachlan, R.

    The use of computer technology in history instruction permits students to explore the data, and formulate and test their own hypotheses within the confines of the data, rather than being passive receptors of someone else's interpretations. The Gallipoli project brought together materials from a national war archive to develop a multimedia teaching…

  15. The National University of Zaire: Birth, Organizational Structure and Development

    ERIC Educational Resources Information Center

    Ngobaasu, Akwesi

    1974-01-01

    The National University of Zaire was established in 1971 from the merger of three formerly independent universities and 17 institutions of higher learning. The reform changed higher education administrative organization, emphasized African culture and Africanization of the academic staff, and achieved statutory integration of the university into…

  16. A shift toward birthing relatively large infants early in human evolution.

    PubMed

    DeSilva, Jeremy M

    2011-01-18

    It has long been argued that modern human mothers give birth to proportionately larger babies than apes do. Data presented here from human and chimpanzee infant:mother dyads confirm this assertion: humans give birth to infants approximately 6% of their body mass, compared with approximately 3% for chimpanzees, even though the female body weights of the two species are moderately convergent. Carrying a relatively large infant both pre- and postnatally has important ramifications for birthing strategies, social systems, energetics, and locomotion. However, it is not clear when the shift to birthing large infants occurred over the course of human evolution. Here, known and often conserved relationships between adult brain mass, neonatal brain mass, and neonatal body mass in anthropoids are used to estimate birthweights of extinct hominid taxa. These estimates are resampled with direct measurements of fossil postcrania from female hominids, and also compared with estimates of female body mass to assess when human-like infant:mother mass ratios (IMMRs) evolved. The results of this study suggest that 4.4-Myr-old Ardipithecus possessed IMMRs similar to those found in African apes, indicating that a low IMMR is the primitive condition in hominids. Australopithecus females, in contrast, had significantly heavier infants compared with dimensions of the femoral head (n = 7) and ankle (n = 7) than what is found in chimpanzees, and are estimated to have birthed neonates more than 5% of their body mass. Carrying such proportionately large infants may have limited arboreality in Australopithecus females and may have selected for alloparenting behavior earlier in human evolution than previously thought.

  17. A shift toward birthing relatively large infants early in human evolution

    PubMed Central

    2011-01-01

    It has long been argued that modern human mothers give birth to proportionately larger babies than apes do. Data presented here from human and chimpanzee infant:mother dyads confirm this assertion: humans give birth to infants approximately 6% of their body mass, compared with approximately 3% for chimpanzees, even though the female body weights of the two species are moderately convergent. Carrying a relatively large infant both pre- and postnatally has important ramifications for birthing strategies, social systems, energetics, and locomotion. However, it is not clear when the shift to birthing large infants occurred over the course of human evolution. Here, known and often conserved relationships between adult brain mass, neonatal brain mass, and neonatal body mass in anthropoids are used to estimate birthweights of extinct hominid taxa. These estimates are resampled with direct measurements of fossil postcrania from female hominids, and also compared with estimates of female body mass to assess when human-like infant:mother mass ratios (IMMRs) evolved. The results of this study suggest that 4.4-Myr-old Ardipithecus possessed IMMRs similar to those found in African apes, indicating that a low IMMR is the primitive condition in hominids. Australopithecus females, in contrast, had significantly heavier infants compared with dimensions of the femoral head (n = 7) and ankle (n = 7) than what is found in chimpanzees, and are estimated to have birthed neonates more than 5% of their body mass. Carrying such proportionately large infants may have limited arboreality in Australopithecus females and may have selected for alloparenting behavior earlier in human evolution than previously thought. PMID:21199942

  18. Effect of Embryo Banking on U.S. National Assisted Reproductive Technology Live Birth Rates

    PubMed Central

    Kushnir, Vitaly A.; Barad, David H.; Albertini, David F.; Darmon, Sarah K.; Gleicher, Norbert

    2016-01-01

    Background Assisted Reproductive Technology (ART) reports generated by the Centers for Disease Control and Prevention (CDC) exclude embryo banking cycles from outcome calculations. Methods We examined data reported to the CDC in 2013 for the impact of embryo banking exclusion on national ART outcomes by recalculating autologous oocyte ART live birth rates. Inflation of reported fresh ART cycle live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births with reference to number of initiated fresh cycles (excluding embryo banking cycles), as typically reported by the CDC, and fresh cycle live births with reference to total initiated fresh ART cycles (including embryo banking cycles). Results During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7%) involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women <35 years to 56.5% in women >44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P <0.0001). Exclusion of embryo banking cycles led to inflation of live birth rates in fresh ART cycles, increasing in size in parallel to advancing female age and utilization of embryo banking, reaching 56.3% in women age >44. The inflation of live birth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater. Conclusions Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women. Précis Exclusion of embryo banking cycles from US National Assisted Reproductive Technology outcome reports significantly inflates reported success rates especially in older women. PMID:27159215

  19. Effect of Embryo Banking on U.S. National Assisted Reproductive Technology Live Birth Rates.

    PubMed

    Kushnir, Vitaly A; Barad, David H; Albertini, David F; Darmon, Sarah K; Gleicher, Norbert

    2016-01-01

    Assisted Reproductive Technology (ART) reports generated by the Centers for Disease Control and Prevention (CDC) exclude embryo banking cycles from outcome calculations. We examined data reported to the CDC in 2013 for the impact of embryo banking exclusion on national ART outcomes by recalculating autologous oocyte ART live birth rates. Inflation of reported fresh ART cycle live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births with reference to number of initiated fresh cycles (excluding embryo banking cycles), as typically reported by the CDC, and fresh cycle live births with reference to total initiated fresh ART cycles (including embryo banking cycles). During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7%) involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women <35 years to 56.5% in women >44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P <0.0001). Exclusion of embryo banking cycles led to inflation of live birth rates in fresh ART cycles, increasing in size in parallel to advancing female age and utilization of embryo banking, reaching 56.3% in women age >44. The inflation of live birth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater. Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women. Exclusion of embryo banking cycles from US National Assisted Reproductive Technology outcome reports significantly inflates reported success rates especially in older women.

  20. Pre-pregnancy Dating Violence and Birth Outcomes among Adolescent Mothers in a National Sample

    PubMed Central

    Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W.

    2015-01-01

    Background Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birthweight and gestational age of infants born to adolescent mothers. Methods Data from the National Longitudinal Study of Adolescent Health Waves I (1995/96), II (1996), and IV (2007/08) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (n=558) self-reported infants’ birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age; parent education; age at pregnancy; time between reporting abuse and birth; and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black). Results On average, births occurred two years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birthweight and prevalence of verbal dating violence victimization were significantly lower in Black compared to non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birthweight (p<.001) and 4.72 fewer weeks gestational age (p<0.01) for Black mothers who gave birth two years post-reporting abuse. Physical dating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers. Conclusions Reducing physical dating violence in

  1. Longitudinal Rates and Risk Factors for Adverse Birth Weight Among First Nations Pregnancies in Alberta.

    PubMed

    Oster, Richard Thomas; Toth, Ellen Louise

    2016-01-01

    We wished to identify the prevalence, longitudinal trends, and associated risk factors for various birth weight categories by First Nations ethnicity in the province of Alberta. We performed a retrospective analysis of administrative data for the years 2000 to 2009 inclusive. Age-adjusted prevalence trends for high birth weight (HBW; > 4000g), very HBW (> 4500g), low birth weight (LBW; < 2500g), and very LBW (< 1500g) were compared via average annual percent change analyses. Logistic regression analysis was used to determine risk factors. First Nations ethnicity was a significant independent predictor of HBW (OR 1.82 [95% CI 1.75, 1.89]), very HBW (OR 2.35 [95% CI 2.18, 2.52]), and very LBW (OR 1.35 [95% CI 1.23, 1.48]), but not of LBW (OR 0.98 [95% CI 0.93, 1.03]). However, HBW prevalence decreased and other birth weight categories remained stable over time in First Nations populations. Gestational diabetes and maternal weight ≥ 91 kg were potentially manageable risk factors for HBW. Potentially manageable risk factors for LBW included pre-gestational renal disease, hypertension, and maternal weight ≤ 45 kg, as well as smoking, illicit drug dependence, and alcohol consumption. Although HBW, very HBW, and very LBW remain more common in Alberta First Nations populations than in the general population, their prevalence is not increasing. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  2. Congenital malformations in Ecuadorian children: urgent need to create a National Registry of Birth Defects

    PubMed Central

    González-Andrade, Fabricio; López-Pulles, Ramiro

    2010-01-01

    Aim This study sets out (a) to estimate the prevalence of admissions by birth defects, using the official database of hospitals of Ecuador; and (b) to set the basis for a new National Register of Birth Defects in Ecuador that works as a program for the clinical and epidemiological investigation of risk factors in the etiology of congenital anomalies in Ecuadorian hospitals, using a case-control methodological approach. This is the first report in their class. Methods The data used in this study are derived from the National Register of Hospital Admission/Discharges of the Instituto Nacional de Estadísticas y Censos; data of the Ministry of Public Health were also used. Ecuador does not have an official Medical Birth Registry or a Congenital Malformations Registry. Results A total of 51,375 discharges by congenital malformations were registered in a 7-year period. Of these, 16,679 admissions were of children aged less than 1 year of age, with a birth prevalence rate (BPR) of 72.33/10,000 births. 77% of the congenital defects registered comprise the 50 most common birth defects observed in this age group. Cleft lip was the most prevalent birth defect in children less than 1 year of age and the second most common defect in children 1 to 5 years of age. Unilateral cleft lip shows a BPR of 4.57/10,000 births; cardiac birth defects as a group have a BPR of 4.2; hydrocephalus a BPR of 3.77; and Down’s syndrome a BPR of 3.70. Undescended testicle was the most prevalent birth defect in children between 1 to 5 years. 9384 children under 1 year of age were male (55.9%) and 7053 were female (42.1%). BPR in males was 40.45 and in females 30.40. Conclusion This report documents the prevalence estimates for birth defects reported in the hospital discharge data. These estimates are important to 1) plan for health-care and education needs of the Ecuadorian population, 2) identify increased occurrences of birth defects in specific geographic regions, 3) serve as a reference point

  3. Mode of birth and medical interventions among women at low risk of complications: A cross-national comparison of birth settings in England and the Netherlands

    PubMed Central

    Peters, Lilian; Geerts, Caroline C.; van Roosmalen, Jos J. M.; Twisk, Jos W. R.; Brocklehurst, Peter; Hollowell, Jennifer

    2017-01-01

    Objectives To compare mode of birth and medical interventions between broadly equivalent birth settings in England and the Netherlands. Methods Data were combined from the Birthplace study in England (from April 2008 to April 2010) and the National Perinatal Register in the Netherlands (2009). Low risk women in England planning birth at home (16,470) or in freestanding midwifery units (11,133) were compared with Dutch women with planned home births (40,468). Low risk English women with births planned in alongside midwifery units (16,418) or obstetric units (19,096) were compared with Dutch women with planned midwife-led hospital births (37,887). Results CS rates varied across planned births settings from 6.5% to 15.5% among nulliparous and 0.6% to 5.1% among multiparous women. CS rates were higher among low risk nulliparous and multiparous English women planning obstetric unit births compared to Dutch women planning midwife-led hospital births (adjusted (adj) OR 1.89 (95% CI 1.64 to 2.18) and 3.66 (2.90 to 4.63) respectively). Instrumental vaginal birth rates varied from 10.7% to 22.5% for nulliparous and from 0.9% to 5.7% for multiparous women. Rates were lower in the English comparison groups apart from planned births in obstetric units. Transfer, augmentation and episiotomy rates were much lower in England compared to the Netherlands for all midwife-led groups. In most comparisons, epidural rates were higher among English groups. Conclusions When considering maternal outcomes, findings confirm advantages of giving birth in midwife-led settings for low risk women. Further research is needed into strategies to decrease rates of medical intervention in obstetric units in England and to reduce rates of avoidable transfer, episiotomy and augmentation of labour in the Netherlands. PMID:28749944

  4. Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort.

    PubMed

    Viner, R M; Taylor, B

    2007-10-01

    The aim of the study was to determine outcomes in adult life of binge drinking in adolescence in a national birth cohort. Longitudinal birth cohort: 1970 British Birth Cohort Study surveys at 16 years (1986) and 30 years (2000). A total of 11 622 subjects participated at age 16 years and 11 261 subjects participated at age 30 years. At the age of 16 years, data on binge drinking (defined as two or more episodes of drinking four or more drinks in a row in the previous 2 weeks) and frequency of habitual drinking in the previous year were collected. Thirty-year outcomes recorded were alcohol dependence/abuse (CAGE questionnaire), regular weekly alcohol consumption (number of units), illicit drug use, psychological morbidity (Malaise Inventory) and educational, vocational and social history. 17.7% of participants reported binge drinking in the previous 2 weeks at the age of 16 years. Adolescent binge drinking predicted an increased risk of adult alcohol dependence (OR 1.6, 95% CI 1.3 to 2.0), excessive regular consumption (OR 1.7, 95% CI 1.4 to 2.1), illicit drug use (OR 1.4, 95% CI 1.1 to 1.8), psychiatric morbidity (OR 1.4, 95% CI 1.1 to 1.9), homelessness (OR 1.6, 95% CI 1.1 to 2.4), convictions (1.9, 95% CI 1.4 to 2.5), school exclusion (OR 3.9, 95% CI 1.9 to 8.2), lack of qualifications (OR 1.3, 95% CI 1.1 to 1.6), accidents (OR 1.4, 95% CI 1.1 to 1.6) and lower adult social class, after adjustment for adolescent socioeconomic status and adolescent baseline status of the outcome under study. These findings were largely unchanged in models including both adolescent binge drinking and habitual frequent drinking as main effects. Adolescent binge drinking is a risk behaviour associated with significant later adversity and social exclusion. These associations appear to be distinct from those associated with habitual frequent alcohol use. Binge drinking may contribute to the development of health and social inequalities during the transition from adolescence to

  5. Discovery of genetic susceptibility factors for human birth defects: an opportunity for a National Agenda.

    PubMed

    Olshan, Andrew F; Hobbs, Charlotte A; Shaw, Gary M

    2011-08-01

    A recent workshop highlighted the current challenges and new opportunities for studying the role of genetic factors in the etiology of human birth defects. The workshop provided a series of recommendations pertaining to the use of animal models, key elements of population-based designs, the need for national collaborative projects, biorepositories, and consortia, investigation of new types of structural genetic variants, examination of gene-exposure interactions, and a strategy for gene variant discovery. A key reason to hold the recent workshop and contribute this concise communication to the literature is to draw attention to and initiate action toward advancing discoveries about the genetic etiologies of birth defects.

  6. Preterm birth associated with maternal fine particulate matter exposure: A global, regional and national assessment.

    PubMed

    Malley, Christopher S; Kuylenstierna, Johan C I; Vallack, Harry W; Henze, Daven K; Blencowe, Hannah; Ashmore, Mike R

    2017-04-01

    Reduction of preterm births (<37 completed weeks of gestation) would substantially reduce neonatal and infant mortality, and deleterious health effects in survivors. Maternal fine particulate matter (PM2.5) exposure has been identified as a possible risk factor contributing to preterm birth. The aim of this study was to produce the first estimates of ambient PM2.5-associated preterm births for 183 individual countries and globally. To do this, national, population-weighted, annual average ambient PM2.5 concentration, preterm birth rate and number of livebirths were combined to calculate the number of PM2.5-associated preterm births in 2010 for 183 countries. Uncertainty was quantified using Monte-Carlo simulations, and analyses were undertaken to investigate the sensitivity of PM2.5-associated preterm birth estimates to assumptions about the shape of the concentration-response function at low and high PM2.5 exposures, inclusion of provider-initiated preterm births, and exposure to indoor air pollution. Globally, in 2010, the number of PM2.5-associated preterm births was estimated as 2.7 million (1.8-3.5 million, 18% (12-24%) of total preterm births globally) with a low concentration cut-off (LCC) set at 10μgm(-3), and 3.4 million (2.4-4.2 million, 23% (16-28%)) with a LCC of 4.3μgm(-3). South and East Asia, North Africa/Middle East and West sub-Saharan Africa had the largest contribution to the global total, and the largest percentage of preterm births associated with PM2.5. Sensitivity analyses showed that PM2.5-associated preterm birth estimates were 24% lower when provider-initiated preterm births were excluded, 38-51% lower when risk was confined to the PM2.5 exposure range in the studies used to derive the effect estimate, and 56% lower when mothers who live in households that cook with solid fuels (and whose personal PM2.5 exposure is likely dominated by indoor air pollution) were excluded. The concentration-response function applied here derives from a

  7. Sex ratio at birth, polygyny, and fertility: a cross-national study.

    PubMed

    Barber, Nigel

    2004-01-01

    The sex ratio at birth may reflect frequency of intercourse that affects the timing of conception. If so, cross-national variation in polygyny and fertility might account for country differences in secondary sex ratios. Consistent with the timing of intercourse hypothesis, the birth sex ratios of 148 countries declined with total fertility rates and polygyny intensity, and increased with contraception use in correlational analysis. Regression analysis confirmed that polygyny was a negative predictor of the sex ratio (and contraception was a positive predictor), with level of economic development and mother's age controlled, but the effects disappeared with total fertility added to the equation. The sex ratio evidently declines with increases in fertility because more children are born at a later birth order when frequency of intercourse is lower.

  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. 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…

  10. Cell Phone Exposures and Hearing Loss in Children in the Danish National Birth Cohort

    PubMed Central

    Sudan, Madhuri; Kheifets, Leeka; Arah, Onyebuchi A.; Olsen, Jorn

    2013-01-01

    Background Children today are exposed to cell phones early in life, and may be the most vulnerable if exposure is harmful to health. We investigated the association between cell phone use and hearing loss in children. Methods The Danish National Birth Cohort (DNBC) enrolled pregnant women between 1996 and 2002. Detailed interviews were conducted during gestation, and when the children were 6 months, 18 months, and 7 years of age. We used multivariable-adjusted logistic regression, marginal structural models (MSM) with inverse-probability weighting, and doubly-robust estimation (DRE) to relate hearing loss at age 18 months to cell phone use at age seven years, and to investigate cell phone use reported at age seven in relation to hearing loss at age seven. Results Our analyses included data from 52,680 children. We observed weak associations between cell phone use and hearing loss at age seven, with odds ratios and 95% confidence intervals from the traditional logistic regression, MSM, and DRE models being 1.21 [0.99–1.46], 1.23 [1.01–1.49], and 1.22 [1.00–1.49], respectively. Conclusions Our findings could have been affected by various biases and are not sufficient to conclude that cell phone exposures have an effect on hearing. This is the first large-scale epidemiologic study to investigate this potentially important association among children, and replication of these findings is needed. PMID:23574412

  11. Parental concerns based general developmental screening tool and autism risk: the Taiwan National Birth cohort study.

    PubMed

    Lung, For-Wey; Shu, Bih-Ching; Chiang, Tung-Liang; Lin, Shio-Jean

    2010-02-01

    Early detection of developmental delay and childhood disorders are important for early intervention. This study aimed to describe the distribution of responses in a large population-based survey, identify cutoff points for the parent concern checklist (PCC) suitable for the Chinese language and culture, and explore how many children were identified as having evidence of problems at age 18 mo different from those at age 6 mo. Using a national randomly selected sample, the overall development of 21,248 children was investigated using the Taiwan Birth Cohort study instrument, and the PCC, a problem-oriented screening instrument. The Newton-Raphson iteration showed that the PCC should be separated into three groups, those scoring 1-2 in the first group, 3- 6 in the second group, and 7- 8 in the third group.Structural equation models showed that 6-mo development was predictive of 18-mo development; additionally, 18-mo development and the PCC showed good concurrent validity. This study identified three groups with distinct developmental trajectories and two cutoff points of 2/3 and 6/7. Thus, the PCC can be used as a first-stage screening instrument in a two-stage window screening procedure. Further studies are needed to investigate the factors, which contribute to the differences among these groups;follow-up on the typical and atypical development of these children is necessary.

  12. Cell phone exposures and hearing loss in children in the Danish National Birth Cohort.

    PubMed

    Sudan, Madhuri; Kheifets, Leeka; Arah, Onyebuchi A; Olsen, Jorn

    2013-05-01

    Children today are exposed to cell phones early in life, and may be the most vulnerable if exposure is harmful to health. We investigated the association between cell phone use and hearing loss in children. The Danish National Birth Cohort (DNBC) enrolled pregnant women between 1996 and 2002. Detailed interviews were conducted during gestation, and when the children were 6 months, 18 months and 7 years of age. We used multivariable-adjusted logistic regression, marginal structural models (MSM) with inverse-probability weighting, and doubly robust estimation (DRE) to relate hearing loss at age 18 months to cell phone use at age 7 years, and to investigate cell phone use reported at age 7 in relation to hearing loss at age 7. Our analyses included data from 52 680 children. We observed weak associations between cell phone use and hearing loss at age 7, with odds ratios and 95% confidence intervals from the traditional logistic regression, MSM and DRE models being 1.21 [95% confidence interval [CI] 0.99, 1.46], 1.23 [95% CI 1.01, 1.49] and 1.22 [95% CI 1.00, 1.49], respectively. Our findings could have been affected by various biases and are not sufficient to conclude that cell phone exposures have an effect on hearing. This is the first large-scale epidemiologic study to investigate this potentially important association among children, and replication of these findings is needed. © 2013 Blackwell Publishing Ltd.

  13. National and state patterns of teen births in the United States, 1940-2013.

    PubMed

    Ventura, Stephanie J; Hamilton, Brady E; Matthews, T J

    2014-08-20

    This report presents trends from 1940 through 2013 in national birth rates for teenagers, with particular focus on the period since 1991. The percent changes in rates for 1991-2012 and for 2007-2012 are presented for the United States and for states. Preliminary data for 2013 are shown where available. Tabular and graphical descriptions of the trends in teen birth rates for the United States and each state, by age group, race, and Hispanic origin, are presented and discussed. Data are shown for the U.S. territories. Birth rates for U.S. teenagers have generally fallen in the United States since peaking in 1957. The rate fell 57% between 1991 and 2013. The 2013 preliminary rate (26.6 per 1,000 aged 15-19) is less than one-third of the historically highest rate (96.3 in 1957). During 1991-2012, rates fell for all race and Hispanic ethnicity groups, with the largest declines measured for non-Hispanic black teenagers. In the more recent period, 2007-2012, the declines have been steepest for Hispanic teenagers. Birth rates declined significantly for teenagers in all states during 1991-2012; during 2007-2012, rates fell for all but two states. The drop in teen birth rates translates into an estimated 4 million fewer births to teenagers from 1992 through 2012. The declines in teen birth rates reflect a number of behavioral changes, including decreased sexual activity, increases in the use of contraception at first sex and at most recent sex, and the adoption and increased use of hormonal contraception, injectables, and intrauterine devices. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  14. Monitoring trends in under-5 mortality rates through national birth history surveys.

    PubMed

    Korenromp, E L; Arnold, F; Williams, B G; Nahlen, B L; Snow, R W

    2004-12-01

    We assessed whether Demographic and Health Surveys (DHS), a large and high-quality source of under-5 mortality estimates in developing countries, would be able to detect reductions in under-5 mortality as established in global child health goals. Mortality estimates from 41 DHS conducted in African countries between 1986 and 2002, for the interval of 0-4 years preceding each survey (with a mean time lag of 2.5 years), were reviewed. The median relative error on national mortality rates was 4.4%. In multivariate regression, the relative error decreased with increasing sample size, increasing fertility rates, and increasing mortality rates. The error increased with the magnitude of the survey design effect, which resulted from cluster sampling. With levels of precision observed in previous surveys, reductions in all-cause under-5 mortality rates between two subsequent surveys of 15% or more would be detectable. The detection of smaller mortality reductions would require increases in sample size, from a current median of 7060 to over 20,000 women. Across the actual surveys conducted between 1986 and 2002, varying mortality trends were apparent at a national scale, but only around half of these were statistically significant. The interpretation of changes in under-5 mortality rates between subsequent surveys needs to take into account statistical significance. DHS birth history surveys with their present sampling design would be able to statistically confirm under-5 mortality reductions in African countries if true reductions were 15% or larger, and are highly relevant to tracking progress towards existing international child health targets.

  15. NLST: the Indian National Large Solar Telescope

    NASA Astrophysics Data System (ADS)

    Hasan, S. S.; Soltau, D.; Kärcher, H.; Süss, M.; Berkefeld, T.

    2010-07-01

    India is planning a new solar telescope with an aperture of 2-m for carrying out high resolution studies of the Sun. Site characterization is underway at high altitude locations in the Himalayan mountains. A detailed concept design for NLST (National Large Solar Telescope) has been completed. The optical design of the telescope is optimized for high optical throughput and uses a minimum number of optical elements. A high order AO system is integrated part of the design that works with a modest Fried's parameter of 7-cm to give diffraction limited performance. The telescope will be equipped with a suite of post-focus instruments including a high resolution spectrograph and a polarimeter. NLST will also be used for carrying out stellar observations during the night. The mechanical design of the telescope, building, and the innovative dome is optimized to take advantage of the natural air flush which will help to keep the open telescope in temperature equilibrium. After its completion (planned for 2014), NLST will fill a gap in longitude between the major solar facilities in USA and Europe, and it will be for years the largest solar telescope in the world

  16. Large optics for the National Ignition Facility

    SciTech Connect

    Baisden, P.

    2015-01-12

    The National Ignition Facility (NIF) laser with its 192 independent laser beams is not only the world’s largest laser, it is also the largest optical system ever built. With its 192 independent laser beams, the NIF requires a total of 7648 large-aperture (meter-sized) optics. One of the many challenges in designing and building NIF has been to carry out the research and development on optical materials, optics design, and optics manufacturing and metrology technologies needed to achieve NIF’s high output energies and precision beam quality. This paper describes the multiyear, multi-supplier, development effort that was undertaken to develop the advanced optical materials, coatings, fabrication technologies, and associated process improvements necessary to manufacture the wide range of NIF optics. The optics include neodymium-doped phosphate glass laser amplifiers; fused silica lenses, windows, and phase plates; mirrors and polarizers with multi-layer, high-reflectivity dielectric coatings deposited on BK7 substrates; and potassium di-hydrogen phosphate crystal optics for fast optical switches, frequency conversion, and polarization rotation. Also included is a discussion of optical specifications and custom metrology and quality-assurance tools designed, built, and fielded at supplier sites to verify compliance with the stringent NIF specifications. In addition, a brief description of the ongoing program to improve the operational lifetime (i.e., damage resistance) of optics exposed to high fluence in the 351-nm (3ω) is provided.

  17. Returning birth: the politics of midwifery implementation on First Nations reserves in Canada.

    PubMed

    Olson, Rachel; Couchie, Carol

    2013-08-01

    to explore the role of midwives in the implementation of an elective birthing programme in one remote First Nation community in Canada, and to identify current barriers and challenges to the practice of midwifery in these settings the study is a multisited ethnography based on 15 months of fieldwork in Manitoba, Canada. Thirty-nine individual qualitative, semi-structured interviews were completed. The data from the interviews were coded into themes and presented in the paper. the study focuses on one First Nation community and their process of implementation of midwifery services. This case study is used to address broader themes of midwifery and policy at a national level. participants included Aboriginal midwives from across Canada, policy makers from provincial and federal jurisdictions, medical professionals involved in Aboriginal health care, Aboriginal political leadership, and Aboriginal women and their families. national policy and issues of jurisdiction among levels of government were shown to be a barrier to midwifery implementation. the current policy of evacuation in most Aboriginal communities does not effectively address the Millennium Development Goal of having a skilled birth attendant at every birth. The role of midwifery is central to the process of returning birth to Aboriginal communities, and steps must be taken at both the policy and clinical level to ensure that midwifery implementation and education can become an option for all Aboriginal communities in Canada. when considering midwifery implementation in communities, midwives must engage in both political and clinical negotiations to ensure their ability to practice effectively. Understanding the complexity of the policy discourse, along with the place of midwifery within the existing clinical guidelines is integral to the success of this process. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Control selection and participation in an ongoing, population-based, case-control study of birth defects: the National Birth Defects Prevention Study.

    PubMed

    Cogswell, Mary E; Bitsko, Rebecca H; Anderka, Marlene; Caton, Alissa R; Feldkamp, Marcia L; Hockett Sherlock, Stacey M; Meyer, Robert E; Ramadhani, Tunu; Robbins, James M; Shaw, Gary M; Mathews, T J; Royle, Marjorie; Reefhuis, Jennita

    2009-10-15

    To evaluate the representativeness of controls in an ongoing, population-based, case-control study of birth defects in 10 centers across the United States, researchers compared 1997-2003 birth certificate data linked to selected controls (n = 6,681) and control participants (n = 4,395) with those from their base populations (n = 2,468,697). Researchers analyzed differences in population characteristics (e.g., percentage of births at > or =2,500 g) for each group. Compared with their base populations, control participants did not differ in distributions of maternal or paternal age, previous livebirths, maternal smoking, or diabetes, but they did differ in other maternal (i.e., race/ethnicity, education, entry into prenatal care) and infant (i.e., birth weight, gestational age, and plurality) characteristics. Differences in distributions of maternal, but not infant, characteristics were associated with participation by selected controls. Absolute differences in infant characteristics for the base population versus control participants were < or =1.3 percentage points. Differences in infant characteristics were greater at centers that selected controls from hospitals compared with centers that selected controls from electronic birth certificates. These findings suggest that control participants in the National Birth Defects Prevention Study generally are representative of their base populations. Hospital-based control selection may slightly underascertain infants affected by certain adverse birth outcomes.

  19. Elevated Maternal C-Reactive Protein is Associated with Increased Risk of Schizophrenia in a National Birth Cohort

    PubMed Central

    Canetta, Sarah; Sourander, Andre; Surcel, Helja-Marja; Hinkka-Yli-Salomäki, Susanna; Leiviskä, Jaana; Kellendonk, Christoph; McKeague, Ian W.; Brown, Alan S.

    2014-01-01

    Objective The goal of the present study was to investigate an association between early gestational C-reactive protein (CRP), an established inflammatory biomarker, prospectively assayed in maternal sera, and schizophrenia in a large national birth cohort with an extensive serum biobank. Methods This study utilized a nested case-control design from the Finnish Prenatal Study of Schizophrenia cohort. 777 schizophrenia cases (630 with schizophrenia, 147 with schizoaffective disorder) that had maternal sera available for CRP testing were identified and matched to 777 controls in the analysis. Maternal CRP levels were assessed using a latex immunoassay from archived maternal serum specimens. Results Increasing maternal CRP levels, classified as a continuous variable, were significantly associated with schizophrenia in offspring (adjusted odds ratio (OR)=1.31, 95% confidence interval (CI)=1.10-1.56, p=0.003). This finding remained significant after adjusting for potential confounders including maternal and parental history of psychiatric disorders, twin/singleton birth, urbanicity, province of birth, and maternal socioeconomic status. Conclusion This finding provides the most robust evidence to date that maternal inflammation may play a significant role in schizophrenia, with possible implications for identifying preventive strategies and pathogenic mechanisms in schizophrenia and other neurodevelopmental disorders. PMID:24969261

  20. Predicting nurse staffing needs for a labor and birth unit in a large-volume perinatal service.

    PubMed

    Simpson, Kathleen Rice

    2015-01-01

    This project was designed to test a nurse staffing model for its ability to accurately determine staffing needs for a large-volume labor and birth unit based on a staffing gap analysis using the nurse staffing guidelines from the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). The staffing model and the AWHONN staffing guidelines were found to be reliable methods to predict staffing needs for a large-volume labor and birth unit.

  1. Newborns health in the Danube Region: Environment, biomonitoring, interventions and economic benefits in a large prospective birth cohort study.

    PubMed

    Andersen, Zorana J; Sram, Radim J; Ščasný, Milan; Gurzau, Eugen S; Fucic, Aleksandra; Gribaldo, Laura; Rossner, Pavel; Rossnerova, Andrea; Kohlová, Markéta Braun; Máca, Vojtěch; Zvěřinová, Iva; Gajdosova, Dagmar; Moshammer, Hanns; Rudnai, Peter; Knudsen, Lisbeth E

    2016-03-01

    The EU strategy for the Danube Region addresses numerous challenges including environment, health and socioeconomic disparities. Many old environmental burdens and heavily polluted areas in Europe are located in the Danube Region, consisting of 14 countries, with over 100 million people. Estimating the burden of environmental exposures on early-life health is a growing research area in Europe which has major public health implications, but the data from the Danube Region are largely missing. This review presents an inventory of current environmental challenges, related early-life health risks, and knowledge gaps in the Danube Region, based on publicly available databases, registers, and literature, as a rationale and incentive for a new integrated project. The review also proposes the concept for the project aiming to characterize in utero exposures to multiple environmental factors and estimate their effect on early-life health, evaluate economic impact, as well as identify interventions with a potential to harness social norms to reduce emissions, exposures and health risks in the Danube Region. Experts in environmental epidemiology, human biomonitoring and social science in collaboration with clinicians propose to establish a new large multi-center birth cohort of mother-child pairs from Danube countries, measure biomarkers of exposure and health in biological samples at birth, collect centrally measured climate, air and water pollution data, conduct pre- and postnatal surveys on lifestyle, indoor exposures, noise, occupation, socio-economic status, risk-averting behavior, and preferences; and undertake clinical examinations of children at and after birth. Birth cohort will include at least 2000 newborns per site, and a subset of at least 200 mother-child pairs per site for biomonitoring. Novel biomarkers of exposure, susceptibility, and effect will be applied, to gain better mechanistic insight. Effects of multiple environmental exposures on fetal and child

  2. Good practices according to WHO's recommendation for normal labor and birth and women's assessment of the care received: the "birth in Brazil" national research study, 2011/2012.

    PubMed

    Baldisserotto, Marcia Leonardi; Theme Filha, Mariza Miranda; da Gama, Silvana Granado Nogueira

    2016-10-17

    The World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care. The aim of this study was to evaluate the association between adoption of good practices according to WHO's recommendation for normal labor and birth and assessment by women of the care received. Birth in Brazil is a national hospital-based study with countrywide representation consisting of 23,894 mothers and their newborns, conducted between February 2011 and October 2012. The present study analysed a subsample of this national survey. Postpartum women classified as low risk during pregnancy who had experienced either spontaneous or induced labor were included in this study, totalling 4102 mothers. To estimate the association between assessment by women of the childbirth care received (dependent variable) and good practices according to WHO's recommendation during normal labor and birth (independent variables), a multinomial logistic regression analysis was used and crude and adjusted odds ratios calculated with their 95 % confidence intervals. The good practices associated with positive assessment of the care received by women during labor and birth included the partner's presence, privacy in the birthing place, time available to ask questions, clarity of information received, and empathic support from caregivers during labor and birth. Freedom of movement, free nutrition offered, choice of companions, nonpharmacological analgesia, skin-to-skin contact and breastfeeding in the childbirth room were not associated with the assessment by women of the care received. Our findings reveal the importance to mothers of their relationship with the team of caregivers during labor and birth. Therefore, caregiver teams must be qualified within a more humanistic vision of childbirth health care.

  3. Urban Living is Not Associated with Better Birth and Infant Outcomes among Inuit and First Nations in Quebec

    PubMed Central

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

    2011-01-01

    Objective There is limited and inconsistent evidence concerning rural versus urban differences in birth and infant outcomes for Indigenous peoples. We assessed birth and infant outcomes among Inuit, First Nations and French mother tongue groups by rural versus urban residence in Quebec, Canada. Study Deign A retrospective birth cohort study of 5,184 First Nations, 2,527 Inuit and 652,940 French mother tongue (the majority reference) births in Quebec, 1991–2000. Results In general, rural living was associated with slightly less favorable birth outcomes for French mother tongue women, but somewhat better outcomes for Indigenous women. For both Inuit and First Nations, rural births were half as likely to be small-for-gestational-age compared to urban births. Among First Nations, the difference in infant mortality rates comparing urban to rural areas was not statistically significant. Compared to infants of French mother tongue women, Inuit and First Nations infants were much less likely to be small-for-gestational-age in rural areas, while such an “advantage” diminished for First Nations and reversed for Inuit in urban areas. The disparities in infant mortality among First Nations versus French mother tongue births were greater in urban than in rural areas. These patterns of results remained after adjusting for maternal characteristics. Conclusion Living in urban areas was not associated with better birth and infant outcomes for Inuit and First Nations in Quebec despite universal health insurance coverage, strongly indicating a need for improved socioeconomic conditions, perinatal and infant care for Indigenous people living in urban areas. PMID:22287996

  4. Urban Living is Not Associated with Better Birth and Infant Outcomes among Inuit and First Nations in Quebec.

    PubMed

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

    2010-01-01

    OBJECTIVE: There is limited and inconsistent evidence concerning rural versus urban differences in birth and infant outcomes for Indigenous peoples. We assessed birth and infant outcomes among Inuit, First Nations and French mother tongue groups by rural versus urban residence in Quebec, Canada. STUDY DEIGN: A retrospective birth cohort study of 5,184 First Nations, 2,527 Inuit and 652,940 French mother tongue (the majority reference) births in Quebec, 1991-2000. RESULTS: In general, rural living was associated with slightly less favorable birth outcomes for French mother tongue women, but somewhat better outcomes for Indigenous women. For both Inuit and First Nations, rural births were half as likely to be small-for-gestational-age compared to urban births. Among First Nations, the difference in infant mortality rates comparing urban to rural areas was not statistically significant. Compared to infants of French mother tongue women, Inuit and First Nations infants were much less likely to be small-for-gestational-age in rural areas, while such an "advantage" diminished for First Nations and reversed for Inuit in urban areas. The disparities in infant mortality among First Nations versus French mother tongue births were greater in urban than in rural areas. These patterns of results remained after adjusting for maternal characteristics. CONCLUSION: Living in urban areas was not associated with better birth and infant outcomes for Inuit and First Nations in Quebec despite universal health insurance coverage, strongly indicating a need for improved socioeconomic conditions, perinatal and infant care for Indigenous people living in urban areas.

  5. Association between antibiotic use among pregnant women with urinary tract infections in the first trimester and birth defects, National Birth Defects Prevention Study 1997 to 2011.

    PubMed

    Ailes, Elizabeth C; Gilboa, Suzanne M; Gill, Simerpal K; Broussard, Cheryl S; Crider, Krista S; Berry, Robert J; Carter, Tonia C; Hobbs, Charlotte A; Interrante, Julia D; Reefhuis, Jennita

    2016-11-01

    Previous studies noted associations between birth defects and some antibiotics (e.g., nitrofurantoin, sulfonamides) but not others (e.g., penicillins). It is unclear if previous findings were due to antibiotic use, infections, or chance. To control for potential confounding by indication, we examined associations between antibiotic use and birth defects, among women reporting urinary tract infections (UTIs). The National Birth Defects Prevention Study is a multi-site, population-based case-control study. Case infants/fetuses have any of over 30 major birth defects and controls are live-born infants without major birth defects. We analyzed pregnancies from 1997 to 2011 to estimate the association between maternally reported periconceptional (month before conception through the third month of pregnancy) use of nitrofurantoin, trimethoprim-sulfamethoxazole, or cephalosporins and specific birth defects, among women with periconceptional UTIs. Women with periconceptional UTIs who reported penicillin use served as the comparator. Periconceptional UTIs were reported by 7.8% (2029/26,068) of case and 6.7% (686/10,198) of control mothers. Most (68.2% of case, 66.6% of control mothers) also reported antibiotic use. Among 608 case and 231 control mothers reporting at least one periconceptional UTI and certain antibiotic use, compared with penicillin, nitrofurantoin use was associated with oral clefts in the offspring (adjusted odds ratio, 1.97 [95% confidence interval, 1.10-3.53]), trimethoprim-sulfamethoxazole use with esophageal atresia (5.31 [1.39-20.24]) and diaphragmatic hernia (5.09 [1.20-21.69]), and cephalosporin use with anorectal atresia/stenosis (5.01 [1.34-18.76]). Periconceptional exposure to some antibiotics might increase the risk for certain birth defects. However, because individual birth defects are rare, absolute risks should drive treatment decisions.Birth Defects Research (Part A) 106:940-949, 2016.© 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals

  6. Postponing Second Teen Births in the 1990s: Longitudinal Analyses of National Data.

    ERIC Educational Resources Information Center

    Manlove, Jennifer; Mariner, Carrie; Romano, Angela

    A sample of high school-age mothers was followed from 1988 to 1994 in order to examine factors associated with having a second teen birth or closely spaced second teen birth. Factors associated with postponing a second teen birth included characteristics measured prior to the first birth, at the time of the first birth, and after the first birth.…

  7. Periconceptional folic acid supplementation and the risk of preterm births in China: a large prospective cohort study

    PubMed Central

    Li, Zhiwen; Ye, Rongwei; Zhang, Le; Li, Hongtian; Liu, Jianmeng; Ren, Aiguo

    2014-01-01

    Background: Folic acid-containing multivitamins have been associated with a reduced risk of preterm birth. We examined whether periconceptional use of folic acid alone reduced this risk. Methods: Data were derived from a large population-based cohort study conducted in China to evaluate the prevention of neural tube defects with folic acid supplementation. The sample comprised 207 936 singleton live births delivered at gestational ages of 20–42 weeks to women from two provinces in southern China. Healthcare workers recorded folic acid intake prospectively each month. Gestational age calculation was based on the first day of the last menstrual period. Preterm births were categorized into three clinical subtypes: iatrogenic preterm birth, preterm premature rupture of membranes (PPROM) and spontaneous preterm birth. Logistic regression was used to evaluate the association between folic acid use and the risk of preterm birth, adjusting for potential confounders. Results: The incidence of preterm birth was significantly lower among folic acid users (5.28%) than among non-users (6.10%). Folic acid use showed a 14% risk reduction for preterm birth overall [adjusted risk ratio (RR) = 0.86, 95% confidence interval (CI) 0.82–0.90]. This association was strongest for spontaneous preterm birth (adjusted RR = 0.81, 95% CI 0.78–0.86) and was not significant for iatrogenic preterm birth (adjusted RR = 0.97, 95% CI 0.88–1.07) or PPROM (adjusted RR = 1.07, 95% CI 0.93–1.23). Conclusions: Daily intake of 400 μg folic acid alone during the periconceptional period was associated with a reduced risk of spontaneous preterm birth. PMID:24603317

  8. The associations of parental under-education and unemployment on the risk of preterm birth: 2003 Korean National Birth Registration database.

    PubMed

    Shin, Seung Han; Lim, Hyung-tak; Park, Hyun-young; Park, Sang Min; Kim, Han-suk

    2012-04-01

    This study aimed to investigate the associations of combined parental low educational level and combined parental unemployment on the risk of preterm birth (PTB) in Korea. Data on 427,857 singleton births were obtained from the National Birth Registration (NBR) database in 2003 and analyzed. Parental education and parental employment status were combined as exposure for analysis. Place of birth, sex, marital status, parental age and parity were included for analysis of unconditional multiple logistic regressions. PTB was defined as birth before a gestational age of 37 complete weeks. Group of the lowest educational level, below high school, had the highest odds of PTB in both father and mother in multivariable analysis [odds ratio (OR) 1.15 and 1.16, respectively]. After combining parental educational status for the multivariable analysis, the highest probability of PTB was in families where both parents had below college level education (OR 1.22). As for paternal employment, the multivariable analysis showed an increased rate of PTB occurred where the father was unemployed (OR 1.11). After combining the employment status of both parents, the multivariable analysis revealed that PTB was only significant in families where both parents were unemployed (OR 1.09). We found that combined parental low educational level and combined parental unemployment increased the likelihood of preterm birth.

  9. Maternal exposures in the National Birth Defects Prevention Study: Time trends of selected exposures.

    PubMed

    Dawson, April L; Razzaghi, Hilda; Arth, Annelise; Canfield, Mark A; Parker, Samantha E; Reefhuis, Jennita

    2015-08-01

    Our objective was to describe time trends in selected pregnancy exposures in the National Birth Defects Prevention Study (NBDPS). We analyzed data from the NBDPS, a multi-site case-control study of major birth defects, for mothers of live-born infants without birth defects (controls), with an expected date of delivery (EDD) from 1998 to 2011. Mothers from the 10 participating centers across the United States were interviewed by phone between 6 weeks and 2 years after the EDD. We focused on maternal race/ethnicity and five maternal risk factors: obesity, use of folic acid-containing multivitamins, opioid analgesics, selective serotonin reuptake inhibitors, and loratadine because of their prevalence of use and some reports of associations with major birth defects. Prevalence time trends were examined using the Kendall's τβ test statistic. The exposure trend analysis included 11,724 control mothers with EDDs from 1998 to 2011. We observed a significant increase in obesity prevalence among control mothers, as well as use of selective serotonin reuptake inhibitors and loratadine. We also observed an increase in periconceptional use of folic acid-containing multivitamins. Some of the time trends varied by race/ethnicity. No remarkable trend in the overall use of opioid analgesics was observed. The racial/ethnic distribution of mothers changed slightly during the study period. Long-term, population-based case-control studies continue to be an effective way to assess exposure-birth defects associations and provide guidance to health care providers. However, investigators examining rare outcomes covering many years of data collection need to be cognizant of time trends in exposures. © 2015 Wiley Periodicals, Inc.

  10. Maternal exposures in the National Birth Defects Prevention Study: time trends of selected exposures

    PubMed Central

    Dawson, April L.; Razzaghi, Hilda; Arth, Annelise; Canfield, Mark A.; Parker, Samantha E.; Reefhuis, Jennita

    2015-01-01

    Background Our objective was to describe time trends in selected pregnancy exposures in the National Birth Defects Prevention Study (NBDPS). Methods We analyzed data from the NBDPS, a multi-site case-control study of major birth defects, for mothers of live-born infants without birth defects (controls), with an expected date of delivery (EDD) from 1998 –2011. Mothers from the 10 participating centers across the United States were interviewed by phone between six weeks and two years after the EDD. We focused on maternal race/ethnicity and five maternal risk factors: obesity, use of folic acid-containing multivitamins, opioid analgesics, selective serotonin reuptake inhibitors (SSRIs), and loratadine because of their prevalence of use and some reports of associations with major birth defects. Prevalence time trends were examined using the Kendall’s τβ test statistic. Results The exposure trend analysis included 11,724 control mothers with EDDs from 1998–2011. We observed a significant increase in obesity prevalence among control mothers, as well as use of SSRIs and loratadine. We also observed an increase in periconceptional use of folic acid-containing multivitamins. Some of the time trends varied by race/ethnicity. No remarkable trend in the overall use of opioid analgesics was observed. The racial/ethnic distribution of mothers changed slightly during the study period. Conclusions Long-term, population-based case-control studies continue to be an effective way to assess exposure-birth defects associations and provide guidance to health care providers. However, investigators examining rare outcomes covering many years of data collection need to be cognizant of time trends in exposures. PMID:25884728

  11. Risk factors for isolated biliary atresia, National Birth Defects Prevention Study, 1997-2002.

    PubMed

    The, Natalie S; Honein, Margaret A; Caton, Alissa R; Moore, Cynthia A; Siega-Riz, Anna Maria; Druschel, Charlotte M

    2007-10-01

    Biliary atresia is a rare birth defect that affects 1 in 12,000 to 1 in 19,500 live births. We used data from the National Birth Defects Prevention Study, a multistate case-control study, to identify potential risk factors for isolated biliary atresia (no additional unrelated major birth defects diagnosed). Infants were identified from eight states from 1997 to 2002, with clinical information abstracted from medical records. Potential risk factors assessed include: demographic factors, seasonality, preterm birth, maternal smoking, maternal alcohol use, maternal illicit drug use, maternal health, maternal medication use, maternal vitamin use, and maternal nutrition. Infants of non-Hispanic black mothers were more likely to have biliary atresia than infants of non-Hispanic white mothers (adjusted odds ratio (aOR) = 2.29, 95% confidence interval (CI) 1.07-4.93) and infants conceived during the spring season were more likely to have biliary atresia than infants conceived in winter (aOR = 2.33, 95%CI 1.05-5.16). Low intakes of vitamin E, copper, phosphorus, and beta tocopherol were associated with the occurrence of isolated biliary atresia (borderline significance). Low iron intake had a borderline inverse association with biliary atresia. While this analysis provides support for previous reports of a possible association between seasonal variation and the occurrence of biliary atresia, more data are needed to evaluate whether the seasonal variation is related to infectious agents. The role of nutrients in the development of biliary atresia remains unclear. Further studies of genetic, infectious, and nutrient exposures and the association of biliary atresia are warranted. 2007 Wiley-Liss, Inc

  12. Trends in birth choices after caesarean section in Japan: A national survey examining information and access to vaginal birth after caesarean.

    PubMed

    Torigoe, Ikuyo; Shorten, Brett; Yoshida, Shizuka; Shorten, Allison

    2016-06-01

    in the context of a rising caesarean section (CS) rate in Japan, the objectives of this study were; to investigate the national situation for women's birth options after primary CS; to explore characteristics of institutions accepting planned vaginal birth after caesarean (VBAC); to identify the timing and type of information given to women about their birth options by health professionals. a national census study using a self-administered postal survey of nursing managers within obstetric departments in Japanese hospitals and clinics was conducted. Data were analyzed to explore characteristics of institutions accepting or not accepting VBAC and information given to women about planned VBAC and planned repeat CS. institutions included hospitals and clinics providing childbirth services throughout Japan. nursing managers from hospitals (n=303) and clinics (n=196) completed surveys about their institutional policies and practices around birth after CS. only 154 (30.9%) of 499 institutions examined, accepted planned vaginal birth as an option for birth after CS. The success rate of VBAC was 77.0% in these institutions. Availability of transport services for institutional transfer and existence of a Maternal Fetal Intensive Care Unit (MFICU) were significantly associated with acceptance of VBAC (OR=5.39, p<0.001; OR=2.96, p=0.04). Information about options for birth method was mostly provided in the form of consent documents, and doctors were the sole provider of information about method of childbirth in 55.7% of institutions. Nursing managers described challenges in caring for women who strongly desire VBAC when women did not have access to information or if institutional policies conflicted with women's wishes. They recommended evidence-based information for women regarding birth choices after CS and recognised the necessity of emotional support for women faced with decision dilemmas. institutional policies and practices for birth after CS vary widely in Japan, with

  13. Geocoding capacity of birth defects surveillance programs: results from the National Birth Defects Prevention Network Geocoding Survey.

    PubMed

    Wang, Ying; O'Leary, Leslie A; Rickard, Russel S; Mason, Craig A

    2010-01-01

    A Web-based survey focusing on geocoding of birth defects data was developed and administrated to gain an understanding of the capacity of state birth defects programs to geocode maternal residence and to identify barriers to geocoding birth defects data. The survey consisted of 21 questions related to geocoding of maternal residence, type of software used, barriers to geocoding, and data linkage. In August 2007, an e-mail with a Web link to the survey was sent to all state birth defects program contacts in the United States, including the District of Columbia, Puerto Rico, and the Centers for Disease Control and Prevention (CDC) requesting they complete the online survey. By October 2007, 39 (74%) out of 53 birth defects program contacts completed the survey. Although nearly all birth defects programs collect maternal residential data, many are not currently geocoding that data. Results indicated that 97% of the programs that completed the survey reported they collected data on maternal residence, 53% of which reported that the birth defects surveillance data were geocoded to the street address level using maternal residential address at delivery. Twenty six percent of the programs that do not currently geocode the data identified "Software and address reference file are not available" as the most significant barrier to geocoding; another 16% chose "Lack of funding" as the most significant barrier to geocoding. Since geocoding is an important component of spatial analyses used to detect potential clusters of birth defects, leveraging resources to overcome the barriers that prevent programs from geocoding is important.

  14. Prenatal Nitrate Intake from Drinking Water and Selected Birth Defects in Offspring of Participants in the National Birth Defects Prevention Study

    PubMed Central

    Weyer, Peter J.; Romitti, Paul A.; Mohanty, Binayak P.; Shinde, Mayura U.; Vuong, Ann M.; Sharkey, Joseph R.; Dwivedi, Dipankar; Horel, Scott A.; Kantamneni, Jiji; Huber, John C.; Zheng, Qi; Werler, Martha M.; Kelley, Katherine E.; Griesenbeck, John S.; Zhan, F. Benjamin; Langlois, Peter H.; Suarez, Lucina; Canfield, Mark A.

    2013-01-01

    Background: Previous studies of prenatal exposure to drinking-water nitrate and birth defects in offspring have not accounted for water consumption patterns or potential interaction with nitrosatable drugs. Objectives: We examined the relation between prenatal exposure to drinking-water nitrate and selected birth defects, accounting for maternal water consumption patterns and nitrosatable drug exposure. Methods: With data from the National Birth Defects Prevention Study, we linked addresses of 3,300 case mothers and 1,121 control mothers from the Iowa and Texas sites to public water supplies and respective nitrate measurements. We assigned nitrate levels for bottled water from collection of representative samples and standard laboratory testing. Daily nitrate consumption was estimated from self-reported water consumption at home and work. Results: With the lowest tertile of nitrate intake around conception as the referent group, mothers of babies with spina bifida were 2.0 times more likely (95% CI: 1.3, 3.2) to ingest ≥ 5 mg nitrate daily from drinking water (vs. < 0.91 mg) than control mothers. During 1 month preconception through the first trimester, mothers of limb deficiency, cleft palate, and cleft lip cases were, respectively, 1.8 (95% CI: 1.1, 3.1), 1.9 (95% CI: 1.2, 3.1), and 1.8 (95% CI: 1.1, 3.1) times more likely than control mothers to ingest ≥ 5.42 mg of nitrate daily (vs. < 1.0 mg). Higher water nitrate intake did not increase associations between prenatal nitrosatable drug use and birth defects. Conclusions: Higher water nitrate intake was associated with several birth defects in offspring, but did not strengthen associations between nitrosatable drugs and birth defects. Citation: Brender JD, Weyer PJ, Romitti PA, Mohanty BP, Shinde MU, Vuong AM, Sharkey JR, Dwivedi D, Horel SA, Kantamneni J, Huber JC Jr., Zheng Q, Werler MM, Kelley KE, Griesenbeck JS, Zhan FB, Langlois PH, Suarez L, Canfield MA, and the National Birth Defects Prevention Study

  15. Process Improvement to Enhance Quality in a Large Volume Labor and Birth Unit.

    PubMed

    Bell, Ashley M; Bohannon, Jessica; Porthouse, Lisa; Thompson, Heather; Vago, Tony

    The goal of the perinatal team at Mercy Hospital St. Louis is to provide a quality patient experience during labor and birth. After the move to a new labor and birth unit in 2013, the team recognized many of the routines and practices needed to be modified based on different demands. The Lean process was used to plan and implement required changes. This technique was chosen because it is based on feedback from clinicians, teamwork, strategizing, and immediate evaluation and implementation of common sense solutions. Through rapid improvement events, presence of leaders in the work environment, and daily huddles, team member engagement and communication were enhanced. The process allowed for team members to offer ideas, test these ideas, and evaluate results, all within a rapid time frame. For 9 months, frontline clinicians met monthly for a weeklong rapid improvement event to create better experiences for childbearing women and those who provide their care, using Lean concepts. At the end of each week, an implementation plan and metrics were developed to help ensure sustainment. The issues that were the focus of these process improvements included on-time initiation of scheduled cases such as induction of labor and cesarean birth, timely and efficient assessment and triage disposition, postanesthesia care and immediate newborn care completed within approximately 2 hours, transfer from the labor unit to the mother baby unit, and emergency transfers to the main operating room and intensive care unit. On-time case initiation for labor induction and cesarean birth improved, length of stay in obstetric triage decreased, postanesthesia recovery care was reorganized to be completed within the expected 2-hour standard time frame, and emergency transfers to the main hospital operating room and intensive care units were standardized and enhanced for efficiency and safety. Participants were pleased with the process improvements and quality outcomes. Working together as a team

  16. SUPERFUND: FOCUSING ON THE NATION AT LARGE

    EPA Science Inventory

    In 1986 Congress enacted sweeping amendments to the nation's law to cleanup abandoned hazardous waste sites. Two years later Administrator Reilly set a course for the Superfund program designed to improve the program's performance and to increase the role of the private sector in...

  17. SUPERFUND: FOCUSING ON THE NATION AT LARGE

    EPA Science Inventory

    In 1986 Congress enacted sweeping amendments to the nation's law to cleanup abandoned hazardous waste sites. Two years later Administrator Reilly set a course for the Superfund program designed to improve the program's performance and to increase the role of the private sector in...

  18. A national registry of haemoglobinopathies in Greece: deducted demographics, trends in mortality and affected births.

    PubMed

    Voskaridou, Ersi; Ladis, Vasilis; Kattamis, Antonis; Hassapopoulou, Eleni; Economou, Marina; Kourakli, Alexandra; Maragkos, Konstantinos; Kontogianni, Kalliopi; Lafioniatis, Stilianos; Vrettou, Eleni; Koutsouka, Freideriki; Papadakis, Alexandros; Mihos, Andreas; Eftihiadis, Eftihios; Farmaki, Kallistheni; Papageorgiou, Ourania; Tapaki, Georgia; Maili, Polixeni; Theohari, Maria; Drosou, Marouso; Kartasis, Zafeiris; Aggelaki, Maria; Basileiadi, Artemis; Adamopoulos, Ioannis; Lafiatis, Ioannis; Galanopoulos, Athanasios; Xanthopoulidis, Georgios; Dimitriadou, Efthimia; Mprimi, Agapi; Stamatopoulou, Maria; Haile, Elanso Damba; Tsironi, Maria; Anastasiadis, Athanasios; Kalmanti, Maria; Papadopoulou, Margarita; Panori, Evaggelia; Dimoxenou, Peristera; Tsirka, Antigoni; Georgakopoulos, Dimitrios; Drandrakis, Pantelis; Dionisopoulou, Dionisia; Ntalamaga, Androniki; Davros, Ioannis; Karagiorga, Markisia

    2012-09-01

    Haemoglobinopathies are the most common hereditary disorders in Greece. Although there is a successful national prevention program, established 35 years ago, there is lack of an official registry and collection of epidemiological data for haemoglobinopathies. This paper reports the results of the first National Registry for Haemoglobinopathies in Greece (NRHG), recently organized by the Greek Society of Haematology. NRHG records all patients affected by thalassaemia major (TM), thalassaemia intermedia (TI), "H" Haemoglobinopathy (HH) and sickle cell disease (SCD). Moreover, data about the annual rate of new affected births along with deaths, between 2000 and 2010, are reported. A total of 4,506 patients are registered all over the country while the number of affected newborns was significantly decreased during the last 3 years. Main causes for still having affected births are: (1) lack of medical care due to financial reasons or low educational level; (2) unawareness of time limitations for prenatal diagnosis (PD); due either to obstetricians' malpractice or to delayed demand of medical care of couples at risk; and (3) religious, social or bioethical reasons. Cardiac and liver disorders consist main causes for deaths while life expectancy of patients lengthened after 2005 (p < 0.01). The NRHG of patients affected by haemoglobinopathies in Greece provides useful data about the haemoglobinopathies in the Greek population and confirms the efficacy of the National Thalassaemia Prevention Program on impressively decreasing the incidence of TM and sickle cell syndromes.

  19. Vaginal birth after cesarean delivery: comparison of ACOG practice bulletin with other national guidelines.

    PubMed

    Hill, James B; Ammons, Alex; Chauhan, Suneet P

    2012-12-01

    Evidence-based guidelines regarding vaginal birth after cesarean from 3 countries (United States, Canada, and United Kingdom) were reviewed. The similarities in the 3 national guidelines (trial of labor after 1 previous cesarean, informed consent, delivery facility and available resources, epidural analgesia, continuous fetal monitoring, and induction and augmentation of labor) are understandable. Differences in recommendations (uterine rupture risk, success rate, intrauterine pressure catheter, and mechanical cervical ripening) are not explained. The likelihood of recommendations being categorized as level A differed: United States, 27% (3/11); Canada, 32% (6/19); and United Kingdom, 0% (0/17). Only 6 publications were cited by all 3 guidelines.

  20. Seasonal patterns of birth for subjects with bulimia nervosa, binge eating, and purging: results from the National Women's Study.

    PubMed

    Brewerton, Timothy D; Dansky, Bonnie S; O'Neil, Patrick M; Kilpatrick, Dean G

    2012-01-01

    Studies of birth patterns in anorexia nervosa have shown relative increases between March and August, while studies in Bulimia Nervosa (BN) have been negative. Since there are no studies using representative, nonclinical samples, we looked for seasonal birth patterns in women with BN and in those who ever endorsed bingeing or purging. A national, representative sample of 3,006 adult women completed structured telephone interviews including screenings for bulimia nervosa (BN) and questions about month, date, and year of birth. Season of birth was calculated using traditional definitions. Differences across season of birth between subjects with (n = 85) and without BN (n = 2,898), those with (n = 749) and without bingeing (n = 2,229), and those with (n = 267) and without any purging (n = 2,715) were compared using chi-square analyses. There were significant differences across season of birth between subjects: (1) with and without BN (p = 0.033); (2) with and without bingeing (p = 0.034), and; (3) with and without purging (p = 0.001). Fall had the highest relative number of births for all categories, while spring had the lowest. In a national representative study of nontreatment seeking subjects significant differences in season of birth were found for subjects with lifetime histories of BN, binge eating and purging. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012). Copyright © 2011 Wiley Periodicals, Inc.

  1. Impact of Time to Maternal Interview on Interview Responses in the National Birth Defects Prevention Study

    PubMed Central

    Tinker, Sarah C.; Gibbs, Cassandra; Strickland, Matthew J.; Devine, Owen J.; Crider, Krista S.; Werler, Martha M.; Anderka, Marlene T.; Reefhuis, Jennita

    2013-01-01

    Prenatal exposures often are assessed using retrospective interviews. Time from exposure to interview may influence data accuracy. We investigated the association of time to interview (TTI) with aspects of interview responses in the National Birth Defects Prevention Study, a population-based case-control study of birth defects in 10 US states. Mothers completed a computer-assisted telephone interview 1.5–24 months after their estimated date of delivery. Proxy metrics for interview quality were whether certain exposures were reported, whether the start month of reported medication use or illness was reported, or whether responses were missing. Interaction by case status was assessed. Interviews were completed with 30,542 mothers (22,366 cases and 8,176 controls) who gave birth between 1997 and 2007. Mothers of cases were interviewed later than were mothers of controls (11.7 months vs. 9.5 months, respectively). In adjusted analyses, having a TTI that was greater than 6 months was associated with only a few aspects of interview responses (e.g., start month of pseudoephedrine use). Interaction by case-control status was observed for some exposures; mothers of controls had a greater reduction in interview quality with increased TTI in these instances (e.g., report of morning sickness, start month of acetaminophen use and ibuprofen use). The results suggest that TTI might impact interview responses; however, the impact may be minimal and specific to the type of exposure. PMID:23645625

  2. Preventing large birth size in women with preexisting diabetes mellitus: The benefit of appropriate gestational weight gain

    PubMed Central

    Kim, Shin Y.; Sharma, Andrea J.; Sappenfield, William; Salihu, Hamisu M.

    2016-01-01

    Objective To estimate the percentage of infants with large birth size attributable to excess gestational weight gain (GWG), independent of prepregnancy body mass index, among mothers with preexisting diabetes mellitus (PDM). Study design We analyzed 2004–2008 Florida linked birth certificate and maternal hospital discharge data of live, term (37–41 weeks) singleton deliveries (N = 641,857). We calculated prevalence of large-for-gestational age (LGA) (birth weight-for-gestational age ≥ 90th percentile) and macrosomia (birth weight > 4500 g) by GWG categories (inadequate, appropriate, or excess). We used multivariable logistic regression to estimate the relative risk (RR) of large birth size associated with excess compared to appropriate GWG among mothers with PDM. We then estimated the population attributable fraction (PAF) of large birth size due to excess GWG among mothers with PDM (n = 4427). Results Regardless of diabetes status, half of mothers (51.2%) gained weight in excess of recommendations. Large birth size was higher in infants of mothers with PDM than in infants of mothers without diabetes (28.8% versus 9.4% for LGA, 5.8% versus 0.9% for macrosomia). Among women with PDM, the adjusted RR of having an LGA infant was 1.7 (95% CI 1.5, 1.9) for women with excess GWG compared to those with appropriate gain; the PAF was 27.7% (95% CI 22.0, 33.3). For macrosomia, the adjusted RR associated with excess GWG was 2.1 (95% CI 1.5, 2.9) and the PAF was 38.6% (95% CI 24.9, 52.4). Conclusion Preventing excess GWG may avert over one-third of macrosomic term infants of mothers with PDM. Effective strategies to prevent excess GWG are needed. PMID:27539071

  3. Offspring birth weight, gestational age and maternal characteristics in relation to glucose status at age 53 years: evidence from a national birth cohort

    PubMed Central

    Kuh, D; Mishra, G D; Black, S; Lawlor, D A; Smith, G Davey; Okell, L; Wadsworth, M; Hardy, R

    2008-01-01

    Aims We investigated pathways linking offspring birth weight to maternal diabetes risk in later life by taking into account a range of prospective early-life and adult maternal factors. Methods In a national birth cohort study, we examined the relationship between offspring birth weight and maternal glycated haemoglobin (HbA1c) at age 53 years in 581 mothers who had a first birth between age 19 and 25 years, and had data on potential confounders or mediators. Results Mean age at first birth was 21.5 years. After adjustment for maternal body mass index (BMI), mean percentage change in maternal HbA1c per kilogram increase in offspring birth weight was −1.8%[95% confidence interval (CI) −3.5, −0.1; P = 0.03]. This relationship was mostly accounted for by gestational age that was inversely related to maternal HbA1c (−0.9%; 95% CI −1.5, −0.4; P = 0.001). Other risk factors for high HbA1c were smoking and high BMI at 53 years. There was a significant interaction between offspring birth weight and maternal childhood social class (P = 0.01). Mothers from a manual background with higher birth weight offspring had lower HbA1c (BMI adjusted: −3.1%; 95% CI −5.0, −1.1); this was not observed for mothers from a non-manual background (BMI adjusted: 1.9%; 95% CI −1.3, 5.0). Conclusions Short gestational age and low offspring birth weight may be part of a pathway linking impaired early maternal growth to diabetes risk in later life. A second possible pathway linking higher offspring birth weight to later maternal glucose status was also identified. These potential pathways require further investigation in cohorts with a wider maternal age range so that the early targeting of public health initiatives can be assessed. Diabet. Med. 25, 530–535 (2008) PMID:18445168

  4. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study

    PubMed Central

    Wang, Sufang; Ge, Xing; Zhu, Beibei; Xuan, Yujie; Huang, Kun; Rutayisire, Erigene; Mao, Leijing; Huang, Sanhuan; Yan, Shuangqin; Tao, Fangbiao

    2016-01-01

    Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma’anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma’anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA) births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04)). This relation was strong or monotonic after adjusting for maternal age, newborn’s gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To confirm these

  5. Estimating bias from loss to follow-up in the Danish National Birth Cohort.

    PubMed

    Greene, Naomi; Greenland, Sander; Olsen, Jørn; Nohr, Ellen Aagaard

    2011-11-01

    Loss to follow-up in cohort studies may result in biased association estimates. Of 61,895 women entering the Danish National Birth Cohort and completing the first data-collection phase, 37,178 (60%) opted to be in the 7-year follow-up. Using national registry data to obtain end point information on all members of the cohort, we estimated associations in the baseline and the 7-year follow-up participant populations for 5 exposure-outcome associations: (a) size at birth and childhood asthma, (b) assisted reproductive treatment and childhood hospitalizations, (c) prepregnancy body mass index and childhood infections, (d) alcohol drinking in early pregnancy and childhood developmental disorders, and (e) maternal smoking in pregnancy and childhood attention-deficit hyperactivity disorder (ADHD). We estimated follow-up bias in the odds or rate ratios by calculating relative ratios. For all but one of the above analyses, the bias appeared to be small, between -10% and +8%. For maternal smoking in pregnancy and childhood ADHD, we estimated a positive bias of approximately 33% (95% bootstrap limits of -30% and +152%). The presence and magnitude of bias due to loss to follow-up depended on the nature of the factors or outcomes examined, with the most pronounced contribution in this study coming from maternal smoking. Our methods and results may inform bias analyses in future pregnancy cohort studies.

  6. The Association Between Health Insurance Coverage and Skilled Birth Attendance in Ghana: A National Study.

    PubMed

    Khan, Shane M; Singh, Kavita

    2016-03-01

    Skilled birth attendance (SBA) is a key health intervention used by roughly two-thirds of women in Ghana. The National Health Insurance Scheme provided by the Government of Ghana is widely expected to improve maternal health outcomes by removing financial barriers to health services. In this paper, we examine if indeed health insurance is able to improve SBA, a key maternal outcome. We use data from the 2011 Ghana Multiple Indicator Cluster Survey implemented by the Ghana Statistical Services with support from the United Nations Children's Fund (UNICEF). We use a multivariate logistic model controlling for a number of enabling and predisposing factors and past experience with the health system to examine the effect of health insurance on skilled birth attendance. The sample is 2528 women. Our results show that women with health insurance are 47 % more likely to use SBA than women without health insurance. Results also underscore that women with repetitive contact with the health system (such as antenatal care) are more likely to have a skilled delivery (OR 3.00, p value 0.000). We also find that higher parity, rural and poor women are much less likely to use SBA. Health insurance may indeed be a useful mechanism to improve coverage of SBA, though many barriers to delivery care still exist for women. Further work to understand the effect of health insurance on other maternal outcomes is also warranted.

  7. Differences in risk factors for 2nd and 3rd degree hypospadias in the National Birth Defects Prevention Study

    PubMed Central

    in 't Woud, Sander Groen; van Rooij, Iris A.L.M.; van Gelder, Marleen M.H.J.; Olney, Richard S.; Carmichael, Suzan L.; Roeleveld, Nel; Reefhuis, Jennita

    2015-01-01

    Background Hypospadias is a frequent birth defect with three phenotypic subtypes. With data from the National Birth Defects Prevention Study, a large, multi-state, population-based, case-control study, we compared risk factors for second and third degree hypospadias. Methods A wide variety of data on maternal and pregnancy-related risk factors for isolated second and third degree hypospadias was collected via computer-assisted telephone interviews to identify potential etiological differences between the two phenotypes. Logistic regression was used to calculate odds ratios including a random effect by study center. Results In total, 1547 second degree cases, 389 third degree cases, and 5183 male controls were included in our study. Third degree cases were more likely to have a non-Hispanic black or Asian/Pacific Islander mother, be delivered preterm, have a low birth weight, be small for gestational age, and be conceived with fertility treatments than second degree cases and controls. Associations with both second and third degree hypospadias were observed for maternal age, family history, parity, plurality, and hypertension during pregnancy. Risk estimates were generally higher for third degree hypospadias except for family history. Conclusions Most risk factors were associated with both or neither phenotype. Therefore, it is likely that the underlying mechanism is at least partly similar for both phenotypes. However, some associations were different between 2nd and 3rd degree hypospadias, and went in opposite directions for second and third degree hypospadias for Asian/Pacific Islander mothers. Effect estimates for subtypes of hypospadias may be over- or underestimated in studies without stratification by phenotype. PMID:25181604

  8. Streamlining and Large Ancestral Genomes in Archaea Inferred with a Phylogenetic Birth-and-Death Model

    PubMed Central

    Miklós, István

    2009-01-01

    Homologous genes originate from a common ancestor through vertical inheritance, duplication, or horizontal gene transfer. Entire homolog families spawned by a single ancestral gene can be identified across multiple genomes based on protein sequence similarity. The sequences, however, do not always reveal conclusively the history of large families. To study the evolution of complete gene repertoires, we propose here a mathematical framework that does not rely on resolved gene family histories. We show that so-called phylogenetic profiles, formed by family sizes across multiple genomes, are sufficient to infer principal evolutionary trends. The main novelty in our approach is an efficient algorithm to compute the likelihood of a phylogenetic profile in a model of birth-and-death processes acting on a phylogeny. We examine known gene families in 28 archaeal genomes using a probabilistic model that involves lineage- and family-specific components of gene acquisition, duplication, and loss. The model enables us to consider all possible histories when inferring statistics about archaeal evolution. According to our reconstruction, most lineages are characterized by a net loss of gene families. Major increases in gene repertoire have occurred only a few times. Our reconstruction underlines the importance of persistent streamlining processes in shaping genome composition in Archaea. It also suggests that early archaeal genomes were as complex as typical modern ones, and even show signs, in the case of the methanogenic ancestor, of an extremely large gene repertoire. PMID:19570746

  9. Early Signs of Autism in Toddlers: A Follow-Up Study in the Danish National Birth Cohort

    ERIC Educational Resources Information Center

    Lemcke, Sanne; Juul, Svend; Parner, Erik T.; Lauritsen, Marlene B.; Thorsen, Poul

    2013-01-01

    To identify possible early signs of autism spectrum disorder (ASD) within the Danish National Birth Cohort, we studied prospectively collected interviews from 76,441 mothers about their children's development and behaviour at 6 and 18 months. In Danish national registries, 720 children with ASD and 231 children with intellectual disability (ID)…

  10. Early Signs of Autism in Toddlers: A Follow-Up Study in the Danish National Birth Cohort

    ERIC Educational Resources Information Center

    Lemcke, Sanne; Juul, Svend; Parner, Erik T.; Lauritsen, Marlene B.; Thorsen, Poul

    2013-01-01

    To identify possible early signs of autism spectrum disorder (ASD) within the Danish National Birth Cohort, we studied prospectively collected interviews from 76,441 mothers about their children's development and behaviour at 6 and 18 months. In Danish national registries, 720 children with ASD and 231 children with intellectual disability (ID)…

  11. Prenatal nitrate intake from drinking water and selected birth defects in offspring of participants in the national birth defects prevention study.

    PubMed

    Brender, Jean D; Weyer, Peter J; Romitti, Paul A; Mohanty, Binayak P; Shinde, Mayura U; Vuong, Ann M; Sharkey, Joseph R; Dwivedi, Dipankar; Horel, Scott A; Kantamneni, Jiji; Huber, John C; Zheng, Qi; Werler, Martha M; Kelley, Katherine E; Griesenbeck, John S; Zhan, F Benjamin; Langlois, Peter H; Suarez, Lucina; Canfield, Mark A

    2013-09-01

    Previous studies of prenatal exposure to drinking-water nitrate and birth defects in offspring have not accounted for water consumption patterns or potential interaction with nitrosatable drugs. We examined the relation between prenatal exposure to drinking-water nitrate and selected birth defects, accounting for maternal water consumption patterns and nitrosatable drug exposure. With data from the National Birth Defects Prevention Study, we linked addresses of 3,300 case mothers and 1,121 control mothers from the Iowa and Texas sites to public water supplies and respective nitrate measurements. We assigned nitrate levels for bottled water from collection of representative samples and standard laboratory testing. Daily nitrate consumption was estimated from self-reported water consumption at home and work. With the lowest tertile of nitrate intake around conception as the referent group, mothers of babies with spina bifida were 2.0 times more likely (95% CI: 1.3, 3.2) to ingest ≥ 5 mg nitrate daily from drinking water (vs. < 0.91 mg) than control mothers. During 1 month preconception through the first trimester, mothers of limb deficiency, cleft palate, and cleft lip cases were, respectively, 1.8 (95% CI: 1.1, 3.1), 1.9 (95% CI: 1.2, 3.1), and 1.8 (95% CI: 1.1, 3.1) times more likely than control mothers to ingest ≥ 5.42 mg of nitrate daily (vs. < 1.0 mg). Higher water nitrate intake did not increase associations between prenatal nitrosatable drug use and birth defects. Higher water nitrate intake was associated with several birth defects in offspring, but did not strengthen associations between nitrosatable drugs and birth defects.

  12. Maternal Thyroid Autoantibody and Elevated Risk of Autism in a National Birth Cohort

    PubMed Central

    Brown, Alan S.; Surcel, Heljä-Marja; Hinkka-Yli-Salomäki, Susanna; Cheslack-Postava, Keely; Bao, Yuanyuan; Sourander, Andre

    2014-01-01

    Objective Autoimmune disruption may contribute to risk for autism; however, since previous studies relied upon clinical diagnoses, exposure misclassification and recall bias are limitations. Thyroid peroxidase antibody (TPO-Ab) is an autoantibody involved in autoimmune thyroiditis. We aimed to test the a priori hypothesis that positivity to maternal serum TPO-Ab (TPO-Ab+) (defined as > 156 IU/ml) during pregnancy is related to childhood autism. Method The study was based on a nested case-control design of the Finnish Prenatal Study of Autism (FiPS-A), a national birth cohort that includes prospectively drawn archived maternal serum specimens from virtually the entire pregnant population of Finland. Cases of childhood autism (ICD-10 F84.0) born from 1987–2005 were ascertained by performing linkages between national birth and inpatient/outpatient registries. All diagnosed cases of childhood autism in Finland over the birth years, and comparison subjects without ASD or severe/profound intellectual disability were matched 1:1 on date of birth, sex, birthplace, and residence in Finland. Maternal serum specimens were assayed in 967 matched case-control pairs for TPO-Ab by a chemiluminescent microparticle immunoassay blind to case/control status. Data were analyzed by conditional logistic regression for matched sets. Results The prevalence of maternal TPO-Ab+ was significantly increased in pregnancies giving rise to autism cases (6.15%) compared to controls (3.54%). The odds of autism were increased by nearly 80% among offspring of mothers who were TPO-Ab+ during pregnancy (OR=1.78, 95% CI=1.16–2.75, p=0.009), compared to mothers negative for this autoantibody. There was also a significant relationship between maternal TPO-Ab defined as a continuous variable and odds of autism (OR=1.09, 95% CI=1.01, 1.17, p=0.02). Measures of maternal thyroid hormones did not differ between groups. Conclusions These findings provide the first biomarker-based evidence that a class of

  13. Maternal thyroid autoantibody and elevated risk of autism in a national birth cohort.

    PubMed

    Brown, Alan S; Surcel, Heljä-Marja; Hinkka-Yli-Salomäki, Susanna; Cheslack-Postava, Keely; Bao, Yuanyuan; Sourander, Andre

    2015-03-03

    Autoimmune disruption may contribute to risk for autism; however, since previous studies relied upon clinical diagnoses, exposure misclassification and recall bias are limitations. Thyroid peroxidase antibody (TPO-Ab) is an autoantibody involved in autoimmune thyroiditis. We aimed to test the a priori hypothesis that positivity to maternal serum TPO-Ab (TPO-Ab+) (defined as >156 IU/ml) during pregnancy is related to childhood autism. The study was based on a nested case-control design of the Finnish Prenatal Study of Autism (FiPS-A), a national birth cohort that includes prospectively drawn archived maternal serum specimens from virtually the entire pregnant population of Finland beginning in 1983. Cases of childhood autism (ICD-10F84.0) born from 1987 to 2005 were ascertained by performing linkages between national birth and inpatient/outpatient registries. All diagnosed cases in Finland over the birth years, and comparison subjects without ASD or severe/profound intellectual disability were matched 1:1 on date of birth, sex, birthplace, and residence in Finland. Maternal serum specimens were assayed in 967 matched case-control pairs for TPO-Ab by a chemiluminescent microparticle immunoassay blind to case/control status. Data were analyzed by conditional logistic regression for matched sets. The prevalence of maternal TPO-Ab+ was significantly increased in pregnancies giving rise to autism cases (6.15%) compared to controls (3.54%). The odds of autism were increased by nearly 80% among offspring of mothers who were TPO-Ab+ during pregnancy (OR=1.78, 95% CI=1.16-2.75, p=0.009), compared to mothers negative for this autoantibody. There was also a significant relationship between maternal TPO-Ab defined as a continuous variable and odds of autism (OR=1.09, 95% CI=1.01, 1.17, p=0.02). Measures of maternal thyroid hormones did not differ between groups. These findings provide the first biomarker-based evidence that a class of known maternal autoimmune disorders is

  14. Births: Final Data for 1999. National Vital Statistics Reports, Volume 49, Number 1.

    ERIC Educational Resources Information Center

    Ventura, Stephanie J.; Martin, Joyce A.; Curtin, Sally C.; Menacker, Fay; Hamilton, Brady E.

    This report presents data on U.S. births using information from the birth certificates of the 3.96 million births in 1999. Data are presented for maternal demographics (age, live-birth order, race, Hispanic origin, marital status, and educational attainment); maternal characteristics (medical risk factors, weight gain, tobacco use, and alcohol…

  15. Births: Preliminary Data for 2011. National Vital Statistics Reports. Volume 61, Number 5

    ERIC Educational Resources Information Center

    Hamilton, Brady E.; Martin, Joyce A.; Ventura, Stephanie J.

    2012-01-01

    Objectives: This report presents preliminary data for 2011 on births in the United States. U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother. Data on marital status, cesarean delivery, preterm births, and low birthweight are also presented. Methods: Data in this report are based on approximately 100…

  16. Large effects on birth weight follow inheritance pattern consistent with gametic imprinting and X chromosome

    USDA-ARS?s Scientific Manuscript database

    Birth weight (BW) records of 28,638 Brangus and Simbrah calves (12,295 of which were produced by embryo transfer) were provided by a private seedstock breeder. The objectives were to determine the genetic mechanism(s) responsible for previously observed 12.3 and 6.9 kg differences in birth weight b...

  17. Trends in Down's syndrome live births and antenatal diagnoses in England and Wales from 1989 to 2008: analysis of data from the National Down Syndrome Cytogenetic Register.

    PubMed

    Morris, Joan K; Alberman, Eva

    2009-10-26

    To describe trends in the numbers of Down's syndrome live births and antenatal diagnoses in England and Wales from 1989 to 2008. Design and setting The National Down Syndrome Cytogenetic Register holds details of 26488 antenatal and postnatal diagnoses of Down's syndrome made by all cytogenetic laboratories in England and Wales since 1989. Antenatal screening, diagnosis, and subsequent termination of Down's syndrome pregnancies. The number of live births with Down's syndrome. Despite the number of births in 1989/90 being similar to that in 2007/8, antenatal and postnatal diagnoses of Down's syndrome increased by 71% (from 1075 in 1989/90 to 1843 in 2007/8). However, numbers of live births with Down's syndrome fell by 1% (752 to 743; 1.10 to 1.08 per 1000 births) because of antenatal screening and subsequent terminations. In the absence of such screening, numbers of live births with Down's syndrome would have increased by 48% (from 959 to 1422), since couples are starting families at an older age. Among mothers aged 37 years and older, a consistent 70% of affected pregnancies were diagnosed antenatally. In younger mothers, the proportions of pregnancies diagnosed antenatally increased from 3% to 43% owing to improvements in the availability and sensitivity of screening tests. Since 1989, expansion of and improvements in antenatal screening have offset an increase in Down's syndrome resulting from rising maternal age. The proportion of antenatal diagnoses has increased most strikingly in younger women, whereas that in older women has stayed relatively constant. This trend suggests that, even with future improvements in screening, a large number of births with Down's syndrome are still likely, and that monitoring of the numbers of babies born with Down's syndrome is essential to ensure adequate provision for their needs.

  18. Socioeconomic disparities in birth weight and body mass index during infancy through age 7 years: a study within the Danish National Birth Cohort

    PubMed Central

    Morgen, Camilla Schmidt; Mortensen, Laust Hvas; Howe, Laura D; Rasmussen, Mette; Due, Pernille; Sørensen, Thorkild I A; Andersen, Anne-Marie Nybo

    2017-01-01

    Background Socioeconomic inequalities in birth weight and in body mass index (BMI) later in childhood are in opposite directions, which raises questions about when during childhood the change in direction happens. We examined how maternal and paternal education and household income were associated with birthweight z-scores and with BMI z-scores at age 5 and 12 months and 7 years, and we examined the socioeconomic differences in the tracking of these z-scores across infancy and childhood. Methods The associations were studied in a cohort of children in the Danish National Birth Cohort, single born between 1997 and 2003, for whom information on body size from at least 1 of 4 time points (n=85 062) was recorded. We examined the associations using linear mixed-effects modelling. Results Children from families with a low maternal and paternal educational level changed their body size z-scores upwards between birth and age 7 years. At age 5 and 12 months, there were no educational gradient. A low maternal educational level was associated with lower birth weight for gestational age z-scores at birth for boys (−0.199; 95% CI −0.230 to −0.169) and girls (−0.198; 95% CI −0.229 to −0.167) and higher BMI z-scores at age 7 for boys (0.198; 95% CI 0.154 to 0.242) and girls (0.218; 95% CI 0.173 to 0.264). There was not a similarly clear pattern in the tracking between different household income groups. However, a low household income level was associated with higher z-scores of both birth weight and BMI at age 7 years, but with a much weaker gradient at 5 and 12 months. Conclusions The educational gradient shifts from positive with birth weight, to none during infancy to inverse with BMI at age 7 years. In contrast, the income gradient was positive at birth and at 7 years and much weaker during infancy. PMID:28110282

  19. Exploring prenatal outdoor air pollution, birth outcomes and neonatal health care utilization in a nationally representative sample

    PubMed Central

    Trasande, Leonardo; Wong, Kendrew; Roy, Angkana; Savitz, David A.; Thurston, George

    2015-01-01

    The impact of air pollution on fetal growth remains controversial, in part, because studies have been limited to sub-regions of the United States with limited variability. No study has examined air pollution impacts on neonatal health care utilization. We performed descriptive, univariate and multivariable analyses on administrative hospital record data from 222,359 births in the 2000, 2003 and 2006 Kids Inpatient Database linked to air pollution data drawn from the US Environmental Protection Agency’s Aerometric Information Retrieval System. In this study, air pollution exposure during the birth month was estimated based on birth hospital address. Although air pollutants were not individually associated with mean birth weight, a three-pollutant model controlling for hospital characteristics, demographics, and birth month identified 9.3% and 7.2% increases in odds of low birth weight and very low birth weight for each µg/m3 increase in PM2.5 (both P<0.0001). PM2.5 and NO2 were associated with −3.0% odds/p.p.m. and +2.5% odds/p.p.b. of preterm birth, respectively (both P<0.0001). A four-pollutant multivariable model indicated a 0.05 days/p.p.m. NO2 decrease in length of the birth hospitalization (P=0.0061) and a 0.13 days increase/p.p.m. CO (P=0.0416). A $1166 increase in per child costs was estimated for the birth hospitalization per p.p.m. CO (P=0.0002) and $964 per unit increase in O3 (P=0.0448). A reduction from the 75th to the 25th percentile in the highest CO quartile for births predicts annual savings of $134.7 million in direct health care costs. In a national, predominantly urban, sample, air pollutant exposures during the month of birth are associated with increased low birth weight and neonatal health care utilization. Further study of this database, with enhanced control for confounding, improved exposure assessment, examination of exposures across multiple time windows in pregnancy, and in the entire national sample, is supported by these initial

  20. Estimating the Impact of Large Cigarette Tax Hikes--The Case of Maternal Smoking and Infant Birth Weight

    ERIC Educational Resources Information Center

    Lien, Diana S.; Evans, William

    2005-01-01

    Substantial increases in cigarette taxes result in decrease in smoking by pregnant women. It is also observed that there is consequent improvement in infant birth weight. The conclusions are based on the data from four states that opted to raise cigarette taxes by a large margin.

  1. Age- and cause-specific contributions to income difference in life expectancy at birth: findings from nationally representative data on one million South Koreans.

    PubMed

    Khang, Young-Ho; Bahk, Jinwook; Yi, Nari; Yun, Sung-Cheol

    2016-04-01

    Income is not frequently used to monitor health equity on a national level largely due to the lack of public data on income. Information on income allows policy makers to identify the economically disadvantaged population in a country directly. We examined differences in life expectancy (LE) at birth by income and quantified age- and cause-specific contributions to the LE differences using national health insurance data. Data from a nationally representative sample of 1 097 333 South Koreans (2% of the total population) collected between 2002 and 2010 (39 737 deaths) were used. National health insurance premiums were used to estimate income level. Age- and cause-specific contributions to differences in LE at birth by income were estimated using Arriaga's decomposition method. LE at birth gradually increased with income in both genders. Interquintile income LE differences were 7.93 years in males and 3.82 years in females. Most of LE differentials were attributed to differences in mortality in middle-aged and older adults. Suicide and cerebrovascular accidents were the two leading causes of death contributing the most to income LE differences in both males and females. The top 10 causes of death accounted for over 50% of the total LE differences by income in both genders. Alcohol-related causes of death explained the majority of the gender differences in the income LE differentials. Income differentials in LE at birth according to national health insurance premiums and data linkage systems could provide a valuable opportunity for monitoring and prioritizing population health inequalities in South Korea. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. The relationship of drinking and birth outcome in a US national sample of expectant mothers.

    PubMed

    Faden, V B; Graubard, B I; Dufour, M

    1997-04-01

    Alcohol consumption by pregnant women and birth outcome were studied in 9953 livebirths, 3309 fetal deaths and 5332 infant deaths from the 1988 National Maternal and Infant Health Survey. In crude analyses, race, age, mother's education, prenatal care, parity, low birthweight, gestational age, smoking and alcohol consumption during pregnancy were significantly related to the occurrence of fetal deaths and infant deaths. Among women having livebirths, race, age, mother's education, prenatal care, prematurity, gestational age, smoking and alcohol consumption during pregnancy were significantly related to having a low birthweight baby (< 2500 g). In this group, women who drank more during pregnancy also smoked more, were younger and less educated than women who drank at lower levels or not at all. The relationship of alcohol consumption during pregnancy and infant birthweight for those women having livebirths was studied using multivariable linear regression. The results indicated that race, mother's education, baby's sex, parity, mother's height, mother's body mass index and smoking, but not alcohol consumption, were significantly related to birthweight. Multivariable logistic regressions were performed for the occurrence of low birthweight, fetal death and infant death. The effect of alcohol was significant in all these analyses. These results indicate that alcohol has an important relationship with birth outcome, but that for the drinking reported in this study, the alcohol effect on mean birthweight is small relative to that of other risk factors, accounting for the non-significant result in the multiple linear regression.

  3. Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis

    PubMed Central

    Shiferaw, Solomon; Abdullah, Muna; Mekonnen, Yared; Maïga, Abdoulaye; Akinyemi, Akanni; Amouzou, Agbessi; Friedman, Howard; Barros, Aluisio J. D.; Hounton, Sennen

    2015-01-01

    Background Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR) and distribution of births by demographic risk factors as defined by mother's age, birth interval, and birth order at the sub-national level in Ethiopia. Design Analyses used data from three Demographic and Health Surveys in Ethiopia (2000, 2005, and 2011), which are nationally representative data collected through questionnaire-based interviews from women 15–49 using a stratified, two-stage cluster sampling. First, we examined the trends of and relationship between TFR (in the 3 years before each survey) and modern contraceptive use among currently married women in all administrative regions over the time period 2000–2011 using linear regression analysis. We also examined the relationship between birth risks and under-five mortality using the no-risk group as a reference. Finally, multiple logistic regression analysis was performed to estimate the relationship between the effect of being a resident in one of the regions and having an avoidable birth risk (which includes births to mothers younger than 18 and older than 34 years, birth interval of less than 24 months and birth order higher than third) after adjusting for select covariates including wealth, educational status, residence, religion and exposure to family planning information. Results Sub-national-level regression analysis showed an inverse relationship between modern contraceptive use among married women and the TFR, with an average decrease of TFR by one child per woman associated with a 13 percentage point increase in modern contraceptive use between 2000 and 2011. A high percentage of births in Ethiopia (62%) fall in one of the risk categories (excluding first births), with wide

  4. Parental divorce and adult psychological distress: evidence from a national birth cohort: a research note.

    PubMed

    Rodgers, B; Power, C; Hope, S

    1997-10-01

    An association was found between childhood parental divorce and adult psychological distress in a British national birth cohort at ages 23 and 33. No moderating effects were found for gender, age at separation, or remarriage of the custodial parent. Participants who were young adults when their parents divorced also showed increased levels of symptomatology, whereas those who experienced parental death in childhood showed no increased risk. An interaction between parental divorce and own divorce in women, giving particularly high symptom levels, arose from a selection process in those from divorced families of origin only, with high 23-year scores predicting subsequent divorce. Own divorce was associated with an increase in distress between age 23 and 33, but this was irrespective of family of origin.

  5. Birth outcomes and infant mortality among First Nations Inuit, and non-Indigenous women by northern versus southern residence, Quebec

    PubMed Central

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

    2011-01-01

    Background In circumpolar countries such as Canada, northern regions represent a unique geographical entity climatically, socioeconomically and environmentally. There is a lack of comparative data on birth outcomes among Indigenous and non-Indigenous subpopulations within northern regions and compared with southern regions. Methods A cohort study of all births by maternal mother tongue to residents of northern (2616 First Nations (North American Indians), 2388 Inuit and 5006 non-Indigenous) and southern (2563 First Nations, 810 643 non-Indigenous) Quebec, 1991–2000. Results Compared with births to southern non-Indigenous mother tongue women, births to northern women of all three mother tongue groups were at substantially elevated risks of infant death (adjusted OR (aOR) 1.7–2.9), especially postneonatal death (aOR 2.2–4.4) after controlling for maternal education, age, marital status and parity. The risk elevation in perinatal death was greater for southern First Nations (aOR 1.6) than for northern First Nations (aOR 1.2). Infant macrosomia was highly prevalent among First Nations in Quebec, especially in the north (31% vs 24% in the south). Within northern regions, Inuit births were at highest risk of preterm delivery (aOR 1.4) and infant death (aOR 1.6). Conclusion All northern infants (First Nations, Inuit or non-Indigenous) were at substantially elevated risk of infant death in Quebec, despite a universal health insurance system. Southern First Nations newborns have not benefited from the more advanced perinatal care facilities in southern regions. Environmental influences may partly account for the very high prevalence of macrosomia among First Nations in northern Quebec. PMID:21051777

  6. Association between Native American-owned casinos and the prevalence of large-for-gestational-age births.

    PubMed

    Jones-Smith, Jessica C; Dow, William H; Oddo, Vanessa M

    2017-04-19

    A small number of studies have used a natural experiment approach to examine the health impacts of increased economic resources stemming from Native American-owned casinos. We build on this work by examining whether casinos are associated with obesity-related health in utero . We examined whether casino openings or expansion (as proxy for increased economic resources) are associated with a decreased likelihood of infants being born large-for-gestational-age (LGA), an important risk factor for childhood overweight/obesity. We used repeated cross-sectional data from California birth records (1987-2011) to assess the prevalence of LGA births among Native Americans ( n = 21 011). Using zip code fixed-effect regression models, we compared how prevalence of LGA births changed in association with casino openings or expansions, while controlling for secular trends through the inclusion of a comparison group of Native American newborns in zip codes that were eligible to open or expand casinos, but did not do so. In sensitivity analyses, we evaluated whether there was any change in small-for-gestational-age births (SGA). Average prevalence of LGA births over the period was 11%. Every one slot machine per capita increase was associated with a 0.13 percentage point decrease (95% confidence interval: -0.25, -0.01) in the prevalence of LGA births but was not associated with SGA prevalence. Casino expansion in California is associated with a lower prevalence of LGA births. Interpreted in combination with previous work showing that California casino expansions were associated with a lower body mass index (BMI) among schoolchildren, these results suggest that casinos are associated with improvement in a surrogate marker of excess adiposity. Further studies are needed to elucidate the mechanisms by which casinos might be associated with obesity-related health outcomes among Native Americans.

  7. Birth seasonality and calf mortality in a large population of Asian elephants

    PubMed Central

    Mumby, Hannah S; Courtiol, Alexandre; Mar, Khyne U; Lummaa, Virpi

    2013-01-01

    In seasonal environments, many species concentrate their reproduction in the time of year most likely to maximize offspring survival. Asian elephants (Elephas maximus) inhabit regions with seasonal climate, but females can still experience 16-week reproductive cycles throughout the year. Whether female elephants nevertheless concentrate births on periods with maximum offspring survival prospects remains unknown. We investigated the seasonal timing of births, and effects of birth month on short- and long-term mortality of Asian elephants, using a unique demographic data set of 2350 semicaptive, longitudinally monitored logging elephants from Myanmar experiencing seasonal variation in both workload and environmental conditions. Our results show variation in birth rate across the year, with 41% of births occurring between December and March. This corresponds to the cool, dry period and the beginning of the hot season, and to conceptions occurring during the resting, nonlogging period between February and June. Giving birth during the peak December to March period improves offspring survival, as the odds for survival between age 1 and 5 years are 44% higher for individuals born during the high birth rate period than those conceived during working months. Our results suggest that seasonal conditions, most likely maternal workload and/or climate, limit conception rate and calf survival in this population through effects on maternal stress, estrus cycles, or access to mates. This has implications for improving the birth rate and infant survival in captive populations by limiting workload of females of reproductive age. As working populations are currently unsustainable and supplemented through the capture of wild elephants, it is imperative to the conservation of Asian elephants to understand and alleviate the effects of seasonal conditions on vital rates in the working population in order to reduce the pressure for further capture from the wild. PMID:24198940

  8. Premature Birth and Large for Gestational Age Are Associated with Risk of Barrett’s Esophagus in Adults

    PubMed Central

    Shiota, Seiji; El-Serag, Hashem B.; Thrift, Aaron P.

    2015-01-01

    Background Birth characteristics, including weight and gestational age, may be associated with risk of Barrett’s esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited. Aims To examine associations between various birth characteristics and BE, and whether these associations are mediated by known risk factors for BE. Methods Data were obtained from a cross-sectional study among eligible Veterans Affairs patients scheduled for an upper endoscopy, and a sample identified from primary care clinics. Participants underwent an esophagogastroduodenoscopy and completed a survey that captured information on sociodemographic and clinical factors, as well as birth information. We compared 263 patients with histologically confirmed BE to 1,416 controls without BE on endoscopy. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using multivariate logistic regression. Results Premature birth was independently associated with risk of BE after adjusted by age, sex, race, and other birth characteristics (OR 3.28, 95% CI 1.22–8.79). On the other hand, large for gestational age was inversely associated with risk of BE (OR 0.46, 95% CI 0.21–0.98). These effects were stronger for patients with long-segment BE than short-segment BE. The associations were not mediated by gastroesophageal reflux disease symptoms, use of proton pump inhibitors, Helicobacter Pylori infection, waist-hip-ratio, height or presence of hiatus hernia. Conclusions Premature birth and large for gestational age may be associated with risk of BE in adults. These associations do not appear to be mediated through known risk factors for BE; however, additional studies are required to confirm our findings. PMID:26611860

  9. Prenatal exposure to loratadine in children with hypospadias: a nested case-control study within the Danish National Birth Cohort.

    PubMed

    Pedersen, Lars; Nørgaard, Mette; Skriver, Mette Vinther; Olsen, Jørn; Sørensen, Henrik Toft

    2006-01-01

    The aim of this study was to examine the risk of hypospadias after reported exposure to loratadine and other antihistamines during pregnancy, based on data from the Danish National Birth Cohort. We examined the risk of hypospadias in a nested case-control design based on women enrolled in the Danish National Birth Cohort from 1998 to 2002 ( approximately 95,000 pregnant women). Data on maternal use of medicine in pregnancy were retrieved from questionnaires and telephone interviews, and data on birth outcomes were obtained from the Hospital Discharge Registry (HDR). Within the Danish National Birth Cohort, we identified cases with a diagnosis of hypospadias and randomly selected 10 controls per case without such a diagnosis (matched by date of birth). We identified 203 cases of hypospadias recorded in the HDR within 1 year postpartum and 2030 controls. One case (0.5%) and 25 (1.2%) controls reported exposure to loratadine in the first trimester or up to 30 days before the time of conception. The adjusted odds ratio (OR) for hypospadias among users of loratadine relative to nonusers was 0.9 (95% CI: 0.1-6.9) and the corresponding OR for other antihistamines was 0.5 (95% CI: 0.1-1.9). These data do not indicate an increased risk of hypospadias associated with maternal exposure to loratadine. In addition, this study does not suggest any risk differential between maternal exposure to loratadine and other antihistamines. However, the statistical precision of the risk estimates was low.

  10. Large prospective birth cohort studies on environmental contaminants and child health – Goals, challenges, limitations and needs

    PubMed Central

    Luo, Zhong-Cheng; Liu, Jian-Meng; Fraser, William D.

    2011-01-01

    SUMMARY The adverse health effects of environmental contaminants (ECs) are a rising public health concern, and a major threat to sustainable socioeconomic development. The developing fetuses and growing children are particularly vulnerable to the adverse effects of ECs. However, assessing the health impact of ECs presents a major challenge, given that multiple outcomes may arise from one exposure, multiple exposures may result in one outcome, and the complex interactions between ECs, and between ECs, nutrients and genetic factors, and the dynamic temporal changes in EC exposures during the life course. Large-scale prospective birth cohort studies collecting extensive data and specimen starting from the prenatal or pre-conception period, although costly, hold promise as a means to more clearly quantify the health effects of ECs, and to unravel the complex interactions between ECs, nutrients and genotypes. A number of such large-scale studies have been launched in some developed counties. We present an overview of “why”, “what” and “how” behind these efforts with an objective to uncover major unidentified limitations and needs. Three major limitations were identified: (1) limited data and bio-specimens regarding early life EC exposure assessments in some birth cohort studies; (2) heavy participant burdens in some birth cohort studies may bias participant recruitment, and risk substantial loss to follow-up, protocol deviations limiting the quality of data and specimens collection, with an overall potential bias towards the null effect; (3) lack of concerted efforts in building comparable birth cohorts across countries to take advantage of natural “experiments” (large EC exposure level differences between countries) for more in-depth assessments of dose–response relationships, threshold exposure levels, and positive and negative effect modifiers. Addressing these concerns in current or future large-scale birth cohort studies may help to produce better

  11. Declines in Teenage Birth Rates, 1991-97: National and State Patterns.

    ERIC Educational Resources Information Center

    Ventura, Stephanie J.; Mathews, T. J.; Curtin, Sally C.

    1998-01-01

    This report presents data on the numbers of teenage births and teenage birth rates for the United States for the period 1950-97 and state-specific birth rates for teenagers for 1991-96. After increasing sharply in the late 1980s, birth rates declined for American teenagers from 1991 through 1997. Rates fell overall by 16% for teenagers aged 15-17…

  12. Family size, birth order, and intelligence in a large South American sample.

    PubMed

    Velandia, W; Grandon, G M; Page, E B

    1978-01-01

    The confluence theory, which hypothesizes a relationship between intellectual development birth order, and family size, was examined in a colombian study of more than 36,000 college applicants. The results of the study did not support the confluence theory. The confluence theory states that the intellectual development of a child is related to average mental age of the members of his family at the time of his birth. The mental age of the parents is always assigned a value of 30 and siblings are given scores equivalent to their chronological age at the birth of the subject. Therefore, the average mental age of family members for a 1st born child is 30, or 60 divided by 2. If a subject is born into a family consisting of 2 parents and a 6-year old sibling, the average mental age of family members tends, therefore, to decrease with each birth order. The hypothesis derived from the confluence theory states that there is a positive relationship between average mental age of a subject's family and the subject's performance on intelligence tests. In the Colombian study, data on family size, birth order and socioeconomic status was derived from college application forms. Intelligence test scores for each subject was obtained from college entrance exams. The mental age of each applicant's family at the time of the applicant's birth was calculated. Multiple correlation analysis and path analysis were used to assess the relationship. Results were 1) the test scores of subjects from families with 2,3,4, and 5 children were higher than test scores of the 1st born subjects; 2) the rank order of intelligence by family size was 3,4,5,2,6,1 instead of the hypothesized 1,2,3,4,5,6; and 3) only 1% of the variability in test scores was explained by the variables of birth order and family size. Further analysis indicated that socioeconomic status was a far more powerful explanatory variable than family size.

  13. A prominent large high-density lipoprotein at birth enriched in apolipoprotein C-I identifies a new group of infancts of lower birth weight and younger gestational age

    SciTech Connect

    Kwiterovich Jr., Peter O.; Cockrill, Steven L.; Virgil, Donna G.; Garrett, Elizabeth; Otvos, James; Knight-Gibson, Carolyn; Alaupovic, Petar; Forte, Trudy; Farwig, Zachlyn N.; Macfarlane, Ronald D.

    2003-10-01

    Because low birth weight is associated with adverse cardiovascular risk and death in adults, lipoprotein heterogeneity at birth was studied. A prominent, large high-density lipoprotein (HDL) subclass enriched in apolipoprotein C-I (apoC-I) was found in 19 percent of infants, who had significantly lower birth weights and younger gestational ages and distinctly different lipoprotein profiles than infants with undetectable, possible or probable amounts of apoC-I-enriched HDL. An elevated amount of an apoC-I-enriched HDL identifies a new group of low birth weight infants.

  14. National Survey To Validate General Growth Outcomes for Children between Birth and Age Eight: Initial Results. Technical Report #3.

    ERIC Educational Resources Information Center

    McConnell, Scott; McEvoy, Mary; Carta, Judith J.; Greenwood, Charles R.; Kaminski, Ruth; Good, Roland H., III; Shinn, Mark

    This monograph reports on a national mail survey to validate a set of general growth outcomes for children, including those with disabilities, between birth and age 8. The survey was part of a 5-year project to create a comprehensive measurement system to track the developmental progress of individual children with disabilities in this age range…

  15. Infertility, infertility treatment and psychomotor development: the Danish National Birth Cohort.

    PubMed

    Zhu, Jin Liang; Basso, Olga; Obel, Carsten; Hvidtjørn, Dorte; Olsen, Jørn

    2009-03-01

    Babies born of infertile couples, regardless of treatment, have a higher risk of preterm birth and low birthweight, conditions associated with delayed development. We examined developmental milestones in singletons as a function of parental infertility [time to pregnancy (TTP) > 12 months] and infertility treatment. From the Danish National Birth Cohort (1997-2003), we identified 37 897 singletons born of fertile couples (TTP < or = 12 months), 4351 born of infertile couples conceiving naturally (TTP > 12 months), and 3309 born after infertility treatment. When the children were about 18 months old, mothers reported 12 developmental milestones by responding to structured questions. We defined a failure to achieve the assessed milestone or the minimal numbers of milestones in a summary (motor, or cognitive/language skills) as delay. Naturally conceived children born of infertile couples had a pattern of psychomotor development similar to that of children born of fertile couples, but increasing TTP correlated with a modest delay. When the analysis was restricted to infertile couples (treated and untreated), children born after treatment showed a slight delay in cognitive/language development (odds ratio 1.24, [95% confidence interval 1.01, 1.53]) for not meeting at least three out of six cognitive/language milestones); children born after intracytoplasmic sperm injection (ICSI) had the highest estimated relative risk of delay for most milestones, especially motor milestones. These results suggest that a long TTP may be associated with a modest developmental delay. Infertility treatment, especially ICSI, may be associated with a slight delay for some of these early milestones.

  16. Birth centres and the national maternity services review: response to consumer demand or compromise?

    PubMed

    Dahlen, H; Jackson, M; Schmied, V; Tracy, S; Priddis, H

    2011-12-01

    In February 2009 the Improving Maternity Services in Australia - The Report of the Maternity Services Review (MSR) was released and recommended improving women's access to and availability of birth centres. It was unclear if this was in response to an overwhelming request for birth centres in the submissions received by the commonwealth or a compromise for excluding homebirth from the maternity service reforms. The aim of this paper was to examine what was said in the submissions to the MSR about birth centres. Data for this study comprised 832 submissions to the MSR that are publicly available on the Commonwealth of Australia Department of Health and Ageing website. All 832 submissions were downloaded, and read for any mention of the words 'birth centre', 'birth center'. Content analysis was used to categorise and report the data. Of the 832 submissions to the MSR 197 (24%) mentioned birth centres while 470 (60%) of the submissions mentioned homebirth. Only 31 (4%) of the submissions to the Maternity Review mentioned birth centres without mentioning home birth also. Most of the submissions emphasised that 'everything should be on the menu' when it came to place of birth and care provider. Reasons for choosing a birth centre were identified as: 'the best compromise available, 'the right and natural way' and 'the birth centre as safe'. Women had certain requirements of a birth centre that included: 'continuity of carer', 'midwife led', 'a sanctum from medicalised care', 'resources to cope with demand', 'close to home', and 'flexible guidelines and admission criteria'. Women weighed up a series of requirements when deciding whether to give birth in a birth centre. The recommendation by the MSR to expand birth centres and ignore home birth is at odds with the strong view expressed that 'everything should be on the menu'. The requirements women described of birth centre care are also at odds with current trends. If there is to be an expansion of birth centres, service

  17. Risk factors of preterm birth in France in 2010 and changes since 1995: Results from the French National Perinatal Surveys.

    PubMed

    Prunet, C; Delnord, M; Saurel-Cubizolles, M-J; Goffinet, F; Blondel, B

    2017-01-01

    To investigate risk factors of total, spontaneous and induced preterm birth in 2010 and differences between 1995 and 2010. The national perinatal surveys are based on a representative sample of births in France. We selected live-born singletons (n=14,326 in 2010 and 12,885 in 1995) and used multiple regression analyses to calculate adjusted odds ratios (aOR) for maternal sociodemographic characteristics, obstetric history, prenatal care and smoking. The main risk factors in 2010 were parity 1 compared to parity 2 (aOR=1.9 [95% CI 1.5-1.3]), previous preterm delivery (aOR=6.6 [5.0-8.7]), pre-pregnancy body mass index<18.5 compared to 18.5-24.9kg/m(2) (aOR=1.7 [1.4-2.2]), level of education completed: high school or less, inadequate prenatal care and cannabis use. Most risk factors of spontaneous and induced preterm births were similar. Compared to 1995, maternal age≥35 years and previous induced abortion were no longer associated with preterm birth in 2010. Identified risk factors for preterm birth in France in 2010 agree with the literature. Increases in baseline rates for maternal age and medically induced abortions may explain changes in certain preterm birth risk factors. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. [Impact and changes of maternal hemoglobin on birth weight in pregnant women of Zhuang Nationality, in Guangxi].

    PubMed

    Chen, J H; Guo, X F; Liu, S; Long, J H; Zhang, G Q; Huang, M C; Qiu, X Q

    2017-02-10

    Objective: To investigate the hemoglobin (Hb) levels during pregnancy and Hb changes from early pregnancy and association with birth weight on infants. Methods: Mothers of Zhuang Nationality who participated in the pregnancy care program and delivered at the Pingguo County Hospital from May 2013 to May 2015 were included in this study. Retrospective analysis was applied to collect data of health care and pregnancy outcomes. Multiple regression analysis and unconditional logistic regression model were used for data analysis. Results: The mean birth weight appeared as (313 5.92±435.84) grams. The Hb levels at early pregnancy showed significantly positive association with birth weight. Results from our study demonstrated that when Hb levels increased + 1 g/dl at early pregnancy, birth weight would increase 17.61(95% CI: 0.60-34.67) grams, in the adjusted model. The Hb levels at late pregnancy were significantly inversely associated with birth weight. Our findings suggested that when Hb levels increased + 1 g/dl at late pregnancy, birth weight would reduce 19.61(95% CI: -37.53 --1.70) grams in the adjusted model. Changes in Hb from early pregnancy stages were significantly inversely associated with birth weight after adjusting for confounders and Hb levels in the early pregnancy stages. The results also indicated that when Hb levels increased a + 1 g/dl from early to late pregnancy, the birth weight would decrease 32.63 g(95% CI: -48.93--16.32). Compared to the non-anemia group, the anemia group showed significantly increase of small-for-gestational-age (SGA)(OR=1.58, 95%CI: 1.08-2.32) in early pregnancy. Compared to women under the most reduction status, women with the least reduction had a significantly increase of SGA (OR= 1.87, 95% CI:1.24-2.81) among their infants. With the magnitude of reduction on Hb concentration during pregnancy, the risk of delivering babies with SGA showed a gradual trends of increase. Conclusion: Hb levels at early pregnancy were

  19. Child Maltreatment and Adolescent Mental Health Problems in a Large Birth Cohort

    ERIC Educational Resources Information Center

    Mills, Ryan; Scott, James; Alati, Rosa; O'Callaghan, Michael; Najman, Jake M.; Strathearn, Lane

    2013-01-01

    Objective: To examine whether notified child maltreatment is associated with adverse psychological outcomes in adolescence, and whether differing patterns of psychological outcome are seen depending on the type of maltreatment. Methods: The participants were 7,223 mother and child pairs enrolled in a population-based birth cohort study in…

  20. Child Maltreatment and Adolescent Mental Health Problems in a Large Birth Cohort

    ERIC Educational Resources Information Center

    Mills, Ryan; Scott, James; Alati, Rosa; O'Callaghan, Michael; Najman, Jake M.; Strathearn, Lane

    2013-01-01

    Objective: To examine whether notified child maltreatment is associated with adverse psychological outcomes in adolescence, and whether differing patterns of psychological outcome are seen depending on the type of maltreatment. Methods: The participants were 7,223 mother and child pairs enrolled in a population-based birth cohort study in…

  1. Planning, Designing, Building, and Moving a Large Volume Maternity Service to a New Labor and Birth Unit.

    PubMed

    Thompson, Heather; Legorreta, Kimberly; Maher, Mary Ann; Lavin, Melanie M

    Our health system recognized the need to update facility space and associated technology for the labor and birth unit within our large volume perinatal service to improve the patient experience, and enhance safety, quality of care, and staff satisfaction. When an organization decides to invest $30 million dollars in a construction project such as a new labor and birth unit, many factors and considerations are involved. Financial support, planning, design, and construction phases of building a new unit are complex and therefore require strong interdisciplinary collaboration, leadership, and project management. The new labor and birth unit required nearly 3 years of planning, designing, and construction. Patient and family preferences were elicited through consumer focus groups. Multiple meetings with the administrative and nursing leadership teams, staff nurses, nurse midwives, and physicians were held to generate ideas for improvement in the new space. Involving frontline clinicians and childbearing women in the process was critical to success. The labor and birth unit moved to a new patient tower in a space that was doubled in square footage and geographically now on three separate floors. In the 6 months prior to the move, many efforts were made in our community to share our new space. The marketing strategy was very detailed and creative with ongoing input from the nursing leadership team. The nursing staff was involved in every step along the way. It was critical to have champions as workflow teams emerged. We hosted simulation drills and tested scenarios with new workflows. Move day was rehearsed with representatives of all members of the perinatal team participating. These efforts ultimately resulted in a move time of ~5 hours. Birth volumes increased 7% within the first 6 months. After 3 years in our new space, our birth volumes have risen nearly 15% and are still growing. Key processes and roles responsible for a successful build, efficient and safe move

  2. A National Census of Birth Weight in Purebred Dogs in Italy

    PubMed Central

    Groppetti, Debora; Pecile, Alessandro; Palestrini, Clara; Marelli, Stefano P.; Boracchi, Patrizia

    2017-01-01

    Simple Summary Birth weight is a key factor for neonatal mortality and morbidity in most mammalian species. The great morphological variability in size, body weight and breed, as well as in skeletal and cranial conformation makes it challenging to define birth weight standards in dogs. A total of 3293 purebred pups were surveyed to study which maternal aspects can determine birth weight considering head and body shape, size, body weight and breed in bitches, as well as litter size and sex in pups. In our sample, multivariate analysis outcomes suggested that birth weight and litter size were directly proportional to maternal size. The maternal body shape influenced both birth weight and litter size, whereas the maternal head shape had impact only on birth weight. Sex differences in birth weight were found. Birth weight and litter size also varied among breeds. The results of the present study could have practical implications allowing one to identify pups in need of admission to intensive nursing care, as occurs in humans. A deeper knowledge of the factors that significantly influence birth weight could positively affect the canine breeding management helping to prevent and reduce neonatal mortality. Abstract Despite increasing professionalism in dog breeding, the physiological range of birth weight in this species remains unclear. Low birth weight can predispose to neonatal mortality and growth deficiencies in humans. To date, the influence of the morphotype on birth weight has never been studied in dogs. For this purpose, an Italian census of birth weight was collected from 3293 purebred pups based on maternal morphotype, size, body weight and breed, as well as on litter size and sex of pups. Multivariate analysis outcomes showed that birth weight (p < 0.001) and litter size (p < 0.05) increased with maternal size and body weight. Birth weight was also influenced by the maternal head and body shape, with brachycephalic and brachymorph dogs showing the heaviest and

  3. National evaluation for calving ease, gestation length and birth weight by linear and threshold model methodologies.

    PubMed

    Lee, Deukhwan; Misztal, Ignacy; Bertrand, J Keith; Rekaya, Romdhane

    2002-01-01

    Data included 393,097 calving ease, 129,520 gestation length, and 412,484 birth weight records on 412,484 Gelbvieh cattle. Additionally, pedigrees were available on 72,123 animals. Included in the models were effects of sex and age of dam, treated as fixed, as well as direct, maternal genetic and permanent environmental effects and effects of contemporary group (herd-year-season), treated as random. In all analyses, birth weight and gestation length were treated as continuous traits. Calving ease (CE) was treated either as a continuous trait in a mixed linear model (LM), or as a categorical trait in linear-threshold models (LTM). Solutions in TM obtained by empirical Bayes (TMEB) and Monte Carlo (TMMC) methodologies were compared with those by LM. Due to the computational cost, only 10,000 samples were obtained for TMMC. For calving ease, correlations between LM and TMEB were 0.86 and 0.78 for direct and maternal genetic effects, respectively. The same correlations but between TMEB and TMMC were 1.00 and 0.98, respectively. The correlations between LM and TMMC were 0.85 and 0.75, respectively. The correlations for the linear traits were above.97 between LM and TMEB but as low as 0.91 between LM and TMMC, suggesting insufficient convergence of TMMC. Computing time required was about 2 hrs, 5 hrs, and 6 days for LM, TMEB and TMMC, respectively, and memory requirements were 169, 171, and 445 megabytes, respectively. Bayesian implementation of threshold model is simple, can be extended to multiple categorical traits, and allows easy calculation of accuracies; however, computing time is prohibitively long for large models.

  4. Impact of Periconceptional Folic Acid Supplementation on Low Birth Weight and Small-for-Gestational-Age Infants in China: A Large Prospective Cohort Study.

    PubMed

    Li, Nan; Li, Zhiwen; Ye, Rongwei; Liu, Jianmeng; Ren, Aiguo

    2017-08-01

    To explore the effects of maternal folic acid supplementation alone during pregnancy on the incidence of low birth weight (LBW) and small-for-gestational-age (SGA) infant status. Data were derived from a large population-based cohort study performed in China to evaluate the prevention of neural tube defects with folic acid supplementation. The sample comprised 200 589 singleton live births registered in 2 southern Chinese provinces by mothers for whom detailed information on folic acid use was available. Gestational age was calculated from the first day of the last menstrual period. LBW was defined as a birth weight <2500 g. Infants were considered SGA when the age-adjusted birth weight was below the 10th percentile as defined by a national survey performed in 1998. Logistic regression was used to estimate the effects of folic acid after adjusting for the principal potential confounders. The overall incidence of LBW and SGA status was 2.18% and 5.82%, respectively. The incidence of LBW and SGA status was 2.09% and 5.73% in women who took folic acid, and 2.27% and 5.90% in those who did not. The adjusted risk ratios associated with folic acid use were 0.85 (95% CI: 0.80-0.90) for LBW and 0.93 (95% CI: 0.89-0.96) for SGA status. Folic acid use during pregnancy appeared to be particularly important to prevent LBW and SGA status. A maternal daily intake of 400 µg folic acid alone significantly reduced the risks of infant LBW and SGA status. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. US National Large-scale City Orthoimage Standard Initiative

    USGS Publications Warehouse

    Zhou, G.; Song, C.; Benjamin, S.; Schickler, W.

    2003-01-01

    The early procedures and algorithms for National digital orthophoto generation in National Digital Orthophoto Program (NDOP) were based on earlier USGS mapping operations, such as field control, aerotriangulation (derived in the early 1920's), the quarter-quadrangle-centered (3.75 minutes of longitude and latitude in geographic extent), 1:40,000 aerial photographs, and 2.5 D digital elevation models. However, large-scale city orthophotos using early procedures have disclosed many shortcomings, e.g., ghost image, occlusion, shadow. Thus, to provide the technical base (algorithms, procedure) and experience needed for city large-scale digital orthophoto creation is essential for the near future national large-scale digital orthophoto deployment and the revision of the Standards for National Large-scale City Digital Orthophoto in National Digital Orthophoto Program (NDOP). This paper will report our initial research results as follows: (1) High-precision 3D city DSM generation through LIDAR data processing, (2) Spatial objects/features extraction through surface material information and high-accuracy 3D DSM data, (3) 3D city model development, (4) Algorithm development for generation of DTM-based orthophoto, and DBM-based orthophoto, (5) True orthophoto generation by merging DBM-based orthophoto and DTM-based orthophoto, and (6) Automatic mosaic by optimizing and combining imagery from many perspectives.

  6. Smoking, physical exercise, BMI and late foetal death: a study within the Danish National Birth Cohort.

    PubMed

    Morales-Suárez-Varela, Maria; Nohr, Ellen A; Bech, Bodil H; Wu, Chunsen; Olsen, Jørn

    2016-10-01

    The aim of this paper was to estimate the effect of maternal and paternal smoking on foetal death (miscarriage and stillbirth) and to estimate potential interactions with physical exercise and pre-pregnancy body mass index. We selected 87,930 pregnancies from the population-based Danish National Birth Cohort. Information about lifestyle, occupational, medical and obstetric factors was obtained from a telephone interview and data on pregnancy outcomes came from the Danish population based registries. Cox regression was used to estimate the hazard ratios (adjusted for potential confounders) for predominantly late foetal death (miscarriage and stillbirth). An interaction contrast ratio was used to assess potential effect measure modification of smoking by physical exercise and body mass index. The adjusted hazard ratio of foetal death was 1.22 (95 % CI 1.02-1.46) for couples where both parents smoked compared to non-smoking parents (miscarriage: 1.18, 95 % CI 0.96-1.44; stillbirth: 1.32, 95 % CI 0.93-1.89). On the additive scale, we detected a small positive interaction for stillbirth between smoking and body mass index (overweight women). In conclusion, smoking during pregnancy was associated with a slightly higher hazard ratio for foetal death if both parents smoked. This study suggests that smoking may increase the negative effect of a high BMI on foetal death, but results were not statistically significant for the interaction between smoking and physical exercise.

  7. Infant nutrition and cognitive development in the first offspring of a national UK birth cohort.

    PubMed

    Richards, M; Wadsworth, M; Rahimi-Foroushani, A; Hardy, R; Kuh, D; Paul, A

    1998-03-01

    Several studies show a modest beneficial effect of breastfeeding on cognitive development after controlling for sociodemographic confounders. It is still unclear, however, to what extent this is due to the nutritional advantage of breast milk or to environmental influences associated with breastfeeding. We compared verbal ability scores at age 8 years in 511 first-born offspring of the National Survey of Health and Development who were ever or never breastfed, adjusting for paternal occupation, maternal education, maternal cognitive performance, attendance at nursery school, and maternal age at birth of the participant. A positive association between breastfeeding and cognitive performance was found but this was no longer the case after adjusting for either paternal occupation, maternal education, or maternal cognitive performance in turn. In contrast, an association between breastfeeding and cognitive function was not found for mothers of these offspring. Breastfeeding was increasingly associated with a non-manual social class across the generations although it remains unclear how this might mediate the effect of breastfeeding on cognitive performance.

  8. Social integration and maternal smoking: A longitudinal analysis of a national birth cohort

    PubMed Central

    Mumford, Elizabeth A; Liu, Weiwei

    2016-01-01

    Objectives Social support and engagement are related to smoking behavior in general populations, but it is unknown whether these measures of social integration as experienced by recent mothers are related to longitudinal maternal smoking patterns. The purpose of this study is, first, to describe longitudinal patterns of maternal smoking before, during, and after pregnancy through the early childhood parenting years, as well as variation in these patterns; and second, to examine these patterns in relation to social integration, emotional, behavioral, and sociodemographic factors. Methods Among 9,050 mothers of the Early Childhood Longitudinal Study-Birth Cohort (a nationally representative probability sample of children born in 2001), we estimated trajectories of maternal smoking with general growth mixture model (GGMM), and examined how baseline predictors are associated with these patterns over a 5 to 6 year period beginning three months prior to pregnancy. Results A 5-class solution identified trajectories of nonsmokers (70.5%), temporary quitters (9.4%), pregnancy-inspired quitters (3.3%), delayed initiators (5.1%), and persistent smokers (11.7%). Modifiable risk factors included postpartum alcohol consumption and behavioral cues from co-resident smokers, while breastfeeding beyond six months and social engagement through religious service attendance were protective characteristics. Conclusions Prevention of and treatment for maternal perinatal and postpartum smoking is best informed by mothers’ emotional, behavioral and sociodemographic characteristics. Religious service attendance, but not measures of social support or social engagement, is a protective factor for maternal smoking trajectories. PMID:26987858

  9. Age at Menarche and Risk of Multiple Sclerosis: A Prospective Cohort Study Based on the Danish National Birth Cohort.

    PubMed

    Nielsen, Nete Munk; Harpsøe, Maria; Simonsen, Jacob; Stenager, Egon; Magyari, Melinda; Koch-Henriksen, Nils; Baker, Jennifer L; Hjalgrim, Henrik; Frisch, Morten; Bager, Peter

    2017-03-25

    Few studies have addressed the possible association between age at menarche and multiple sclerosis (MS), and results are conflicting. We studied this issue in a large prospective cohort study. The study cohort comprised 77,330 women included in the Danish National Birth Cohort (1996-2002). Information on menarcheal age was ascertained at the first interview, which took place in the 16th week of pregnancy. Women were followed for MS from the first interview to December 31, 2011. Associations between age at menarche and risk of MS were evaluated with hazard ratios and 95% confidence intervals using Cox proportional hazards regression models. Overall, 226 women developed MS during an average follow-up period of 11.7 years. Age at menarche among women with MS was generally lower than that among women without MS (Wilcoxon rank-sum test; P = 0.002). We observed an inverse association between age at menarche and MS risk. For each 1-year increase in age at menarche, risk of MS was reduced by 13% (hazard ratio = 0.87, 95% confidence interval: 0.79, 0.96). Early age at menarche appears to be associated with an increased risk of MS. The mechanisms behind this association remain to be established.

  10. A successful healthy live birth from a female patient with hypogonadotropic hypogonadism and oocytes with unusually large cytoplasmic inclusions.

    PubMed

    Duvan, Candan İltemir; Pekel, Aslıhan; Ercan, Ummu Gulsum; Arıkan, Yuksel Onaran

    2016-03-01

    This study aimed to report the case of a successful live birth from a woman having oocytes with abnormally large cytoplasmic inclusions. The patient described in this case is a 28 year-old woman with hypogonadotropic hypogonadism (HH) with a history of two previous unsuccessful in vitro fertilization (IVF) attempts offered an antagonist protocol. Stimulation was performed with human menopausal gonadotropin 300 IU/day. The intracytoplasmic sperm injection (ICSI) procedure was performed 4-6 hours after oocyte aspiration for all mature oocytes. Six oocytes were retrieved, five of which mature (MII). All oocytes had abnormal cytoplasmic structures. Two were fertilized after ICSI and two top quality embryos were transferred on Day 2. Our case report suggests that HH patients with refractile bodies/lipofuscin in their oocytes may not have their pregnancies negatively affected. While there have been several reports of successful births from dysmorphic oocytes, no cases of successful pregnancies followed by live births from young women with HH and oocytes with large cytoplasmic inclusions had been reported to date.

  11. Identifying women who are afraid of giving birth: A comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort.

    PubMed

    Haines, H M; Pallant, J F; Fenwick, J; Gamble, J; Creedy, D K; Toohill, J; Hildingsson, I

    2015-12-01

    The WDEQ-A is the most widely used measure of childbirth fear in pregnant women; however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice. To compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women. Self-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of ≥85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics. 1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p < 0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean. This study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

  12. 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

  13. The social determinants of infant mortality and birth outcomes in Western developed nations: a cross-country systematic review.

    PubMed

    Kim, Daniel; Saada, Adrianna

    2013-06-05

    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.

  14. Trends in cell phone use among children in the Danish national birth cohort at ages 7 and 11 years.

    PubMed

    Sudan, Madhuri; Olsen, Jørn; Sigsgaard, Torben; Kheifets, Leeka

    2016-11-01

    We prospectively examined trends in cell phone use among children in the Danish National Birth Cohort. Cell phone use was assessed at ages 7 and 11 years, and we examined use patterns by age, by year of birth, and in relation to specific individual characteristics. There was an increase in cell phone use from age 7 (37%) to 11 years (94%). There was a clear pattern of greater reported cell phone use among children at age 7 years with later birth year, but this trend disappeared at age 11. Girls and those who used phones at age 7 talked more often and for longer durations at age 11 years. Low socio-economic status and later year of birth were associated with voice calls at age 7 but not at age 11 years. At age 11 most used cell phones for texting and gaming more than for voice calls. Further, children who started using cell phones at age 7 years were more likely to be heavy cell phone voice users at age 11 years, making early use a marker for higher cumulative exposure regardless of year of birth. As cell phone technology continues to advance, new use patterns will continue to emerge, and exposure assessment research among children must reflect these trends.

  15. Hypospadias and maternal exposure to atrazine via drinking water in the National Birth Defects Prevention study.

    PubMed

    Winston, Jennifer J; Emch, Michael; Meyer, Robert E; Langlois, Peter; Weyer, Peter; Mosley, Bridget; Olshan, Andrew F; Band, Lawrence E; Luben, Thomas J

    2016-07-15

    Hypospadias is a relatively common birth defect affecting the male urinary tract. It has been suggested that exposure to endocrine disrupting chemicals might increase the risk of hypospadias by interrupting normal urethral development. Using data from the National Birth Defects Prevention Study, a population-based case-control study, we considered the role of maternal exposure to atrazine, a widely used herbicide and potential endocrine disruptor, via drinking water in the etiology of 2nd and 3rd degree hypospadias. We used data on 343 hypospadias cases and 1,422 male controls in North Carolina, Arkansas, Iowa, and Texas from 1998-2005. Using catchment level stream and groundwater contaminant models from the US Geological Survey, we estimated atrazine concentrations in public water supplies and in private wells. We assigned case and control mothers to public water supplies based on geocoded maternal address during the critical window of exposure for hypospadias (i.e., gestational weeks 6-16). Using maternal questionnaire data about water consumption and drinking water, we estimated a surrogate for total maternal consumption of atrazine via drinking water. We then included additional maternal covariates, including age, race/ethnicity, parity, and plurality, in logistic regression analyses to consider an association between atrazine and hypospadias. When controlling for maternal characteristics, any association between hypospadias and daily maternal atrazine exposure during the critical window of genitourinary development was found to be weak or null (odds ratio for atrazine in drinking water = 1. 00, 95 % CI = 0.97 to 1.03 per 0.04 μg/day increase; odds ratio for maternal consumption = 1.02, 95 % CI = 0.99 to 1.05; per 0.05 μg/day increase). While the association that we observed was weak, our results suggest that additional research into a possible association between atrazine and hypospadias occurrence, using a more sensitive exposure metric

  16. Risk Factors of Early Otitis Media in the Danish National Birth Cohort

    PubMed Central

    Koch, Anders; Niclasen, Janni; Dammeye, Jesper; Lous, Jørgen; Olsen, Sjurdur Frodi; Homøe, Preben

    2016-01-01

    Objective To assess risk factors of otitis media (OM) in six-months-old children. Method The sample consisted of 69,105 mothers and their children from the Danish National Birth Cohort. The women were interviewed twice during pregnancy and again 6 months after birth. The outcome “one or more” maternal reported episodes of OM at age six months. In total 37 factors were assessed, covering prenatal, maternal, perinatal and postnatal factors. Results At age six months 5.3% (95% CI 5.1–5.5) of the children had experienced one or more episodes of OM. From the regression analysis, 11 variables were associated with a risk of OM. When a Bonferroni correction was introduced, gender, prematurity, parity, maternal age, maternal self-estimated health, taking penicillin during pregnancy, and terminating breastfeeding before age six months, was associated with a risk of early OM. The adjusted ORs of OM for boys versus girls was 1.30 (95% CI 1.18–1.44). The OR having one sibling versus no siblings was 3.0 (95% CI 2.64–3.41). If the woman had been taking penicillin during pregnancy, the OR was 1.35 (95% CI 1.15–1.58). Children born before 38th gestational week had an increased OR for early OM of 1.49 (95% CI 1.21–1.82). Children of young women had an increased OR of early OM compared to children of older women. Additionally, children of women who rated their own health low compared to those rating their health as high, had an increased OR of 1.38 (95% CI 1.10–1.74). Finally, children being breastfeed less than 6 months, had an increased OR of 1.42 (95% CI 1.28–1.58) compared to children being breastfeed beyond 6 months. Conclusion These findings indicate that prenatal factors are of less importance regarding early OM before the age of six months. Postnatal risk factors seem to pose the main risk of early OM. PMID:27851778

  17. Superfund: Focusing on the nation at large. A decade of progress at National Priorities List sites

    SciTech Connect

    Not Available

    1990-09-01

    The publication summarizes the progress made in hazardous site clean-up of sites on the National Priorities List (NPL). It also provides a state-by-state summary of 422 improved sites. 'Superfund: Focusing on the Nation at Large' is supplemented by individual State books which contain detailed information on all 1,236 NPL sites.

  18. Personal birth preferences and actual mode of delivery outcomes of obstetricians and gynaecologists in South West England; with comparison to regional and national birth statistics.

    PubMed

    Lightly, Katie; Shaw, Elisabeth; Dailami, Narges; Bisson, Dina

    2014-10-01

    To determine personal birth preferences of obstetricians in various clinical scenarios, in particular elective caesarean section for maternal request. To determine actual rates of modes of deliveries amongst the same group. To compare the obstetrician's mode of delivery rates, to the general population. Following ethical approval, a piloted online survey link was sent via email to 242 current obstetricians and gynaecologists, (consultants and trainees) in South West England. Mode of delivery results were compared to regional and national population data, using Hospital Episode Statistics and subjected to statistical analysis. The response rate was 68%. 90% would hypothetically plan a vaginal delivery, 10% would consider a caesarean section in an otherwise uncomplicated primiparous pregnancy. Of the 94/165 (60%) respondents with children (201 children), mode of delivery for the first born child; normal vaginal delivery 48%, caesarean section 26.5% (elective 8.5%, emergency 18%), instrumental 24.5% and vaginal breech 1%. Only one chose an elective caesarean for maternal request. During 2006-2011 obstetricians have the same overall actual modes of birth as the population (p=0.9). Ten percent of obstetricians report they would consider requesting caesarean section for themselves/their partner, which is the lowest rate reported within UK studies. However only 1% actually had a caesarean solely for maternal choice. When compared to regional/national statistics obstetricians currently have modes of delivery that are not significantly different than the population and suggests that they choose non interventional delivery if possible. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Antiherpetic medication use and the risk of gastroschisis: Findings from the National Birth Defects Prevention Study, 1997-2007

    PubMed Central

    Ahrens, Katherine A.; Anderka, Marlene T.; Feldkamp, Marcia L.; Canfield, Mark A.; Mitchell, Allen A.; Werler, Martha M.

    2013-01-01

    Background Previous studies examining the teratogenic effects of antiherpetic medications have found no associations for birth defects overall but have not examined the risk of specific birth defects. Methods The National Birth Defects Prevention Study ascertains population-based cases with birth defects and live-born controls without birth defects in ten states across the United States for the purpose of identifying potential teratogenic risk factors. Mothers of cases and controls are interviewed within two years of their estimated date of delivery about demographic, medical and behavioral factors before and during pregnancy. This analysis examined the possible association between use of antiherpetic medications (acyclovir, valacyclovir or famciclovir) during early pregnancy and gastroschisis, a birth defect of the abdominal wall. Results The mothers of 1.1% (n=10) of 941 gastroschisis cases and 0.3% (n=27) of 8339 controls reported antiherpetic medication use during the month before conception through the third month of pregnancy. The adjusted odds ratios for such use in relation to gastroschisis were 4.68 (95% confidence interval [1.65, 13.28]) and 4.68 [1.15, 19.03] among women with and without self-reported genital herpes, respectively, when compared to women without antiherpetic use or herpes. Among women reporting no antiherpetic medication use, the odds ratio for self-reported genital herpes in relation to gastroschisis was 3.00 [1.58, 5.68]. Conclusions Our study raises the possibility of an increased risk of gastroschisis due to either antiherpetic medication use during early pregnancy or the underlying genital herpes infection for which it was indicated. PMID:23772935

  20. Geographical variation in life expectancy at birth in England and Wales is largely explained by deprivation

    PubMed Central

    Woods, L.; Rachet, B.; Riga, M.; Stone, N.; Shah, A.; Coleman, M.

    2005-01-01

    Study objective: To describe the population mortality profile of England and Wales by deprivation and in each government office region (GOR) during 1998, and to quantify the influence of geography and deprivation in determining life expectancy. Design: Construction of life tables describing age specific mortality rates and life expectancy at birth from death registrations and estimated population counts. Life tables were created for (a) quintiles of income deprivation based on the income domain score of the index of multiple deprivation 2000, (b) each GOR and Wales, and (c) every combination of deprivation and geography. Setting: England and Wales. Patients/participants: Residents of England and Wales, 1998. Main results: Life expectancy at birth varies with deprivation quintile and is highest in the most affluent groups. The differences are mainly attributable to differences in mortality rates under 75 years of age. Regional life expectancies display a clear north-south gradient. Linear regression analysis shows that deprivation explains most of the geographical variation in life expectancy. Conclusions: Geographical patterns of life expectancy identified within these data for England and Wales in 1998 are mainly attributable to variations in deprivation status as defined by the IMD 2000 income domain score. PMID:15650142

  1. Country of birth, acculturation status and abdominal obesity in a national sample of Mexican-American women and men.

    PubMed

    Sundquist, J; Winkleby, M

    2000-06-01

    Few studies have examined the influence of country of birth and acculturation status on indicators of obesity using national samples of Mexican-American women and men. We analysed data for 1387 Mexican-American women and 1404 Mexican- American men, ages 25-64, from the third National Health and Nutrition Examination Survey (1988-1994). We examined whether waist circumference and abdominal obesity varied by country of birth and acculturation status (primary language spoken), and whether among those with abdominal obesity, number of associated cardiovascular disease (CVD) risk factors varied by country of birth and acculturation status. Both country of birth and, to a lesser degree, acculturation status were significantly associated with waist circumference and abdominal obesity. Mexican-born women and men had the smallest waist circumference (90.4 cm, 94.0 cm respectively), US-born English-speaking women and men had intermediate waist circumference (93.6 cm, 97.3 cm), and US-born Spanish-speaking women and men had the largest waist circumference (96.9 cm, 97.7 cm), after accounting for age, education, per cent of energy from dietary fat, leisure-time physical activity, and smoking. All women had high prevalences of abdominal obesity, particularly US-born Spanish-speaking women (68.7%). In addition, US-born Spanish-speaking women with abdominal obesity were significantly more likely than their counterparts to have one or more of the following CVD risk factors: high serum insulin, non-insulin dependent diabetes, high blood lipids, and/or hypertension. These findings illustrate the heterogeneity of the Mexican-American population and suggest that country of birth and lack of acculturation to the majority culture, as well as secondary lifestyle changes, may explain the significant clinical differences observed in abdominal obesity within Mexican-American population subgroups.

  2. Risk of adverse pregnancy outcome in women exposed to livestock: a study within the Danish National Birth Cohort.

    PubMed

    Nielsen, S Y; Henriksen, T B; Hjøllund, N H; Mølbak, K; Andersen, A M N

    2014-07-01

    Maternal infection in pregnancy is a known risk factor for adverse pregnancy outcome, and a number of zoonotic pathogens may constitute a risk to pregnant women and their fetuses. With animal contact as a proxy for the risk of zoonotic infection, this study aimed to evaluate pregnancy outcome in women with self-reported occupational or domestic contact with livestock compared to pregnant women without such contact. The Danish National Birth Cohort collected information on pregnancy outcome from 100 418 pregnant women (1996-2002) from which three study populations with occupational and/or domestic exposure to livestock and a reference group of women with no animal contact was sampled. Outcome measures were miscarriage, very preterm birth (before gestational week 32), preterm birth (before 37 gestational weeks), small for gestational age (SGA), and perinatal death. Adverse reproductive outcomes were assessed in four different exposure groups of women with occupational or domestic exposure to livestock with no association found between exposure to livestock and miscarriage, preterm birth, SGA or perinatal death. These findings should diminish general occupational health concerns for pregnant women with exposures to a range of different farm animals.

  3. Risk factors for non-syndromic holoprosencephaly in the National Birth Defects Prevention Study.

    PubMed

    Miller, Eric A; Rasmussen, Sonja A; Siega-Riz, Anna Maria; Frías, Jaime L; Honein, Margaret A

    2010-02-15

    Holoprosencephaly (HPE) is a complex structural brain anomaly that results from incomplete cleavage of the forebrain. The prevalence of HPE at birth is low, and risk factors have been difficult to identify. Using data from a large multi-state population-based case-control study, we examined risk factors for non-syndromic HPE. Data from maternal telephone interviews were available for 74 infants with HPE and 5871 controls born between 1997 and 2004. Several characteristics and exposures were examined, including pregnancy history, medical history, maternal diet and use of nutritional supplements, medications, tobacco, alcohol, and illegal substances. We used chi(2)-tests and logistic regression (excluding women with pre-existing diabetes) to examine associations with HPE. Except for diet (year before pregnancy) and sexually transmitted infections (STIs) (throughout pregnancy), most exposures were examined for the time period from the month before to the third month of pregnancy. HPE was found to be associated with pre-existing diabetes (chi(2) = 6.0; P = 0.01), aspirin use [adjusted odds ratio (aOR) = 3.4; 95% confidence interval (CI) 1.6-6.9], lower education level (aOR = 2.5; 95%CI 1.1-5.6), and use of assisted reproductive technologies (ART) (crude OR = 4.2; 95%CI 1.3-13.7). Consistent maternal folic acid use appeared to be protective (aOR = 0.4; 95%CI 0.2-1.0), but the association was of borderline statistical significance. While some of these findings support previous observations, other potential risk factors identified warrant further study.

  4. Who and where are the uncounted children? Inequalities in birth certificate coverage among children under five years in 94 countries using nationally representative household surveys.

    PubMed

    Bhatia, Amiya; Ferreira, Leonardo Zanini; Barros, Aluísio J D; Victora, Cesar Gomes

    2017-08-18

    Birth registration, and the possession of a birth certificate as proof of registration, has long been recognized as a fundamental human right. Data from a functioning civil registration and vital statistics (CRVS) system allows governments to benefit from accurate and universal data on birth and death rates. However, access to birth certificates remains challenging and unequal in many low and middle-income countries. This paper examines wealth, urban/rural and gender inequalities in birth certificate coverage. We analyzed nationally representative household surveys from 94 countries between 2000 and 2014 using Demographic Health Surveys and Multiple Indicator Cluster Surveys. Birth certificate coverage among children under five was examined at the national and regional level. Absolute measures of inequality were used to measure inequalities in birth certificate coverage by wealth quintile, urban/rural residence and sex of the child. Over four million children were included in the analysis. Birth certificate coverage was over 90% in 29 countries and below 50% in 36 countries, indicating that more than half the children under five surveyed in these countries did not have a birth certificate. Eastern & Southern Africa had the lowest average birth certificate coverage (26.9%) with important variability among countries. Significant wealth inequalities in birth certificate coverage were observed in 74 countries and in most UNICEF regions, and urban/rural inequalities were present in 60 countries. Differences in birth certificate coverage between girls and boys tended to be small. We show that wealth and urban/rural inequalities in birth certificate coverage persist in most low and middle income countries, including countries where national birth certificate coverage is between 60 and 80%. Weak CRVS systems, particularly in South Asia and Africa lead rural and poor children to be systematically excluded from the benefits tied to a birth certificate, and prevent these

  5. Impact of a national beta-thalassemia carrier screening program on the birth rate of thalassemia major.

    PubMed

    Chern, Jimmy P S; Lin, Kai-Hsin; Su, Yi-Ning; Lu, Meng-Yao; Jou, Shiann-Tarng; Lin, Dong-Tsamn; Wang, Shih-Chung; Lin, Kuo-Sin

    2006-01-01

    In Taiwan, the prevalence of beta-thalassemia trait is at least 1.1%. The Taiwan government initiated a National Screening Program in 1993. Herein we examine the differences before and after the initiation of this program. Data consisting of the total number of patients and the birth prevalence beta-thalassemia major were collected. Ninety-one patients with transfusion-dependent thalassemia treated in our hospitals were included for analysis. DNA analysis was performed for 86 patients. In Taiwan 361 patients exist. The birth prevalence of per 100,000 births was 5.6% in 1994 and declined to 1.21 in 2002. Fourteen patients were born after the program's initiation. DNA analysis of them revealed a new mutation (IVS-1-5 (G-C)), which was introduced through an inter-racial marriage. Otherwise, the remainder was the common beta-thalassemia mutations found in Taiwan. Despite how successful the National Screening Program is, a few doctors still failed to detect parents at risk. In addition, we are concerned about the emerging problem of the increase of interracial marriages where parents may not have appropriate screening. Hence, postgraduate education programs for physicians, health education for the general population, and timely screening of inter-racial marriage should become a priority.

  6. Geographic distribution of unexplained low birth weight

    SciTech Connect

    Jason, C.J.; Samuhel, M.E.; Glick, B.J.; Welsh, A.K.

    1986-08-01

    Low birth weight, largely in the form of intrauterine growth retardation, has been used in animal studies as a sensitive indicator of adverse reproductive outcomes to suspect toxic agents. Methodological problems have severely curtailed studies of low birth weight for human risk assessment. For white and black births, we explore the use of statistical techniques to adjust for maternal risk factors and to isolate US counties having a significantly elevated rate of unexplained low-birth-weight births in 1979. The data are derived from individual birth certificate information made available by the National Center for Health Statistics. Removing variation due to socioeconomic and other intrinsic factors available on birth certificates, clusters of high-risk counties appear. This paper discusses the methodology used to identify these counties.

  7. Development of large-scale functional networks from birth to adulthood: a guide to neuroimaging literature.

    PubMed

    Grayson, David S; Fair, Damien A

    2017-02-01

    The development of human cognition results from the emergence of coordinated brain activity betweeen distant brain areas. Network science, combined with non-invasive functional imaging, has generated unprecedented insights regarding the adult brain's functional organization, and promises to help elucidate the development of functional architectures supporting complex behavior. Here we review what is known about functional network development from birth until adulthood, particularly as understood through the use of resting-state functional connectivity MRI (rs-fcMRI). We attempt to synthesize rs-fcMRI findings with other functional imaging techniques, with macro-scale structural connectivity, and with knowledge regarding the development of micro-scale structure. We highlight a number of outstanding conceptual and technical barriers that need to be addressed, as well as previous developmental findings that may need to be revisited. Finally, we discuss key areas ripe for future research in order to 1) better characterize normative developmental trajectories, 2) link these trajectories to biologic mechanistic events, as well as component behaviors and 3) better understand the clinical implications and pathophysiological basis of aberrant network development.

  8. Infants born large-for-gestational-age display slower growth in early infancy, but no epigenetic changes at birth.

    PubMed

    Chiavaroli, Valentina; Cutfield, Wayne S; Derraik, José G B; Pan, Zengxiang; Ngo, Sherry; Sheppard, Allan; Craigie, Susan; Stone, Peter; Sadler, Lynn; Ahlsson, Fredrik

    2015-09-30

    We evaluated the growth patterns of infants born large-for-gestational-age (LGA) from birth to age 1 year compared to those born appropriate-for-gestational-age (AGA). In addition, we investigated possible epigenetic changes associated with being born LGA. Seventy-one newborns were classified by birth weight as AGA (10(th)-90(th) percentile; n = 42) or LGA (>90(th) percentile; n = 29). Post-natal follow-up until age 1 year was performed with clinical assessments at 3, 6, and 12 months. Genome-wide DNA methylation was analysed on umbilical tissue in 19 AGA and 27 LGA infants. At birth, LGA infants had greater weight (p < 0.0001), length (p < 0.0001), ponderal index (p = 0.020), as well as greater head (p < 0.0001), chest (p = 0.044), and abdominal (p = 0.007) circumferences than AGA newborns. LGA infants were still larger at the age of 3 months, but by age 6 months there were no more differences between groups, due to higher length and weight increments in AGA infants between 0 and 6 months (p < 0.0001 and p = 0.002, respectively). Genome-wide analysis showed no epigenetic differences between LGA and AGA infants. Overall, LGA infants had slower growth in early infancy, being anthropometrically similar to AGA infants by 6 months of age. In addition, differences between AGA and LGA newborns were not associated with epigenetic changes.

  9. Maternal Exposure to Criteria Air Pollutants and Congenital Heart Defects in Offspring: Results from the National Birth Defects Prevention Study

    PubMed Central

    Luben, Thomas J.; Daniels, Julie L.; Fuentes, Montserrat; Richardson, David B.; Aylsworth, Arthur S.; Herring, Amy H.; Anderka, Marlene; Botto, Lorenzo; Correa, Adolfo; Gilboa, Suzanne M.; Langlois, Peter H.; Mosley, Bridget; Shaw, Gary M.; Siffel, Csaba; Olshan, Andrew F.

    2014-01-01

    Background: Epidemiologic literature suggests that exposure to air pollutants is associated with fetal development. Objectives: We investigated maternal exposures to air pollutants during weeks 2–8 of pregnancy and their associations with congenital heart defects. Methods: Mothers from the National Birth Defects Prevention Study, a nine-state case–control study, were assigned 1-week and 7-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide and 24-hr measurements of fine and coarse particulate matter using the closest air monitor within 50 km to their residence during early pregnancy. Depending on the pollutant, a maximum of 4,632 live-birth controls and 3,328 live-birth, fetal-death, or electively terminated cases had exposure data. Hierarchical regression models, adjusted for maternal demographics and tobacco and alcohol use, were constructed. Principal component analysis was used to assess these relationships in a multipollutant context. Results: Positive associations were observed between exposure to nitrogen dioxide and coarctation of the aorta and pulmonary valve stenosis. Exposure to fine particulate matter was positively associated with hypoplastic left heart syndrome but inversely associated with atrial septal defects. Examining individual exposure-weeks suggested associations between pollutants and defects that were not observed using the 7-week average. Associations between left ventricular outflow tract obstructions and nitrogen dioxide and between hypoplastic left heart syndrome and particulate matter were supported by findings from the multipollutant analyses, although estimates were attenuated at the highest exposure levels. Conclusions: Using daily maximum pollutant levels and exploring individual exposure-weeks revealed some positive associations between certain pollutants and defects and suggested potential windows of susceptibility during pregnancy. Citation: Stingone JA, Luben TJ

  10. Racial disparities in infant mortality: what has birth weight got to do with it and how large is it?

    PubMed Central

    2010-01-01

    Background It has been hypothesized that birth weight is not on the causal pathway to infant mortality, at least among "normal" births (i.e. those located in the central part of the birth weight distribution), and that US racial disparities (African American versus European American) may be underestimated. Here these hypotheses are tested by examining the role of birth weight on racial disparities in infant mortality. Methods A two-component Covariate Density Defined mixture of logistic regressions model is used to decompose racial disparities, 1) into disparities due to "normal" versus "compromised" components of the birth cohort, and 2) further decompose these components into indirect effects, which are associated with birth weight, versus direct effects, which are independent of birth weight. Results The results indicate that a direct effect is responsible for the racial disparity in mortality among "normal" births. No indirect effect of birth weight is observed despite significant disparities in birth weight. Among "compromised" births, an indirect effect is responsible for the disparity, which is consistent with disparities in birth weight. However, there is also a direct effect among "compromised" births that reduces the racial disparity in mortality. This direct effect is responsible for the "pediatric paradox" and maybe due to differential fetal loss. Model-based adjustment for this effect indicates that racial disparities corrected for fetal loss could be as high as 3 or 4 fold. This estimate is higher than the observed racial disparities in infant mortality (2.1 for both sexes). Conclusions The results support the hypothesis that birth weight is not on the causal pathway to infant mortality among "normal" births, although birth weight could play a role among "compromised" births. The overall size of the US racial disparities in infant mortality maybe considerably underestimated in the observed data possibly due to racial disparities in fetal loss. PMID

  11. Association of Paternal Age and Risk for Major Congenital Anomalies from the National Birth Defects Prevention Study, 1997–2004

    PubMed Central

    Green, Ridgely Fisk; Devine, Owen; Crider, Krista S.; Olney, Richard S.; Archer, Natalie; Olshan, Andrew F.; Shapira, Stuart K.

    2009-01-01

    Purpose The objective of this study was to examine the associations between paternal age and birth defects of unknown etiologies while carefully controlling for maternal age. Methods Using 1997–2004 data from the National Birth Defects Prevention Study, we fit logistic regression models with paternal and maternal age as continuous variables while adjusting for demographic and other factors. Results Elevated odds ratios for each year increase in paternal age were found for cleft palate (odds ratio (OR) = 1.02, 95% confidence interval (CI): 1.00, 1.04), diaphragmatic hernia (OR = 1.04, 95% CI: 1.02, 1.06), right ventricular outflow tract obstruction (OR = 1.03, 95% CI: 1.01, 1.04), and pulmonary valve stenosis (OR = 1.02, 95% CI: 1.01, 1.04). At younger paternal ages, each year increase in paternal age correlated with increased odds of having offspring with encephalocele, cataract, esophageal atresia, anomalous pulmonary venous return, and coarctation of the aorta, but these increased odds were not observed at older paternal ages. The effect of paternal age was modified by maternal age for gastroschisis, omphalocele, spina bifida, all orofacial clefts, and septal heart defects. Conclusions Our findings suggest that paternal age may be a risk factor for some multifactorial birth defects. PMID:20056435

  12. The geography of belonging: the experience of birthing at home for First Nations women.

    PubMed

    Kornelsen, Jude; Kotaska, Andrew; Waterfall, Pauline; Willie, Louisa; Wilson, Dawn

    2010-07-01

    The number of rural hospitals offering maternity care in British Columbia has significantly declined since 2000, mirroring trends of closures and service reductions across Canada. The impact on Aboriginal women is significant, contributing to negative maternal and newborn health and social outcomes. The present qualitative case study explored the importance of local birth for Aboriginal women from a remote BC community after the closure of local maternity services. Data collection consisted of 12 interviews and 55 completed surveys. The average participant age was 32 years old at the time of the study. From the perspective of losing local services, participants expressed the importance of local birth in reinforcing the attributes that contributed to their identities, including the importance of community and kinship ties and the strength of ties to their traditional territory.

  13. Comparing profiles of mental disorder across birth cohorts: results from the 2007 Australian National Survey of Mental Health and Wellbeing.

    PubMed

    Sunderland, Matthew; Carragher, Natacha; Buchan, Heather; Batterham, Philip J; Slade, Tim

    2014-05-01

    To describe and compare individuals with any DSM-IV mental disorder from three different birth cohorts - young (16-34 years), middle age (35-59 years) and older age (60-85 years) - on a range of clinically relevant factors. Data were derived from the 2007 Australian National Survey of Mental Health and Wellbeing. Individuals from three birth cohorts with a range of mental health and substance use disorders were identified using DSM-IV criteria and compared using regression analysis. The specific factors that were compared include: (1) type of disorder/disorders present; (2) suicidality; (3) number of co-occurring disorders; (4) levels of distress and impairment; (5) self-assessed physical and mental health; (6) presence of physical conditions; (7) size and quality of social support/network; and (8) treatment-seeking behaviour. The birth cohorts differed dramatically in terms of the specific disorders that were present. The older cohort were significantly more likely to experience internalising disorders and significantly less likely to experience externalising disorders in comparison to the young cohort. The older cohort were significantly more likely to experience co-morbid physical conditions as well as lower life satisfaction, poorer self-rated physical health, increased functional impairment, and more days out of role. The younger cohort had a significantly larger peer group that they could confide in and rely on in comparison to the older cohort. Clinicians and researchers need to be cognisant that mental disorders manifest as highly heterogeneous constructs. The presentation of a disorder in a younger individual could be vastly different from the presentation of the same disorder in an older individual. The additional burden associated with these factors and how they apply to different birth cohorts must be taken into consideration when planning mental health services and effective treatment for the general population.

  14. Maternal Occupational Pesticide Exposure and Risk of Congenital Heart Defects in the National Birth Defects Prevention Study

    PubMed Central

    Rocheleau, Carissa M.; Bertke, Stephen J.; Lawson, Christina C.; Romitti, Paul A.; Sanderson, Wayne T.; Malik, Sadia; Lupo, Philip J.; Desrosiers, Tania A.; Bell, Erin; Druschel, Charlotte; Correa, Adolfo; Reefhuis, Jennita

    2015-01-01

    BACKGROUND Congenital heart defects (CHDs) are common birth defects, affecting approximately 1% of live births. Pesticide exposure has been suggested as an etiologic factor for CHDs, but previous results were inconsistent. METHODS We examined maternal occupational exposure to fungicides, insecticides, and herbicides for 3328 infants with CHDs and 2988 unaffected control infants of employed mothers using data for 1997 through 2002 births from the National Birth Defects Prevention Study, a population-based multisite case-control study. Potential pesticide exposure from 1 month before conception through the first trimester of pregnancy was assigned by an expert-guided task-exposure matrix and job history details self-reported by mothers. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression. RESULTS Maternal occupational exposure to pesticides was not associated with CHDs overall. In examining specific CHD subtypes compared with controls, some novel associations were observed with higher estimated pesticide exposure: insecticides only and secundum atrial septal defect (OR =1.8; 95% CI, 1.3–2.7, 40 exposed cases); both insecticides and herbicides and hypoplastic left heart syndrome (OR =5.1; 95% CI, 1.7–15.3, 4 exposed cases), as well as pulmonary valve stenosis (OR =3.6; 95% CI, 1.3–10.1, 5 exposed cases); and insecticides, herbicides, and fungicides and tetralogy of Fallot (TOF) (OR =2.2; 95% CI, 1.2–4.0, 13 exposed cases). CONCLUSION Broad pesticide exposure categories were not associated with CHDs overall, but examining specific CHD subtypes revealed some increased odds ratios. These results highlight the importance of examining specific CHDs separately. Because of multiple comparisons, additional work is needed to verify these associations. PMID:26033688

  15. Early signs of autism in toddlers: a follow-up study in the Danish National Birth Cohort.

    PubMed

    Lemcke, Sanne; Juul, Svend; Parner, Erik T; Lauritsen, Marlene B; Thorsen, Poul

    2013-10-01

    To identify possible early signs of autism spectrum disorder (ASD) within the Danish National Birth Cohort, we studied prospectively collected interviews from 76,441 mothers about their children's development and behaviour at 6 and 18 months. In Danish national registries, 720 children with ASD and 231 children with intellectual disability (ID) were identified. At 6 months, associations between early signs and ASD or ID were found only in few areas. At 18 months social, language, and motor skills were delayed, and suspicion of vision and hearing problems were increased for both groups. Signs distinguishing ASD from ID were unclear, and the positive predictive values regarding ASD were below 10 % for individual predictors and aggregated risk scores.

  16. Energetics and Birth Rates of Supernova Remnants in the Large Magellanic Cloud

    NASA Astrophysics Data System (ADS)

    Leahy, D. A.

    2017-03-01

    Published X-ray emission properties for a sample of 50 supernova remnants (SNRs) in the Large Magellanic Cloud (LMC) are used as input for SNR evolution modeling calculations. The forward shock emission is modeled to obtain the initial explosion energy, age, and circumstellar medium density for each SNR in the sample. The resulting age distribution yields a SNR birthrate of 1/(500 yr) for the LMC. The explosion energy distribution is well fit by a log-normal distribution, with a most-probable explosion energy of 0.5× {10}51 erg, with a 1σ dispersion by a factor of 3 in energy. The circumstellar medium density distribution is broader than the explosion energy distribution, with a most-probable density of ∼0.1 cm‑3. The shape of the density distribution can be fit with a log-normal distribution, with incompleteness at high density caused by the shorter evolution times of SNRs.

  17. Perinatal outcomes of women intending to give birth in birth centers in Australia.

    PubMed

    Laws, Paula J; Tracy, Sally K; Sullivan, Elizabeth A

    2010-03-01

    A recent Australian study showed perinatal mortality was lower among women who gave birth in a birth center than in a comparable low-risk group of women who gave birth in a hospital. The current study used the same large population database to investigate whether perinatal outcomes were improved for women intending to give birth in a birth center at the onset of labor, regardless of the actual place of birth. Data were obtained from the National Perinatal Data Collection (NPDC) in Australia. The study included 822,955 mothers who gave birth during the 5-year period, 2001 to 2005, and their 836,919 babies. Of these, 22,222 women (2.7%) intended to give birth in a birth center at the onset of labor. Maternal and perinatal factors and outcomes were compared according to the intended place of birth. Data were not available on congenital anomalies, or cause, or timing of death. Women intending to give birth in a birth center at the onset of labor had lower rates of intervention and of adverse perinatal outcomes compared with women intending to give birth in a hospital, including less preterm birth and low birthweight. No statistically significant difference was found in perinatal mortality for term babies of mothers intending to give birth in a birth center compared with term babies of low-risk women intending to give birth in a hospital (1.3 per 1,000 births [99% CI = 0.66, 1.95] vs 1.7 per 1,000 births [99% CI = 1.50, 1.80], respectively). Term babies of women who intended to give birth in a birth center were less likely to be admitted to a neonatal intensive care unit or special care nursery, and no significant difference was found in other perinatal outcomes compared with term babies of low-risk women who intended to give birth in a hospital labor ward. Birth center care remains a viable option for eligible women giving birth at term.

  18. Higher multiple births: socio-economic implications in a developing nation.

    PubMed

    Adinma, J I

    1991-01-01

    A case of successful quadruplet pregnancy followed from date of diagnosis, through delivery, and to the third year of life is presented. The emotional, social, and economic problems encountered by the parents and hospital personnel are examined with a detailed analysis of the financial burden placed on all parties. Individual, voluntary donations made at the time of delivery have proved insufficient to cover the care involved before, during, and after the birth of multiples. A more concrete commitment on the part of government in the form of legislation or subvention is suggested in order to ease some of the stress on the parents of multiples.

  19. Preconception Blood Pressure and Risk of Low Birth Weight and Small for Gestational Age: A Large Cohort Study in China.

    PubMed

    Li, Nan; Li, Zhiwen; Ye, Rongwei; Zhang, Le; Li, Hongtian; Zhu, Yibing; Li, Shun; Yang, Na; Liu, Jianmeng; Ren, Aiguo

    2016-10-01

    Our objective was to examine whether high blood pressure in the preconception period was associated with low birth weight (LBW) and small-for-gestational age (SGA) in Chinese women. Data were obtained from the China-US Collaborative Project for Neural Tube Defects Prevention, a large population-based cohort study. We included 43 718 singleton live births delivered at gestational ages of 28-45 weeks to women who were registered before pregnancy in 7 counties in southern China. Blood pressure was measured during registration by trained healthcare workers, and other health-related information was recorded prospectively. We used logistic regression to evaluate the associations between preconception blood pressure and the risk of LBW and SGA, adjusting for potential confounders. The prevalence of hypertension in the preconception study population was 4.62% (2019/43 718). The incidences of LBW and SGA were 2.33% and 5.05% for the hypertension group and 2.01% and 5.68% for the nonhypertension group. Compared with the nonhypertension group, the hypertension group did not show significantly increased risk for LBW overall (adjusted risk ratio =1.16, 95% confidence interval 0.86-1.57) or SGA (adjusted risk ratio =0.89, 95% confidence interval 0.73-1.09). When participants with normal blood pressure were used as the reference, the adjusted risk ratio of SGA for prehypertensive women was 1.13 (95% confidence interval 1.03-1.25). Our results do not support an association between hypertension or higher blood pressure before pregnancy and increased risk of LBW or SGA. © 2016 American Heart Association, Inc.

  20. Risk Factors Associated with Very Low Birth Weight in a Large Urban Area, Stratified by Adequacy of Prenatal Care.

    PubMed

    Xaverius, Pamela; Alman, Cameron; Holtz, Lori; Yarber, Laura

    2016-03-01

    This study examined risk and protective factors associated with very low birth weight (VLBW) for babies born to women receiving adequate or inadequate prenatal care. Birth records from St. Louis City and County from 2000 to 2009 were used (n = 152,590). Data was categorized across risk factors and stratified by adequacy of prenatal care (PNC). Multivariate logistic regression and population attributable risk (PAR) was used to explore risk factors for VLBW infants. Women receiving inadequate prenatal care had a higher prevalence of delivering a VLBW infant than those receiving adequate PNC (4.11 vs. 1.44 %, p < .0001). The distribution of risk factors differed between adequate and inadequate PNC regarding Black race (36.4 vs. 79.0 %, p < .0001), age under 20 (13.0 vs. 33.6 %, p < .0001), <13 years of education (35.9 vs. 77.9 %, p < .0001), Medicaid status (35.7 vs. 74.9, p < .0001), primiparity (41.6 vs. 31.4 %, p < .0001), smoking (9.7 vs. 24.5 %, p < .0001), and diabetes (4.0 vs. 2.4 %, p < .0001), respectively. Black race, advanced maternal age, primiparity and gestational hypertension were significant predictors of VLBW, regardless of adequate or inadequate PNC. Among women with inadequate PNC, Medicaid was protective against (aOR 0.671, 95 % CI 0.563-0.803; PAR -32.6 %) and smoking a risk factor for (aOR 1.23, 95 % CI 1.01, 1.49; PAR 40.1 %) VLBW. When prematurity was added to the adjusted models, the largest PAR shifts to education (44.3 %) among women with inadequate PNC. Community actions around broader issues of racism and social determinants of health are needed to prevent VLBW in a large urban area.

  1. Distribution of maternal age and birth order groups in cases with unclassified multiple congenital abnormalities according to the number of component abnormalities: a national population-based case-control study.

    PubMed

    Csermely, Gyula; Czeizel, Andrew E; Veszprémi, Béla

    2015-02-01

    Multiple congenital abnormalities are caused by chromosomal aberrations, mutant major genes and teratogens. A minor proportion of these patients are identified as syndromes but the major part belonging to the group of unclassified multiple CAs (UMCAs). The main objective of this study was to evaluate the maternal age and birth order in pregnant women who had offspring affected with UMCA. The strong association between numerical chromosomal aberrations, e.g., Down syndrome and advanced maternal age is well-known and tested here. The Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980 to 1996, yielded a large population-based national data set with 22,843 malformed newborns or fetuses ("informative cases") included 1349 UMCA cases with their 2407 matched controls. Case-control comparison of maternal age and birth order was made for cases with UMCA, stratified by component numbers and their controls. In addition, 834 cases with Down syndrome were compared to 1432 matched controls. The well-known advanced maternal age with the higher risk for Down syndrome was confirmed. The findings of the study suggest that the young age of mothers associates with the higher risk of UMCA, in addition birth order 4 or more associates with the higher risk for UMCA with 2 and 3 component CAs. This study was the first to analyze the possible maternal and birth order effect for cases with UMCA, and the young age and higher birth order associated with a higher risk for UMCA. © 2014 Wiley Periodicals, Inc.

  2. Birth Control

    MedlinePlus

    ... girlshealth.gov/ Home Body Your sexuality Birth control Birth control Birth control (also called contraception) may seem confusing ... more. What do I need to know about birth control? top The more you know about birth control, ...

  3. Statistical and practical issues in the design of a national probability sample of births for the Vanguard Study of the National Children's Study.

    PubMed

    Montaquila, Jill M; Brick, J Michael; Curtin, Lester R

    2010-06-15

    The National Children's Study is a national household probability sample designed to identify 100,000 children at birth and follow the sampled children for 21 years. Data from the study will support examining numerous hypotheses concerning genetic and environmental effects on the health and development of children. The goals of the study present substantial challenges. For example, the need for preconception, prenatal, and postnatal data requires identifying women in the early stages of pregnancy, the collection of many types of data, and the retention of the children over time. In this paper, we give an overview of the sample design used in a pilot study called the Vanguard Study, and highlight the approaches used to address these challenges. We will also describe the rationale for the sampling choices made at each stage, the unique organizational structure of the NCS and issues we expect to face during implementation.

  4. The Birth of a New Nation: The Republic of South Sudan

    ERIC Educational Resources Information Center

    Totten, Samuel

    2011-01-01

    In early July, the country of Sudan, wracked by civil war since the 1980s, officially split into two separate nations, Sudan and South Sudan. Six months earlier, over a seven-day period, the people in southern Sudan had voted in a national referendum on whether to secede from the North. The voters had two choices: "Separation" or…

  5. The Birth of a New Nation: The Republic of South Sudan

    ERIC Educational Resources Information Center

    Totten, Samuel

    2011-01-01

    In early July, the country of Sudan, wracked by civil war since the 1980s, officially split into two separate nations, Sudan and South Sudan. Six months earlier, over a seven-day period, the people in southern Sudan had voted in a national referendum on whether to secede from the North. The voters had two choices: "Separation" or…

  6. National High School Graduation Rate: Are Recent Birth Cohorts Taking More Time to Graduate?

    ERIC Educational Resources Information Center

    Joo, Myungkook; Kim, Jeounghee

    2016-01-01

    Debates about the national high school graduation rate have heated up as various national high school graduation estimates based on the Common Core of Data (CCD) and the Current Population Survey (CPS) do not coincide with one another partially due to different assumptions about graduation age. This study found that (a) while graduation rate by…

  7. National High School Graduation Rate: Are Recent Birth Cohorts Taking More Time to Graduate?

    ERIC Educational Resources Information Center

    Joo, Myungkook; Kim, Jeounghee

    2016-01-01

    Debates about the national high school graduation rate have heated up as various national high school graduation estimates based on the Common Core of Data (CCD) and the Current Population Survey (CPS) do not coincide with one another partially due to different assumptions about graduation age. This study found that (a) while graduation rate by…

  8. Maternal Occupational Exposure to Polycyclic Aromatic Hydrocarbons and Craniosynostosis among Offspring in the National Birth Defects Prevention Study

    PubMed Central

    O’Brien, Jacqueline L.; Langlois, Peter H.; Lawson, Christina C.; Scheuerle, Angela; Rocheleau, Carissa M.; Waters, Martha A.; Symanski, Elaine; Romitti, Paul A.; Agopian, A.J.; Lupo, Philip J.

    2015-01-01

    Background Evidence in animal models and humans suggests that exposure to polycyclic aromatic hydrocarbons (PAHs) may lead to birth defects. To our knowledge, this relationship has not been evaluated for craniosynostosis, a birth defect characterized by the premature closure of sutures in the skull. We conducted a case-control study to examine associations between maternal occupational exposure to PAHs and craniosynostosis. Methods We used data from craniosynostosis cases and control infants in the National Birth Defects Prevention Study (NBDPS) with estimated delivery dates from 1997–2002. Industrial hygienists reviewed occupational data from the computer-assisted telephone interview and assigned a yes/no rating of probable occupational PAH exposure for each job from one month before conception through delivery. We used logistic regression to assess the association between occupational exposure to PAHs and craniosynostosis. Results The prevalence of exposure was 5.3% in case mothers (16/300) and 3.7% in control mothers (107/2,886). We observed a positive association between exposure to PAHs during the one month before conception through the third month of pregnancy and craniosynostosis [odds ratio (OR) = 1.75; 95% confidence interval (CI): 1.01, 3.05] after adjusting for maternal age and maternal education. The number of cases for each craniosynostosis subtype limited subtype analyses to sagittal craniosynostosis; the odds ratio remained similar (OR = 1.76, 95% CI: 0.82–3.75), but was not significant. Conclusions Our findings support a moderate association between maternal occupational exposure to PAHs and craniosynostosis. Additional work is needed to better characterize susceptibility and the role PAHs may play on specific craniosynostosis subtypes. PMID:26033890

  9. The Short-Run and Long-Run Effects of Birth Weight: Evidence from Large Samples of Siblings and Twins in Taiwan.

    PubMed

    Xie, Zong-Xian; Chou, Shin-Yi; Liu, Jin-Tan

    2017-07-01

    In this paper, we assemble five large administrative data sets in Taiwan to investigate the short-run and long-run effects of birth weight. Comparing with previous studies, our results are more precisely estimated due to the large sample size. Using administrative data sets, the problems arising from self-reported samples are also mitigated. Moreover, we are able to examine both singletons by controlling sibling fixed effects and twins by controlling twin fixed effects. Our results show that an infant's birth weight has positive influence on health and education. Our twin fixed-effects estimates confirm the finding of a long-lasting, but diminishing in the longer run, effects of birth weight. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Effect of the interaction between high altitude and socioeconomic factors on birth weight in a large sample from South America.

    PubMed

    López Camelo, Jorge S; Campaña, Hebe; Santos, Rita; Poletta, Fernando A

    2006-02-01

    Several studies of South American populations showed that altitude is associated with low birth weight and intrauterine growth retardation. Although some of them analyzed the altitude-birth weight association, only a few assessed the effect of the interaction between altitude and socioeconomic factors on birth weight. The purpose of this research is to evaluate such effects on birth weight, after adjustment for confounding factors. This observational descriptive study includes a sample of 37,022 live-born infants without congenital anomalies, weighing >or=500 g, from 75 South American maternity hospitals, during 1982-1999. Of the total sample, 1,187 infants were born in two South American cities located at more than 2,000-m altitude: La Paz, Bolivia (N = 974 at 3,600 m) and Bogota, Colombia (N = 274 at 2,600 m). Among the seven risk factors analyzed, altitude was the main predictor of birth weight (except for gestational age). After adjustment for the other risk factors, birth weight at cities located above 2,000 m showed a decrease of approximately 200 g. When comparing highest and lowest socioeconomic levels, birth weight also showed differences for levels of altitude analyzed (lowland, <2,000 m; middle land, 2,600 m; and highland, 3,600 m). Interaction between both factors showed no effect. High altitude seems to act independent of socioeconomic status in explaining birth weight reduction.

  11. Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort

    PubMed Central

    2014-01-01

    Background Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child’s life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. Methods Using data from 6,550 singleton births from the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-B), we fit growth trajectory models with random effects to examine the relation between maternal depressive symptoms at 9 months based on the twelve-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) and child height and body mass index (BMI) to age 6 years. Results Mothers with moderate/severe depressive symptoms at 9 months postpartum had children with shorter stature at this same point in time [average 0.26 cm shorter; 95% CI: 5 cm, 48 cm] than mothers without depressive symptoms; children whose mothers reported postpartum depressive symptoms remained significantly shorter throughout the child’s first 6 years. Conclusions Results suggest that the first year postpartum is a critical window for addressing maternal depressive symptoms in order to optimize child growth. Future studies should investigate the role of caregiving and feeding practices as potential mechanisms linking maternal depressive symptoms and child growth trajectories. PMID:25047367

  12. Developmental milestones in children born post-term in the Danish National Birth Cohort: a main research article.

    PubMed

    Olesen, A W; Olsen, J; Zhu, J L

    2015-09-01

    To examine the timing of reaching developmental milestones in children born post-term. Cohort study. The Danish National Birth Cohort: children born between 1997 and 2003. Data were obtained from a cohort of 92 892 pregnancies participating in the first pregnancy interview. All singletons born in gestational weeks 39-45 were identified. The study was then restricted to children who participated in an interview at the age of approximately 18 months and had information on at least one developmental milestone. We excluded children of mothers with chronic diseases from the final analysis. The remaining study population constituted of 43 915 singletons (27 503 born at term; 16 412 born post-term). Logistic regression was used to calculate odds ratios of late achievement of these developmental milestones, adjusted for potential confounding factors. Achieving developmental milestones at the time of interview or at a certain age. More children born post-term achieved the assessed developmental milestones compared with children born at term (39-40 weeks). A test for trend for gestational ages 39, 40, and 41 weeks also showed a positive trend at achieving developmental milestones with gestational age at birth in nine out of 14 milestone items. Children born post-term appear to reach the main developmental milestones at an earlier age than children born at term. The association could also result from bias related to a longer time between conception and interviewing, misclassification of end points, or selection bias. © 2014 Royal College of Obstetricians and Gynaecologists.

  13. 22. National Geographic Paper in the making. In this large ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. National Geographic Paper in the making. In this large room, some two hundred feet long, the liquid pulp shown in the previous picture is converted into uncoated paper. At the end of each machine is a tank of the pulp. A film of this pulp flows out upon an endless belt of fine-meshed wire, which is shaken vigorously. The water drops through the wire and gradually the residue solidifies. By the time the endless belt reaches the returning point, this residue is solid enough to hold its form as paper. It is then caught up between two rolls, which squeeze out the remaining water. Thence it passes around a series of iron drums filled with live steam; these dry it. After that is passes between big calender rolls and emerges in the foreground as machine-finish paper, ready for the coating or glazing process. These machines give one an idea of the huge proportions of a modern paper plant. (p.237.) - Champion-International Paper Company, West bank of Spicket River at Canal Street, Lawrence, Essex County, MA

  14. Development and implementation of the first national data quality standards for population-based birth defects surveillance programs in the United States.

    PubMed

    Anderka, Marlene; Mai, Cara T; Romitti, Paul A; Copeland, Glenn; Isenburg, Jennifer; Feldkamp, Marcia L; Krikov, Sergey; Rickard, Russel; Olney, Richard S; Canfield, Mark A; Stanton, Carol; Mosley, Bridget; Kirby, Russell S

    2015-09-19

    Population-based birth defects surveillance is a core public health activity in the United States (U.S.); however, the lack of national data quality standards has limited the use of birth defects surveillance data across state programs. Development of national standards will facilitate data aggregation and utilization across birth defects surveillance programs in the U.S. Based on national standards for other U.S. public health surveillance programs, existing National Birth Defects Prevention Network (NBDPN) guidelines for conducting birth defects surveillance, and information from birth defects surveillance programs regarding their current data quality practices, we developed 11 data quality measures that focused on data completeness (n = 5 measures), timeliness (n = 2), and accuracy (n = 4). For each measure, we established tri-level performance criteria (1 = rudimentary, 2 = essential, 3 = optimal). In January 2014, we sent birth defects surveillance programs in each state, District of Columbia, Puerto Rico, Centers for Disease Control and Prevention (CDC), and the U.S. Department of Defense Birth and Infant Health Registry an invitation to complete a self-administered NBDPN Standards Data Quality Assessment Tool. The completed forms were electronically submitted to the CDC for analyses. Of 47 eligible population-based surveillance programs, 45 submitted a completed assessment tool. Two of the 45 programs did not meet minimum inclusion criteria and were excluded; thus, the final analysis included information from 43 programs. Average scores for four of the five completeness performance measures were above level 2. Conversely, the average scores for both timeliness measures and three of the four accuracy measures were below level 2. Surveillance programs using an active case-finding approach scored higher than programs using passive case-finding approaches for the completeness and accuracy measures, whereas their average scores were lower

  15. The Birth and Growth of the National Ambulance Service in Ghana.

    PubMed

    Zakariah, Ahmed; Stewart, Barclay T; Boateng, Edmund; Achena, Christiana; Tansley, Gavin; Mock, Charles

    2017-02-01

    Introduction This study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified.

  16. The Birth of a Nation Is Only the Beginning: The Travails of South Sudan

    ERIC Educational Resources Information Center

    Totten, Samuel

    2014-01-01

    Just three years since it broke away from Sudan, the new country of South Sudan is embroiled in a violent civil war. This article examines what went wrong and why, by discussing the incredible difficulty of building a new nation from scratch following years of conflict, war, suspicion, and great expectations. How this tragedy will end is anyone's…

  17. Revolution and the Re-Birth of Inequality: The Bolivian National Revolution.

    ERIC Educational Resources Information Center

    Kelley, Jonathan; Klein, Herbert S.

    This study of Bolivia's National Revolution of 1952 illustrates the effects of a peasant revolution on inequality and status inheritance. It was hypothesized that when an exploited peasantry revolts and overthrows the traditonal elite, peasants would be better off because inequality and status inheritance would decline as a result of the…

  18. The Birth of a Nation Is Only the Beginning: The Travails of South Sudan

    ERIC Educational Resources Information Center

    Totten, Samuel

    2014-01-01

    Just three years since it broke away from Sudan, the new country of South Sudan is embroiled in a violent civil war. This article examines what went wrong and why, by discussing the incredible difficulty of building a new nation from scratch following years of conflict, war, suspicion, and great expectations. How this tragedy will end is anyone's…

  19. Measurement and structural invariance of the US version of the Birth Satisfaction Scale-Revised (BSS-R) in a large sample.

    PubMed

    Martin, Colin R; Hollins Martin, Caroline J; Burduli, Ekaterina; Barbosa-Leiker, Celestina; Donovan-Batson, Colleen; Fleming, Susan E

    2017-08-01

    The 10-item Birth Satisfaction Scale-Revised (BSS-R) is being increasingly used internationally. The use of the measure and the concept has gathered traction in the United States following the development of a US version of the tool. A limitation of previous studies of the measurement characteristics of the BSS-R is modest sample size. Unplanned pregnancy is recognised as being associated with a range of negative birth outcomes, but the relationship to birth satisfaction has received little attention, despite the importance of birth satisfaction to a range of postnatal outcomes. The current investigation sought to evaluate the measurement characteristics of the BSS-R in a large postpartum sample. Multiple Groups Confirmatory Factor Analysis (MGCFA) was used to evaluate a series of measurement and structural models of the BSS-R to evaluate fundamental invariance characteristics using planned/unplanned pregnancy status to differentiate groups. Complete data from N=2116 women revealed that the US version of the BSS-R offers an excellent fit to data and demonstrates full measurement and structural invariance. Little difference was observed between women on the basis of planned/unplanned pregnancy stratification on measures of birth satisfaction. The established relationship between unplanned pregnancy and negative perinatal outcomes was not found to extend to birth satisfaction in the current study. The BSS-R demonstrated exemplary measurement and structural invariance characteristics. The current study strongly supports the use of the US version of the BSS-R to compare birth satisfaction across different groups of women with theoretical and measurement confidence. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  20. [The National Academy of Medicine and the birth of cardioangiology in Mexico].

    PubMed

    de Micheli, A

    1989-01-01

    The National Academy of Medicine was founded 125 years ago during the French intervention in Mexico. Under the sponsorship of this brand-new medical association, Mexican cardioangiology began its development in both medical and surgical fields. After the Mexican second empire fell, the medical and surgical advances of this discipline continued. The corresponding publications appeared in different volumes of the "Gaceta Médica de México", the journal of the Academy still published in our time. Papers concerning cardiovascular therapeutics were published later in "El Estudio", the journal of the Instituto Médico Nacional, dedicated to research on national flora and fauna as well as their clinical use. These steps permitted the development of a true cardiology specialty in the 1940s, due to the vision of Professor Ignacio Chávez, one of the founders of modern cardiology.

  1. Positive Effect of Large Birth Intervals on Early Childhood Hemoglobin Levels in Africa Is Limited to Girls: Cross-Sectional DHS Study

    PubMed Central

    Afeworki, Robel; Smits, Jeroen; Tolboom, Jules; van der Ven, Andre

    2015-01-01

    of length of preceding birth interval was highest in young mothers and mothers with higher hemoglobin levels, while for boys, the highest effect was noticed for those living in more highly educated regions. Finally, significantly higher hemoglobin levels of girls compared to boys were observed at birth but with increasing age, the sex difference in hemoglobin level gradually becomes smaller. Conclusions A longer birth interval has a modest positive effect on early childhood hemoglobin levels of girls, and this effect is strongest when their mothers are in their early twenties and have a high hemoglobin level. Remarkably, although the physiological iron requirement is higher for boys than girls, birth spacing has little influence on hemoglobin levels of preschool boys. We speculate that the preference for male offspring in large parts of Africa significantly influences nutritional patterns of African preschool boys and girls, and as such also determines the different effect of birth spacing. Finally, gender aspects should be considered in intervention programs that aim to improve anemia in African children. PMID:26121362

  2. Cesarean Birth

    MedlinePlus

    ... QUESTIONS LABOR, DELIVERY, AND POSTPARTUM CARE FAQ006 Cesarean Birth (C-section) • What is cesarean birth? • What are the reasons for cesarean birth? • Is a cesarean birth necessary if I have ...

  3. The National Large Solar Telescope (NLST) of India

    NASA Astrophysics Data System (ADS)

    Hasan, S. S.

    2012-12-01

    The Indian National Large Solar Telescope (NLST) will be a state-of-the-art 2-m class telescope for carrying out high-resolution studies in the solar atmosphere. Recent numerical simulations suggest that crucial physical processes like vortex flow, dissipation of magnetic fields and the generation of MHD waves can occur efficiently over length scales of tens of kilometers. Current telescopes are unable to resolve solar feature to this level at visible wavelengths. NLST will not only achieve good spatial resolution, but will also have a high photon throughput in order to carry out spectropolarimetric observations to accurately measure vector magnetic fields in the solar atmosphere with a good signal to noise ratio. The main science goals of NLST include: a) Magnetic field generation and the solar cycle; b) Dynamics of magnetized regions; c) Helioseismology; d) Long term variability; e) Energetic phenomena and Activity; and f) Night time astronomy. The optical design of the telescope is optimized for high optical throughput and uses a minimum number of optical elements. A high order adaptive optics system is integrated as part of the design that works with a modest Fried's parameter of 7-cm to give diffraction limited performance. The telescope will be equipped with a suite of post-focus instruments including a high resolution spectrograph and a polarimeter. NLST will also be used for carrying out stellar observations during the night. The mechanical design of the telescope, building, and the innovative dome takes advantage of the natural air flush which will help to keep the open telescope in temperature equilibrium. Critical to the successful implementation of NLST is the selection of a site with optimum atmospheric properties, such as the number of sunshine hours and good "seeing" over long periods. A site characterization programme carried over several years has established the existence of suitable sites in the Ladakh region. After its completion, currently

  4. Maternal Antihypertensive Medication Use and Congenital Heart Defects: Updated Results From the National Birth Defects Prevention Study.

    PubMed

    Fisher, Sarah C; Van Zutphen, Alissa R; Werler, Martha M; Lin, Angela E; Romitti, Paul A; Druschel, Charlotte M; Browne, Marilyn L

    2017-05-01

    Previous NBDPS (National Birth Defects Prevention Study) findings from 1997 to 2003 suggested that maternal antihypertensive use was associated with congenital heart defects (CHDs). We re-examined associations between specific antihypertensive medication classes and specific CHDs with additional NBDPS data from 2004 to 2011. After excluding mothers missing hypertension information or who reported pregestational diabetes mellitus, a multiple birth, or antihypertensive use but no hypertension, we compared self-reported maternal exposure data on 10 625 CHD cases and 11 137 nonmalformed controls. We calculated adjusted odds ratios [95% confidence intervals] to estimate the risk of specific CHDs associated with antihypertensive use during the month before conception through the third month of pregnancy, controlling for maternal age, race/ethnicity, body mass index, first trimester cigarette smoking, and NBDPS site. Overall, 164 (1.5%) case mothers and 102 (0.9%) control mothers reported early pregnancy antihypertensive use for their hypertension. We observed increased risk of 4 CHD phenotypes, regardless of antihypertensive medication class reported: coarctation of the aorta (2.50 [1.52-4.11]), pulmonary valve stenosis (2.19 [1.44-3.34]), perimembranous ventricular septal defect (1.90 [1.09-3.31]), and secundum atrial septal defect (1.94 [1.36-2.79]). The associations for these phenotypes were statistically significant for mothers who reported β-blocker use or renin-angiotensin system blocker use; estimates for other antihypertensive medication classes were generally based on fewer exposed cases and were less stable but remained elevated. Our results support and expand on earlier NBDPS findings that antihypertensive medication use may be associated with increased risk of specific CHDs, although we cannot completely rule out confounding by underlying disease characteristics. © 2017 American Heart Association, Inc.

  5. Childhood cancer mortality and socioeconomic position in South Korea: a national population-based birth cohort study.

    PubMed

    Kong, Kyoung Ae; Khang, Young-Ho; Cha, Eun Shil; Moon, Eun Kyeong; Lee, Yo Han; Lee, Won Jin

    2010-10-01

    Cancer is among the leading causes of death in children, and the influence of socioeconomic inequalities on childhood cancer is an important public health concern. We examined the relationship of socioeconomic position with childhood cancer mortality in South Korea. A retrospective cohort study of South Koreans was conducted using data from the national birth register collected between 1995 and 2006, which was individually linked to mortality data. A cohort of 6,479,406 children was followed from birth until their death or through December 31, 2006. Poisson regression analysis was used to estimate the rate ratios of childhood cancer death according to socioeconomic position. A total of 1,469 cancer deaths were observed during the study period. We found significantly increased cancer mortality to be associated with the educational level of mother (RR = 1.56, 95% CI 1.27-1.91) and father (RR = 1.39, 95% CI 1.15-1.70) in middle school graduate or below compared with those of college graduate or higher. The risks of cancer death increased among children born with fathers outside the workforce (RR = 1.36, 95% CI 1.09-1.69) and with mothers engaged in manual work (RR = 1.41, 95% CI 1.03-1.92), when compared with those of non-manual counterparts. Children born in rural areas showed significantly increased risk of death from cancer. We concluded that in South Korea, there were inequalities in childhood cancer mortality by socioeconomic position.

  6. Exposure to air pollution and noise from road traffic and risk of congenital anomalies in the Danish National Birth Cohort.

    PubMed

    Pedersen, Marie; Garne, Ester; Hansen-Nord, Nete; Hjortebjerg, Dorrit; Ketzel, Matthias; Raaschou-Nielsen, Ole; Nybo Andersen, Anne-Marie; Sørensen, Mette

    2017-07-29

    Ambient air pollution has been associated with certain congenital anomalies, but few studies rely on assessment of fine-scale variation in air quality and associations with noise from road traffic are unexplored. Among 84,218 liveborn singletons (1997-2002) from the Danish National Birth Cohort with complete covariate data and residential address history from conception until birth, we identified major congenital anomalies in 4018 children. Nitrogen dioxide (NO2) and noise from road traffic (Lden) burden during fetal life was modeled. Outcome and covariate data were derived from registries, hospital records and questionnaires. Odds ratios (ORs) for eleven major anomaly groups associated with road traffic pollution during first trimester were estimated using logistic regression with generalized estimating equation (GEE) approach. Most of the associations tested did not suggest increased risks. A 10-µg/m(3) increase in NO2 exposure during first trimester was associated with an adjusted ORs of 1.22 (95% confidence interval: 0.98-1.52) for ear, face and neck anomalies; 1.14 0.98-1.33) for urinary anomalies. A 10-dB increase in road traffic noise was also associated with these subgroups of anomalies as well as with an increased OR for orofacial cleft anomalies (1.17, 0.94-1.47). Inverse associations for several both air pollution and noise were observed for atrial septal defects (0.85, 0.68-1.04 and 0.81, 0.65-0.99, respectively). Residential road traffic exposure to noise or air pollution during pregnancy did not seem to pose a risk for development of congenital anomalies. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Association between order of birth and chronic malnutrition of children: a study of nationally representative Bangladeshi sample.

    PubMed

    Rahman, Mosfequr

    2016-02-01

    This paper examines the net effect of birth order on child nutritional status in Bangladesh using data from the Bangladesh Demographic Health Survey, 2011 (BDHS). Analyses were restricted to 4,120 surviving, lastborn singleton children who were younger than 36 months at the time of the survey. Logistic regression was used to assess the association between birth order and child nutritional status. Results indicate 38.1% children are stunted and 8.2% children are fifth or higher order birth. Order of birth is one of the significant predictors of child being stunted. Third order, fourth order, and fifth or higher order children are 24%, 30%, and 72%, respectively, more likely to be stunted after adjusting for all other variables. Besides birth order, results also indicate that child age, size at birth, birth intention, maternal education, maternal body mass index, wealth index, place of residence and mass media access exert strong influences over child malnutrition. Reducing birth rates which limit number of births and birth order as well may reduce child malnutrition in Bangladesh.

  8. An examination of cesarean and vaginal birth histories among Hispanic women entering prenatal care in two California counties with large immigrant populations.

    PubMed

    Gonzalez-Mendez, Enrique; Gonzales-Mendez, Enrique; Gonzalez-Maddux, Catherine; Hall, Celeste; Maddux-Gonzalez, Mary; Handley, Margaret A

    2012-04-01

    Repeat cesarean delivery (CD) rates among US Hispanic women are the highest of all racial/ethnic groups (90%). Vaginal birth after cesarean (VBAC) is an alternative delivery method, but requires medical records documentation of a non-vertical incision and favorable conditions in the current pregnancy. VBAC rates for Hispanic women are extremely low. This study explores the birth histories and medical records access among Hispanic women in California, taking into account the potential role of immigration on access to VBAC. Study aims are to describe for a sample of Hispanic women: (1) CD and VBAC histories as well as history of vaginal delivery preceding CD; and (2) medical records access, among women who had previous births in Mexico. Chart review was conducted for prenatal patients from three safety net clinics in two California counties with large Mexican migrant populations between August, 2003 and February 2004--during which VBAC was widely available in these two counties to determine: obstetric histories, CD details, birthplace and whether or not medical records had been requested/obtained for CD. 355 multiparous Hispanic women were included. Thirty-three percent had a previous CD, almost two-thirds (64%) had only one CD. Over half of the women (55%) with 2+ births and CD history also reported a vaginal birth history. Medical records for CD were infrequently requested (29%). Of those requested, records were received for 77% of women with a US CD, compared with 13% of women with Mexican CD histories. Policies to address: (1) VBAC opportunities for low risk women, such as those with prior vaginal births and one CD, and (2) overcoming limited medical records access, could mitigate against unnecessary CD and associated medical expenditures and risks for future complications.

  9. Severe birth defects in children perinatal exposed to HIV from a "real-world" setting: Infectious Diseases National Institute, Bucharest, Romania.

    PubMed

    Tudor, Ana Maria

    2014-01-01

    The shift in epidemic trends in recent years in Romania shows new problems in regard of HIV vertical transmission, firstly in intravenous drug user's mothers co-infected with hepatitis viruses and with social problems, and secondly the children of young mothers with an old HIV infection and long antiretroviral therapy history. We studied all HIV perinatal exposed children routinely followed up in the Paediatric Department of the National Institute of Infectious Diseases, since January 1st 2006 till December 31st 2012. The analyses consisted of describing the birth defects and association with certain risk factors: gender, mother's age at birth and exposure to antiretrovirals in the first trimester of pregnancy. We analyzed 244 children born to HIV-infected mothers. The incidence of HIV infection was 16.39%. The rate of birth defects was 39.34% (96/244 cases). The most frequent findings were cardiac malformations (47/96), followed by musculoskeletal defects (24/96), neurologic defects (20/96), urogenital malformations (13/96), digestive tract defects (3/93), metabolic disorders (2/96) and genetic disorders (2/96). We found nine cases of severe congenital anomalies: complex heart defect, total congenital aganglionic megacolon, anal imperforation, Dandy-Walker syndrome, gangliosidosis, Niemann-Pick syndrome, Down syndrome, true hermaphroditism and cleft palate. Two children died during first year of life due to severe malformations. 9% of cases had associated malformations. The gender rate was in favour of males in group with birth defects (58/38) and with no birth defects (82/66). The median age at birth in mothers was 22 years, similar in both groups. The highest mean age at birth was in offspring's mothers with neurologic congenital defects 25, 15 years old, but is not statistically significant (p=0.1). In the studied period the highest number of birth defects were found in 2012, 37 children, compared with less than 15 in previous years (not statistically

  10. Demographic consequences of increased winter births in a large aseasonally breeding mammal (Bos taurus) in response to climate change.

    PubMed

    Burthe, Sarah; Butler, Adam; Searle, Kate R; Hall, Stephen J G; Thackeray, Stephen J; Wanless, Sarah

    2011-11-01

    1. Studies examining changes in the scheduling of breeding in response to climate change have focused on species with well-defined breeding seasons. Species exhibiting year-round breeding have received little attention and the magnitudes of any responses are unknown. 2. We investigated phenological data for an enclosed feral population of cattle (Bos taurus L.) in northern England exhibiting year-round breeding. This population is relatively free of human interference. 3. We assessed whether the timing of births had changed over the last 60 years, in response to increasing winter and spring temperatures, changes in herd density, and a regime of lime fertilisation. 4. Median birth date became earlier by 1·0 days per year. Analyses of the seasonal distribution of calving dates showed that significantly fewer calves were born in summer (decline from 44% of total births to 20%) and significantly more in winter (increase from 12% to 30%) over the study period. The most pronounced changes occurred in winter, with significant increases in both the proportion and number of births. Winter births arise from conceptions in the previous spring, and we considered models that investigated climate and weather variables associated with the winter preceding and the spring of conceptions. 5. The proportion of winter births was higher when the onset of the plant growing season was earlier during the spring of conceptions. This relationship was much weaker during years when the site had been fertilised with lime, suggesting that increased forage biomass was over-riding the impacts of changing plant phenology. When the onset of the growing season was late, winter births increased with female density. 6. Recruitment estimates from a stage-structured state-space population model were significantly negatively correlated with the proportion of births in the preceding winter, suggesting that calves born in winter are less likely to survive than those born in other seasons. 7.

  11. Paternal and joint parental occupational pesticide exposure and spina bifida in the National Birth Defects Prevention Study, 1997 to 2002.

    PubMed

    Pettigrew, Stacy M; Bell, Erin M; Van Zutphen, Alissa R; Rocheleau, Carissa M; Shaw, Gary M; Romitti, Paul A; Olshan, Andrew; Lupo, Philip J; Soim, Aida; Makelarski, Jennifer A; Michalski, Adrian M; Sanderson, Wayne

    2016-11-01

    Because of persistent concerns over the association between pesticides and spina bifida, we examined the role of paternal and combined parental occupational pesticide exposures in spina bifida in offspring using data from a large population-based study of birth defects. Occupational information from fathers of 291 spina bifida cases and 2745 unaffected live born control infants with estimated dates of delivery from 1997 to 2002 were collected by means of maternal report. Two expert industrial hygienists estimated exposure intensity and frequency to insecticides, herbicides, and fungicides. Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for exposure to any pesticide and to any class of pesticide (yes/no; and by median), and exposure to combinations of pesticides (yes/no) and risk of spina bifida. Adjusted odds ratios were also estimated by parent exposed to pesticides (neither, mother only, father only, both parents). Joint parental occupational pesticide exposure was positively associated with spina bifida (aOR, 1.5; 95% CI, 0.9-2.4) when compared with infants with neither maternal nor paternal exposures; a similar association was not observed when only one parent was exposed. There was a suggested positive association between combined paternal insecticide and fungicide exposures and spina bifida (aOR, 1.5; 95% CI, 0.8-2.8), however, nearly all other aORs were close to unity. Overall, there was little evidence paternal occupational pesticide exposure was associated with spina bifida. However, the small numbers make it difficult to precisely evaluate the role of pesticide classes, individually and in combination. Birth Defects Research (Part A) 106:963-971, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Adverse birth outcomes among native-born and immigrant women: replicating national evidence regarding Mexicans at the local level.

    PubMed

    Cervantes, A; Keith, L; Wyshak, G

    1999-06-01

    For almost two decades, the literature has consistently described an epidemiologic paradox relating to better birth outcomes among high-risk groups, particularly new immigrants from Mexico and Southeast Asia. We hypothesize that regardless of their sociodemographic profile, Mexican immigrants will exhibit lower rates of low birth weight and preterm deliveries than native-(U.S.) born women of Mexican origin, non-Hispanic White and Black women, and Puerto Rican Women. We studied 57,324 live-born singleton infants born to residents in the city of Chicago in a linked data set of 1994 birth-death records. Multivariate logistic regression was used to analyze race/ethnicity differentials in two pregnancy outcome measures, low birth weight and preterm birth. Overall better birth outcome is related to maternal immigrant status regardless of race/ethnic groups. Immigrant Mexican women had a significantly lower risk of both low birth weight [adjusted odds ratio (AOR): 0.78, 95% confidence interval (CI) 0.66-0.91] and preterm births (AOR: 0.75, 95% CI 0.65-0.86) and were at 28% and 33% lower risks of delivering a low birth weight infant or a premature infant, respectively, than non-Hispanic White women.

  13. Adverse birth outcomes among pregnancies of teen mothers: age-specific analysis of national data in Taiwan.

    PubMed

    Chen, C-W; Tsai, C-Y; Sung, F-C; Lee, Y-Y; Lu, T-H; Li, C-Y; Ko, Ming-Chung

    2010-03-01

    This study was conducted to evaluate the risks of adverse birth outcomes including low birthweight, preterm and small-for-gestational age among teen mothers. Data were collected from the Taiwan Birth Registry between 1985 and 1997. Among a total of 1,185,597 live births born to mothers aged 24 years or less, 151,259 (12.8%) were born to teen mothers aged 19 years or less. Crude odds ratios (ORs), adjusted ORs (AORs), their 95% confidence intervals and test for linear trend of maternal age-specific AOR were estimated using logistic regression analysis. After controlling for certain birth characteristics and socio-economic factors, the age-specific analysis showed significantly gradient variations in increased risks of adverse birth outcomes among births of teen mothers, where the elevated risk was lessened in older teen mothers. Teen mothers aged 16 years or less were observed to experience particularly high AORs for all adverse birth outcomes of interest. Not all teen mothers experienced the same magnitude of increased risk of adverse birth outcomes in Taiwan. Considering all teen mothers as the same group may have overlooked the particularly high risks of adverse birth outcomes among very young teen mothers (16 years or less), who are especially vulnerable to such elevated risks.

  14. The Birth and Growth of the National Ambulance Service in Ghana

    PubMed Central

    Zakariah, Ahmed; Stewart, Barclay T.; Boateng, Edmund; Achena, Christiana; Tansley, Gavin; Mock, Charles

    2017-01-01

    Introduction This study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified. Methods Data routinely collected by the Ghana NAS from 2004–2014 were described, including: patient demographics, reason for the call, response location, target destination, and ti1mes of service. Additionally, the organizational structure and challenges encountered during the development and maturation of the NAS were reported. Results In 2004, the NAS piloted operations with 69 newly trained emergency medical technicians (EMTs), nine ambulances, and seven stations. The NAS expanded service delivery with 199 ambulances at 128 stations operated by 1,651 EMTs and 47 administrative and maintenance staff in 2014. In 2004, nine percent of the country was covered by NAS services; in 2014, 81% of Ghana was covered. Health care transfers and roadside responses comprised the majority of services (43%–80% and 10%–57% by year, respectively). Increased mean response time, stable case holding time, and shorter vehicle engaged time reflect greater response ranges due to increased service uptake and improved efficiency of ambulance usage. Specific internal and external challenges with regard to NAS operations also were described. Conclusion The steady growth of the NAS is evidence of the need for Emergency Medical Services and the effects of sound planning and timely responses to changes in program indicators. The way forward includes further capacity building to increase the number of scene responses, strengthening ties with local health facilities to ensure timely emergency medical care and appropriateness of transfers, assuring a more stable funding stream, and improving

  15. National land cover monitoring using large, permanent photo plots

    Treesearch

    Raymond L. Czaplewski; Glenn P. Catts; Paul W. Snook

    1987-01-01

    A study in the State of North Carplina, U.S.A. demonstrated that large, permanent photo plots (400 hectares) can be used to monitor large regions of land by using remote sensing techniques. Estimates of area in a variety of land cover categories were made by photointerpretation of medium-scale aerial photography from a single month using 111 photo plots. Many of these...

  16. Hypothesis-Free Search for Connections between Birth Month and Disease Prevalence in Large, Geographically Varied Cohorts.

    PubMed

    Borsi, John P

    2016-01-01

    We have sought to replicate and extend the Season-wide Association Study (SeaWAS) of Boland, et al.(1) in identifying birth month-disease associations from electronic health records (EHRs). We used methodology similar to that implemented by Boland on three geographically distinct cohorts, for a total of 11.8 million individuals derived from multiple data sources. We were able to identify eleven out of sixteen literature-supported birth month associations as compared to seven of sixteen for SeaWAS. Of the nine novel cardiovascular birth month associations discovered by SeaWAS, we were able to replicate four. None of the novel non-cardiovascular associations discovered by SeaWAS emerged as significant relations in our study. We identified thirty birth month disease associations not previously reported; of those, only six associations were validated in more than one cohort. These results suggest that differences in cohort composition and location can cause consequential variation in results of hypothesis-free searches.

  17. Hypothesis-Free Search for Connections between Birth Month and Disease Prevalence in Large, Geographically Varied Cohorts

    PubMed Central

    Borsi, John P.

    2016-01-01

    We have sought to replicate and extend the Season-wide Association Study (SeaWAS) of Boland, et al.1 in identifying birth month-disease associations from electronic health records (EHRs). We used methodology similar to that implemented by Boland on three geographically distinct cohorts, for a total of 11.8 million individuals derived from multiple data sources. We were able to identify eleven out of sixteen literature-supported birth month associations as compared to seven of sixteen for SeaWAS. Of the nine novel cardiovascular birth month associations discovered by SeaWAS, we were able to replicate four. None of the novel non-cardiovascular associations discovered by SeaWAS emerged as significant relations in our study. We identified thirty birth month disease associations not previously reported; of those, only six associations were validated in more than one cohort. These results suggest that differences in cohort composition and location can cause consequential variation in results of hypothesis-free searches. PMID:28269826

  18. Physical exercise and pelvic girdle pain in pregnancy: A nested case-control study within the Danish National Birth Cohort.

    PubMed

    Andersen, Linda Kahr; Backhausen, Mette; Hegaard, Hanne Kristine; Juhl, Mette

    2015-12-01

    Pelvic girdle pain is a frequent cause of sick leave among pregnant women in Denmark. Studies regarding prevention of pelvic girdle pain are sparse. The aim of this study was to examine the association between physical exercise and pelvic girdle pain in pregnancy. A nested case-control study within the Danish National Birth Cohort (n = 5304). This study used self-reported data on pelvic girdle pain obtained from an interview six months after childbirth. Information on physical exercise was obtained from the pregnancy interview around gestational week 16. The association was estimated using logistic regression analysis. Physical exercise in pregnancy was associated with decreased risk of overall pelvic girdle pain (OR = 0.87; 95% CI: 0.77-0.99, p = 0.028). Tests for trend indicated decreasing odds for pelvic girdle pain with increasing number of hours per week spent on exercise (p < 0.001). Compared to no exercise, swimming was associated with a decreased risk of pelvic girdle pain (OR = 0.73; 95% CI: 0.58-0.91, p = 0.005). The findings suggest a possible protective effect of physical exercise on pelvic girdle pain during pregnancy. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. The association between congenital anomalies and autism spectrum disorders in a Finnish national birth cohort.

    PubMed

    Timonen-Soivio, Laura; Vanhala, Raija; Malm, Heli; Leivonen, Susanna; Jokiranta, Elina; Hinkka-Yli-Salomäki, Susanna; Gissler, Mika; Brown, Alan S; Sourander, Andre

    2015-01-01

    The first aim of this study was to evaluate the association between different subgroups of autism spectrum disorders (ASDs) (childhood autism, Asperger syndrome, and pervasive developmental disorder/pervasive developmental disorder - not otherwise specified [PDD/PDD-NOS]) and congenital anomalies. Second, we assessed the association among intellectually disabled children with ASDs in the subgroups of childhood autism and PDD/PDD-NOS. Nationwide population-based register data for children with a diagnosis of ASD (n=4449; 3548 males, 901 females) were collected during years 1987-2000 from the Finnish Hospital Discharge Register. Data on congenital anomalies were derived from the National Register of Congenital Malformations. Conditional logistic regression models were used as a statistical method. The association between ASD subgroups and congenital anomalies was stratified by the presence or absence of intellectual disability. Congenital anomalies occurred more frequently in all subgroups of ASD than in comparison participants (adjusted odds ratio [OR] for major congenital anomalies 1.8, 95% confidence interval [CI] 1.5-2.2, p<0.001). The association between congenital anomalies and childhood autism (OR 2.4, 95% CI 1.6-3.6, p<0.001) and between congenital anomalies and PDD/PDD-NOS (OR 3.7, 95% CI 2.4-5.7, p<0.001) among children with an intellectual disability was strong but remained significant also without intellectual disability (childhood autism: OR 1.7, 95% CI 1.3-2.3, p<0.001; PDD/PDD-NOS: OR 2.3, 95% CI 1.9-2.8, p<0.001). The results suggest a significant association between ASDs and congenital anomalies regardless of the ASD subgroup. The association between childhood autism and PDD/PDD-NOS and congenital anomalies is stronger among children with intellectual disability is stronger than among those without intellectual disability. These results may have relevance in examining early risk factors in autism during fetal neurodevelopment. © 2014 Mac Keith Press.

  20. The association between congenital anomalies and autism spectrum disorders in a Finnish national birth cohort

    PubMed Central

    TIMONEN-SOIVIO, LAURA; VANHALA, RAIJA; MALM, HELI; LEIVONEN, SUSANNA; JOKIRANTA, ELINA; HINKKA-YLI-SALOMÄKI, SUSANNA; GISSLER, MIKA; BROWN, ALAN S; SOURANDER, ANDRE

    2014-01-01

    Aim The first aim of this study was to evaluate the association between different subgroups of autism spectrum disorders (ASDs) (childhood autism, Asperger syndrome, and pervasive developmental disorder/pervasive developmental disorder – not otherwise specified [PDD/PDD-NOS]) and congenital anomalies. Second, we assessed the association among intellectually disabled children with ASDs in the subgroups of childhood autism and PDD/PDD-NOS. Method Nationwide population-based register data for children with a diagnosis of ASD (n=4449; 3548 males, 901 females) were collected during years 1987–2000 from the Finnish Hospital Discharge Register. Data on congenital anomalies were derived from the National Register of Congenital Malformations. Conditional logistic regression models were used as a statistical method. The association between ASD subgroups and congenital anomalies was stratified by the presence or absence of intellectual disability. Results Congenital anomalies occurred more frequently in all subgroups of ASD than in comparison participants (adjusted odds ratio [OR] for major congenital anomalies 1.8, 95% confidence interval [CI] 1.5–2.2, p<0.001). The association between congenital anomalies and childhood autism (OR 2.4, 95% CI 1.6–3.6, p<0.001) and between congenital anomalies and PDD/PDD-NOS (OR 3.7, 95% CI 2.4–5.7, p<0.001) among children with an intellectual disability was strong but remained significant also without intellectual disability (childhood autism: OR 1.7, 95% CI 1.3–2.3, p<0.001; PDD/PDD-NOS: OR 2.3, 95% CI 1.9–2.8, p<0.001). Interpretation The results suggest a significant association between ASDs and congenital anomalies regardless of the ASD subgroup. The association between childhood autism and PDD/PDD-NOS and congenital anomalies is stronger among children with intellectual disability is stronger than among those without intellectual disability. These results may have relevance in examining early risk factors in autism during

  1. Improving early identification of HIV-infected neonates with birth PCR testing in a large urban hospital in Johannesburg, South Africa: successes and challenges.

    PubMed

    Technau, Karl-Günter; Kuhn, Louise; Coovadia, Ashraf; Carmona, Sergio; Sherman, Gayle

    2017-04-10

    Timely diagnosis is necessary to avert early death in HIV-infected neonates. Birth PCR testing may improve early identification and facilitate access to care. We implemented a birth HIV diagnosis programme in Johannesburg, South Africa and present successes and challenges of the first two and a half years of operation. Between June 2014 and December 2016, we sought to identify all HIV-exposed births and offer newborn HIV PCR testing before discharge after delivery. The programme identified newly delivered women who had tested positive during pregnancy and provided post-partum HIV antibody testing for women without recent negative results. HIV-positive women were required to consent for neonatal birth testing and asked to return a week later to obtain their results. Neonatal venous blood was sampled and tested at the national laboratory using Roche COBAS® TaqMan® HIV-1 Qualitative Test (Version 2.0). Non-negative results triggered active follow-up for confirmatory testing and appropriate treatment. Of 30,591 women with live births, 6864 (22.4%) were known to be HIV positive and an additional 221 women (1.4% of those tested) were identified during maternal postnatal testing. Of 7085 HIV-positive women, 6372 (89.9%) were interviewed and agreed to data collection, 6358 (99.8%) consented to birth testing for 6467 neonates and a blood sample was collected for 6377 (98.6%). If tested, 6210 (97.4%) tested negative, 91 (1.4%) positive, 57 (0.9%) revealed errors and 19 (0.3%) were indeterminate . Seven of the 19 neonates with indeterminate results and one with initial error result were found to be infected on subsequent testing yielding an intrauterine transmission rate of 1.6% (95% CI: 1.3-1.9). Sixteen (16%) of 99 infected infants were born to women (n = 221) identified during postnatal testing. With active outreach, 95/99 (96%) infected infants were initiated on antiretroviral therapy. Of 6261 neonates with negative results, 3251 (52%) returned to receive their test

  2. First trimester coffee and tea intake and risk of gestational diabetes mellitus: a study within a national birth cohort.

    PubMed

    Hinkle, S N; Laughon, S K; Catov, J M; Olsen, J; Bech, B H

    2015-02-01

    Coffee and tea consumption is associated with a decreased type 2 diabetes risk in non-pregnant adults. We examined the relation between first trimester coffee and tea consumption and gestational diabetes mellitus (GDM) risk. Population-based cohort study. Denmark 1996-2002. Non-diabetic women with singleton pregnancies in the Danish National Birth Cohort (n = 71,239). Estimated adjusted relative risks (RR) and 95% confidence intervals (95%CI) for the association between first trimester coffee and tea or estimated total caffeine and GDM. GDM ascertained from the National Hospital Discharge Register or maternal interview. Coffee or tea intake was reported in 81.2% (n = 57,882) and 1.3% (n = 912) of pregnancies were complicated by GDM. Among non-consumers, 1.5% of pregnancies were complicated by GDM. Among coffee drinkers, GDM was highest among women who drank ≥8 cups/day (1.8%) with no significant difference across intake levels (P = 0.10). Among tea drinkers, there was no difference in GDM across intake levels (1.2%; P = 0.98). After adjustment for age, socio-occupational status, parity, pre-pregnancy body mass index, smoking, and cola, there was suggestion of a protective, but non-significant association with increasing coffee (RR ≥8 versus 0 cups/day = 0.89 [95%CI 0.64-1.25]) and tea (RR ≥8 versus 0 cups/day = 0.77 [95%CI 0.55-1.08]). Results were similar by smoking status, except a non-significant 1.45-fold increased risk with ≥8 coffee cups/day for non-smokers. There was a non-significant reduced GDM risk with increasing total caffeine. Our results suggest that moderate first trimester coffee and tea intake were not associated with GDM increased risk and possibly may have a protective effect. © 2014 Royal College of Obstetricians and Gynaecologists.

  3. First trimester coffee and tea intake and risk of gestational diabetes mellitus: a study within a national birth cohort

    PubMed Central

    Hinkle, Stefanie N.; Laughon, S. Katherine; Catov, Janet M.; Olsen, Jorn; Bech, Bodil Hammer

    2014-01-01

    Objective Coffee and tea consumption is associated with a decreased type 2 diabetes risk in non-pregnant adults. We examined the relation between first trimester coffee and tea consumption and gestational diabetes mellitus (GDM) risk. Design Population-based cohort study. Setting Denmark 1996-2002. Population Non-diabetic women with singleton pregnancies in the Danish National Birth Cohort (n=71,239). Methods Estimated adjusted relative risks (RR) and 95% confidence intervals (95%CI) for the association between first trimester coffee and tea or estimated total caffeine and GDM. Main outcome measures GDM ascertained from the National Hospital Discharge Register or maternal interview. Results Coffee or tea intake was reported in 81.2% (n=57,882) and GDM complicated 1.3% (n=912) of pregnancies. Among non-consumers, GDM complicated 1.5% of pregnancies. Among coffee drinkers, GDM was highest among women who drank ≥8 cups/d (1.8%) with no significant difference across intake levels (P=.10). Among tea drinkers, there was no difference in GDM across intake levels (1.2%) (P=.98). After adjustment for age, socio-occupational status, parity, prepregnancy body mass index, smoking, and cola, there was suggestion of a protective, but non-significant association with increasing coffee [RR ≥8 vs 0 cups/d=0.89 (95%CI 0.64-1.25)] and tea [RR ≥8 vs 0 cups/d=0.77 (95%CI 0.55-1.08)]. Results were similar by smoking status, except a non-significant 1.45-fold increased risk with ≥8 coffee cups/d for non-smokers. There was a non-significant reduced GDM risk with increasing total caffeine. Conclusions Our results suggest that moderate first trimester coffee and tea intake were not associated with GDM increased risk and possibly may have a protective effect. PMID:24947484

  4. Social selection in cohort studies and later representation of childhood psychiatric diagnoses: The Danish National Birth Cohort.

    PubMed

    Madsen, Kathrine Bang; Hohwü, Lena; Zhu, Jin Liang; Olsen, Jørn; Obel, Carsten

    2017-08-01

    This study aimed to estimate the relative representation of childhood psychiatric diagnoses and use of psychotropic medication in the Danish National Birth Cohort (DNBC) compared to the general population. The general population was identified as all childbirths in Denmark during 1998-2002 ( N=344,160). Linking the DNBC ( N=91,442) and the general population to the Danish national health registries, all children were followed until they received an ICD-10 psychiatric diagnosis, had a prescription of psychotropic medication or to the end of follow-up in 2013. The prevalence ratios (PRs) with corresponding 95% confidence intervals (CI) were estimated for each psychiatric diagnosis and by sex. Age at first diagnosis presented as means were compared using the one-sample t-test. In the DNBC, the selected childhood psychiatric diagnoses were underrepresented by 3% (PR=0.97, 95% CI 0.94-0.99), ranging from a 20% underrepresentation for schizophrenia (PR=0.80, 95% CI 0.59-1.09) to a 6% over-representation for anxiety disorder or obsessive-compulsive disorder (PR=1.06, 95% CI 0.97-1.17). The majority of the specific diagnoses were modestly underrepresented in the DNBC compared to the general population, while use of psychotropic medication had similar representation. Girls were generally more underrepresented than boys. Depression was on average diagnosed 0.4 years earlier in the DNBC than in the general population ( p=0.023). These findings suggest that the social selection may influence the prevalence of diagnosed childhood psychiatric disorders in the DNBC.

  5. Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study

    PubMed Central

    Petrou, Stavros; Patel, Nishma; Hollowell, Jennifer; Puddicombe, David; Redshaw, Maggie; Brocklehurst, Peter

    2012-01-01

    Objectives To estimate the cost effectiveness of alternative planned places of birth. Design Economic evaluation with individual level data from the Birthplace national prospective cohort study. Setting 142 of 147 trusts providing home birth services, 53 of 56 freestanding midwifery units, 43 of 51 alongside midwifery units, and a random sample of 36 of 180 obstetric units, stratified by unit size and geographical region, in England, over varying periods of time within the study period 1 April 2008 to 30 April 2010. Participants 64 538 women at low risk of complications before the onset of labour. Interventions Planned birth in four alternative settings: at home, in freestanding midwifery units, in alongside midwifery units, and in obstetric units. Main outcome measures Incremental cost per adverse perinatal outcome avoided, adverse maternal morbidity avoided, and additional normal birth. The non-parametric bootstrap method was used to generate net monetary benefits and construct cost effectiveness acceptability curves at alternative thresholds for cost effectiveness. Results The total unadjusted mean costs were £1066, £1435, £1461, and £1631 for births planned at home, in freestanding midwifery units, in alongside midwifery units, and in obstetric units, respectively (equivalent to about €1274, $1701; €1715, $2290; €1747, $2332; and €1950, $2603). Overall, and for multiparous women, planned birth at home generated the greatest mean net benefit with a 100% probability of being the optimal setting across all thresholds of cost effectiveness when perinatal outcomes were considered. There was, however, an increased incidence of adverse perinatal outcome associated with planned birth at home in nulliparous low risk women, resulting in the probability of it being the most cost effective option at a cost effectiveness threshold of £20 000 declining to 0.63. With regards to maternal outcomes in nulliparous and multiparous women, planned birth at home

  6. Birth in a Health Facility –Inequalities among the Ethiopian Women: Results from Repeated National Surveys

    PubMed Central

    Yesuf, Elias Ali; Kerie, Mirkuzie Woldie; Calderon-Margalit, Ronit

    2014-01-01

    Background Uptake of health facilities for delivery care in Ethiopia has not been examined in the light of equality. We investigated differences in institutional deliveries by urbanity, administrative region, economic status and maternal education. Methods This study was based on nation-wide repeated surveys undertaken in the years 2000, 2005, and 2011. The surveys used a cluster sampling design. Women of reproductive age were interviewed on the place of their last delivery. Data was analyzed using logistic regressions to estimate the weighted association between birth in a health facility and study's predictors. Results Utilization of health institutions for deliveries has improved throughout the study period, however, rates remain low (5.4%,2000 and 11.8%,2011). Compared with women from rural places, women from urban areas had independent OR of a health facility delivery of 4.9 (95% CI: 3.4, 7.0), 5.0 (95% CI: 3.6, 6.9), and 4.6 (95% CI: 3.5, 6.0) in 2000, 2005, and 2011, respectively. Women with secondary/higher education had more deliveries in a healthcare facility than women with no education, and these gaps widened over the years (OR: 35.1, 45.0 and 53.6 in 2000, 2005, and 2011, respectively). Women of the upper economic quintile had 3.0–7.2 times the odds of healthcare facility deliveries, compared with the lowest quintile, with no clear trend over the years. While Addis-Ababa and Dire Dawa remained with the highest OR for deliveries in a health facility compared with Amhara, other regions displayed shifts in their relative ranking with Oromiya, SNNPR, Afar, Harari, and Somali getting relatively worse over time. Conclusions The disparity related to urbanity or education in the use of health facility for birth in Ethiopia is staggering. There is a small inequality between most regions except Addis Ababa/Dire Dawa and sign of abating inequity between economic strata except for the richest households. PMID:24751600

  7. Environmental Focus in a Large National Sample of Schools.

    ERIC Educational Resources Information Center

    Gottfredson, Gary D.

    This paper reviews research stimulated by Holland's (1997) theory of vocational personalities and work environments. It describes new research extending an examination of one part of the theory, environmental identity, to a large sample of school environments. The Organizational Focus Scale (G.D. Gottfredson and Holland, 1996b) was administrated…

  8. Factors affecting maternal participation in the genetic component of the National Birth Defects Prevention Study—United States, 1997–2007

    PubMed Central

    Glidewell, Jill; Reefhuis, Jennita; Rasmussen, Sonja A.; Woomert, Alison; Hobbs, Charlotte; Romitti, Paul A.; Crider, Krista S.

    2015-01-01

    Purpose As epidemiological studies expand to examine gene–environment interaction effects, it is important to identify factors associated with participation in genetic studies. The National Birth Defects Prevention Study is a multisite case–control study designed to investigate environmental and genetic risk factors for major birth defects. The National Birth Defects Prevention Study includes maternal telephone interviews and mailed buccal cell self-collection kits. Because subjects can participate in the interview, independent of buccal cell collection, detailed analysis of factors associated with participation in buccal cell collection was possible. Methods Multivariable logistic regression models were used to identify the factors associated with participation in the genetic component of the study. Results Buccal cell participation rates varied by race/ethnicity (non-Hispanic whites, 66.9%; Hispanics, 60.4%; and non-Hispanic blacks, 47.3%) and study site (50.2–74.2%). Additional monetary incentive following return of buccal cell kit and shorter interval between infant’s estimated date of delivery and interview were associated with increased participation across all racial/ethnic groups. Higher education and delivering an infant with a birth defect were associated with increased participation among non-Hispanic whites and Hispanics. Conclusion Factors associated with participation varied by race/ethnicity. Improved understanding of factors associated with participation may facilitate strategies to increase participation, thereby improving generalizability of study findings. PMID:24071796

  9. Birth weight is positively related to bone size in adolescents but inversely related to cortical bone mineral density: findings from a large prospective cohort study.

    PubMed

    Steer, Colin D; Sayers, Adrian; Kemp, John; Fraser, William D; Tobias, Jon H

    2014-08-01

    To examine the influence of intrauterine environment on subsequent bone development, we investigated the relationship between birth weight and cortical bone parameters, and the role of puberty, bone resorption and insulin as possible mediators. Bone outcomes were obtained from mid-tibial pQCT scans performed at age 15.5 years in 1960 males and 2192 females from the ALSPAC birth cohort. Birth weight was positively related to periosteal circumference (PC) [beta=0.40 (0.34, 0.46)], which was largely but not completely attenuated after adjustment for height and weight [beta=0.07 (0.02, 0.12)] (SD change in outcome per 1 kg increase in birth weight with 95% CI). Based on our height and weight adjusted model, the association was stronger in females compared to males (P=0.02 for gender interaction), and persisted in 2842 participants with equivalent results at age 17.7 years. Conversely, birth weight was inversely related to cortical bone mineral density (BMDC) at age 15.5 years after adjusting for height and weight [beta=-0.18 (-0.23, -0.13)], with a stronger association in males compared to females (P=0.01 for gender interaction), but an equivalent association was not seen at 17.7 years. In further analyses performed on data from age 15.5 years, the association between birth weight and PC was unaffected by adjustment for puberty (Tanner stage at age 13.5 years), bone resorption (fasting beta-carboxyterminal cross linking telopeptide (βCTX) at age 15.5 years) or insulin (fasting insulin at age 15.5 years). In contrast, the association with BMDC was attenuated by approximately 30% after adjustment for puberty or bone resorption, and by 50% after adjustment for both factors combined. We conclude that the inverse relationship between birth weight and BMDC is in part mediated by effects of puberty and bone resorption, which may help to explain the transitory nature of this association, in contrast to the more persisting relationship with PC. Copyright © 2014 The Authors

  10. Maternal occupation and the risk of major birth defects: A follow-up analysis from the National Birth Defects Prevention Study

    PubMed Central

    Lin, Shao; Herdt-Losavio, Michele L.; Chapman, Bonnie R.; Munsie, Jean-Pierre; Olshan, Andrew F.; Druschel, Charlotte M.

    2013-01-01

    This study further examined the association between selected maternal occupations and a variety of birth defects identified from prior analysis and explored the effect of work hours and number of jobs held and potential interaction between folic acid and occupation. Data from a population-based, multi-center case-control study was used. Analyses included 45 major defects and specific sub-occupations under five occupational groups: healthcare workers, cleaners, scientists, teachers and personal service workers. Both logistic regression and Bayesian models (to minimize type-1 errors) were used, adjusted for potential confounders. Effect modification by folic acid was also assessed. More than any other occupation, nine different defects were positively associated with maids or janitors [odds ratio (OR) range: 1.72-3.99]. Positive associations were also seen between the following maternal occupations and defects in their children (OR range: 1.35-3.48): chemists/conotruncal heart and neural tube defects (NTDs), engineers/conotruncal defects, preschool teachers/cataracts and cleft lip with/without cleft palate (CL/P), entertainers/athletes/gastroschisis, and nurses/hydrocephalus and left ventricular outflow tract heart defects. Non-preschool teachers had significantly lower odds of oral clefts and gastroschisis in their offspring (OR range: 0.53-0.76). There was a suggestion that maternal folic acid use modified the effects with occupations including lowering the risk of NTDs and CL/P. No consistent patterns were found between maternal work hours or multiple jobs by occupation and the risk of birth defects. Overall, mothers working as maids, janitors, biologists, chemists, engineers, nurses, entertainers, child care workers and preschool teachers had increased risks of several malformations and non-preschool teachers had a lower risk of some defects. Maternal folic acid use reduced the odds of NTDs and CL/P among those with certain occupations. This hypothesis

  11. Finite-time and finite-size scalings in the evaluation of large-deviation functions: Analytical study using a birth-death process

    NASA Astrophysics Data System (ADS)

    Nemoto, Takahiro; Guevara Hidalgo, Esteban; Lecomte, Vivien

    2017-01-01

    The Giardinà-Kurchan-Peliti algorithm is a numerical procedure that uses population dynamics in order to calculate large deviation functions associated to the distribution of time-averaged observables. To study the numerical errors of this algorithm, we explicitly devise a stochastic birth-death process that describes the time evolution of the population probability. From this formulation, we derive that systematic errors of the algorithm decrease proportionally to the inverse of the population size. Based on this observation, we propose a simple interpolation technique for the better estimation of large deviation functions. The approach we present is detailed explicitly in a two-state model.

  12. Social circumstances and education: life course origins of social inequalities in metabolic risk in a prospective national birth cohort.

    PubMed

    Langenberg, Claudia; Kuh, Diana; Wadsworth, Michael E J; Brunner, Eric; Hardy, Rebecca

    2006-12-01

    We investigated the relative importance of education and childhood and adult social class in the risk of metabolic syndrome. We conducted a prospective birth cohort study of 1311 men and 1318 women aged 53 years in 1999, when metabolic syndrome components were measured. Logistic regression analyses were used to calculate relative index of inequality estimates. Relative to men and women at the highest education levels, men (odds ratio [OR]=2.0; 95% confidence interval [CI]=1.2, 3.2) and women (OR=2.7; 95% CI=1.5, 4.6) with the least education were at twice the risk or more of having the metabolic syndrome. Adjustment for childhood and adult social class strengthened this result among men and weakened it among women. Childhood social class was independently associated with the metabolic syndrome in women (OR=2.0; 95% CI=1.1, 3.6) but not in men (OR=1.1; 95% CI= 0.7, 1.8). Associations between adult social class and the metabolic syndrome or its components were largely accounted for by childhood socioeconomic measures. Educational differences should be considered in the design of interventions aimed at reducing the burden of the metabolic syndrome in socially disadvantaged groups.

  13. Development and validation of a national data registry for midwife-led births: the Midwives Alliance of North America Statistics Project 2.0 dataset.

    PubMed

    Cheyney, Melissa; Bovbjerg, Marit; Everson, Courtney; Gordon, Wendy; Hannibal, Darcy; Vedam, Saraswathi

    2014-01-01

    In 2004, the Midwives Alliance of North America's (MANA's) Division of Research developed a Web-based data collection system to gather information on the practices and outcomes associated with midwife-led births in the United States. This system, called the MANA Statistics Project (MANA Stats), grew out of a widely acknowledged need for more reliable data on outcomes by intended place of birth. This article describes the history and development of the MANA Stats birth registry and provides an analysis of the 2.0 dataset's content, strengths, and limitations. Data collection and review procedures for the MANA Stats 2.0 dataset are described, along with methods for the assessment of data accuracy. We calculated descriptive statistics for client demographics and contributing midwife credentials, and assessed the quality of data by calculating point estimates, 95% confidence intervals, and kappa statistics for key outcomes on pre- and postreview samples of records. The MANA Stats 2.0 dataset (2004-2009) contains 24,848 courses of care, 20,893 of which are for women who planned a home or birth center birth at the onset of labor. The majority of these records were planned home births (81%). Births were attended primarily by certified professional midwives (73%), and clients were largely white (92%), married (87%), and college-educated (49%). Data quality analyses of 9932 records revealed no differences between pre- and postreviewed samples for 7 key benchmarking variables (kappa, 0.98-1.00). The MANA Stats 2.0 data were accurately entered by participants; any errors in this dataset are likely random and not systematic. The primary limitation of the 2.0 dataset is that the sample was captured through voluntary participation; thus, it may not accurately reflect population-based outcomes. The dataset's primary strength is that it will allow for the examination of research questions on normal physiologic birth and midwife-led birth outcomes by intended place of birth.

  14. Birth Control

    MedlinePlus

    Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ... releasing eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive ...

  15. Hispanic ethnicity and acculturation, maternal age and the risk of gastroschisis in the National Birth Defects Prevention Study.

    PubMed

    Khodr, Zeina G; Lupo, Philip J; Canfield, Mark A; Chan, Wenyaw; Cai, Yi; Mitchell, Laura E

    2013-08-01

    Studies indicate that gastroschisis is associated with maternal age, ethnicity, and acculturation. This analysis was conducted to further define the associations between gastroschisis and parental Hispanic ethnicity and acculturation, and to determine whether such associations vary by maternal age. This study was based on data from mothers of 753 gastroschisis cases and 6,496 control infants in the National Birth Defects Prevention Study. The relationships between gastroschisis and both parental Hispanic ethnicity and acculturation, within maternal age strata (<20 versus ≥20 years at conception), were assessed using logistic regression and principal component analyses. The risk of gastroschisis in offspring of women <20 years old was not significantly associated with parental Hispanic ethnicity or acculturation. Among mothers ≥20 years old, US-born non-Hispanic white parents had a lower risk of gastroschisis in offspring as compared to either US-born Hispanic (odds ratios [ORs] ranging from 0.55 to 0.60) or English-speaking Hispanic (ORs ranging from 0.58 to 0.65) parents. Further, compared with US born Hispanic women ≥20 years, the risk of gastroschisis was lower for Hispanic women who had lived in the US <5 years (OR=0.35, 95% confidence interval [CI]: 0.17, 0.74) or who migrated to the US at ≥20 years (OR=0.47, 95% CI: 0.25, 0.88). These results provide further evidence that gastroschisis risk is associated with ethnicity and some aspects of acculturation. Additionally, these associations were limited to the offspring of women who are ≥20 at the time of conception. Copyright © 2013 Wiley Periodicals, Inc.

  16. Diabetes and obesity-related genes and the risk of neural tube defects in the national birth defects prevention study.

    PubMed

    Lupo, Philip J; Canfield, Mark A; Chapa, Claudia; Lu, Wei; Agopian, A J; Mitchell, Laura E; Shaw, Gary M; Waller, D Kim; Olshan, Andrew F; Finnell, Richard H; Zhu, Huiping

    2012-12-15

    Few studies have evaluated genetic susceptibility related to diabetes and obesity as a risk factor for neural tube defects (NTDs). The authors investigated 23 single nucleotide polymorphisms among 9 genes (ADRB3, ENPP1, FTO, LEP, PPARG, PPARGC1A, SLC2A2, TCF7L2, and UCP2) associated with type 2 diabetes or obesity. Samples were obtained from 737 NTD case-parent triads included in the National Birth Defects Prevention Study during 1999-2007. Log-linear models were used to evaluate maternal and offspring genetic effects. After application of the false discovery rate, there were 5 significant maternal genetic effects. The less common alleles at the 4 FTO single nucleotide polymorphisms showed a reduction of NTD risk (for rs1421085, relative risk (RR) = 0.73 (95% confidence interval (CI): 0.62, 0.87); for rs8050136, RR = 0.79 (95% CI: 0.67, 0.93); for rs9939609, RR = 0.79 (95% CI: 0.67, 0.94); and for rs17187449, RR = 0.80 (95% CI: 0.68, 0.95)). Additionally, maternal LEP rs2071045 (RR = 1.31, 95% CI: 1.08, 1.60) and offspring UCP2 rs660339 (RR = 1.32, 95% CI: 1.06, 1.64) were associated with NTD risk. Furthermore, the maternal genotype for TCF7L2 rs3814573 suggested an increased NTD risk among obese women. These findings indicate that maternal genetic variants associated with glucose homeostasis may modify the risk of having an NTD-affected pregnancy.

  17. Association between maternal occupational exposure to organic solvents and congenital heart defects, National Birth Defects Prevention Study, 1997–2002

    PubMed Central

    Gilboa, SM; Desrosiers, TA; Lawson, CC; Lupo, PJ; Riehle-Colarusso, T; Stewart, PA; van Wijngaarden, E; Waters, MA; Correa, A

    2015-01-01

    Objective To examine the relation between congenital heart defects (CHDs) in offspring and estimated maternal occupational exposure to chlorinated solvents, aromatic solvents, and Stoddard solvent during the period from one month before conception through the first trimester. Methods The study population included mothers of infants with simple, isolated CHDs and mothers of control infants who delivered from 1997 through 2002 and participated in the National Birth Defects Prevention Study. Two methods to assess occupational solvent exposure were employed: an expert consensus-based approach and a literature-based approach. Multiple logistic regression was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between solvent classes and CHDs. Results 2,951 control mothers and 2,047 CHD case mothers were included. Using the consensus-based approach, associations were observed for exposure to any solvent and any chlorinated solvent with perimembranous ventricular septal defects (OR 1.6; 95% CI 1.0 to 2.6 and OR 1.7; 95% CI 1.0 to 2.8 respectively). Using the literature-based approach, associations were observed for: any solvent exposure with aortic stenosis (OR 2.1; 95% CI 1.1 to 4.1); and Stoddard solvent exposure with d-transposition of the great arteries (OR 2.0; 95% CI 1.0 to 4.2), right ventricular outflow tract obstruction defects (OR 1.9; 95% CI 1.1 to 3.3), and pulmonary valve stenosis (OR 2.1; 95% CI 1.1 to 3.8). Conclusions We found evidence of associations between occupational exposure to solvents and several types of CHDs. These results should be interpreted in light of the potential for misclassification of exposure. PMID:22811060

  18. Alcohol use at the cusp of adolescence: a prospective national birth cohort study of prevalence and risk factors.

    PubMed

    Maggs, Jennifer L; Staff, Jeremy; Patrick, Megan E; Wray-Lake, Laura; Schulenberg, John E

    2015-06-01

    To estimate the prevalence of alcohol use at the age of 10-11 years and document variation by early sociodemographic and concurrent alcohol-specific risk factors. The Millennium Cohort Study is a prospective, nationally representative study of live births in the United Kingdom across 12 months. A random sample of electoral wards was stratified to adequately represent U.K. countries, economically deprived areas, and areas with high concentrations of Asian and Black British families. A total of 12,305 child-mother pairs provided self-report data at 9 months (mother's marital status, age, education, occupational level; child gender, ethnicity, country) and age 10-11 years (adolescent alcohol use and attitudes). After adjusting for attrition and sampling design, 13.4% of 10- to 11-year-olds had had an alcoholic drink (more than few sips), 1.2% had felt drunk, and .6% had five or more drinks at a time. Odds of ever drinking were higher among boys (1.47, 95% confidence interval, 1.29-1.68) and lower among early adolescents who were Asian British (vs. white; .09, .05-.17) or Black British (.42, .29-.62). Beyond sociodemographic differences, more positive attitudes about alcohol were associated with greater odds of drinking (1.70, 1.51-1.91), feeling drunk (2.96, 2.07-4.24), and having five or more drinks (4.20, 2.66-6.61). Alcohol use in the last year of primary school was identified but not common. Its use varied by sociodemographic groups; early adolescents with more positive alcohol attitudes had especially high risks of early alcohol initiation. Results support calls for increased surveillance and screening for very early drinking. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Maternal Caffeine Consumption during Pregnancy and Behavioral Disorders in 11-Year-Old Offspring: A Danish National Birth Cohort Study.

    PubMed

    Hvolgaard Mikkelsen, Susanne; Obel, Carsten; Olsen, Jørn; Niclasen, Janni; Bech, Bodil Hammer

    2017-10-01

    To examine the association between maternal caffeine consumption from coffee and tea during pregnancy and offspring behavioral disorders. We studied 47 491 children enrolled in the Danish National Birth Cohort between 1996 and 2002. Data on maternal coffee and tea consumption was collected at 15 and 30 weeks of gestation. When the child was 11 years old, the Strength and Difficulties Questionnaire was filled in by children, parents, and teachers. We estimated risk ratios (RRs) for offspring behavioral disorders. At 15 weeks of gestation 3% and 4% of the pregnant women consumed ≥8 cups/d of coffee or tea, respectively. Maternal coffee consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of hyperactivity-inattention disorder (RR 1.47; 95% CI 1.18-1.83), conduct-oppositional disorders (RR 1.22; 95% CI 1.01-1.48), and any psychiatric disorder (RR 1.23; 95% CI 1.08-1.40). Maternal tea consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of anxiety-depressive disorders (RR 1.28; 95% CI 1.09-1.52) and any psychiatric disorder (RR 1.24; 95% CI 1.11-1.40). An increased risk of hyperactivity-inattention disorder was observed with increasing daily caffeine consumption at 15 weeks of gestation. High maternal caffeine consumption from coffee and tea at 15 weeks of gestation was associated with behavioral disorders in 11-year-old offspring. We hypothesize that caffeine exposure may affect the fetal brain and program for behavioral disorders later in life. The fetal brain seems to be more sensitive to caffeine exposure at 15 weeks of pregnancy compared with 30 weeks of gestation. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Maternal occupation and the risk of major birth defects: a follow-up analysis from the National Birth Defects Prevention Study.

    PubMed

    Lin, Shao; Herdt-Losavio, Michele L; Chapman, Bonnie R; Munsie, Jean-Pierre; Olshan, Andrew F; Druschel, Charlotte M

    2013-06-01

    This study further examined the association between selected maternal occupations and a variety of birth defects identified from prior analysis and explored the effect of work hours and number of jobs held and potential interaction between folic acid and occupation. Data from a population-based, multi-center case-control study was used. Analyses included 45 major defects and specific sub-occupations under five occupational groups: healthcare workers, cleaners, scientists, teachers and personal service workers. Both logistic regression and Bayesian models (to minimize type-1 errors) were used, adjusted for potential confounders. Effect modification by folic acid was also assessed. More than any other occupation, nine different defects were positively associated with maids or janitors [odds ratio (OR) range: 1.72-3.99]. Positive associations were also seen between the following maternal occupations and defects in their children (OR range: 1.35-3.48): chemists/conotruncal heart and neural tube defects (NTDs), engineers/conotruncal defects, preschool teachers/cataracts and cleft lip with/without cleft palate (CL/P), entertainers/athletes/gastroschisis, and nurses/hydrocephalus and left ventricular outflow tract heart defects. Non-preschool teachers had significantly lower odds of oral clefts and gastroschisis in their offspring (OR range: 0.53-0.76). There was a suggestion that maternal folic acid use modified the effects with occupations including lowering the risk of NTDs and CL/P. No consistent patterns were found between maternal work hours or multiple jobs by occupation and the risk of birth defects. Overall, mothers working as maids, janitors, biologists, chemists, engineers, nurses, entertainers, child care workers and preschool teachers had increased risks of several malformations and non-preschool teachers had a lower risk of some defects. Maternal folic acid use reduced the odds of NTDs and CL/P among those with certain occupations. This hypothesis

  1. Assessment of risk factors for infantile cataracts using a case-control study: National Birth Defects Prevention Study, 2000-2004.

    PubMed

    Prakalapakorn, Sasapin G; Rasmussen, Sonja A; Lambert, Scott R; Honein, Margaret A

    2010-08-01

    To identify risk factors for infantile cataracts of unknown etiology. Case-control study. Case infants (n = 152) and control infants (n = 4205) enrolled in the National Birth Defects Prevention Study for birth years 2000-2004. Multivariate analysis was performed exploring associations for risk factors for bilateral and unilateral infantile cataracts of unknown etiology. Infantile cataracts of unknown etiology. Maternal interviews were completed for 43 case infants with bilateral and 109 with unilateral infantile cataracts of unknown etiology. Very low birth weight (<1500 g) was associated with both unilateral (adjusted odds ratio [OR], 6.0; 95% confidence interval [CI], 2.2-16.3) and bilateral (OR, 13.2; 95% CI, 4.2-41.1) cataracts, whereas low birth weight (1500-2499 g) was only associated with bilateral cataracts (OR, 3.3; 95% CI, 1.3-8.1). Infants with unilateral cataracts were more likely to be born to primigravid women (OR, 1.6; 95% CI, 1.0-2.7) than women with > or =2 previous pregnancies, although this was of borderline significance. Although not significant, effect estimates were elevated suggesting a possible association between unilateral cataracts and maternal substance abuse during pregnancy, and between bilateral cataracts and urinary tract infection during pregnancy and aspirin use during pregnancy. Very low birth weight is associated with both bilateral and unilateral cataracts, whereas low birth weight is associated with bilateral cataracts and primigravidity with unilateral cataracts. Other associations, although not statistically significant, suggest risk factors that merit further research. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  2. Assessment of risk factors for infantile cataracts using a case-control study, National Birth Defects Prevention Study, 2000–2004

    PubMed Central

    Prakalapakorn, Sasapin G.; Rasmussen, Sonja A.; Lambert, Scott R.; Honein, Margaret A.

    2010-01-01

    Objective To identify risk factors for infantile cataracts of unknown etiology. Design Case-control study Participants Case-infants (N=152) and control-infants (N=4205) enrolled in the National Birth Defects Prevention Study for birth years 2000–2004. Methods Multivariate analysis was performed exploring associations for risk factors for bilateral and unilateral infantile cataracts of unknown etiology. Main Outcome Measures Infantile cataracts of unknown etiology Results Maternal interviews were completed for 43 case-infants with bilateral and 109 with unilateral infantile cataracts of unknown etiology. Very low birth weight (<1500g) was associated with both unilateral (adjusted odds ratio [OR]=6.0; 95% confidence interval [CI]=2.2–16.3) and bilateral (OR=13.2; 95% CI=4.2–41.1) cataracts, while low birth weight (1500–2499g) was only associated with bilateral cataracts (OR=3.3; 95% CI=1.3–8.1). Infants with unilateral cataracts were more likely to be born to primigravid women (OR=1.6; 95% CI=1.0–2.7) than women with two or more previous pregnancies, although this was of borderline significance. While not statistically significant, effect estimates were elevated suggesting a possible association between unilateral cataracts and maternal substance abuse during pregnancy, and between bilateral cataracts and urinary tract infection during pregnancy and aspirin use during pregnancy. Conclusions Very low birth weight is associated with both bilateral and unilateral cataracts, while low birth weight is associated with bilateral cataracts and primigravidity with unilateral cataracts. Other associations, while not of statistical significance, suggest risk factors that merit further research. PMID:20363508

  3. Cyclopia: an epidemiologic study in a large dataset from the International Clearinghouse of Birth Defects Surveillance and Research.

    PubMed

    Orioli, Iêda M; Amar, Emmanuelle; Bakker, Marian K; Bermejo-Sánchez, Eva; Bianchi, Fabrizio; Canfield, Mark A; Clementi, Maurizio; Correa, Adolfo; Csáky-Szunyogh, Melinda; Feldkamp, Marcia L; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R Brian; Mastroiacovo, Pierpaolo; Morgan, Margery; Mutchinick, Osvaldo M; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Szabova, Elena; Castilla, Eduardo E

    2011-11-15

    Cyclopia is characterized by the presence of a single eye, with varying degrees of doubling of the intrinsic ocular structures, located in the middle of the face. It is the severest facial expression of the holoprosencephaly (HPE) spectrum. This study describes the prevalence, associated malformations, and maternal characteristics among cases with cyclopia. Data originated in 20 Clearinghouse (ICBDSR) affiliated birth defect surveillance systems, reported according to a single pre-established protocol. A total of 257 infants with cyclopia were identified. Overall prevalence was 1 in 100,000 births (95%CI: 0.89-1.14), with only one program being out of range. Across sites, there was no correlation between cyclopia prevalence and number of births (r = 0.08; P = 0.75) or proportion of elective termination of pregnancy (r = -0.01; P = 0.97). The higher prevalence of cyclopia among older mothers (older than 34) was not statistically significant. The majority of cases were liveborn (122/200; 61%) and females predominated (male/total: 42%). A substantial proportion of cyclopias (31%) were caused by chromosomal anomalies, mainly trisomy 13. Another 31% of the cases of cyclopias were associated with defects not typically related to HPE, with more hydrocephalus, heterotaxia defects, neural tube defects, and preaxial reduction defects than the chromosomal group, suggesting the presence of ciliopathies or other unrecognized syndromes. Cyclopia is a very rare defect without much variability in prevalence by geographic location. The heterogeneous etiology with a high prevalence of chromosomal abnormalities, and female predominance in HPE, were confirmed, but no effect of increased maternal age or association with twinning was observed.

  4. Cyclopia: An Epidemiologic Study in a Large Dataset From the International Clearinghouse of Birth Defects Surveillance and Research

    PubMed Central

    Orioli, Iêda M.; Amar, Emmanuelle; Bakker, Marian K.; Bermejo-Sánchez, Eva; Bianchi, Fabrizio; Canfield, Mark A.; Clementi, Maurizio; Correa, Adolfo; Csáky-Szunyogh, Melinda; Feldkamp, Marcia L.; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R. Brian; Mastroiacovo, Pierpaolo; Morgan, Margery; Mutchinick, Osvaldo M.; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Szabova, Elena; Castilla, Eduardo E.

    2015-01-01

    Cyclopia is characterized by the presence of a single eye, with varying degrees of doubling of the intrinsic ocular structures, located in the middle of the face. It is the severest facial expression of the holoprosencephaly (HPE) spectrum. This study describes the prevalence, associated malformations, and maternal characteristics among cases with cyclopia. Data originated in 20 Clearinghouse (ICBDSR) affiliated birth defect surveillance systems, reported according to a single pre-established protocol. A total of 257 infants with cyclopia were identified. Overall prevalence was 1 in 100,000 births (95%CI: 0.89–1.14), with only one program being out of range. Across sites, there was no correlation between cyclopia prevalence and number of births (r = 0.08; P=0.75) or proportion of elective termination of pregnancy (r= −0.01; P=0.97). The higher prevalence of cyclopia among older mothers (older than 34) was not statistically significant. The majority of cases were liveborn (122/200; 61%) and females predominated (male/total: 42%). A substantial proportion of cyclopias (31%) were caused by chromosomal anomalies, mainly trisomy 13. Another 31% of the cases of cyclopias were associated with defects not typically related to HPE, with more hydrocephalus, heterotaxia defects, neural tube defects, and preaxial reduction defects than the chromosomal group, suggesting the presence of ciliopathies or other unrecognized syndromes. Cyclopia is a very rare defect without much variability in prevalence by geographic location. The heterogeneous etiology with a high prevalence of chromosomal abnormalities, and female predominance in HPE, were confirmed, but no effect of increased maternal age or association with twinning was observed. PMID:22006661

  5. Small area analysis on a large scale--the California experience in mapping teenage birth "hot spots" for resource allocation.

    PubMed

    Taylor, Don; Chavez, Gilberto

    2002-03-01

    Small-area analysis has become an important tool in the effective targeting of limited public health resources. In California, new funding for teenage pregnancy prevention programs required more and better information to justify the allocation of these funds to areas with the greatest need. Consequently, these funds were allocated using maps with census tract analyses of teenage birth rates and an overlay of geographic frequencies. State and local agencies' programs have responded with positive feedback to the maps, and public health management subsequently has augmented funding for mapping equipment and training. The lessons learned and future directions are discussed.

  6. Birth Defects

    MedlinePlus

    A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of ... in the United States is born with a birth defect. A birth defect may affect how the ...

  7. Teen Birth Rate. Facts at a Glance, 2002.

    ERIC Educational Resources Information Center

    Papillo, Angela Romano, Comp.; Franzetta, Kerry, Comp.; Manlove, Jennifer, Comp.; Moore, Kristin Anderson, Comp.; Terry-Humen, Elizabeth, Comp.; Ryan, Suzanne, Comp.

    This publication reports trends in teen childbearing in the nation, in each state, and in large cities using data from the 2001 National Center for Health Statistics (NCHS). Rates of teenage childbearing continue to steadily decline, and the 2001 rates are historic lows for each age group. NCHS data showed that almost 80% of teen births nationwide…

  8. Intrapartum-related birth asphyxia in South Africa--lessons from the first national perinatal care survey.

    PubMed

    Buchmann, E J; Pattinson, R C; Nyathikazi, N

    2002-11-01

    The recent amalgamation of data by users of the Perinatal Problem Identification Programme (PPIP) throughout South Africa has culminated in the publication of the Saving Babies report. To determine the absolute rate of death from intrapartum-related birth asphyxia, and the contribution of intrapartum-related asphyxia to total perinatal mortality in South African hospitals, and to identify the primary obstetric causes and avoidable factors for these deaths. The amalgamated PPIP data for the year 2000 were obtained from 27 state hospitals (6 metropolitan, 12 town and 9 rural) in South Africa. In PPIP-based audit, all perinatal deaths are assigned primary obstetric causes and avoidable factors, and these elements were obtained for all deaths resulting from intrapartum-related birth asphyxia. There were 123,508 births in the hospitals surveyed, with 4,142 perinatal deaths among infants > or = 1,000 g, giving a perinatal mortality rate of 33.5/1,000 births. The perinatal mortality rate from intrapartum-related birth asphyxia was 4.8/1,000 births. The most frequent avoidable factors were delay by mothers in seeking attention during labour (36.6%), signs of fetal distress interpreted incorrectly (24.9%), inadequate fetal monitoring (18.0%) and no response to poor progress in labour (7.0%). The perinatal mortality rates for metropolitan, town, and rural areas were 30.0, 39.4 and 30.9/1,000 births respectively. The contribution of intrapartum-related birth asphyxia to perinatal mortality in these areas was 10.8%, 16.7% and 26.4% respectively. The high rates of perinatal death from intrapartum-related birth asphyxia in South Africa are typical of those in underdeveloped countries, with the most serious deficiencies in rural areas. Most of these deaths are avoidable and the reduction of these rates presents an important challenge to providers of perinatal care in this country. Areas worthy of research and action include provision of mothers' waiting facilities in rural

  9. Strategies to achieve sustainability and quality in birth defects registries: the experience of the National Registry of Congenital Anomalies of Argentina.

    PubMed

    Groisman, Boris; Bidondo, Maria Paz; Gili, Juan Antonio; Barbero, Pablo; Liascovich, Rosa

    2013-01-01

    In many low-and middle-income countries, birth defects are not considered a public health priority and are perceived by the medical community as rare, unpreventable events. In this context, a registry of birth defects should address not only the collection, analysis, and dissemination of information but also contribute to local interventions like prevention, diagnosis, and treatment. We describe the National Registry of Congenital Anomalies of Argentina (RENAC) in terms of case definition, data collection, quality assurance, and data sending, coding, analysis, and information dissemination and we present the strategies used to ensure its sustainability. We emphasize strategies for motivating the people collecting data, such as training activities, participation in research projects, returning the processed data, making useful clinical information available, giving non-monetary rewards, and linking cases to genetic services.

  10. Newborn birth-weight of pregnant women on methadone or buprenorphine maintenance treatment: A national contingency management approach trial.

    PubMed

    Peles, Einat; Sason, Anat; Schreiber, Shaul; Adelson, Miriam

    2017-03-01

    Methadone maintenance treatment (MMT) is the gold standard for pregnant women with opioid use disorders. Still, low birth-weights were reported, in particular of mothers who became pregnant before admission to MMT. We studied whether an escalating incentive contingency-management approach may contribute to better newborn birth-weights. A nationwide controlled randomized trial among all Israeli methadone/buprenorphine maintenance treatment (MBMT), newly or already in treatment pregnant women was performed. A modified contingency-management protocol with coupons of escalating value depending upon reduction of drug use, cigarette smoking, and alcohol consumption was compared to standard care arm. Drugs in urine, smoking (Fagerstrom score), alcohol use, and depression were monitored. Thirty-five women had 46 pregnancies. In their first pregnancy, 19 from the contingency-management and 16 from the standard care arms were studied. Contingency-management group as compared to the standard care arm included more newly admitted women (36.8% vs. 6.3%, p = .05), with benzodiazepine and cannabis onset at a younger age, and higher proportion of any drug abuse while pregnant (100% vs. 68.8%, p = .01). Fifteen of the contingency-management and 14 of the control arm gave birth (78.9% vs. 87.5%, p = .3) with similar proportions of normal (>2,500 g) birth-weight (71.4% vs. 61.5%, p = .8). Newborns' birth-weight was comparable among the two study arms indicating no contribution of the contingency-management approach. Small sample and baseline differences between arms might have influenced results. Intensive intervention should be evaluated on a larger scale of participants. (Am J Addict 2017;26:167-175). © 2017 American Academy of Addiction Psychiatry.

  11. Cleanliness improvements of NIF (National Ignition Facility) amplifiers as compared to previous large-scale lasers

    SciTech Connect

    Honig, J

    2004-06-09

    Prior to the recent commissioning of the first NIF (National Ignition Facility) beamline, full-scale laser-amplifier-glass cleanliness experiments were performed. Aerosol measurements and obscuration data acquired using a modified flatbed scanner compare favorably to historical large-scale lasers and indicate that NIF is the cleanest large-scale laser built to date.

  12. Resolving the Debate over Birth Order, Family Size, and Intelligence.

    ERIC Educational Resources Information Center

    Rodgers, Joseph Lee; Cleveland, H. Harrington; van den Oord, Edwin; Rowe, David C.

    2000-01-01

    Investigated the relationship between birth order, family size, and intelligence quotient (IQ), evaluating sibling data from the National Longitudinal Survey of Youth and comparing results with those from other studies using within-family data. Results indicated that although low IQ parents were making large families, large families were not…

  13. Resolving the Debate over Birth Order, Family Size, and Intelligence.

    ERIC Educational Resources Information Center

    Rodgers, Joseph Lee; Cleveland, H. Harrington; van den Oord, Edwin; Rowe, David C.

    2000-01-01

    Investigated the relationship between birth order, family size, and intelligence quotient (IQ), evaluating sibling data from the National Longitudinal Survey of Youth and comparing results with those from other studies using within-family data. Results indicated that although low IQ parents were making large families, large families were not…

  14. The Medium Term Schooling and Health Effects of Low Birth Weight: Evidence from Siblings

    ERIC Educational Resources Information Center

    Fletcher, Jason M.

    2011-01-01

    Research has shown that low birth weight is linked to infant mortality as well as longer term outcomes. This paper examines the medium term outcomes that may link low birth weight to adult disadvantage using a national longitudinal sample with a large sample of siblings (Add Health). Results show strong effects on several educational outcomes,…

  15. Sirenomelia: an epidemiologic study in a large dataset from the International Clearinghouse of Birth Defects Surveillance and Research, and literature review.

    PubMed

    Orioli, Iêda M; Amar, Emmanuelle; Arteaga-Vazquez, Jazmin; Bakker, Marian K; Bianca, Sebastiano; Botto, Lorenzo D; Clementi, Maurizio; Correa, Adolfo; Csaky-Szunyogh, Melinda; Leoncini, Emanuele; Li, Zhu; López-Camelo, Jorge S; Lowry, R Brian; Marengo, Lisa; Martínez-Frías, María-Luisa; Mastroiacovo, Pierpaolo; Morgan, Margery; Pierini, Anna; Ritvanen, Annukka; Scarano, Gioacchino; Szabova, Elena; Castilla, Eduardo E

    2011-11-15

    Sirenomelia is a very rare limb anomaly in which the normally paired lower limbs are replaced by a single midline limb. This study describes the prevalence, associated malformations, and maternal characteristics among cases with sirenomelia. Data originated from 19 birth defect surveillance system members of the International Clearinghouse for Birth Defects Surveillance and Research, and were reported according to a single pre-established protocol. Cases were clinically evaluated locally and reviewed centrally. A total of 249 cases with sirenomelia were identified among 25,290,172 births, for a prevalence of 0.98 per 100,000, with higher prevalence in the Mexican registry. An increase of sirenomelia prevalence with maternal age less than 20 years was statistically significant. The proportion of twinning was 9%, higher than the 1% expected. Sex was ambiguous in 47% of cases, and no different from expectation in the rest. The proportion of cases born alive, premature, and weighting less than 2,500 g were 47%, 71.2%, and 88.2%, respectively. Half of the cases with sirenomelia also presented with genital, large bowel, and urinary defects. About 10-15% of the cases had lower spinal column defects, single or anomalous umbilical artery, upper limb, cardiac, and central nervous system defects. There was a greater than expected association of sirenomelia with other very rare defects such as bladder exstrophy, cyclopia/holoprosencephaly, and acardia-acephalus. The application of the new biological network analysis approach, including molecular results, to these associated very rare diseases is suggested for future studies.

  16. The associations of large-for-gestational-age and infant feeding practices with children's body mass index z-score trajectories: the Early Childhood Longitudinal Study, Birth Cohort.

    PubMed

    Salahuddin, M; Pérez, A; Ranjit, N; Hoelscher, D M; Kelder, S H

    2017-10-01

    Very few studies have examined if high birth weight and infant feeding practices have implications for the trajectory of body mass index (BMI) growth across the early childhood period. The goal of this study was to assess if large-for-gestational-age (LGA) and infant feeding practices (exclusive breastfeeding for 6 months, and early introduction of complementary food prior to 4 months) are associated with BMI z-score trajectories over the early childhood period. Group-based trajectory modelling (GBTM) methods were employed to describe and classify developmental BMI z-score trajectories (the outcome of interest) in children from 9 months to 4 years of age (n = 4497) born to prenatal non-smoking mothers in the Early Childhood Longitudinal Study, Birth Cohort (2001-2005). Further analyses examined if the identified BMI z-score trajectories varied systematically with the exposures, LGA and specific infant feeding practices, after accounting for sociodemographic and other early-life factors. Two BMI z-score trajectory groups were identified: normal BMI z-score (56.2%) and high BMI z-score (43.8%). Children who were LGA infants had 2.3 times (risk ratio 95% confidence interval: 1.2, 4.5) greater risk of being in high BMI z-score group relative to normal BMI z-score group. BMI z-score trajectory groups did not differ by infant feeding practices, after controlling for LGA at birth. Membership in the high BMI z-score group was associated with LGA, but not with infant feeding practices. Healthcare professionals should provide early obesity counselling to parents of LGA infants so that parents can take appropriate obesity prevention measures for their children. © 2017 World Obesity Federation.

  17. Sirenomelia: An Epidemiologic Study in a Large Dataset From the International Clearinghouse of Birth Defects Surveillance and Research, and Literature Review

    PubMed Central

    ORIOLI, IÊDA M.; AMAR, EMMANUELLE; ARTEAGA-VAZQUEZ, JAZMIN; BAKKER, MARIAN K.; BIANCA, SEBASTIANO; BOTTO, LORENZO D.; CLEMENTI, MAURIZIO; CORREA, ADOLFO; CSAKY-SZUNYOGH, MELINDA; LEONCINI, EMANUELE; LI, ZHU; LÓPEZ-CAMELO, JORGE S.; LOWRY, R. BRIAN; MARENGO, LISA; MARTÍNEZ-FRÍAS, MARÍA-LUISA; MASTROIACOVO, PIERPAOLO; MORGAN, MARGERY; PIERINI, ANNA; RITVANEN, ANNUKKA; SCARANO, GIOACCHINO; SZABOVA, ELENA; CASTILLA, EDUARDO E.

    2015-01-01

    Sirenomelia is a very rare limb anomaly in which the normally paired lower limbs are replaced by a single midline limb. This study describes the prevalence, associated malformations, and maternal characteristics among cases with sirenomelia. Data originated from 19 birth defect surveillance system members of the International Clearinghouse for Birth Defects Surveillance and Research, and were reported according to a single pre-established protocol. Cases were clinically evaluated locally and reviewed centrally. A total of 249 cases with sirenomelia were identified among 25,290,172 births, for a prevalence of 0.98 per 100,000, with higher prevalence in the Mexican registry. An increase of sirenomelia prevalence with maternal age less than 20 years was statistically significant. The proportion of twinning was 9%, higher than the 1% expected. Sex was ambiguous in 47% of cases, and no different from expectation in the rest. The proportion of cases born alive, premature, and weighting less than 2,500 g were 47%, 71.2%, and 88.2%, respectively. Half of the cases with sirenomelia also presented with genital, large bowel, and urinary defects. About 10–15% of the cases had lower spinal column defects, single or anomalous umbilical artery, upper limb, cardiac, and central nervous system defects. There was a greater than expected association of sirenomelia with other very rare defects such as bladder exstrophy, cyclopia/holoprosencephaly, and acardia-acephalus. The application of the new biological network analysis approach, including molecular results, to these associated very rare diseases is suggested for future studies. PMID:22002878

  18. Birth Injury

    MedlinePlus

    ... Are Up to Date Additional Content Medical News Birth Injury By Arthur E. Kopelman, MD, Professor of ... Problems in Newborns Overview of Problems in Newborns Birth Injury Prematurity Postmaturity Small for Gestational Age (SGA) ...

  19. Breech birth

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000623.htm Breech birth To use the sharing features on this page, ... safer for your baby to pass through the birth canal. In the last weeks of pregnancy, your ...

  20. A Large Neutrino Detector at the National Spallation Neutron Source in Oak Ridge National Laboratory

    NASA Astrophysics Data System (ADS)

    Fazely, Ali R.; Avignone, F.; Bugg, B.; Cochran, A. K.; Cohn, H.; Efremenko, Yu.; Gabriel, T. A.; Imlay, R.; Kamishkov, Yu.; Metcalf, W.; Plasil, F.; Svoboda, R.; Tashakkori, R.

    1997-10-01

    We propose to construct a massive detector to search for neutrino oscillations and other neutrino induced reactions, as a comprehensive test of the electroweak theory of the Standard Model of particle phyiscs, at the National Spallation Neutron Source proposed to be built at the Oak Ridge National Laboratory. The principal motivation of the experiment is to perform a class of experiments to rigorously test the validity of the standard model of particle physics using neutrinos as a probe. The proposed detector will yield high statistics neutrino-electron scattering for precise neutral current studies. The experiment will search for the appearance of barνe from barν_μ produced in the beam-stop from muons decaying at rest. It will also search for ν_μ arrow νe oscillations with super high sensitivity. The detector is to be used in conjunction with the newly proposed high-intensity short beam-spill spallation source. The experiment will yield data with high statistical precision and small systematic errors due to the precise measurement of νe + ^12C arrow ^12N_g.s. + e^- cross section. The proposed detector makes it also possible to measure other neutrino cross sections with super high precision which are of interest to fundamental physics as well as nuclear physics and astrophysics.

  1. Evaluating narrow windows of maternal exposure to ozone and preterm birth in a large urban area in Southeast Texas.

    PubMed

    Symanski, Elaine; McHugh, Michelle K; Zhang, Xuan; Craft, Elena S; Lai, Dejian

    2016-01-01

    The association between O3 exposure and preterm birth (PTB) remains unclear. We evaluated associations for three categories of PTB and O3 in Harris County, Texas, during narrow periods of gestation. We computed two sets of exposure metrics during every 4 weeks of pregnancy for 152,214 mothers who delivered singleton, live-born infants in 2005-2007, accounting first for temporal variability and then for temporal and spatial sources of variability in ambient O3 levels. Associations were assessed using multiple logistic regression. We also examined the potential for a fixed cohort bias. In the bias-corrected cohort where associations were somewhat stronger, elevated odds ratios (ORs) per 10 parts per billion increase in O3 exposure (county-level metric) were detected for the fifth (OR=1.08, 95% confidence interval (CI): 1.04-1.12), sixth (OR=1.05, 95% CI=1.01-1.09), and seventh (OR=1.07, 95% CI=1.03-1.10) 4-week periods of pregnancy for late PTB (33-36 completed weeks gestation), the fifth (OR=1.13, 95% CI=1.02-1.25) and seventh (OR=1.15, 95% CI=1.04-1.27) 4-week periods of pregnancy for moderate PTB (29-32 completed weeks gestation), and the fifth (OR=1.21, 95% CI=1.08-1.36) 4-week period of pregnancy for severe PTB (20-28 completed weeks gestation). Conversely, decreased odds were found in the first 4-week period of pregnancy for severe PTB (OR=0.83, 95% CI=0.74-0.94). Associations were slightly attenuated using the spatially interpolated (kriged) metrics, and for women who did not work outside of the home. Our analyses confirm reports in other parts of the United States and elsewhere with findings that suggest that maternal exposure to ambient levels of O3 is associated with PTB.

  2. Duration and urgency of transfer in births planned at home and in freestanding midwifery units in England: secondary analysis of the Birthplace national prospective cohort study

    PubMed Central

    2013-01-01

    Background In England, there is a policy of offering healthy women with straightforward pregnancies a choice of birth setting. Options may include home or a freestanding midwifery unit (FMU). Transfer rates from these settings are around 20%, and higher for nulliparous women. The duration of transfer is of interest because of the potential for delay in access to specialist care and is also of concern to women. We aimed to estimate the duration of transfer in births planned at home and in FMUs and explore the effects of distance and urgency on duration. Methods This was a secondary analysis of data collected in a national prospective cohort study including 27,842 ‘low risk’ women with singleton, term, ‘booked’ pregnancies, planning birth in FMUs or at home in England from April 2008 to April 2010. We described transfer duration using the median and interquartile range, for all transfers and those for reasons defined as potentially urgent or non-urgent, and used cumulative distribution curves to compare transfer duration by urgency. We explored the effect of distance for transfers from FMUs and described outcomes in women giving birth within 60 minutes of transfer. Results The median overall transfer time, from decision to transfer to first OU assessment, was shorter in transfers from home compared with transfers from FMUs (49 vs 60 minutes; p < 0.001). The median duration of transfers before birth for potentially urgent reasons (home 42 minutes, FMU 50 minutes) was 8–10 minutes shorter compared with transfers for non-urgent reasons. In transfers for potentially urgent reasons, the median overall transfer time from FMUs within 20 km of an OU was 47 minutes, increasing to 55 minutes from FMUs 20-40 km away and 61 minutes in more remote FMUs. In women who gave birth within 60 minutes after transfer, adverse neonatal outcomes occurred in 1-2% of transfers. Conclusions Transfers from home or FMU commonly take up to 60 minutes from decision to

  3. Duration and urgency of transfer in births planned at home and in freestanding midwifery units in England: secondary analysis of the birthplace national prospective cohort study.

    PubMed

    Rowe, Rachel E; Townend, John; Brocklehurst, Peter; Knight, Marian; Macfarlane, Alison; McCourt, Christine; Newburn, Mary; Redshaw, Maggie; Sandall, Jane; Silverton, Louise; Hollowell, Jennifer

    2013-12-05

    In England, there is a policy of offering healthy women with straightforward pregnancies a choice of birth setting. Options may include home or a freestanding midwifery unit (FMU). Transfer rates from these settings are around 20%, and higher for nulliparous women. The duration of transfer is of interest because of the potential for delay in access to specialist care and is also of concern to women. We aimed to estimate the duration of transfer in births planned at home and in FMUs and explore the effects of distance and urgency on duration. This was a secondary analysis of data collected in a national prospective cohort study including 27,842 'low risk' women with singleton, term, 'booked' pregnancies, planning birth in FMUs or at home in England from April 2008 to April 2010. We described transfer duration using the median and interquartile range, for all transfers and those for reasons defined as potentially urgent or non-urgent, and used cumulative distribution curves to compare transfer duration by urgency. We explored the effect of distance for transfers from FMUs and described outcomes in women giving birth within 60 minutes of transfer. The median overall transfer time, from decision to transfer to first OU assessment, was shorter in transfers from home compared with transfers from FMUs (49 vs 60 minutes; p < 0.001). The median duration of transfers before birth for potentially urgent reasons (home 42 minutes, FMU 50 minutes) was 8-10 minutes shorter compared with transfers for non-urgent reasons. In transfers for potentially urgent reasons, the median overall transfer time from FMUs within 20 km of an OU was 47 minutes, increasing to 55 minutes from FMUs 20-40 km away and 61 minutes in more remote FMUs. In women who gave birth within 60 minutes after transfer, adverse neonatal outcomes occurred in 1-2% of transfers. Transfers from home or FMU commonly take up to 60 minutes from decision to transfer, to first assessment in an OU, even for

  4. Effect of ethnicity on live birth rates after in vitro fertilisation/intracytoplasmic sperm injection treatment: analysis of UK national database.

    PubMed

    Maalouf, W; Maalouf, W; Campbell, B; Jayaprakasan, K

    2017-05-01

    To evaluate the effect of ethnicity of women on the outcome of in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment. Observational cohort study. UK National Database. Data from 2000 to 2010 involving 38 709 women undergoing their first IVF/ICSI cycle were analysed. Anonymous data were obtained from the Human Fertilization and Embryology Authority (HFEA), the statutory regulator of IVF and ICSI treatment in the UK. Data analysis was performed by regression analysis with adjustment for age, cause and type of infertility and treatment type (IVF or ICSI) to express results as odds ratio (OR) and 95% confidence intervals (95% CI). Live birth rate per cycle of IVF or ICSI treatment. While white Irish (OR 0.73; 95% CI 0.60-0.90), Indian (0.85; 0.75-0.97), Bangladeshi (0.53: 0.33-0.85), Pakistani (0.68; 0.58-0.80), Black African (0.60; 0.51-0.72), and other non-Caucasian Asian (0.86; 0.73-0.99) had a significantly lower odds of live birth rates per fresh IVF/ICSI cycle than White British women, ethnic groups of White European (1.04; 0.96-1.13), Chinese (1.12; 0.77-1.64), Black Caribbean (0.76; 0.51-1.13), Middle Eastern (0.73; 0.51-1.04), Mediterranean European (1.18; 0.83-1.70) and Mixed race population (0.94; 0.73-1.19) had live birth rates that did not differ significantly. The cumulative live birth rates showed similar patterns across different ethnic groups. Ethnicity is a major determinant of IVF/ICSI treatment outcome as indicated by significantly lower live birth rates in some of the ethnic minority groups compared with white British women. Ethnicity affects IVF outcome with lower live birth rates in some ethnic groups more than in white British. © 2016 Crown copyright. BJOG:An International Journal of Obstetrics and Gynaecology © 2016 Royal College of Obstetricians and Gynaecologists.

  5. Next generation sequencing in a large cohort of patients presenting with neuromuscular disease before or at birth.

    PubMed

    Todd, Emily J; Yau, Kyle S; Ong, Royston; Slee, Jennie; McGillivray, George; Barnett, Christopher P; Haliloglu, Goknur; Talim, Beril; Akcoren, Zuhal; Kariminejad, Ariana; Cairns, Anita; Clarke, Nigel F; Freckmann, Mary-Louise; Romero, Norma B; Williams, Denise; Sewry, Caroline A; Colley, Alison; Ryan, Monique M; Kiraly-Borri, Cathy; Sivadorai, Padma; Allcock, Richard J N; Beeson, David; Maxwell, Susan; Davis, Mark R; Laing, Nigel G; Ravenscroft, Gianina

    2015-11-17

    Fetal akinesia/hypokinesia, arthrogryposis and severe congenital myopathies are heterogeneous conditions usually presenting before or at birth. Although numerous causative genes have been identified for each of these disease groups, in many cases a specific genetic diagnosis remains elusive. Due to the emergence of next generation sequencing, virtually the entire coding region of an individual's DNA can now be analysed through "whole" exome sequencing, enabling almost all known and novel disease genes to be investigated for disorders such as these. Genomic DNA samples from 45 patients with fetal akinesia/hypokinesia, arthrogryposis or severe congenital myopathies from 38 unrelated families were subjected to next generation sequencing. Clinical features and diagnoses for each patient were supplied by referring clinicians. Genomic DNA was used for either whole exome sequencing or a custom-designed neuromuscular sub-exomic supercapture array containing 277 genes responsible for various neuromuscular diseases. Candidate disease-causing variants were investigated and confirmed using Sanger sequencing. Some of the cases within this cohort study have been published previously as separate studies. A conclusive genetic diagnosis was achieved for 18 of the 38 families. Within this cohort, mutations were found in eight previously known neuromuscular disease genes (CHRND, CHNRG, ECEL1, GBE1, MTM1, MYH3, NEB and RYR1) and four novel neuromuscular disease genes were identified and have been published as separate reports (GPR126, KLHL40, KLHL41 and SPEG). In addition, novel mutations were identified in CHRND, KLHL40, NEB and RYR1. Autosomal dominant, autosomal recessive, X-linked, and de novo modes of inheritance were observed. By using next generation sequencing on a cohort of 38 unrelated families with fetal akinesia/hypokinesia, arthrogryposis, or severe congenital myopathy we therefore obtained a genetic diagnosis for 47% of families. This study highlights the power and

  6. Choosing Wisely for Birth

    PubMed Central

    Budin, Wendy C.

    2015-01-01

    ABSTRACT In this column, the editor of The Journal of Perinatal Education describes the American Academy of Nursing’s engagement in the national Choosing Wisely campaign and how it has implications for promoting normal birth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth. PMID:26937155

  7. Underwater birth.

    PubMed

    Simpson, Kathleen Rice

    2013-01-01

    To determine potential risks and/or benefits of underwater birth for mother and infant. The PubMed, Cochrane Library, EMBASE, and CINAHL online databases were searched for relevant English language articles related to research about underwater birth published from 1966 to April 2013. Reference lists of articles retrieved were reviewed to identify additional potentially pertinent publications. Two randomized controlled trials comparing underwater birth to traditional birth ("on land") were identified and served as the primary focus of the analysis. One systematic review of water immersion during labor and birth, one systematic review of neonatal risks of underwater birth, and case reports of neonatal morbidity after underwater birth were also identified. Guidelines regarding underwater birth from professional organizations were reviewed. Data from the two randomized controlled trials were extracted and organized under the following headings: author, year, setting, country, study design, sample size, participants, outcomes, findings and comments. Systematic reviews, case reports, and guidelines from professional organizations were summarized. Research findings and guidelines from professional associations were evaluated regarding potential risks and benefits of underwater birth to the mother and infant. Only two randomized controlled trials comparing underwater birth to birth on land have been published. Results suggest minimal benefit of underwater birth to the mother and no benefit to the infant. Both studies were underpowered to adequately evaluate risk of neonatal harm; however, a number of cases of neonatal morbidity have been reported. Based on these findings, underwater birth requires more rigorous study. In the United States, underwater birth is not supported by the American Academy of Pediatrics or the American College of Obstetricians and Gynecologists outside the context of a randomized controlled trial. © 2013 AWHONN, the Association of Women's Health

  8. The MRC National Survey of Health and Development reaches age 70: maintaining participation at older ages in a birth cohort study.

    PubMed

    Kuh, Diana; Wong, Andrew; Shah, Imran; Moore, Adam; Popham, Maria; Curran, Philip; Davis, Daniel; Sharma, Nikhil; Richards, Marcus; Stafford, Mai; Hardy, Rebecca; Cooper, Rachel

    2016-11-01

    A life course approach to ageing relies on maintaining participation rates in national birth cohorts and other long-term longitudinal studies. This reduces the risk of selective attrition biasing associations between lifetime risk factors and health outcomes in later life and ensures the studies remain as representative as possible of the original population. We report the participation patterns for a postal questionnaire and home visit at 68-69 years of study members in the MRC National Survey of Health and Development, the oldest and longest-running British birth cohort study. We investigated how participation varied by lifetime and recent contact, health status, previous clinical feedback and study engagement, taking account of prior socioeconomic and cognitive characteristics. Overall participation and home visit participation remained high (94 and 80%, respectively) and there were no gender differences. Participation was higher in those with higher levels of prior contact and lower in those with the poorest health status. Having previously received clinical feedback on actionable blood results was associated with reduced home visit participation but other forms of clinical feedback were not associated with subsequent participation. Activities that fostered study engagement were associated with increased home visit participation. These findings inform strategies to maintain participation in life course studies.

  9. Birth order and post-traumatic stress disorder.

    PubMed

    Green, Ben; Griffiths, Emily C

    2014-01-01

    To compare the birth order of patients with post-traumatic stress disorder (PTSD) and adjustment disorder (AD) with population norms. 83 PTSD patients and 104 AD control patients from a psychiatric trauma clinic were diagnosed according to DCR-10 guidelines. A family history was taken as to number of siblings, and their birth order. We compared the distribution of birth order for each patient group against birth order distributions expected by chance for the same years of birth using UK population-level birth order from the Office for National Statistics. Psychiatric patients with PTSD were more likely to be from a large family, specifically to be the fifth child or later (OR 4.78, p < .001) and less likely to be the eldest child (OR .65, p < .001) than the general population in England and Wales. There were no differences for birth order between AD patients and the general population. People with PTSD are more likely to be the youngest children from large families than expected from a random sample of people born in the same years. This association with birth order was not found for another psychiatric diagnosis AD from the same clinic. We discuss possible psychosocial and biological causes, and implications for further research.

  10. Development and Validation of a Vitamin D Status Prediction Model in Danish Pregnant Women: A Study of the Danish National Birth Cohort

    PubMed Central

    Bjørn Jensen, Camilla; Thorne-Lyman, Andrew L.; Vadgård Hansen, Linda; Strøm, Marin; Odgaard Nielsen, Nina; Cohen, Arieh; Olsen, Sjurdur Frodi

    2013-01-01

    Vitamin D has been hypothesized to reduce risk of pregnancy complications such as preeclampsia, gestational diabetes mellitus, and preterm delivery. However, many of these outcomes are rare and require a large sample size to study, representing a challenge for cohorts with a limited number of preserved samples. The aims of this study were to (1) identify predictors of serum 25-hydroxy-vitamin D (25(OH)D) among pregnant women in a subsample (N = 1494) of the Danish National Birth Cohort (DNBC) and (2) develop and validate a score predicting 25(OH)D-status in order to explore associations between vitamin D and maternal and offspring health outcomes in the DNBC. In our study sample, 42.3% of the population had deficient levels of vitamin D (<50 nmol/L 25(OH)D) and average levels of 25(OH)D-status were 56.7(s.d. 24.6) nmol/L. A prediction model consisting of intake of vitamin D from diet and supplements, outdoor physical activity, tanning bed use, smoking, and month of blood draw explained 40.1% of the variance in 25(OH)D and mean measured 25(OH)D-level increased linearly by decile of predicted 25(OH)D-score. In total 32.2% of the women were placed in the same quintile by both measured and predicted 25(OH)D-values and 69.9% were placed in the same or adjacent quintile by both methods. Cohen's weighted kappa coefficient (Κ = 0.3) reflected fair agreement between measured 25(OH)D-levels and predicted 25(OH)D-score. These results are comparable to other settings in which vitamin D scores have shown similar associations with disease outcomes as measured 25(OH)D-levels. Our findings suggest that predicted 25(OH)D-scores may be a useful alternative to measured 25(OH)D for examining associations between vitamin D and disease outcomes in the DNBC cohort, but cannot substitute for measured 25(OH)D-levels for estimates of prevalence. PMID:23326380

  11. The Association Between Childhood Seizures and Later Childhood Emotional and Behavioral Problems: Findings From a Nationally Representative Birth Cohort

    PubMed Central

    Kariuki, Symon M.; Newton, Charles R.J.C.; Prince, Martin J.; Das-Munshi, Jayati

    2016-01-01

    ABSTRACT Objectives Emotional/behavioral disorders are often comorbid with childhood epilepsy, but both may be predicted by social disadvantage and fetal risk indicators (FRIs). We used data from a British birth cohort, to assess the association of epilepsy, single unprovoked seizures, and febrile seizures with the later development of emotional/behavioral problems. Methods A total of 17,416 children in the 1958 British birth cohort were followed up until age 16 years. Logistic and modified Poisson regression models were used to determine a) the association of social disadvantage at birth and FRI with epilepsy, single unprovoked seizures, and febrile seizures at 7 years, and emotional/behavioral disorders in later childhood, and (ii) the association of childhood seizures by age 7 years with emotional/behavioral disorders in later childhood, after accounting for social disadvantage and FRI. Results Higher scores on FRI and social disadvantage were associated with emotional/behavioral problems at 7, 11, and 16 years, but not with seizure disorders at age 7 years. Epilepsy was associated with emotional/behavioral problems at 7 years (odds ratio [OR] = 2.50, 95% confidence interval [CI] = 1.29–4.84), 11 years (OR = 2.00, 95% CI = 1.04–3.81), and 16 years (OR = 5.47, 95% CI = 1.65–18.08), whereas single unprovoked seizures were associated with emotional/behavioral problems at 16 years (OR = 1.44, 95% CI = 1.02–2.01), after adjustment for FRI and social disadvantage. Febrile convulsions were not associated with increased risk for emotional/behavioral problems. Conclusions Emotional/behavioral problems in children are related to an earlier diagnosis of epilepsy and single unprovoked seizures after accounting for social disadvantage and FRI, whereas febrile convulsions are not associated with emotional/behavioral problems. PMID:26894324

  12. The Association Between Childhood Seizures and Later Childhood Emotional and Behavioral Problems: Findings From a Nationally Representative Birth Cohort.

    PubMed

    Kariuki, Symon M; Newton, Charles R J C; Prince, Martin J; Das-Munshi, Jayati

    2016-06-01

    Emotional/behavioral disorders are often comorbid with childhood epilepsy, but both may be predicted by social disadvantage and fetal risk indicators (FRIs). We used data from a British birth cohort, to assess the association of epilepsy, single unprovoked seizures, and febrile seizures with the later development of emotional/behavioral problems. A total of 17,416 children in the 1958 British birth cohort were followed up until age 16 years. Logistic and modified Poisson regression models were used to determine a) the association of social disadvantage at birth and FRI with epilepsy, single unprovoked seizures, and febrile seizures at 7 years, and emotional/behavioral disorders in later childhood, and (ii) the association of childhood seizures by age 7 years with emotional/behavioral disorders in later childhood, after accounting for social disadvantage and FRI. Higher scores on FRI and social disadvantage were associated with emotional/behavioral problems at 7, 11, and 16 years, but not with seizure disorders at age 7 years. Epilepsy was associated with emotional/behavioral problems at 7 years (odds ratio [OR] = 2.50, 95% confidence interval [CI] = 1.29-4.84), 11 years (OR = 2.00, 95% CI = 1.04-3.81), and 16 years (OR = 5.47, 95% CI = 1.65-18.08), whereas single unprovoked seizures were associated with emotional/behavioral problems at 16 years (OR = 1.44, 95% CI = 1.02-2.01), after adjustment for FRI and social disadvantage. Febrile convulsions were not associated with increased risk for emotional/behavioral problems. Emotional/behavioral problems in children are related to an earlier diagnosis of epilepsy and single unprovoked seizures after accounting for social disadvantage and FRI, whereas febrile convulsions are not associated with emotional/behavioral problems.

  13. Secular trends in the national and provincial births of new thalassemia cases in Iran from 2001 to 2006.

    PubMed

    Dehshal, Mahmoud Hadipour; Ahmadvand, Alireza; Darestani, Sakineh Yousefi; Manshadi, Mohsen; Abolghasemi, Hassan

    2013-01-01

    Thalassemia is one of the genetic diseases for which there are only a few successful prevention protocols. In this study, we aimed to analyze data for thalassemia newborns in a period of 6 years to find out the geographical distribution of cases, the "high-risk" provinces in Iran, the causes of thalassemia newborn cases, the coverage rate of the prevention programs and the limitations of the thalassemia registration system. To further our aim, an analytic cross-sectional study was designed at the Iranian Blood Transfusion Organization (IBTO), Tehran, Iran. A questionnaire was then prepared to gather data from each of the 30 provincial centers to find out the number and causes of thalassemia births. Furthermore, another questionnaire, to be completed by the physicians in charge, was aimed at gathering data from all 207 thalassemia care centers. We then performed a stratified analysis of the frequency of distributions; the associations among the existing variables were evaluated using the χ(2) or Fisher's exact tests at a 5.0% significance level. According to the findings, from 2001-2006, a total of 2091 thalassemia patients were born. The main causes were: the at-risk couples not using prenatal diagnosis (PND), marriages before the commencement of Iranian prevention plans, unregistered marriages based on religious conventions, among foreign citizens and the existence of some test errors. The causes of birth for 284 (13.6%) of new cases were not documented. There was a statistically significant difference between the five high-risk provinces regarding the proportional causes of thalassemia newborns [Pearson χ(2) = 4.549; degree of freedom (df) = 8, p value = 0.0001]. Although the plan succeeded in avoiding the annual birth of 826 new cases on average, there is continuing concern that more than 300 new cases were born every year during 2001-2006 and new prevention strategies need to be put into practice. It is highly recommended that focus be put on factors

  14. Prenatal investments, breastfeeding, and birth order.

    PubMed

    Buckles, Kasey; Kolka, Shawna

    2014-10-01

    Mothers have many opportunities to invest in their own or their child's health and well-being during pregnancy and immediately after birth. These investments include seeking prenatal care, taking prenatal vitamins, and breastfeeding. In this paper, we investigate a potential determinant of mothers' investments that has been largely overlooked by previous research-birth order. Data are from the National Longitudinal Study of Youth 1979 (NLSY79) Child and Young Adult Survey, which provides detailed information on pre- and post-natal behaviors of women from the NLSY79. These women were between the ages of 14 and 22 in 1979, and form a nationally representative sample of youth in the United States. Our sample includes births to these women between 1973 and 2010 (10,328 births to 3755 mothers). We use fixed effects regression models to estimate within-mother differences in pre- and post-natal behaviors across births. We find that mothers are 6.6 percent less likely to take prenatal vitamins in a fourth or higher-order birth than in a first and are 10.6 percent less likely to receive early prenatal care. Remarkably, mothers are 15.4 percent less likely to breastfeed a second-born child than a first, and are 20.9 percent less likely to breastfeed a fourth or higher-order child. These results are not explained by changing attitudes toward investments over time. These findings suggest that providers may want to increase efforts to encourage these behaviors at women with higher parity. The results also identify a potential mechanism for the emergence of differences in health and other outcomes across birth orders. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. The Birth Satisfaction Scale-Revised Indicator (BSS-RI).

    PubMed

    Martin, Colin R; Hollins Martin, Caroline; Redshaw, Maggie

    2017-08-29

    The current study sought to develop a short birth satisfaction indicator utilising items from the Birth Satisfaction Scale-Revised (BSS-R) for use as a brief measure of birth satisfaction and as a possible key performance indicator for perinatal service delivery evaluation. Building on the recently developed BSS-R, the study aimed to develop a simplified version of the instrument to assess birth satisfaction easily that could work as a short evaluative measure of clinical service delivery for labour and birth that is consistent with policy documents, placing women at the centre of the birth experience. The six item Birth Satisfaction Scale-Revised Indicator (BSS-RI) was embedded within the 2014 National Maternity Survey for England. A random selection of mothers who had given birth in a two week period in England were surveyed three months after the birth. Using a two-stage design and split-half dataset, exploratory factor analysis, confirmatory factor analysis, internal consistency, convergent, divergent and known-groups discriminant validity evaluation were conducted in a secondary analysis of the survey data. Using this large population based survey of recent mothers the short revised measure was found to comprise two distinct domains of birth satisfaction, 'stress and emotional response to labour and birth' and 'quality of care'. The psychometric qualities of the tool were robust as were the indices of validity and reliability evaluated. The BSS-RI represents a short easily administered and scored measure of women's satisfaction with care and the experience of labour and birth. The instrument is potentially useful for researchers, service evaluation and policy makers.

  16. Strategic Leadership for Large-Scale Reform: The Case of England's National Literacy and Numeracy Strategy

    ERIC Educational Resources Information Center

    Leithwood, Kenneth; Jantzi, Doris; Earl, Lorna; Watson, Nancy; Levin, Benjamin; Fullan, Michael

    2004-01-01

    Both 'strategic' and 'distributed' forms of leadership are considered promising responses to the demands placed on school systems by large-scale reform initiatives. Using observation, interview and survey data collected as part of a larger evaluation of England's National Literacy and Numeracy Strategies, this study inquired about sources of…

  17. Integrating land and resource management plans and applied large-scale research on two national forests

    Treesearch

    Callie Jo Schweitzer; Stacy Clark; Glen Gaines; Paul Finke; Kurt Gottschalk; David Loftis

    2008-01-01

    Researchers working out of the Southern and Northern Research Stations have partnered with two National Forests to conduct two large-scale studies designed to assess the effectiveness of silvicultural techniques used to restore and maintain upland oak (Quercus spp.)-dominated ecosystems in the Cumberland Plateau Region of the southeastern United...

  18. Re-examining the association between residential exposure to magnetic fields from power lines and childhood asthma in the Danish National Birth Cohort.

    PubMed

    Sudan, Madhuri; Arah, Onyebuchi A; Becker, Thomas; Levy, Yael; Sigsgaard, Torben; Olsen, Jørn; Vergara, Ximena; Kheifets, Leeka

    2017-01-01

    A study reported an increased risk of asthma in children whose mothers were exposed to magnetic field (MF) levels above 0.2 μT during pregnancy. We re-examined this association using data from mothers and children in the Danish National Birth Cohort (DNBC). This study included 92,676 singleton-born children and their mothers from the DNBC. MF exposure from power lines was estimated for all residences where the mothers lived during pregnancy and for all children from birth until the end of follow up. Exposure was categorized into 0 μT, 0.1 μT, and ≥ 0.2 μT for analysis. Definitive and possible asthma cases were identified using data from three independent data sources: 1) mothers' reports, 2) a national hospitalization register, 3) a national prescription drug register. We calculated hazard ratios (HR) and 95% confidence intervals (CI) for the association between the highest level of exposure during pregnancy and asthma in children, adjusting for several potential confounding factors. We also examined the sensitivity of the risk estimates to changes in exposure and outcome definitions. No differences or trends in the risk of asthma development were detected between children with different levels of MF exposure regardless of the asthma case definition or outcome data source. For definitive cases, the HR (95% CI) for those with any exposure was 0.72 (0.27-1.92), and it was 0.41 (0.06-2.92) for those exposed to ≥ 0.2 μT. Adjustments for confounding and variations in the exposure definition did not appreciably alter the results. We did not find evidence that residential exposure to MF during pregnancy or early childhood increased the risk of childhood asthma. This interpretation is in line with the lack of an established biological mechanism directly linking MF exposure to asthma, but high exposure was very rare in this cohort.

  19. Factors affecting development: similarities and differences among children who were small, average, and large for gestational age at birth.

    PubMed

    Ounsted, M; Moar, V A; Scott, A

    1986-03-01

    The development of 118 small-for-gestational age (SGA), 137 average-for-gestational age (AGA), and 118 large-for-gestational age (LGA) children was assessed at 7 years. The contributions of different factors to the variance in developmental scores were investigated by multiple regression analyses. All three groups showed the powerful influence of social class on intellectual ability at this age; and in the SGA and AGA groups the gross and fine-motor skills of girls were superior to boys. Smoking had a small effect in the AGA group, and in the two extreme groups first-born children did slightly better than later-born. Hypertension was associated with reduced scores in the SGA group, and LGA children who had spontaneous vaginal deliveries had higher scores than those delivered instrumentally or by caesarean section. There was a significant positive correlation between gestational age and developmental scores in the AGA group; but in the SGA group the relationship was in the reverse direction. Social class and sex affect the development of most children aged 7 years. Other factors seem to manifest an effect only under specified conditions.

  20. Implementation of a protocol proposed by the Brazilian National Health Surveillance Agency for antibiotic use in very low birth weight infants.

    PubMed

    Pinto, Maria Cristina F Guedes; Bueno, Arnaldo C; Vieira, Alan A

    2013-01-01

    To analyze the implementation of a protocol proposed by the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) to improve sepsis diagnosis in very low birth weight newborns. This was a prospective study that evaluated the implementation of a protocol involving clinical and laboratory criteria (hematologic scoring system of Rodwell and C-reactive protein serial measurements), recommended by ANVISA, to improve the diagnosis of neonatal sepsis in very low birth weight newborns. The study included all patients who were born and remained in the neonatal intensive care unit until discharge or death, and excluded those with congenital diseases. The main outcomes measured in newborns before (2006-2007) and after implementation of the protocol (2008) were the rates of early and late-onset sepsis, use of antibiotics, and mortality. Means were compared by Student's t-test and categorical variables were compared by the chi-squared test; the significance level for all tests was set at 95%. The study included 136 newborns with very low birth weight. There was no difference between groups regarding general clinical characteristics in the studied periods. There was, however, a decrease in the number of diagnoses of probable early-onset sepsis (p<0.001), use of antimicrobial regimens (p<0.001), and overall mortality and infection-related mortality (p=0.009 and p=0.049, respectively). The implementation of the protocol allowed improvement of sepsis diagnosis by reducing the diagnosis of probable early-onset sepsis, thus promoting efficient antimicrobial use in this population. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Physical growth and cognitive skills in early-life: evidence from a nationally representative US birth cohort.

    PubMed

    Murasko, Jason E

    2013-11-01

    This paper establishes associations between length/height and cognitive skills in infancy, toddlerhood, and school-entry. The data come from the Early Childhood Longitudinal Study--Birth Cohort (ECLS-B), a representative longitudinal sample of US children born in 2001. A positive association between length/height and cognition is found as early as 9 months and continues through school-entry. These associations are robust to controls for birthweight and economic status. Early growth is also shown to be a stronger predictor of reading and math skills in kindergarten than attained height. Girls exhibit stronger evidence of this latter result than boys. These findings have implications for the interpretation of early life as a critical period for the growth-cognition relationship.

  2. National Growth Charts for United Arab Emirates Children With Down Syndrome From Birth to 15 Years of Age

    PubMed Central

    H Aburawi, Elhadi; Nagelkerke, Nicolas; Deeb, Asma; Abdulla, Shahrban; Abdulrazzaq, Yousef M.

    2015-01-01

    Background Specific centile growth charts for children with Down syndrome (DS) have been produced in many countries and are known to differ from those of normal children. Since growth assessment depends on the growth pattern characteristic for these conditions, disorder-specific charts are desirable for various ethnic groups. Aims To provide cross-sectional weight, height, and head circumference (HC) references for healthy United Arab Emirates (UAE) children with DS. Methods A retrospective and cross-sectional growth study of Emirati children with DS, aged 0 to 18 years old, was conducted. Height, weight, and HC were measured in each child. Cole’s LMS statistical method was applied to estimate age-specific percentiles, and measurements were compared to UAE reference values for normal children. Results Incidence of DS in the UAE population is 1 in 374 live births (267 in 10 000 live births). We analyzed 1263 growth examinations of 182 children with DS born between 1994 and 2012. The male-to-female ratio was 1.6:1. Height, weight, and HC centile charts were constructed for ages 0 to 13 years. The prevalence of overweight and obesity in DS children aged 10 to 13 years of age was 32% and 19%, respectively. The DS children were significantly shorter and heavier than normal children in the UAE. Conclusions Weight, height, and HC growth charts were created for children with DS. These can be used as a reference standard for the UAE children with DS. Overweight and obesity are quite common in DS children ≥10 years of age, as DS children tend to be shorter and heavier than non-DS children. PMID:25196167

  3. National trends in beverage consumption in children from birth to 5 years: analysis of NHANES across three decades

    PubMed Central

    2012-01-01

    Background Given the epidemic of childhood obesity, it is crucial to assess food and beverage intake trends. Beverages can provide a large number of calories and since consumption patterns seem to develop at a young age we examined beverage consumption trends over three decades. The objective of this study was to assess the beverage (milk, fruit juice, fruit drinks, tea, soy beverages, and soft drinks) consumption trends in children <1-5 years of age. Methods Data from individuals ages <1-5 years participating in the National Health and Nutrition Examination Survey (NHANES) from 1976–1980, 1988–1994 and 2001–2006 were used to assess beverage consumption and associated calorie and nutrient intakes. Results During the NHANES 1976–1980 and 1988–1994 periods, approximately 84–85% of children were consuming milk, whereas only 77% were consuming milk during NHANES 2001–2006. Flavored milk intake was relatively low, but increased to 14% during the last decade (p < 0.001). Fruit juice consumption increased dramatically during NHANES 2001–2006 to more than 50% of the population compared to about 30% in the older surveys (p < 0.001). No significant changes were observed in fruit drink intake across all three decades with 35-37% of this population consuming fruit drinks. At least 30% of children consumed soft drinks. Milk was the largest beverage calorie contributor in all three decades surveyed and was the primary contributor of calcium (52-62%), phosphorus (37-42%), magnesium (27-28%), and potassium (32-37%). Fruit juice and fruit drinks each provided 8-10% of calories with soft drinks providing 5-6% of calories. Fruit juice was an important provider of potassium (16-19%) and magnesium (11%). Fruit drinks provided less than 5% of nutrients examined and soft drinks provided very little of the nutrients evaluated. Conclusions Given concerns about childhood obesity and the need to meet nutrition requirements, it is prudent that parents, educators and child

  4. Smoking Initiation Associated With Specific Periods in the Life Course From Birth to Young Adulthood: Data From the National Longitudinal Survey of Youth 1997

    PubMed Central

    Chen, Xinguang

    2014-01-01

    Objectives. Guided by the life-course perspective, we examined whether there were subgroups with different likelihood curves of smoking onset associated with specific developmental periods. Methods. Using 12 waves of panel data from 4088 participants in the National Longitudinal Survey of Youth 1997, we detected subgroups with distinctive risk patterns by employing developmental trajectory modeling analysis. Results. From birth to age 29 years, 72% of female and 74% of US males initiated smoking. We detected 4 exclusive groups with distinctive risk patterns for both genders: the Pre-Teen Risk Group initiated smoking by age 12 years, the Teenage Risk Group initiated smoking by age 18 years, the Young Adult Risk Group initiated smoking by age 25 years, and the Low Risk Group experienced little or no risk over time. Groups differed on several etiological and outcome variables. Conclusions. The process of smoking initiation from birth to young adulthood is nonhomogeneous, with distinct subgroups whose risk of smoking onset is linked to specific stages in the life course. PMID:24328611

  5. Birthing Classes

    MedlinePlus

    ... Birth Control Family HealthInfants and Toddlers Kids and Teens Pregnancy and Childbirth Women Men SeniorsIn The NewsYour Health ... Birth Control Family HealthInfants and Toddlers Kids and Teens Pregnancy and Childbirth Women Men SeniorsIn The NewsYour Health ...

  6. Birth, simply.

    PubMed

    Gibbons, Mary

    2006-01-01

    In this column, a mother describes the home birth of her fourth child, which included the supportive presence of her husband, young children, and other family members, along with the help of a midwife. The mother's experience demonstrates the advantages of normal birth and its benefits to the entire family.

  7. Birth, Simply

    PubMed Central

    Gibbons, Mary

    2006-01-01

    In this column, a mother describes the home birth of her fourth child, which included the supportive presence of her husband, young children, and other family members, along with the help of a midwife. The mother's experience demonstrates the advantages of normal birth and its benefits to the entire family. PMID:17541454

  8. Planned Out-of-Hospital Birth and Birth Outcomes.

    PubMed

    Snowden, Jonathan M; Tilden, Ellen L; Snyder, Janice; Quigley, Brian; Caughey, Aaron B; Cheng, Yvonne W

    2015-12-31

    The frequency of planned out-of-hospital birth in the United States has increased in recent years. The value of studies assessing the perinatal risks of planned out-of-hospital birth versus hospital birth has been limited by cases in which transfer to a hospital is required and a birth that was initially planned as an out-of-hospital birth is misclassified as a hospital birth. We performed a population-based, retrospective cohort study of all births that occurred in Oregon during 2012 and 2013 using data from newly revised Oregon birth certificates that allowed for the disaggregation of hospital births into the categories of planned in-hospital births and planned out-of-hospital births that took place in the hospital after a woman's intrapartum transfer to the hospital. We assessed perinatal morbidity and mortality, maternal morbidity, and obstetrical procedures according to the planned birth setting (out of hospital vs. hospital). Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P=0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth. Planned out-of-hospital birth was also strongly associated with unassisted vaginal delivery (93.8%, vs. 71.9% with planned in-hospital births; P<0.001) and with decreased odds for obstetrical procedures. Perinatal mortality was higher with planned out-of-hospital birth than with planned in-hospital birth, but the absolute risk of death was low in both settings. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.).

  9. Planned Out-of-Hospital Birth and Birth Outcomes

    PubMed Central

    Snowden, Jonathan M.; Tilden, Ellen L.; Snyder, Janice; Quigley, Brian; Caughey, Aaron B.; Cheng, Yvonne W.

    2016-01-01

    Background The frequency of planned out-of-hospital birth in the United States has increased in recent years. The value of studies assessing the perinatal risks of planned out-of-hospital birth versus hospital birth has been limited by cases in which transfer to a hospital is required and a birth that was initially planned as an out-of-hospital birth is misclassified as a hospital birth. Methods We performed a population-based, retrospective cohort study of all births that occurred in Oregon during 2012 and 2013 using data from newly revised Oregon birth certificates that allowed for the disaggregation of hospital births into the categories of planned in-hospital births and planned out-of-hospital births that took place in the hospital after a woman’s intrapartum transfer to the hospital. We assessed perinatal morbidity and mortality, maternal morbidity, and obstetrical procedures according to the planned birth setting (out of hospital vs. hospital). Results Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P = 0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth. Planned out-of-hospital birth was also strongly associated with unassisted vaginal delivery (93.8%, vs. 71.9% with planned in-hospital births; P<0.001) and with decreased odds for obstetrical procedures. Conclusions Perinatal mortality was higher with planned out-of-hospital birth than with planned in-hospital birth, but the absolute risk of death was low in both settings. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human

  10. Birth weight and stuttering: Evidence from three birth cohorts.

    PubMed

    McAllister, Jan; Collier, Jacqueline

    2014-03-01

    Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500g; normal range; high birth weight, ≥4000g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Utility of the national embryo morphology data collection by the Society for Assisted Reproductive Technologies (SART): correlation between day-3 morphology grade and live-birth outcome.

    PubMed

    Vernon, Michael; Stern, Judy E; Ball, G David; Wininger, David; Mayer, Jacob; Racowsky, Catherine

    2011-06-30

    Analysis of the "grade" field in the first embryo morphology data collected under the classification system developed by Society for Assisted Reproductive Technology (SART) and reported to the SART Clinic Outcomes Reporting System (SART CORS) database showed that when two embryos of the same grade were transferred on day 3, the live-birth rate declined with decreasing grade (<35 years old: good = 50.4%; fair = 42.2%; poor = 22.0%; ≥ 35 years old: good = 35.1%; fair = 23.4%; poor = 20.0%). These findings provide the first evidence that collecting the "grade" field in the national morphology collection system is valid and can be developed into a standard for use by individual SART programs for quality assurance assessment and for improved embryo selection.

  12. Predicted vitamin D status during pregnancy in relation to offspring forearm fractures in childhood: a study from the Danish National Birth Cohort.

    PubMed

    Petersen, Sesilje B; Strøm, Marin; Maslova, Ekaterina; Granström, Charlotta; Vestergaard, Peter; Mølgaard, Christian; Olsen, Sjurdur F

    2015-12-14

    In a prospective cohort study, the association between maternal vitamin D status during pregnancy and offspring forearm fractures during childhood and adolescence was analysed in 30 132 mother and child pairs recruited to the Danish National Birth Cohort between 1996 and 2002. Data on characteristics, dietary factors and lifestyle factors were collected on several occasions during pregnancy. We analysed the association between predicted vitamin D status, based on a subsample with 25-hydroxyvitamin D (25(OH)D) biomarker measurements (n 1497) from gestation week 25, and first-time forearm fractures among offspring between birth and end of follow-up. Diagnoses were extracted from the Danish National Patient Register. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between predicted vitamin D status (based on smoking, season, dietary and supplementary vitamin D intake, tanning bed use and outdoor physical activity) in pregnancy and offspring forearm fractures. Likewise, measured 25(OH)D, tanning bed use and dietary vitamin D intake were not associated with offspring forearm fractures. In mid-pregnancy, 91 % of the women reported intake of vitamin D from dietary supplements. Offspring of women who took >10 µg/d in mid-pregnancy had a significantly increased risk for fractures compared with the reference level of zero intake (hazard ratios (HR) 1·31; 95% CI 1·06, 1·62), but this was solely among girls (HR 1·48; 95% CI 1·10, 2·00). Supplement use in the peri-conceptional period exhibited similar pattern, although not statistically significant. In conclusion, our data indicated no protective effect of maternal vitamin D status with respect to offspring forearm fractures.

  13. Jonah's Birth.

    PubMed

    Goldstein, Rachel

    2012-01-01

    Rachel Goldstein shares her experience of exploring options related to care provider and place of birth early in her pregnancy. Goldstein and her husband, Marc, after reading and research, chose midwifery care and a home birth. She shares the story of a long labor at home supported by her husband, her doula, and her midwife. Her positive attitude, her ability to use various comfort strategies, and the support she received throughout labor contributed to being able to give birth naturally and ecstatically to her son Jonah.

  14. Factors for Preterm Births in Germany - An Analysis of Representative German Data (KiGGS).

    PubMed

    Weichert, A; Weichert, T M; Bergmann, R L; Henrich, W; Kalache, K D; Richter, R; Neymeyer, J; Bergmann, K E

    2015-08-01

    Introduction: Preterm birth is a global scourge, the leading cause of perinatal mortality and morbidity. This study set out to identify the principal risk factors for preterm birth, based on the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). A range of possible factors influencing preterm birth were selected for inclusion in the questionnaire, covering factors such as gender, national origin, immigrant background, demography, living standard, family structure, parental education and vocational training. Methods: All data were taken from the aforementioned KiGGS survey conducted between 2003 and 2006. A total of 17 641 children and adolescents (8656 girls and 8985 boys) drawn from 167 German towns and municipalities deemed to be representative of the Federal Republic of Germany were included in the study. Gestational age at birth was available for 14 234 datasets. The questionnaire included questions from the following areas as possible factors influencing preterm birth: gender, national origins, immigrant background, demography, living standard, family structure, parental education and vocational training. Results: The preterm birth rate was 11.6 %, higher than that of other national statistical evaluations. Around 57.4 % of multiple pregnancies and 10 % of singleton pregnancies resulted in preterm delivery. Multiple pregnancy was found to be the most important risk factor (OR 13.116). With regard to national origins and immigration background, mothers from Turkey, the Middle East, and North Africa had a higher incidence of preterm birth. Preterm birth was more prevalent in cities and large towns than in small towns and villages. Conclusion: Risk factors associated with preterm birth were identified. These should help with the early identification of pregnant women at risk. The preterm birth rate in our survey was higher than that found in other national statistical evaluations based on process data. More than half of

  15. Factors for Preterm Births in Germany – An Analysis of Representative German Data (KiGGS)

    PubMed Central

    Weichert, A.; Weichert, T. M.; Bergmann, R. L.; Henrich, W.; Kalache, K. D.; Richter, R.; Neymeyer, J.; Bergmann, K. E.

    2015-01-01

    Introduction: Preterm birth is a global scourge, the leading cause of perinatal mortality and morbidity. This study set out to identify the principal risk factors for preterm birth, based on the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). A range of possible factors influencing preterm birth were selected for inclusion in the questionnaire, covering factors such as gender, national origin, immigrant background, demography, living standard, family structure, parental education and vocational training. Methods: All data were taken from the aforementioned KiGGS survey conducted between 2003 and 2006. A total of 17 641 children and adolescents (8656 girls and 8985 boys) drawn from 167 German towns and municipalities deemed to be representative of the Federal Republic of Germany were included in the study. Gestational age at birth was available for 14 234 datasets. The questionnaire included questions from the following areas as possible factors influencing preterm birth: gender, national origins, immigrant background, demography, living standard, family structure, parental education and vocational training. Results: The preterm birth rate was 11.6 %, higher than that of other national statistical evaluations. Around 57.4 % of multiple pregnancies and 10 % of singleton pregnancies resulted in preterm delivery. Multiple pregnancy was found to be the most important risk factor (OR 13.116). With regard to national origins and immigration background, mothers from Turkey, the Middle East, and North Africa had a higher incidence of preterm birth. Preterm birth was more prevalent in cities and large towns than in small towns and villages. Conclusion: Risk factors associated with preterm birth were identified. These should help with the early identification of pregnant women at risk. The preterm birth rate in our survey was higher than that found in other national statistical evaluations based on process data. More than half of

  16. Can Parental Expectations Compensate for the Negative Effects of Low-Birth Weight on Academic Achievement? A Cross-Sectional Analysis of the National PEELS Data

    ERIC Educational Resources Information Center

    Cormier-Zenon, Dolores E.

    2012-01-01

    The purpose of this study is to examine the potential impact parental expectations have on the academic achievement of children born with low-birth weight to inform educational leaders. Literature on levels of children born with birth weights as low as 1 LB to as high as 9 LBS were evaluated based on: birth weight, academic achievement, and…

  17. Can Parental Expectations Compensate for the Negative Effects of Low-Birth Weight on Academic Achievement? A Cross-Sectional Analysis of the National PEELS Data

    ERIC Educational Resources Information Center

    Cormier-Zenon, Dolores E.

    2012-01-01

    The purpose of this study is to examine the potential impact parental expectations have on the academic achievement of children born with low-birth weight to inform educational leaders. Literature on levels of children born with birth weights as low as 1 LB to as high as 9 LBS were evaluated based on: birth weight, academic achievement, and…

  18. Clinical disorders in a post war British cohort reaching retirement: evidence from the First National Birth Cohort study.

    PubMed

    Pierce, Mary B; Silverwood, Richard J; Nitsch, Dorothea; Adams, Judith E; Stephen, Alison M; Nip, Wing; Macfarlane, Peter; Wong, Andrew; Richards, Marcus; Hardy, Rebecca; Kuh, Diana

    2012-01-01

    The medical needs of older people are growing because the proportion of the older population is increasing and disease boundaries are widening. This study describes the distribution and clustering of 15 common clinical disorders requiring medical treatment or supervision in a representative British cohort approaching retirement, and how health tracked across adulthood. The data come from a cohort of 2661 men and women, 84% of the target sample, followed since birth in England, Scotland and Wales in 1946, and assessed at 60-64 years for: cardio and cerebro-vascular disease, hypertension, raised cholesterol, renal impairment, diabetes, obesity, hypothyroidism, hyperthyroidism, anaemia, respiratory disease, liver disease, psychiatric problems, cancers, atrial fibrillation on ECG and osteoporosis. We calculated the proportions disorder-free, with one or more disorders, and the level of undiagnosed disorders; and how these disorders cluster into latent classes and relate to health assessed at 36 years. Participants had, on average, two disorders (range 0-9); only 15% were disorder-free. The commonest disorders were hypertension (54.3%, 95% CI 51.8%-56.7%), obesity (31.1%, 28.8%-33.5%), raised cholesterol (25.6%, 23.1-28.26%), and diabetes or impaired fasting glucose (25.0%, 22.6-27.5%). A cluster of one in five individuals had a high probability of cardio-metabolic disorders and were twice as likely than others to have been in the poorest health at 36 years. The main limitations are that the native born sample is entirely white, and a combination of clinical assessments and self reports were used. Most British people reaching retirement already have clinical disorders requiring medical supervision. Widening disease definitions and the move from a disease-based to a risk-based medical model will increase pressure on health services. The promotion of healthy ageing should start earlier in life and consider the individual's ability to adapt to and self manage changes in

  19. Cesarean Birth

    MedlinePlus

    ... the preparations for cesarean birth? • What type of anesthesia will be used during the procedure? • How is ... of injuring it during surgery. What type of anesthesia will be used during the procedure? You will ...

  20. Birth Plans

    MedlinePlus

    ... deliveries. They're often attractive and have gentle lighting. But some women believe that the most comfortable ... give birth. Do you want music and low lighting? How about the freedom to walk around during ...

  1. Which children and young people are excluded from school? Findings from a large British birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC).

    PubMed

    Paget, A; Parker, C; Heron, J; Logan, S; Henley, W; Emond, A; Ford, T

    2017-09-14

    Exclusion from school is increasingly recognized as pertinent to child health. National educational data reveal that boys, children who are looked-after, living in poverty, have special educational needs, or from certain ethnic minorities, are disproportionately excluded from school. As population-based data on the wider characteristics of excluded children are scarce, we aimed to describe predictors of school exclusion in the Avon Longitudinal Study of Parents and Children. Avon Longitudinal Study of Parents and Children, a prospective U.K. population-based birth cohort study, collected parent reports of permanent school exclusions by 8 years and parent and self-reports of permanent and fixed-term exclusions in the preceding 12 months at 16 years. Potential risk factors were examined for associations with exclusion using logistic regression, with a focus on child mental health and neurodevelopment. Analyses were based on all available data on 53/8,245 (0.6%) pupils excluded from school by 8 years and 390/4,482 (8.7%) at 16 years. Key factors associated with exclusion at both time points included male gender, lower socio-economic status, maternal psychopathology, mental health and behavioural difficulties, psychiatric disorder, social communication difficulties, language difficulties, antisocial activities, bullying/being bulled, lower parental engagement with education, low school engagement, poor relationship with teacher, low educational attainment, and special educational needs (all p < .05). Exclusion from school was associated with child, family and school-related factors identifiable at, or prior to, primary school age. Child health professionals have an important role in the holistic, multidisciplinary assessment of children who are at risk of exclusion from school. Mental health and neurodevelopmental difficulties should be recognized and supported, to improve the health and educational outcomes among this vulnerable group. © 2017 John Wiley & Sons

  2. Twentieth-century decline of large-diameter trees in Yosemite National Park, California, USA

    USGS Publications Warehouse

    Lutz, J.A.; van Wagtendonk, J.W.; Franklin, J.F.

    2009-01-01

    Studies of forest change in western North America often focus on increased densities of small-diameter trees rather than on changes in the large tree component. Large trees generally have lower rates of mortality than small trees and are more resilient to climate change, but these assumptions have rarely been examined in long-term studies. We combined data from 655 historical (1932-1936) and 210 modern (1988-1999) vegetation plots to examine changes in density of large-diameter trees in Yosemite National Park (3027 km2). We tested the assumption of stability for large-diameter trees, as both individual species and communities of large-diameter trees. Between the 1930s and 1990s, large-diameter tree density in Yosemite declined 24%. Although the decrease was apparent in all forest types, declines were greatest in subalpine and upper montane forests (57.0% of park area), and least in lower montane forests (15.3% of park area). Large-diameter tree densities of 11 species declined while only 3 species increased. Four general patterns emerged: (1) Pinus albicaulis, Quercus chrysolepis, and Quercus kelloggii had increases in density of large-diameter trees occur throughout their ranges; (2) Pinus jeffreyi, Pinus lambertiana, and Pinus ponderosa, had disproportionately larger decreases in large-diameter tree densities in lower-elevation portions of their ranges; (3) Abies concolor and Pinus contorta, had approximately uniform decreases in large-diameter trees throughout their elevational ranges; and (4) Abies magnifica, Calocedrus decurrens, Juniperus occidentalis, Pinus monticola, Pseudotsuga menziesii, and Tsuga mertensiana displayed little or no change in large-diameter tree densities. In Pinus ponderosa-Calocedrus decurrens forests, modern large-diameter tree densities were equivalent whether or not plots had burned since 1936. However, in unburned plots, the large-diameter trees were predominantly A. concolor, C. decurrens, and Q. chrysolepis, whereas P. ponderosa

  3. Birth weight in offspring and leukaemia risk in parents--a nation-wide register-based cohort study from Denmark.

    PubMed

    Marklund, Maria; Rostgaard, Klaus; Hjalgrim, Lisa; Schmiegelow, Kjeld; Hjalgrim, Henrik

    2013-02-01

    Spurred by previous observations we assessed the relationship between offspring birth weight and parental leukaemia risk in a register-based investigation including 2.4 million parents of 2 million Danish children. Regardless of analytical approach, offspring birth weight was not associated with parental risk of leukaemia overall or of leukaemia subtypes except for a twofold increased acute lymphatic leukaemia risk in fathers of high birth weight offspring and an increasing paternal risk of chronic myeloid leukaemia with increasing offspring birth weight. These may both be chance findings. Our investigation indicates that offspring birth weight is not strongly associated with parental leukaemia risk.

  4. Attention Deficit/Hyperactivity Disorder and Childhood Autism in Association with Prenatal Exposure to Perfluoroalkyl Substances: A Nested Case–Control Study in the Danish National Birth Cohort

    PubMed Central

    Liew, Zeyan; Ritz, Beate; von Ehrenstein, Ondine S.; Bech, Bodil Hammer; Nohr, Ellen Aagaard; Fei, Chunyuan; Bossi, Rossana; Henriksen, Tine Brink; Bonefeld-Jørgensen, Eva Cecilie

    2014-01-01

    Background: Perfluoroalkyl substances (PFASs) are persistent pollutants found to be endocrine disruptive and neurotoxic in animals. Positive correlations between PFASs and neurobehavioral problems in children were reported in cross-sectional data, but findings from prospective studies are limited. Objectives: We investigated whether prenatal exposure to PFASs is associated with attention deficit/hyperactivity disorder (ADHD) or childhood autism in children. Methods: Among 83,389 mother–child pairs enrolled in the Danish National Birth Cohort during 1996–2002, we identified 890 ADHD cases and 301 childhood autism cases from the Danish National Hospital Registry and the Danish Psychiatric Central Registry. From this cohort, we randomly selected 220 cases each of ADHD and autism, and we also randomly selected 550 controls frequency matched by child’s sex. Sixteen PFASs were measured in maternal plasma collected in early or mid-pregnancy. We calculated risk ratios (RRs) using generalized linear models, taking into account sampling weights. Results: Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in all samples; four other PFASs were quantified in ≥ 90% of the samples. We did not find consistent evidence of associations between mother’s PFAS plasma levels and ADHD [per natural log nanograms per milliliter increase: PFOS RR = 0.87 (95% CI: 0.74, 1.02); PFOA RR = 0.98 (95% CI: 0.82, 1.16)] or autism [per natural log nanograms per milliliter increase: PFOS RR = 0.92 (95% CI: 0.69, 1.22); PFOA RR = 0.98 (95% CI: 0.73, 1.31)]. We found positive as well as negative associations between higher PFAS quartiles and ADHD in models that simultaneously adjusted for all PFASs, but these estimates were imprecise. Conclusions: In this study we found no consistent evidence to suggest that prenatal PFAS exposure increases the risk of ADHD or childhood autism in children. Citation: Liew Z, Ritz B, von Ehrenstein OS, Bech BH, Nohr EA, Fei CY

  5. Clinical Disorders in a Post War British Cohort Reaching Retirement: Evidence from the First National Birth Cohort Study

    PubMed Central

    Pierce, Mary B.; Silverwood, Richard J.; Nitsch, Dorothea; Adams, Judith E.; Stephen, Alison M.; Nip, Wing; Macfarlane, Peter; Wong, Andrew; Richards, Marcus; Hardy, Rebecca; Kuh, Diana

    2012-01-01

    Background The medical needs of older people are growing because the proportion of the older population is increasing and disease boundaries are widening. This study describes the distribution and clustering of 15 common clinical disorders requiring medical treatment or supervision in a representative British cohort approaching retirement, and how health tracked across adulthood. Methods and Findings The data come from a cohort of 2661 men and women, 84% of the target sample, followed since birth in England, Scotland and Wales in 1946, and assessed at 60–64 years for: cardio and cerebro-vascular disease, hypertension, raised cholesterol, renal impairment, diabetes, obesity, hypothyroidism, hyperthyroidism, anaemia, respiratory disease, liver disease, psychiatric problems, cancers, atrial fibrillation on ECG and osteoporosis. We calculated the proportions disorder-free, with one or more disorders, and the level of undiagnosed disorders; and how these disorders cluster into latent classes and relate to health assessed at 36 years. Participants had, on average, two disorders (range 0–9); only 15% were disorder-free. The commonest disorders were hypertension (54.3%, 95% CI 51.8%–56.7%), obesity (31.1%, 28.8%–33.5%), raised cholesterol (25.6%, 23.1–28.26%), and diabetes or impaired fasting glucose (25.0%, 22.6–27.5%). A cluster of one in five individuals had a high probability of cardio-metabolic disorders and were twice as likely than others to have been in the poorest health at 36 years. The main limitations are that the native born sample is entirely white, and a combination of clinical assessments and self reports were used. Conclusions Most British people reaching retirement already have clinical disorders requiring medical supervision. Widening disease definitions and the move from a disease-based to a risk-based medical model will increase pressure on health services. The promotion of healthy ageing should start earlier in life and consider the

  6. Growth and development of very low birth weight infants aged 18-24 months at Queen Sirikit National Institute of Child Health.

    PubMed

    Sangtawesin, Varaporn; Singarj, Yupayao; Kanjanapattanakul, Wiboon

    2011-08-01

    The number of very low birth weight (VLBW) births is increasing worldwide. Despite better care in recent years, they have a high incidence of delayed growth and development. There are no previous studies regarding the growth and development of these infants at Queen Sirikit National Institute of Child Health (QSNICH). To study growth and developmental outcome of VLBW infants, aged 18-24 months who were discharged from QSNICH. VLBW infants who were discharged from QSNICH during the year 2007 were recruited in the study. Patients with chromosomal abnormalities, major congenital anomalies, definite congenital infections and positive maternal anti-HIV tests were excluded. At the corrected age of 18-24 months, the parents were called upon to bring their infants for complete physical examination and developmental evaluation on 2 occasions, two months apart. There were 111 cases of VLBW infants who were discharged from QSNICH during the year 2007. Fifty-four patients were eligible for the present study. Thirty cases (55.56%) were contacted for the first examination. During this examination, there were 3 cases (10%) with low head circumference, 1 case (3.33%) with poor weight gain, 5 cases (16.67%) with visual defect, 1 case (3.33%) with moderately severe hearing loss, 1 case (3.33%) with cerebral palsy and 7 cases (23.33%) with delayed development. Twenty-one cases could be recalled for a second evaluation. Two of the 5 cases had delayed language development. There were no cases with hydrocephalous, blindness or profound hearing loss. VLBW infants at QSNICH had much better survival during recent years. Most of these survivors had normal growth and development. Those with delayed growth and development need aggressive intervention and long-term follow-up for enhancement of quality of their lives.

  7. From Birth Control to Sex Control: Unruly Young Women and the Origins of the National Abstinence-Only Mandate.

    PubMed

    Ehrlich, J Shoshanna

    2013-01-01

    In the early 1980s, conservative politicians in the United States argued that the federal government was promoting promiscuity by providing teens with confidential access to government-funded family planning services. Claiming the problem was not that young women were getting pregnant but that they were having sex, they promised a new national policy-one that would stress self-discipline and family values over sexual indulgence. As argued in this paper, the resulting abstinence-only federal mandate both draws upon and reinforces traditional sexual scripts, which hold young women responsible for keeping male passion in check, thus selectively burdening them with the work of "doing abstinence."

  8. Offspring preterm birth and birth size are related to long-term risk of maternal diabetes.

    PubMed

    Naver, Klara Vinsand; Secher, Niels Jørgen; Ovesen, Per Glud; Gorst-Rasmussen, Anders; Lundbye-Christensen, Søren; Nilas, Lisbeth

    2013-05-01

    The aim of the study is to investigate the association between gestational age, birth size, and the long-term risk of maternal diabetes. We conducted a nation-wide prospective follow-up study of the cohort of all Danish women with a singleton delivery in 1982/1983 (index delivery) and no history of diabetes (n = 100,669). Registries were used to extract information on patients with a hospital or outpatient diagnosis of diabetes, subsequent deliveries, and death/emigration in the period from the index delivery until the end of 2006. The association between the maternal risk of diabetes and the index gestational age and index offspring birth size (birth weight adjusted for gestational age) was investigated by using Cox proportional hazards regression models stratified according to young (≤33 years) and old age (>33 years). During a median follow-up period of 24 years, 2,021 women (2.0 %) were diagnosed as having diabetes. The risk of maternal diabetes was positively associated with increasing index birth size and negatively associated with increasing duration of index gestation in both age strata. Among young women, the highest hazard ratios were found for the exposure category of large index offspring birth size (adjusted HR 9.0, 95 % CI 6.17-13.12) and a preterm delivery at 32-37 weeks (adjusted HR 2.22, 95 % CI 1.46-3.40). Offspring preterm birth and large size for gestational age at birth are associated with increased risk of maternal diabetes.

  9. [Quality of data acceptable for perinatal epidemiology surveillance: assessment of the health certificate at birth and the national obstetrics medical file. Study in three Seine-Maritime maternal wards].

    PubMed

    Germain, J M; Czernichow, P; Josset, V; Torre, J P; Marpeau, L; Le Meur, H; Paquet, M; Pellerin, M A; Hebert, A

    1998-06-01

    Data from several sources could be used for perinatal epidemiology surveillance aimed at an assessment of regional programs such as those proposed by the Superior Committee for Public Health. A retrospective study of 561 births was conducted in three maternity wards in the French Seine Maritime department in order to evaluate the reliability of two data sources: the national obstetrics medical file and the health certificate at birth. The delivery room records were used as the gold standard. The sensitivity of the obstetrics file was better than that of the health certificate. With the obstetrics file, it was possible to identify almost all the vaginal route interventions, almost all the premature births and all the cesareans. With the health certificate, 39-58% of the vaginal route interventions, 61% of the premature births and 61-72% of the cesareans performed in the three wards studied were identified. The quality of data in the obstetrics file appears to be better than that in the health certificate but only concerns 40% of births in the geographical area studied. Inversely, the health certificate is theoretically delivered for all births (actually delivered for 93%). Integrating these two information systems could be an optimum solution.

  10. Hot spots, cluster detection and spatial outlier analysis of teen birth rates in the U.S., 2003–2012

    PubMed Central

    Khan, Diba; Rossen, Lauren M.; Hamilton, Brady E.; He, Yulei; Wei, Rong; Dienes, Erin

    2017-01-01

    Teen birth rates have evidenced a significant decline in the United States over the past few decades. Most of the states in the US have mirrored this national decline, though some reports have illustrated substantial variation in the magnitude of these decreases across the U.S. Importantly, geographic variation at the county level has largely not been explored. We used National Vital Statistics Births data and Hierarchical Bayesian space-time interaction models to produce smoothed estimates of teen birth rates at the county level from 2003–2012. Results indicate that teen birth rates show evidence of clustering, where hot and cold spots occur, and identify spatial outliers. Findings from this analysis may help inform efforts targeting the prevention efforts by illustrating how geographic patterns of teen birth rates have changed over the past decade and where clusters of high or low teen birth rates are evident. PMID:28552189

  11. Hot spots, cluster detection and spatial outlier analysis of teen birth rates in the U.S., 2003-2012.

    PubMed

    Khan, Diba; Rossen, Lauren M; Hamilton, Brady E; He, Yulei; Wei, Rong; Dienes, Erin

    2017-06-01

    Teen birth rates have evidenced a significant decline in the United States over the past few decades. Most of the states in the US have mirrored this national decline, though some reports have illustrated substantial variation in the magnitude of these decreases across the U.S. Importantly, geographic variation at the county level has largely not been explored. We used National Vital Statistics Births data and Hierarchical Bayesian space-time interaction models to produce smoothed estimates of teen birth rates at the county level from 2003-2012. Results indicate that teen birth rates show evidence of clustering, where hot and cold spots occur, and identify spatial outliers. Findings from this analysis may help inform efforts targeting the prevention efforts by illustrating how geographic patterns of teen birth rates have changed over the past decade and where clusters of high or low teen birth rates are evident. Published by Elsevier Ltd.

  12. Birth Control Methods

    MedlinePlus

    ... Z Health Topics Birth control methods Birth control methods > A-Z Health Topics Birth control methods fact ... Publications email updates Enter email Submit Birth control methods Birth control (contraception) is any method, medicine, or ...

  13. Birth defects in India: Hidden truth, need for urgent attention.

    PubMed

    Sharma, Rinku

    2013-04-01

    Birth defects (structural, functional and metabolic disorder present from birth, may be diagnosed later) rising up as an important cause of infant mortality even in developing countries where infant mortality has been reduced to much extent. Seventy percent of birth defects are preventable through the application of various cost effective community genetic services. Indian people are living in the midst of risk factors for birth defects, e.g., universality of marriage, high fertility, large number of unplanned pregnancies, poor coverage of antenatal care, poor maternal nutritional status, high consanguineous marriages rate, and high carrier rate for hemoglobinopathies. India being the second most populous country with a large number infant born annually with birth defects should focus its attention on strategies for control of birth defects. Many population based strategies such as iodization, double fortification of salt, flour fortification with multivitamins, folic acid supplementation, periconceptional care, carrier screening and prenatal screening are some of proven strategies for control of birth defects. Strategies such as iodization of salt in spite of being initiated for a long time in the past do have a very little impact on its consumption (only 50% were using iodized salt). Community genetic services for control of birth defects can be easily flourished and integrated with primary health care in India because of its well established infrastructure and personnel in the field of maternal and child health care. As there is wide variation for infant mortality rate (IMR) in different states in India, so there is a need of deferential approach to implement community genetic services in states those had already achieved national goal of IMR. On the other hand, states those have not achieved the national goal on IMR priority should be given to management of other causes of infant mortality.

  14. Large-Scale Data Collection Metadata Management at the National Computation Infrastructure

    NASA Astrophysics Data System (ADS)

    Wang, J.; Evans, B. J. K.; Bastrakova, I.; Ryder, G.; Martin, J.; Duursma, D.; Gohar, K.; Mackey, T.; Paget, M.; Siddeswara, G.

    2014-12-01

    Data Collection management has become an essential activity at the National Computation Infrastructure (NCI) in Australia. NCI's partners (CSIRO, Bureau of Meteorology, Australian National University, and Geoscience Australia), supported by the Australian Government and Research Data Storage Infrastructure (RDSI), have established a national data resource that is co-located with high-performance computing. This paper addresses the metadata management of these data assets over their lifetime. NCI manages 36 data collections (10+ PB) categorised as earth system sciences, climate and weather model data assets and products, earth and marine observations and products, geosciences, terrestrial ecosystem, water management and hydrology, astronomy, social science and biosciences. The data is largely sourced from NCI partners, the custodians of many of the national scientific records, and major research community organisations. The data is made available in a HPC and data-intensive environment - a ~56000 core supercomputer, virtual labs on a 3000 core cloud system, and data services. By assembling these large national assets, new opportunities have arisen to harmonise the data collections, making a powerful cross-disciplinary resource.To support the overall management, a Data Management Plan (DMP) has been developed to record the workflows, procedures, the key contacts and responsibilities. The DMP has fields that can be exported to the ISO19115 schema and to the collection level catalogue of GeoNetwork. The subset or file level metadata catalogues are linked with the collection level through parent-child relationship definition using UUID. A number of tools have been developed that support interactive metadata management, bulk loading of data, and support for computational workflows or data pipelines. NCI creates persistent identifiers for each of the assets. The data collection is tracked over its lifetime, and the recognition of the data providers, data owners, data

  15. Large-Scale Field Study of Landfill Covers at Sandia National Laboratories

    SciTech Connect

    Dwyer, S.F.

    1998-09-01

    A large-scale field demonstration comparing final landfill cover designs has been constructed and is currently being monitored at Sandia National Laboratories in Albuquerque, New Mexico. Two conventional designs (a RCRA Subtitle `D' Soil Cover and a RCRA Subtitle `C' Compacted Clay Cover) were constructed side-by-side with four alternative cover test plots designed for dry environments. The demonstration is intended to evaluate the various cover designs based on their respective water balance performance, ease and reliability of construction, and cost. This paper presents an overview of the ongoing demonstration.

  16. Characteristics and determinants of Thailand's declining birth rate in women age 35 to 59 years old: data from the Fourth National Health Examination Survey.

    PubMed

    Srithanaviboonchai, Kriengkrai; Moongtui, Wanchai; Panpanich, Ratana; Suwanteerangkul, Jiraporn; Chariyalertsak, Suwat; Sangthong, Rassamee; Kessomboon, Pattapong; Putwatana, Panwadee; Nontarak, Jiraluck; Aekplakorn, Wichai

    2014-02-01

    To describe characteristics and determinants of Thailand's declining birth rate using national representative survey data. The Fourth National Health Examination Survey was conducted between 2008 and 2009. Four stages of stratified probability samples, proportionate to size, were used to represent the whole Thai population. Information from women aged 35 to 59 years old was included in the analysis. Curve estimation was used to characterize the correlation between the number of children ever born and the age of married and un-married women. Binary logistic regression analysis was used to identify predictors of having fewer than two children among ever married women. Of all 4120 women, the number of children decreased sharply among the oldest women aged 45 to 59 years old, decreased less sharply for women younger than 45 years of age, reached the lowest level at the age of 37 and 38 years old, and then increased minimally among the younger women surveyed. Among those who were ever married (n = 3,761), the independent predictors of having one or no child instead of having two or more children were aged 45 to 49 compared to 50 to 59 years old (OR = 1.66; 95% CI = 1.37-2.00), age 35 to 44 compared to 50 to 59 years old (OR = 1.39; 95% CI = 1.16-1.68), living in households with wealth index level 3 compared to level 1 (OR = 1.28; 95% CI = 1.01-1.63), urban residence (OR = 1.33; 95% CI = 1.14-1.57), attaining secondary school education (OR = 1.35; 95% CI = 1.11-1.64), and having junior college diploma or higher level of education compared to elementary or no education (OR = 1.81; 95% CI = 1.39-2.34). Birth rate of Thai women declined steeply in the past then less steeply, and might have begun to rise minimally in recent years. Younger age, living in an urban area, and having higher socioeconomic status were predictors of having fewer than two children.

  17. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

    PubMed Central

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

  18. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    PubMed

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  19. A Comparison of Linking Methods for Estimating National Trends in International Comparative Large-Scale Assessments in the Presence of Cross-national DIF

    ERIC Educational Resources Information Center

    Sachse, Karoline A.; Roppelt, Alexander; Haag, Nicole

    2016-01-01

    Trend estimation in international comparative large-scale assessments relies on measurement invariance between countries. However, cross-national differential item functioning (DIF) has been repeatedly documented. We ran a simulation study using national item parameters, which required trends to be computed separately for each country, to compare…

  20. A Comparison of Linking Methods for Estimating National Trends in International Comparative Large-Scale Assessments in the Presence of Cross-national DIF

    ERIC Educational Resources Information Center

    Sachse, Karoline A.; Roppelt, Alexander; Haag, Nicole

    2016-01-01

    Trend estimation in international comparative large-scale assessments relies on measurement invariance between countries. However, cross-national differential item functioning (DIF) has been repeatedly documented. We ran a simulation study using national item parameters, which required trends to be computed separately for each country, to compare…

  1. Trends in Antibiotic Use by Birth Season and Birth Year.

    PubMed

    Kinlaw, Alan C; Stürmer, Til; Lund, Jennifer L; Pedersen, Lars; Kappelman, Michael D; Daniels, Julie L; Frøslev, Trine; Mack, Christina D; Sørensen, Henrik Toft

    2017-09-01

    We examined 2 birth cohort effects on antibiotic prescribing during the first year of life (henceforth, infancy) in Denmark: (1) the birth season effect on timing and overall occurrence of antibiotic prescribing, and (2) the birth year effect amid emerging nationwide pneumococcal vaccination programs and changing prescribing guidelines. We linked data for all live births in Denmark from 2004 to 2012 (N = 561 729) across the National Health Service Prescription Database, Medical Birth Registry, and Civil Registration System. Across birth season and birth year cohorts, we estimated 1-year risk, rate, and burden of redeemed antibiotic prescriptions during infancy. We used interrupted time series methods to assess prescribing trends across birth year cohorts. Graphical displays of all birth cohort effect data are included. The 1-year risk of having at least 1 redeemed antibiotic prescription during infancy was 39.5% (99% confidence interval [CI]: 39.3% to 39.6%). The hazard of a first prescription increased with age throughout infancy and varied by season; subsequently, Kaplan-Meier-derived risk functions varied by birth season cohort. After rollout of a first vaccination program and new antibiotic prescribing guidelines, 1-year risk decreased by 4.4% over 14 months (99% CI: 3.4% to 5.5%); it decreased again after rollout of a second vaccination program by 6.9% over 3 years (99% CI: 4.4% to 9.3%). In Denmark, birth season and birth year cohort effects influenced timing and risk of antibiotic prescribing during infancy. Future studies of antibiotic stewardship, effectiveness, and safety in children should consider these cohort effects, which may render some children inherently more susceptible than others to downstream antibiotic effects. Copyright © 2017 by the American Academy of Pediatrics.

  2. Monitoring the water quality of the Nation's large rivers: Rio Grande NASQAN Program

    USGS Publications Warehouse

    Lurry, Dee L.; Reutter, David C.; Wells, Frank C.

    1998-01-01

    The U.S. Geological Survey (USGS) has monitored the water quality in the Rio Grande Basin as part of the redesigned National Stream Quality Accounting Network (NASQAN) since 1995 (Hooper and others, 1997). The NASQAN program was designed to characterize the concentrations and transport of sediment and selected chemical constituents found in the Nation's large rivers-including the Mississippi, Colorado, and Columbia in addition to the Rio Grande. In these four basins, the USGS currently (1998) operates a network of 40 NASQAN sites, with an emphasis on quantifying the mass flux for each constituent (the amount of material moving past the site, expressed in tons per day). By applying a consistent flux-based approach in the Rio Grande Basin, the NASQAN program is generating the information needed to identify regional sources for a variety of constituents, including agricultural chemicals and trace elements, in the basin. The effect of the large reservoirs on the Rio Grande can be observed as constituent fluxes are routed downstream. The analysis of constituent fluxes on a basin-wide scale will provide the means to assess the influence of human activity on water-quality conditions in the Rio Grande.

  3. Risk of preterm birth after blastocyst embryo transfer: a large population study using contemporary registry data from Australia and New Zealand.

    PubMed

    Chambers, Georgina M; Chughtai, Abrar A; Farquhar, Cynthia M; Wang, Yueping A

    2015-10-01

    To investigate whether there is an increased risk of preterm birth with blastocyst transfer compared with cleavage-stage embryo transfer (ET) after assisted reproductive technology (ART). A retrospective, population-based study. Not applicable. A total of 50,788 infants conceived after ART treatment performed from 2009 to 2012. None. The rates of preterm birth, low birth weight (LBW), and small for gestational age (SGA) for 43,952 singleton and 3,418 twin deliveries after transfers of blastocyst or cleavage-stage embryos. Among singletons, there was no significant difference in the odds of preterm birth between blastocyst and cleavage-stage ET (9.1% compared with 9.3%, respectively, adjusted odds ratio 1.00, 95% confidence interval 0.94-1.08). Among twins, the crude rates of preterm birth were similar after blastocyst and cleavage-stage ETs (61.5% and 64.4%, respectively). However, after adjusting for potential confounders, blastocyst transfer was associated with a lower odds of preterm birth among twins (adjusted odds ratio 0.80, 95% confidence interval 0.70-0.93). There was no difference in risks of LBW and SGA between blastocyst and cleavage-stage ETs for both singletons and twins after adjusting for potential confounders. In contrast with the findings from a number of other studies, blastocyst culture in Australian and New Zealand is not associated with an increased risk of preterm, LBW, and SGA for singletons. Further studies are needed to assess longer-term outcomes of children born after ART treatment and possible biological or treatment factors related to adverse outcomes. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Demographic characteristics, care, and outcomes for children with oral clefts in three states using participants from the National Birth Defects Prevention Study.

    PubMed

    Damiano, Peter; Tyler, Margaret; Romitti, Paul A; Druschel, Charlotte; Austin, April A; Burnett, Whitney; Kizelnik-Freilich, Sara; Robbins, James M

    2009-11-01

    The primary objective of this study was to evaluate whether there were differences in the characteristics and outcomes of care for children with oral clefts (OCs) among population-based samples in three states. Data on the health status and on speech and esthetic outcomes were collected using structured telephone interviews conducted during 2005-2006 with mothers of children with OCs aged 2 to 7 in Arkansas, Iowa, and New York. Mothers of children born with nonsyndromic OCs on or after January 1, 1998, and on or before December 31, 2003, in Arkansas, Iowa, or New York. Subjects were identified through their participation in the ongoing National Birth Defects Prevention Study. Demographic characteristics, rating of cleft care, severity of condition, health status, esthetic outcomes, and speech problems were evaluated by state of residence. Children with OCs from Arkansas were from lower income families, and their parents were less likely to be married. Children with OCs from Arkansas were more likely to have special health care needs and to require mental health care. Few differences were found across states in type of cleft, severity of cleft, or outcomes of cleft care. Combining results from population-based samples across multiple studies increases the variability of sample characteristics. Including multiple states can be an efficient way to learn more about the outcomes of medical care for less common conditions such as oral cleft.

  5. Human Papillomavirus Vaccination Coverage Among Girls Before 13 Years: A Birth Year Cohort Analysis of the National Immunization Survey-Teen, 2008-2013.

    PubMed

    Jeyarajah, Jenny; Elam-Evans, Laurie D; Stokley, Shannon; Smith, Philip J; Singleton, James A

    2016-09-01

    Routine human papillomavirus (HPV) vaccination is recommended at 11 or 12 years by the Advisory Committee on Immunization Practices. National Immunization Survey-Teen data were analyzed to evaluate, among girls, coverage with one or more doses of HPV vaccination, missed opportunities for HPV vaccination, and potential achievable coverage before 13 years. Results were stratified by birth year cohorts. HPV vaccination coverage before 13 years (≥1 HPV dose) increased from 28.4% for girls born in 1995 to 46.8% for girls born in 2000. Among girls born during 1999-2000 who had not received HPV vaccination before 13 years (57.2%), 80.1% had at least 1 missed opportunity to receive HPV vaccination before 13 years. Opportunities to vaccinate for HPV at age 11 to 12 years are missed. Strategies are needed to decrease these missed opportunities for HPV vaccination. This can be facilitated by the administration of all vaccines recommended for adolescents at the same visit.

  6. Children With Autism Spectrum Disorder and Screen Time: Results From a Large, Nationally Representative US Study.

    PubMed

    Montes, Guillermo

    2016-03-01

    To test the hypotheses that children with autism spectrum disorder (ASD) have higher screen time than other children on a US nationally representative sample and that children with ASD are overrepresented among children who exceed the American Academy of Pediatrics (AAP) screen time recommendation (2 hours or less a day). The National Survey of Children's Health 2011-2012, a nationally representative survey, asked parents to report their child's (aged 6-17 years) average daily media usage. The ASD subpopulation (n = 1393) was compared to children without ASD (non-ASD, n = 64,163). Differences were compared by design-corrected F tests. Regression models were estimated for both groups separately. Adjusted Wald tests were used to rigorously test the hypotheses. More than half of US children exceed the AAP screen time recommendation. Compared to non-ASD, children with ASD had similar amounts of total screen time (3.21 hours per day vs 3.46 hours per day; P > .05), media (TV/video) time, and computer/mobile device leisure time. Children with ASD have a milder age gradient than the general population on computer/mobile device usage. Children with ASD were proportionally represented among high users (more than 2 hours per day). Data did not support hypotheses. In a large, nationally representative US sample, there was no evidence that children with ASD differ in their screen time habits from other children. Both groups have high screen time use. Caution should be exercised before assuming that children with ASD are at higher risk of exceeding AAP screen time recommendations. Efforts to promote adherence to the recommendation are needed, but they should neither target nor exclude children with ASD. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  7. Attention deficit/hyperactivity disorder and childhood autism in association with prenatal exposure to perfluoroalkyl substances: a nested case-control study in the Danish National Birth Cohort.

    PubMed

    Liew, Zeyan; Ritz, Beate; von Ehrenstein, Ondine S; Bech, Bodil Hammer; Nohr, Ellen Aagaard; Fei, Chunyuan; Bossi, Rossana; Henriksen, Tine Brink; Bonefeld-Jørgensen, Eva Cecilie; Olsen, Jørn

    2015-04-01

    Perfluoroalkyl substances (PFASs) are persistent pollutants found to be endocrine disruptive and neurotoxic in animals. Positive correlations between PFASs and neurobehavioral problems in children were reported in cross-sectional data, but findings from prospective studies are limited. We investigated whether prenatal exposure to PFASs is associated with attention deficit/hyperactivity disorder (ADHD) or childhood autism in children. Among 83,389 mother-child pairs enrolled in the Danish National Birth Cohort during 1996-2002, we identified 890 ADHD cases and 301 childhood autism cases from the Danish National Hospital Registry and the Danish Psychiatric Central Registry. From this cohort, we randomly selected 220 cases each of ADHD and autism, and we also randomly selected 550 controls frequency matched by child's sex. Sixteen PFASs were measured in maternal plasma collected in early or mid-pregnancy. We calculated risk ratios (RRs) using generalized linear models, taking into account sampling weights. Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in all samples; four other PFASs were quantified in ≥ 90% of the samples. We did not find consistent evidence of associations between mother's PFAS plasma levels and ADHD [per natural log nanograms per milliliter increase: PFOS RR = 0.87 (95% CI: 0.74, 1.02); PFOA RR = 0.98 (95% CI: 0.82, 1.16)] or autism [per natural log nanograms per milliliter increase: PFOS RR = 0.92 (95% CI: 0.69, 1.22); PFOA RR = 0.98 (95% CI: 0.73, 1.31)]. We found positive as well as negative associations between higher PFAS quartiles and ADHD in models that simultaneously adjusted for all PFASs, but these estimates were imprecise. In this study we found no consistent evidence to suggest that prenatal PFAS exposure increases the risk of ADHD or childhood autism in children.

  8. Obesity and type 2 diabetes mellitus in a birth cohort of First Nation children born to mothers with pediatric-onset type 2 diabetes.

    PubMed

    Mendelson, Michael; Cloutier, Justin; Spence, Louise; Sellers, Elizabeth; Taback, Shayne; Dean, Heather

    2011-05-01

    Children who are born to mothers with pediatric-onset type 2 diabetes mellitus are exposed to a hyperglycemic intra-uterine environment throughout pregnancy. The growth patterns and risk of type 2 diabetes in these offspring may be influenced by unique gene-environment interactions during intra-uterine and postnatal life. We established a cohort of offspring of First Nation mothers with onset of type 2 diabetes before age 18 years in Manitoba, Canada. We measured height or length and weight at study entry and annually thereafter with fasting blood glucose in offspring aged ≥ 7 years. We collected birth and breastfeeding history and determined the population-specific hepatic nuclear factor-1α (HNF-1α) G319S genotype of offspring at age 7 years. From July 2003 to April 2008, we enrolled 76 offspring of 37 mothers. Sixty-four percent (23/36) of the offspring aged 2-19 years were obese at initial assessment. The rates of obesity remained constant throughout the 5 years. As of April 2008, 7/28 (25%) of the offspring aged 7-19 years have diabetes including 6/14 (43%) aged 10-19 years. Most offspring with diabetes (5/7, 71%) were obese at diagnosis. All of the 7 offspring with diabetes have 1 or 2 copies of the G319S polymorphism. The prevalence of type 2 diabetes in this cohort of offspring of First Nation women with pediatric-onset type 2 diabetes is the highest ever reported. Obesity is an important postnatal risk factor for type 2 diabetes in this population and may result from a unique gene-environment interaction. © 2011 John Wiley & Sons A/S.

  9. Maternal intake of vitamins A, E and K in pregnancy and child allergic disease: a longitudinal study from the Danish National Birth Cohort.

    PubMed

    Maslova, Ekaterina; Hansen, Susanne; Strøm, Marin; Halldorsson, Thorhallur I; Olsen, Sjurdur F

    2014-03-28

    Fat-soluble vitamins A, E and K have been shown to play roles in immunity and inflammation, but studies on child allergic disease have been few and inconsistent. The aim of the present study was to examine the relationship between maternal intake of vitamins A, E and K in mid-pregnancy and child asthma and allergic rhinitis. We used data on 44 594 mother-child pairs from the Danish National Birth Cohort. Maternal intake of fat-soluble vitamins was calculated based on the information from a validated FFQ completed in mid-pregnancy. At 18 months, interviews with the mothers were conducted to evaluate doctor-diagnosed child asthma. At age 7 years, we assessed child asthma and allergic rhinitis using questions from the International Study of Asthma and Allergies in Childhood questionnaire and by national registries on hospital contacts and medication use. Current asthma was defined as asthma diagnosis and wheeze in the past 12 months by maternal report. We calculated multivariable risk ratios and 95 % CI by comparing the highest v. lowest quintile (Q) of maternal vitamin A, E and K intake in relation to child allergic disease outcomes. Maternal total vitamin K intake was directly associated with ever admitted asthma (Q5 v. Q1: 1·23, 95 % CI 1·01, 1·50) and current asthma at 7 years (Q5 v. Q1: 1·30, 95 % CI 0·99, 1·70). Weak inverse associations were present for maternal vitamin A and E intake during pregnancy with child allergic rhinitis. Maternal vitamin K intake during pregnancy may increase the risk of child asthma, and should be explored further on a mechanistic level. Conversely, maternal vitamin A and E intake may protect against child allergic rhinitis.

  10. Department of Defense Birth and Infant Health Registry: Birth Defects Among Infants Born to US Military Families: 2001 Annual Report

    DTIC Science & Technology

    2008-05-30

    occurred in US military families worldwide. Data on birth defects were gathered using nationally standardized definitions for major congenital ...calculation of the prevalence of birth defects in all major malformation categories. The DoD Birth and Infant Health Registry reports birth defects...Health Registry 4 Definitions of Birth Defects According to the NBDPN, birth defects are conditions that can result in physical malformations

  11. Avalanche ecology and large magnitude avalanche events: Glacier National Park, Montana, USA

    USGS Publications Warehouse

    Fagre, Daniel B.; Peitzsch, Erich H.

    2010-01-01

    Large magnitude snow avalanches play an important role ecologically in terms of wildlife habitat, vegetation diversity, and sediment transport within a watershed. Ecological effects from these infrequent avalanches can last for decades. Understanding the frequency of such large magnitude avalanches is also critical to avalanche forecasting for the Going-to-the-Sun Road (GTSR). In January 2009, a large magnitude avalanche cycle occurred in and around Glacier National Park, Montana. The study site is the Little Granite avalanche path located along the GTSR. The study is designed to quantify change in vegetative cover immediately after a large magnitude event and document ecological response over a multi-year period. GPS field mapping was completed to determine the redefined perimeter of the avalanche path. Vegetation was inventoried using modified U.S. Forest Service Forest Inventory and Analysis plots, cross sections were taken from over 100 dead trees throughout the avalanche path, and an avalanche chronology was developed. Initial results indicate that the perimeter of this path was expanded by 30%. The avalanche travelled approximately 1200 vertical meters and 3 linear kilometers. Stands of large conifers as old as 150 years were decimated by the avalanche, causing a shift in dominant vegetation types in many parts of the avalanche path. Woody debris is a major ground cover up to 3 m in depth on lower portions of the avalanche path and will likely affect tree regrowth. Monitoring and measuring the post-avalanche vegetation recovery of this particular avalanche path provides a unique dataset for determining the ecological role of avalanches in mountain landscapes.

  12. A Large Neutrino Detector Facility at the Spallation Neutron Source at Oak Ridge National Laboratory

    SciTech Connect

    Efremenko, Y.V.

    1999-02-14

    The ORLaND (Oak Ridge Large Neutrino Detector) collaboration proposes to construct a large neutrino detector in an underground experimental hall adjacent to the first target station of the Spallation Neutron Source (SNS) at the Oak Ridge National Laboratory. The main mission of a large (2000 ton) Scintillation-Cherenkov detector is to measure {bar {nu}}{sub {mu}} {r_arrow} {bar {nu}}{sub e} neutrino oscillation parameters more accurately than they can be determined in other experiments, or significantly extending the covered parameter space below (sin'20 {le} 10{sup {minus}4}). In addition to the neutrino oscillation measurements, ORLaND would be capable of making precise measurements of sin{sup 2} {theta}{sub W}, search for the magnetic moment of the muon neutrino, and investigate the anomaly in the KARMEN time spectrum, which has been attributed to a new neutral particle. With the same facility an extensive program of measurements of neutrino nucleus cross sections is also planned to support nuclear astrophysics.

  13. Phocomelia: A Worldwide Descriptive Epidemiologic Study in a Large Series of Cases From the International Clearinghouse for Birth Defects Surveillance and Research, and Overview of the Literature

    PubMed Central

    Bermejo-Sánchez, Eva; Cuevas, Lourdes; Amar, Emmanuelle; Bianca, Sebastiano; Bianchi, Fabrizio; Botto, Lorenzo D.; Canfield, Mark A.; Castilla, Eduardo E.; Clementi, Maurizio; Cocchi, Guido; Landau, Danielle; Leoncini, Emanuele; Li, Zhu; Lowry, R. Brian; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M.; Rissmann, Anke; Ritvanen, Annukka; Scarano, Gioacchino; Siffel, Csaba; Szabova, Elena; Martínez-Frías, María-Luisa

    2015-01-01

    Epidemiologic data on phocomelia are scarce. This study presents an epidemiologic analysis of the largest series of phocomelia cases known to date. Data were provided by 19 birth defect surveillance programs, all members of the International Clearinghouse for Birth Defects Surveillance and Research. Depending on the program, data corresponded to a period from 1968 through 2006. A total of 22,740,933 live births, stillbirths and, for some programs, elective terminations of pregnancy for fetal anomaly (ETOPFA) were monitored. After a detailed review of clinical data, only true phocomelia cases were included. Descriptive data are presented and additional analyses compared isolated cases with those with multiple congenital anomalies (MCA), excluding syndromes. We also briefly compared congenital anomalies associated with nonsyndromic phocomelia with those presented with amelia, another rare severe congenital limb defect. A total of 141 phocomelia cases registered gave an overall total prevalence of 0.62 per 100,000 births (95% confidence interval: 0.52–0.73). Three programs (Australia Victoria, South America ECLAMC, Italy North East) had significantly different prevalence estimates. Most cases (53.2%) had isolated phocomelia, while 9.9% had syndromes. Most nonsyndromic cases were monomelic (55.9%), with an excess of left (64.9%) and upper limb (64.9%) involvement. Most nonsyndromic cases (66.9%) were live births; most isolated cases (57.9%) weighed more than 2,499 g; most MCA (60.7%) weighed less than 2,500 g, and were more likely stillbirths (30.8%) or ETOPFA (15.4%) than isolated cases. The most common associated defects were musculoskeletal, cardiac, and intestinal. Epidemiological differences between phocomelia and amelia highlighted possible differences in their causes. PMID:22002800

  14. Factors associated with preterm birth in Cardiff, Wales. II. Indicated and spontaneous preterm birth.

    PubMed

    Meis, P J; Michielutte, R; Peters, T J; Wells, H B; Sands, R E; Coles, E C; Johns, K A

    1995-08-01

    Our purpose was to examine and contrast associations of risk factors with spontaneous preterm birth and indicated preterm birth. Separate multiple logistic regression analyses were performed of indicated and spontaneous preterm births in a large database of births in Cardiff, Wales. Spontaneous preterm births were associated with young maternal age, low maternal weight, low or high parity, previous abortion, smoking, and early pregnancy bleeding. Indicated preterm births were associated with older age, low weight, previous stillbirth, bacteriuria, and early pregnancy bleeding. Spontaneous and indicated preterm births have different overall profiles of association with pregnancy risk factors.

  15. Cleaning air pollutants for newborns in China: a national risk assessment on low birth weight caused by ambient fine particles during 2013-2015

    NASA Astrophysics Data System (ADS)

    Xue, T.; Zheng, Y.; Zhang, Q.

    2016-12-01

    With the ending of one-child policy since 2015, the number of newborns are expected to increase in China, where people are surviving from pool air quality. Air pollutants, especially PM2.5 have been confirmed as a top risk factor to cause birth defects including low birth weight (LBW). Motivated by the increasing demands of the newborns for cleaner air in China, we conducted the first national risk assessment study on LBW cases caused by PM2.5. We combined county-level PM2.5 concentrations in 2013-2015 and demographic data (including population counts, birth rates and etc.), province-level baseline incidences of LBW and multiple reference safety concentrations (0 μg/m3, WHO air quality guidelines and interim targets) to estimate the number of PM2.5-associated LBW in 31 provinces. The uncertainty was quantified using Monte Carlo simulations. Based on our results, in 2013 among 334,781 (95% CI: 313,024-344,568) cases of LBW, 122,684 (95% CI: 53,153-173,846, account for 37% of the total LBW) were attributed to PM2.5, when assuming the reference safety concentration as 0 μg/m3; while 53,917 (95% CI: 22,851-82,195, account for 16% of the total LBW) cases of LBW could have been protected, if the air quality met WHO WHO interim target-3, 35 μg/m3. Among 31 provinces, PM2.5-associated LBW were mostly distributed in Hebei (12.99%, 95% CI: 12.42%-17.30%), Henan (9.75%, 95% CI: 9.11%-13.50%) and Guangdong (8.60%, 95% CI: 6.98%-9.42%). During 2013 to 2015, air quality in China was reported to be improved by implement of emission-reduction policies. Similarly, we found significantly decreasing trends of infants weighted concentrations of PM2.5 in most heavily polluted areas, which protected 12,201 (95% CI: 4,749-20,503) and 24,637 (95% CI: 9,619-39,821) PM2.5-associated LBW in 2014 and 2015, account for 3.64% (95% CI: 1.46%-6.21%) and 7.36% (95% CI: 2.93%-12.07%) of that in 2013, respectively. The uncertainty of this study was mainly contributed by that in epidemiology

  16. Parity, hormones and breast cancer subtypes - results from a large nested case-control study in a national screening program.

    PubMed

    Ellingjord-Dale, Merete; Vos, Linda; Tretli, Steinar; Hofvind, Solveig; Dos-Santos-Silva, Isabel; Ursin, Giske

    2017-01-23

    Breast cancer comprises several molecular subtypes with different prognoses and possibly different etiology. Reproductive and hormonal factors are associated with breast cancer overall, and with luminal subtypes, but the associations with other subtypes are unclear. We used data from a national screening program to conduct a large nested case-control study. We conducted a nested case-control study on participants in the Norwegian Breast Cancer Screening Program in 2006 - 2014. There was information on estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) for 4748 cases of breast cancer. Breast cancer subtypes were defined as luminal A-like (ER+ PR+ HER2-), luminal B-like (ER+ PR- HER2- or ER+ PR+/PR-HER2+), HER2-positive (ER- PR- HER2+) and triple-negative (ER- PR- HER2-). Conditional logistic regression was used to estimate odds ratios (ORs) of breast cancer associated with age at first birth, number of pregnancies, oral contraceptive use, intrauterine devices and menopausal hormone therapy. Analyses were adjusted for age, body mass index, education, age at menarche, number of pregnancies and menopausal status. Number of pregnancies was inversely associated with relative risk of luminal-like breast cancers (p-trend ≤0.02), and although not statistically significant, with HER2-positive (OR = 0.60, 95% CI 0.31-1.19) and triple-negative cancer (OR = 0.70, 95% CI 0.41-1.21). Women who had ≥4 pregnancies were at >40% lower risk of luminal-like and HER2-positive cancers than women who had never been pregnant. However, there was a larger discrepancy between tumor subtypes with menopausal hormone use. Women who used estrogen and progesterone therapy (EPT) had almost threefold increased risk of luminal A-like cancer (OR = 2.92, 95% CI 2.36-3.62) compared to never-users, but were not at elevated risk of HER2-positive (OR = 0.88, 95% CI 0.33-2.30) or triple-negative (OR = 0.92, 95% CI 0.43 - 1

  17. Implementing a Large-Scale Reform in Secondary Schools: The Role of the Consultant within England's Secondary National Strategy

    ERIC Educational Resources Information Center

    Cameron, David Hagen

    2010-01-01

    This article examines the role of the consultants in secondary schools and local authorities within a large-scale consultancy-based reform, the Secondary National Strategy (SNS), in London, UK. The SNS follows a cascade model of implementation in which nationally created initiatives are introduced and supported within local authorities (LA) and…

  18. Large underground radioactive waste storage tanks successfully cleaned at Oak Ridge National Laboratory

    SciTech Connect

    Billingsley, K.; Burks, B.L.; Johnson, M.; Mims, C.; Powell, J.; Hoesen, D. van

    1998-05-01

    Waste retrieval operations were successfully completed in two large underground radioactive waste storage tanks in 1997. The US Department of Energy (DOE) and the Gunite Tanks Team worked cooperatively during two 10-week waste removal campaigns and removed approximately 58,300 gallons of waste from the tanks. About 100 gallons of a sludge and liquid heel remain in each of the 42,500 gallon tanks. These tanks are 25 ft. in diameter and 11 ft. deep, and are located in the North Tank Farm in the center of Oak Ridge National Laboratory. Less than 2% of the radioactive contaminants remain in the tanks, proving the effectiveness of the Radioactive Tank Cleaning System, and accomplishing the first field-scale cleaning of contaminated underground storage tanks with a robotic system in the DOE complex.

  19. Precision assembly and alignment of large optic modules for the National Ignition Facility

    SciTech Connect

    Hurst, P.; Grasz, E.

    1998-05-12

    The National Ignition Facility (NIF), currently under design and construction at Lawrence Livermore National Laboratory (LLNL), will be the world`s biggest laser. The optics for the multipass, 192-beam, high-power, neodymium-glass laser will be assembled and aligned in the NIF Optics Assembly Building (OAB), adjacent to the huge Laser and Target Area Building (LTAB), where they will be installed. To accommodate the aggressive schedule for initial installation and activation, rapid assembly and alignment of large aperture optics into line replaceable units (LRUs) will occur through the use of automated handling, semi-autonomous operations, and strict protocols. The OAB will have to maintain rigorous cleanliness levels, achieve both commonality and versatility to handle the various optic types, and allow for just-in-time processing and delivery of the optics into the LTAB without undoing their strict cleanliness and precise alignment. This paper describes the Project`s design philosophy of modularity and hardware commonality and presents the many design challenges encountered. It also describes how, by using a mixture of commercially available and newly designed equipment, we have developed unique systems for assembly and alignment, inspection and verification, and LRU loading and transfer.

  20. Preparing for Multiple Births

    MedlinePlus

    ... Video Games, and the Internet Preparing for Multiple Births KidsHealth > For Parents > Preparing for Multiple Births Print ... a combination of both. The Risks of Multiple Births The most common risk involved with multiple births ...

  1. Who Should Be Targeted for the Prevention of Birth Defects? A Latent Class Analysis Based on a Large, Population-Based, Cross-Sectional Study in Shaanxi Province, Western China

    PubMed Central

    Yang, Wenfang; Li, Danyang; Yang, Xue; Liu, Danli; Zhang, Min; Yan, Hong; Zeng, Lingxia

    2016-01-01

    Background The wide range and complex combinations of factors that cause birth defects impede the development of primary prevention strategies targeted at high-risk subpopulations. Methods Latent class analysis (LCA) was conducted to identify mutually exclusive profiles of factors associated with birth defects among women between 15 and 49 years of age using data from a large, population-based, cross-sectional study conducted in Shaanxi Province, western China, between August and October, 2013. The odds ratios (ORs) and 95% confidence intervals (CIs) of associated factors and the latent profiles of indicators of birth defects and congenital heart defects were computed using a logistic regression model. Results Five discrete subpopulations of participants were identified as follows: No folic acid supplementation in the periconceptional period (reference class, 21.37%); low maternal education level + unhealthy lifestyle (class 2, 39.75%); low maternal education level + unhealthy lifestyle + disease (class 3, 23.71%); unhealthy maternal lifestyle + advanced age (class 4, 4.71%); and multi-risk factor exposure (class 5, 10.45%). Compared with the reference subgroup, the other subgroups consistently had a significantly increased risk of birth defects (ORs and 95% CIs: class 2, 1.75 and 1.21–2.54; class 3, 3.13 and 2.17–4.52; class 4, 5.02 and 3.20–7.88; and class 5, 12.25 and 8.61–17.42, respectively). For congenital heart defects, the ORs and 95% CIs were all higher, and the magnitude of OR differences ranged from 1.59 to 16.15. Conclusions A comprehensive intervention strategy targeting maternal exposure to multiple risk factors is expected to show the strongest results in preventing birth defects. PMID:27183231

  2. Who Should Be Targeted for the Prevention of Birth Defects? A Latent Class Analysis Based on a Large, Population-Based, Cross-Sectional Study in Shaanxi Province, Western China.

    PubMed

    Zhu, Zhonghai; Cheng, Yue; Yang, Wenfang; Li, Danyang; Yang, Xue; Liu, Danli; Zhang, Min; Yan, Hong; Zeng, Lingxia

    2016-01-01

    The wide range and complex combinations of factors that cause birth defects impede the development of primary prevention strategies targeted at high-risk subpopulations. Latent class analysis (LCA) was conducted to identify mutually exclusive profiles of factors associated with birth defects among women between 15 and 49 years of age using data from a large, population-based, cross-sectional study conducted in Shaanxi Province, western China, between August and October, 2013. The odds ratios (ORs) and 95% confidence intervals (CIs) of associated factors and the latent profiles of indicators of birth defects and congenital heart defects were computed using a logistic regression model. Five discrete subpopulations of participants were identified as follows: No folic acid supplementation in the periconceptional period (reference class, 21.37%); low maternal education level + unhealthy lifestyle (class 2, 39.75%); low maternal education level + unhealthy lifestyle + disease (class 3, 23.71%); unhealthy maternal lifestyle + advanced age (class 4, 4.71%); and multi-risk factor exposure (class 5, 10.45%). Compared with the reference subgroup, the other subgroups consistently had a significantly increased risk of birth defects (ORs and 95% CIs: class 2, 1.75 and 1.21-2.54; class 3, 3.13 and 2.17-4.52; class 4, 5.02 and 3.20-7.88; and class 5, 12.25 and 8.61-17.42, respectively). For congenital heart defects, the ORs and 95% CIs were all higher, and the magnitude of OR differences ranged from 1.59 to 16.15. A comprehensive intervention strategy targeting maternal exposure to multiple risk factors is expected to show the strongest results in preventing birth defects.

  3. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study

    PubMed Central

    2011-01-01

    Objective To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Design Prospective cohort study. Setting England: all NHS trusts providing intrapartum care at home, all freestanding midwifery units, all alongside midwifery units (midwife led units on a hospital site with an obstetric unit), and a stratified random sample of obstetric units. Participants 64 538 eligible women with a singleton, term (≥37 weeks gestation), and “booked” pregnancy who gave birth between April 2008 and April 2010. Planned caesarean sections and caesarean sections before the onset of labour and unplanned home births were excluded. Main outcome measure A composite primary outcome of perinatal mortality and intrapartum related neonatal morbidities (stillbirth after start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare outcomes by planned place of birth at the start of care in labour (at home, freestanding midwifery units, alongside midwifery units, and obstetric units). Results There were 250 primary outcome events and an overall weighted incidence of 4.3 per 1000 births (95% CI 3.3 to 5.5). Overall, there were no significant differences in the adjusted odds of the primary outcome for any of the non-obstetric unit settings compared with obstetric units. For nulliparous women, the odds of the primary outcome were higher for planned home births (adjusted odds ratio 1.75, 95% CI 1.07 to 2.86) but not for either midwifery unit setting. For multiparous women, there were no significant differences in the incidence of the primary outcome by planned place of birth. Interventions during labour were substantially lower in all non-obstetric unit settings. Transfers from non-obstetric unit settings were more frequent for nulliparous women (36% to

  4. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study.

    PubMed

    Brocklehurst, Peter; Hardy, Pollyanna; Hollowell, Jennifer; Linsell, Louise; Macfarlane, Alison; McCourt, Christine; Marlow, Neil; Miller, Alison; Newburn, Mary; Petrou, Stavros; Puddicombe, David; Redshaw, Maggie; Rowe, Rachel; Sandall, Jane; Silverton, Louise; Stewart, Mary

    2011-11-23

    To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Prospective cohort study. England: all NHS trusts providing intrapartum care at home, all freestanding midwifery units, all alongside midwifery units (midwife led units on a hospital site with an obstetric unit), and a stratified random sample of obstetric units. 64,538 eligible women with a singleton, term (≥37 weeks gestation), and "booked" pregnancy who gave birth between April 2008 and April 2010. Planned caesarean sections and caesarean sections before the onset of labour and unplanned home births were excluded. A composite primary outcome of perinatal mortality and intrapartum related neonatal morbidities (stillbirth after start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare outcomes by planned place of birth at the start of care in labour (at home, freestanding midwifery units, alongside midwifery units, and obstetric units). There were 250 primary outcome events and an overall weighted incidence of 4.3 per 1000 births (95% CI 3.3 to 5.5). Overall, there were no significant differences in the adjusted odds of the primary outcome for any of the non-obstetric unit settings compared with obstetric units. For nulliparous women, the odds of the primary outcome were higher for planned home births (adjusted odds ratio 1.75, 95% CI 1.07 to 2.86) but not for either midwifery unit setting. For multiparous women, there were no significant differences in the incidence of the primary outcome by planned place of birth. Interventions during labour were substantially lower in all non-obstetric unit settings. Transfers from non-obstetric unit settings were more frequent for nulliparous women (36% to 45%) than for multiparous women (9% to 13%). The results support a policy

  5. Assessment of the technology required to develop photovoltaic power system for large scale national energy applications

    NASA Technical Reports Server (NTRS)

    Lutwack, R.

    1974-01-01

    A technical assessment of a program to develop photovoltaic power system technology for large-scale national energy applications was made by analyzing and judging the alternative candidate photovoltaic systems and development tasks. A program plan was constructed based on achieving the 10 year objective of a program to establish the practicability of large-scale terrestrial power installations using photovoltaic conversion arrays costing less than $0.50/peak W. Guidelines for the tasks of a 5 year program were derived from a set of 5 year objectives deduced from the 10 year objective. This report indicates the need for an early emphasis on the development of the single-crystal Si photovoltaic system for commercial utilization; a production goal of 5 x 10 to the 8th power peak W/year of $0.50 cells was projected for the year 1985. The developments of other photovoltaic conversion systems were assigned to longer range development roles. The status of the technology developments and the applicability of solar arrays in particular power installations, ranging from houses to central power plants, was scheduled to be verified in a series of demonstration projects. The budget recommended for the first 5 year phase of the program is $268.5M.

  6. Large-scale habitat associations of four desert anurans in Big Bend National Park, Texas

    USGS Publications Warehouse

    Dayton, Gage H.; Jung, R.E.; Droege, S.

    2004-01-01

    We used night driving to examine large scale habitat associations of four common desert anurans in Big Bend National Park, Texas. We examined association of soil types and vegetation communities with abundance of Couch's Spadefoots (Scaphiopus couchii), Red-spotted Toads (Bufo punctatus), Texas Toads (Bufo speciosus), and Western Green Toads (Bufo debilis). All four species were disproportionately associated with frequently inundated soils that are relatively high in clay content. Bufo punctatus was associated with rocky soil types more frequently than the other three species. Association between all four species and vegetation types was disproportionate in relation to availability. Bufo debilis and Bufo punctatus were associated with creosote and mixed scrub vegetation. Bufo speciosus and Scaphiopus couchii were associated with mesquite scrub vegetation. Bufo debilis, Scaphiopus couchii, and B. speciosus were more tightly associated with specific habitat types, whereas B. punctatus exhibited a broader distribution across the habitat categories. Examining associations between large-scale habitat categories and species abundance is an important first step in understanding factors that influence species distributions and presence-absence across the landscape.

  7. Cloning, Stem Cells, and the Current National Debate: Incorporating Ethics into a Large Introductory Biology Course

    PubMed Central

    2002-01-01

    Discussing the ethical issues involved in topics such as cloning and stem cell research in a large introductory biology course is often difficult. Teachers may be wary of presenting material biased by personal beliefs, and students often feel inhibited speaking about moral issues in a large group. Yet, to ignore what is happening “out there” beyond the textbooks and lab work is to do a disservice to students. This essay describes a semester-long project in which upperclass students presented some of the most complex and controversial ideas imaginable to introductory students by staging a mock debate and acting as members of the then newly appointed President's Council on Bioethics. Because the upperclass students were presenting the ideas of real people who play an important role in shaping national policy, no student's personal beliefs were put on the line, and many ideas were articulated. The introductory audience could accept or reject what they were hearing and learn information important for making up their own minds on these issues. This project is presented as an example of how current events can be used to put basic cell biology into context and of how exciting it can be when students teach students. PMID:12669102

  8. Cloning, stem cells, and the current national debate: incorporating ethics into a large introductory biology course.

    PubMed

    Fink, Rachel D

    2002-01-01

    Discussing the ethical issues involved in topics such as cloning and stem cell research in a large introductory biology course is often difficult. Teachers may be wary of presenting material biased by personal beliefs, and students often feel inhibited speaking about moral issues in a large group. Yet, to ignore what is happening "out there" beyond the textbooks and lab work is to do a disservice to students. This essay describes a semester-long project in which upperclass students presented some of the most complex and controversial ideas imaginable to introductory students by staging a mock debate and acting as members of the then newly appointed President's Council on Bioethics. Because the upperclass students were presenting the ideas of real people who play an important role in shaping national policy, no student's personal beliefs were put on the line, and many ideas were articulated. The introductory audience could accept or reject what they were hearing and learn information important for making up their own minds on these issues. This project is presented as an example of how current events can be used to put basic cell biology into context and of how exciting it can be when students teach students.

  9. Clara's birth.

    PubMed

    Thorens, S; Richer, D; Bel, A; Bel, B

    1999-01-01

    Advocacy for homebirth is based on the strong assumption that birthing is a physiological process and does not require medical interventions unless things turn "wrong." Let us assume that something might always go wrong, for instance during Clara's birth when the placenta was still retained after three hours. What needs to be done? The moment the midwife entered the house she was endowed with a responsibility for any problem caused by her failure to give proper guidance. With this weight on her shoulder, and according to her training and experience, there was no other way for her than to suggest an intervention regarding the placenta. The two midwives, B, and C., might not agree on risk estimations, the nature of the intervention, whether it should be performed at home or in a hospital. The estimation of abnormalities, evaluation of risks and the procedures with which to handle them are the main practical difference between classic obstetrics and non-interventionist midwifery--by analogy, between allopathy and naturopathy. The rest (positive thinking) is basically literature. A delivery will not remain normal just because we decide it "must" be physiological. Dr. Barua, a professor of obstetrics in Pondicherry, pointed out that normal deliveries are rare--fewer than 10 percent in South India. What we have instead is either pathological or "natural" deliveries in which regenerative processes take care of abnormal situations. Unless she has developed sensitive hands, a birth assistant or midwife must rely on monitoring procedures to evaluate deviations from the normal process. Even with the greatest care, these procedures are intrusive in that they disconnect the parturient from her own sensations. While successful unattended homebirth stories emphasise the extraordinary power and sensitivity of a birthing woman, the whole dream seems to collapse in abnormal or pathological cases. It would have collapsed for Sonia as well, had she not discarded negative suggestions

  10. Analysis of Selected Maternal Exposures and Non-Syndromic Atrioventricular Septal Defects in the National Birth Defects Prevention Study, 1997–2005

    PubMed Central

    Patel, Sonali S.; Burns, Trudy L.; Botto, Lorenzo D.; Riehle-Colarusso, Tiffany J.; Lin, Angela E.; Shaw, Gary M.; Romitti, Paul A.

    2015-01-01

    Although the descriptive epidemiology of atrioventricular septal defects (AVSDs), a group of serious congenital heart defects (CHDs), has been recently reported, non-genetic risk factors have not been consistently identified. Using data (1997–2005) from the National Birth Defects Prevention Study, an ongoing multisite population-based case–control study, the association between selected non-genetic factors and non-syndromic AVSDs was examined. Data on periconceptional exposures to such factors were collected by telephone interview from 187 mothers of AVSD case infants and 6,703 mothers of unaffected infants. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated from logistic regression models. Mothers who reported cigarette smoking during the periconceptional period were more likely to have infants with AVSDs compared with non-smokers, independent of maternal age, periconceptional alcohol consumption, infant gestational age, family history of CHDs, and study site (aOR 1.5, 95% CI 1.1–2.4). The association was strongest in mothers who smoked more than 25 cigarettes/day. In addition, mothers with periconceptional passive smoke exposure were more likely to have infants with AVSDs than unexposed mothers, independent of maternal age, active periconceptional smoking, infant gestational age, and family history of CHDs (aOR 1.4, 95% CI 1.0–2.0). No associations were observed between AVSDs and maternal history of a urinary tract infection or pelvic inflammatory disease, maternal use of a wide variety of medications, maternal occupational exposure, parental drug use, or maternal alcohol consumption. If the results of this preliminary study can be replicated, minimizing maternal active and passive smoke exposure may decrease the incidence of AVSDs. PMID:22903798

  11. Fish intake during pregnancy and the risk of child asthma and allergic rhinitis - longitudinal evidence from the Danish National Birth Cohort.

    PubMed

    Maslova, Ekaterina; Strøm, Marin; Oken, Emily; Campos, Hannia; Lange, Christoph; Gold, Diane; Olsen, Sjurdur F

    2013-10-01

    Maternal fish intake during pregnancy may influence the risk of child asthma and allergic rhinitis, yet evidence is conflicting on its association with these outcomes. We examined the associations of maternal fish intake during pregnancy with child asthma and allergic rhinitis. Mothers in the Danish National Birth Cohort (n 28 936) reported their fish intake at 12 and 30 weeks of gestation. Using multivariate logistic regression, we examined the associations of fish intake with child wheeze, asthma and rhinitis assessed at several time points: ever wheeze, recurrent wheeze (>3 episodes), ever asthma and allergic rhinitis, and current asthma, assessed at 18 months (n approximately 22,000) and 7 years (n approximately 17,000) using self-report and registry data on hospitalisations and prescribed medications. Compared with consistently high fish intake during pregnancy (fish as a sandwich or hot meal > or equal to 2-3 times/week), never eating fish was associated with a higher risk of child asthma diagnosis at 18 months (OR 1·30, 95% CI 1·05, 1·63, P=0·02), and ever asthma by hospitalisation (OR 1·46, 95% CI 0·99, 2·13, P=0·05) and medication prescription (OR 1·37, 95% CI 1·10, 1·71, P=0·01). A dose-response was present for asthma at 18 months only (P for trend=0·001). We found no associations with wheeze or recurrent wheeze at 18 months or with allergic rhinitis. The results suggest that high (v. no) maternal fish intake during pregnancy is protective against both early and ever asthma in 7-year-old children.

  12. Agreement between two methods for retrospective assessment of occupational exposure intensity to six chlorinated solvents: Data from The National Birth Defects Prevention Study.

    PubMed

    Johnson, Candice Y; Rocheleau, Carissa M; Hein, Misty J; Waters, Martha A; Stewart, Patricia A; Lawson, Christina C; Reefhuis, Jennita

    2017-05-01

    The wide variety of jobs encountered in population-based studies makes retrospective exposure assessment challenging in occupational epidemiology. In this analysis, two methods for estimating exposure intensity to chlorinated solvents are compared: rated (assigned by an expert rater) and modeled (assigned using statistical models). Estimates of rated and modeled intensities were compared for jobs held by mothers participating in the National Birth Defects Prevention Study with possible exposure to six chlorinated solvents: carbon tetrachloride, chloroform, methylene chloride, perchloroethylene, 1,1,1-trichloroethane, and trichloroethylene. For each possibly exposed job, an industrial hygienist assigned (1) an exposure intensity (rated intensity) and (2) determinants of exposure to be used in a statistical model of exposure intensity (modeled intensity). Of 12,326 reported jobs, between 31 (0.3%) and 746 (6%) jobs were rated as possibly exposed to each of the six solvents. Agreement between rated and modeled intensities was low overall (Spearman correlation coefficient range: -0.09 to 0.28; kappa range: -0.23 to 0.43). Although no air measurements were available to determine if rated or modeled estimates were more accurate, review of participants' job titles showed that modeled estimates were often unexpectedly high given the low-exposure tasks found in these jobs. Differences between the high-exposure jobs used to create the statistical models (obtained from air measurements in the published literature) and the low-exposure jobs in the actual study population is a potential explanation for the disagreement between the two methods. Investigators should be aware that statistical models estimating exposure intensity using existing data from one type of worker population might not be generalizable to all populations of workers.

  13. Understanding optimal nutrition among women of childbearing age in the United States and Puerto Rico: employing formative research to lay the foundation for national birth defects prevention campaigns.

    PubMed

    Lindsey, Lisa L Massi; Hamner, Heather C; Prue, Christine E; Flores, Alina L; Valencia, Diana; Correa-Sierra, Elia; Kopfman, Jenifer E

    2007-12-01

    Neural tube defects (NTDs) are serious birth defects of the brain and spine that affect approximately 3,000 pregnancies in the United States each year and affected 404 pregnancies in Puerto Rico from 1996 to 2002. Consuming the B vitamin folic acid can reduce the incidence of NTDs 50%-70%, and recent efforts to reduce NTD rates have focused on increasing the number of childbearing-aged women who take a vitamin containing folic acid every day. As the first stage of formative research in campaign planning, two exploratory, qualitative studies were conducted in order to (a) understand the complexity of vitamin use among women in the United States and Puerto Rico and (b) serve as a foundation on which to develop national communication and education interventions. Also, this information shed light on theories that might be used to guide campaign development. Results indicated that campaign messages designed to increase folic acid use through multivitamin supplementation in the United States must address women's barriers to vitamin use (e.g., cost, time), increase women's perceived need for multivitamins (e.g., identify immediate, tangible results from taking a daily multivitamin), and address the relationship between daily food choices and the need for supplementation. Future campaign messages in Puerto Rico must focus on many of these same issues, in addition to increasing women's knowledge about when folic acid should be taken in relation to pregnancy and addressing women's perceptions that vitamins cause weight gain (an undesirable outcome for most participants). The practical and theoretical implications of these results are discussed in terms of their contribution to the development of a creative new approach to increase multivitamin consumption among women of childbearing age in the United States and Puerto Rico.

  14. Polymorphism in xenobiotic and estrogen metabolizing genes, exposure to perfluorinated compounds and subsequent breast cancer risk: A nested case-control study in the Danish National Birth Cohort.

    PubMed

    Ghisari, Mandana; Long, Manhai; Røge, Durita Mohr; Olsen, Jørn; Bonefeld-Jørgensen, Eva C

    2017-04-01

    In the present case-cohort study based on prospective data from Danish women, we aimed to estimate the main effect of polymorphisms in genes known to be involved in the steroid hormone metabolic pathway and xenobiotic metabolism on the risk of developing breast cancer. We also studied a possible effect measure modification between genotypes and levels of serum perfluoroalkylated substances (PFASs) on the risk to breast cancer. We have previously reported a weak association between serum PFASs levels and the risk of breast cancer for this study population of Danish pregnant nulliparous women as well as in a smaller case-control study of Greenlandic women. The study population consisted of 178 breast cancer cases and 233 controls (tabnulliparous and frequency matched on age) nested within the Danish National Birth Cohort (DNBC), which was established in 1996-2002. Blood samples were drawn at the time of enrollment (6-14 week of gestation). Serum levels of 10 perfluorocarboxylated acids (PFCAs), 5 perfluorosulfonated acids (PFSAs) and 1 sulfonamide (perflurooctane-sulfonamide, PFOSA) were measured. Genotyping was conducted for CYP1A1 (Ile462Val; rs1048943), CYP1B1 (Leu432Val; rs1056836), COMT (Val158Met; rs4680), CYP17A1 (A1→ A2; rs743572); CYP19A1 (C→T; rs10046) by the TaqMan allelic discrimination method. In overall, no significant associations were found between the investigated polymorphisms and the risk of breast cancer in this study among Danish women. The previously found association between PFOSA and risk of breast cancer did vary between different genotypes, with significantly increased risk confined to homozygous carriers of the following alleles: COMT (Met), CYP17 (A1) and CYP19 (C).

  15. Fitting parametric random effects models in very large data sets with application to VHA national data.

    PubMed

    Gebregziabher, Mulugeta; Egede, Leonard; Gilbert, Gregory E; Hunt, Kelly; Nietert, Paul J; Mauldin, Patrick

    2012-10-24

    With the current focus on personalized medicine, patient/subject level inference is often of key interest in translational research. As a result, random effects models (REM) are becoming popular for patient level inference. However, for very large data sets that are characterized by large sample size, it can be difficult to fit REM using commonly available statistical software such as SAS since they require inordinate amounts of computer time and memory allocations beyond what are available preventing model convergence. For example, in a retrospective cohort study of over 800,000 Veterans with type 2 diabetes with longitudinal data over 5 years, fitting REM via generalized linear mixed modeling using currently available standard procedures in SAS (e.g. PROC GLIMMIX) was very difficult and same problems exist in Stata's gllamm or R's lme packages. Thus, this study proposes and assesses the performance of a meta regression approach and makes comparison with methods based on sampling of the full data. We use both simulated and real data from a national cohort of Veterans with type 2 diabetes (n=890,394) which was created by linking multiple patient and administrative files resulting in a cohort with longitudinal data collected over 5 years. The outcome of interest was mean annual HbA1c measured over a 5 years period. Using this outcome, we compared parameter estimates from the proposed random effects meta regression (REMR) with estimates based on simple random sampling and VISN (Veterans Integrated Service Networks) based stratified sampling of the full data. Our results indicate that REMR provides parameter estimates that are less likely to be biased with tighter confidence intervals when the VISN level estimates are homogenous. When the interest is to fit REM in repeated measures data with very large sample size, REMR can be used as a good alternative. It leads to reasonable inference for both Gaussian and non-Gaussian responses if parameter estimates are

  16. Perinatal and maternal outcomes in planned home and obstetric unit births in women at 'higher risk' of complications: secondary analysis of the Birthplace national prospective cohort study.

    PubMed

    Li, Y; Townend, J; Rowe, R; Brocklehurst, P; Knight, M; Linsell, L; Macfarlane, A; McCourt, C; Newburn, M; Marlow, N; Pasupathy, D; Redshaw, M; Sandall, J; Silverton, L; Hollowell, J

    2015-04-01

    To explore and compare perinatal and maternal outcomes in women at 'higher risk' of complications planning home versus obstetric unit (OU) birth. Prospective cohort study. OUs and planned home births in England. 8180 'higher risk' women in the Birthplace cohort. We used Poisson regression to calculate relative risks adjusted for maternal characteristics. Sensitivity analyses explored possible effects of differences in risk between groups and alternative outcome measures. Composite perinatal outcome measure encompassing 'intrapartum related mortality and morbidity' (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus or clavicle) and neonatal admission within 48 hours for more than 48 hours. Two composite maternal outcome measures capturing intrapartum interventions/adverse maternal outcomes and straightforward birth. The risk of 'intrapartum related mortality and morbidity' or neonatal admission for more than 48 hours was lower in planned home births than planned OU births [adjusted relative risks (RR) 0.50, 95% CI 0.31-0.81]. Adjustment for clinical risk factors did not materially affect this finding. The direction of effect was reversed for the more restricted outcome measure 'intrapartum related mortality and morbidity' (RR adjusted for parity 1.92, 95% CI 0.97-3.80). Maternal interventions were lower in planned home births. The babies of 'higher risk' women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity. Rates of intrapartum related morbidity and mortality did not differ statistically significantly between settings at the 5% level but a larger study would be required to rule out a clinically important difference between the groups. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John

  17. Large-scale demonstration and deployment project at Los Alamos National Laboratory

    SciTech Connect

    Brown, S.; McFee, J.; Broom, C.; Dugger, H.; Stallings, E.

    1999-04-01

    Established by the US Department of Energy (DOE) Environmental Management program through its Office of Science and Technology, the Deactivation and Decommissioning Focus Area is developing answers to the technological problems that hinder Environmental Management`s extensive cleanup efforts. The optimized application of technologies to ongoing nuclear facility decontamination and dismantlement is critical in meeting the challenge of decommissioning approximately 9,000 buildings and structures within the DOE complex. The significant technical and economic concerns in this area underscore a national imperative for the qualification and timely delivery of cost-reduction technologies and management approaches to meet federal and private needs. At Los Alamos National Laboratory (LANL), a Large-Scale Demonstration and Deployment Project (LSDDP) has been established to facilitate demonstration and deployment of technologies for the characterization, decontamination, and volume reduction of oversized metallic waste, mostly in the form of gloveboxes contaminated with transuranic radionuclides. The LANL LSDDP is being managed by an integrated contractor team (ICT) consisting of IT Corporation, ICF Incorporated, and Florida International University and includes representation from LANL`s Environmental Management Program Office. The ICT published in the Commerce Business Daily a solicitation for interest for innovative technologies capable of improving cost and performance of the baseline process. Each expression of interest response was evaluated and demonstration contract negotiations are under way for those technologies expected to be capable of meeting the project objectives. This paper discusses management organization and approach, the results of the technology search, the technology selection methodology, the results of the selection process, and future plans for the program.

  18. Middle-of-the-Night Hypnotic Use in a Large National Health Plan

    PubMed Central

    Roth, Thomas; Berglund, Patricia; Shahly, Victoria; Shillington, Alicia C.; Stephenson, Judith J.; Kessler, Ronald C.

    2013-01-01

    Study Objectives: Although difficulty maintaining sleep (DMS) is the most common nighttime insomnia symptom among US adults, many FDA-approved hypnotics have indications only for sleep onset, stipulating bedtime administration to offset residual sedation. Given the well-known self-medication tendencies of insomniacs, concern arises that maintenance insomniacs might be prone to self-administer their prescribed hypnotics middle-of-the-night (MOTN) after nocturnal awakenings, despite little efficacy-safety data supporting such use. However, no US data characterize the actual population prevalence or correlates of MOTN hypnotic use. Methods: Telephone interviews assessed patterns of prescription hypnotic use in a national sample of 1,927 commercial health plan members (ages 18-64) receiving prescription hypnotics within 12 months of study. The Brief Insomnia Questionnaire assessed insomnia symptoms. Results: 20.2% of respondents reported MOTN hypnotic use, including 9.0% who sometimes used twice-per-night (once at bedtime plus once MOTN) and another 11.2% who sometimes used MOTN, but never twice-per-night. The remaining 79.8% used exclusively at bedtime. Among exclusive MOTN users, only 14.0% used MOTN on the advice of their physician (52.6% of those seen by sleep medicine specialists and 42.6% by psychiatrists vs. 5.2% to 13.6% seen by other physicians). MOTN use predictors included DMS being the most bothersome sleep problem, long duration of hypnotic use, and low frequency of DMS. Conclusions: One-fifth of patients with prescription hypnotics used MOTN, only a minority on advice from their physicians. Since significant next-day cognitive and psychomotor impairment is documented with off-label MOTN hypnotic use, prescribing physicians should question patients about unsupervised MOTN dosing. Citation: Roth T; Berglund P; Shahly V; Shillington AC; Stephenson JJ; Kessler RC. Middle-of-the-night hypnotic use in a large national health plan. J Clin Sleep Med 2013

  19. Towards large scale stochastic rainfall models for flood risk assessment in trans-national basins

    NASA Astrophysics Data System (ADS)

    Serinaldi, F.; Kilsby, C. G.

    2012-04-01

    While extensive research has been devoted to rainfall-runoff modelling for risk assessment in small and medium size watersheds, less attention has been paid, so far, to large scale trans-national basins, where flood events have severe societal and economic impacts with magnitudes quantified in billions of Euros. As an example, in the April 2006 flood events along the Danube basin at least 10 people lost their lives and up to 30 000 people were displaced, with overall damages estimated at more than half a billion Euros. In this context, refined analytical methods are fundamental to improve the risk assessment and, then, the design of structural and non structural measures of protection, such as hydraulic works and insurance/reinsurance policies. Since flood events are mainly driven by exceptional rainfall events, suitable characterization and modelling of space-time properties of rainfall fields is a key issue to perform a reliable flood risk analysis based on alternative precipitation scenarios to be fed in a new generation of large scale rainfall-runoff models. Ultimately, this approach should be extended to a global flood risk model. However, as the need of rainfall models able to account for and simulate spatio-temporal properties of rainfall fields over large areas is rather new, the development of new rainfall simulation frameworks is a challenging task involving that faces with the problem of overcoming the drawbacks of the existing modelling schemes (devised for smaller spatial scales), but keeping the desirable properties. In this study, we critically summarize the most widely used approaches for rainfall simulation. Focusing on stochastic approaches, we stress the importance of introducing suitable climate forcings in these simulation schemes in order to account for the physical coherence of rainfall fields over wide areas. Based on preliminary considerations, we suggest a modelling framework relying on the Generalized Additive Models for Location, Scale

  20. Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England.

    PubMed

    Heslehurst, Nicola; Sattar, Naveed; Rajasingam, Daghni; Wilkinson, John; Summerbell, Carolyn D; Rankin, Judith

    2012-12-18

    Asians are at increased risk of morbidity at a lower body mass index (BMI) than European Whites, particularly relating to metabolic risk. UK maternal obesity guidelines use general population BMI criteria to define obesity, which do not represent the risk of morbidity among Asian populations. This study compares incidence of first trimester obesity using Asian-specific and general population BMI criteria. A retrospective epidemiological study of 502,474 births between 1995 and 2007, from 34 maternity units across England. Data analyses included a comparison of trends over time between ethnic groups using Asian-specific and general population BMI criteria. Logistic regression estimated odds ratios for first trimester obesity among ethnic groups following adjustment for population demographics. Black and South Asian women have a higher incidence of first trimester obesity compared with White women. This is most pronounced for Pakistani women following adjustment for population structure (OR 2.19, 95% C.I. 2.08, 2.31). There is a twofold increase in the proportion of South Asian women classified as obese when using the Asian-specific BMI criteria rather than general population BMI criteria. The incidence of obesity among Black women is increasing at the most rapid rate over time (p=0.01). The twofold increase in maternal obesity among South Asians when using Asian-specific BMI criteria highlights inequalities among pregnant women. A large proportion of South Asian women are potentially being wrongly assigned to low risk care using current UK guidelines to classify obesity and determine care requirements. Further research is required to identify if there is any improvement in pregnancy outcomes if Asian-specific BMI criteria are utilised in the clinical management of maternal obesity to ensure the best quality of care is provided for women irrespective of ethnicity.

  1. Birth rights.

    PubMed

    Hawkin, R

    1980-06-01

    Despite the marked decline in Singapore's crude birth rate from 42.7/1000 population to 22.1/1000 population from 1957 to 1970, the government adopted a policy of sterilization by coercion with the passage in 1970 of the Voluntary Sterilisation Act. Although sterilization is supposedly voluntary, various regulations make it extremely difficult for couples who wish to retain their fertility. Couples under 40 years of age with more than 2 children must agree to accept sterilization or their children are assigned to a low priority category in regard to primary school admittance. An individual who wishes to marry a non-Singaporean cannot obtain a marriage application unless one of the parties to the marriage agrees to have a sterilization after the birth of their 2nd child. Singapore, with a population density of almost 4000/square kilometer, needs to be concerned about population growth; however, since the population had for the most part already adopted a 2 child family norm, these coercive policies appear to be blatantly excessive.

  2. Finding Autonomy in Birth*

    PubMed Central

    Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret; Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M.; Harris, Lisa

    2009-01-01

    Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside of this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women’s agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be ‘for’ or ‘against’ women’s access to cesarean delivery in the absence of traditional medical indications - and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach, but rather, taking the value of women’s autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women’s full inclusion in a safe and positive birth process. PMID:19076937

  3. Decline in the negative association between low birth weight and cognitive ability

    PubMed Central

    Özcan, Berkay; Myrskylä, Mikko

    2017-01-01

    Low birth weight predicts compromised cognitive ability. We used data from the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS), and the 2000–2002 Millennium Cohort Study (MCS) to analyze how this association has changed over time. Birth weight was divided into two categories, <2,500 g (low) and 2,500–4,500 g (normal) and verbal cognitive ability was measured at the age of 10 or 11 y. A range of maternal and family characteristics collected at or soon after the time of birth were considered. Linear regression was used to analyze the association between birth weight and cognitive ability in a baseline model and in a model that adjusted for family characteristics. The standardized difference (SD) in cognitive scores between low-birth-weight and normal-birth-weight children was large in the NCDS [−0.37 SD, 95% confidence interval (CI): −0.46, −0.27] and in the BCS (−0.34, 95% CI: −0.43, −0.25) cohorts, and it was more than halved for children born in the MCS cohort (−0.14, 95% CI: −0.22, −0.06). The adjustment for family characteristics did not explain the cross-cohort differences. The results show that the association between low birth weight and decreased cognitive ability has declined between the 1950s and 1970s birth cohorts and the 2000--2002 birth cohort, despite a higher proportion of the low-birth-weight babies having a very low birth weight (<1,500 g) in the more recent birth cohort. Advancements in obstetric and neonatal care may have attenuated the negative consequences associated with being born small. PMID:27994141

  4. Examining the effects of birth order on personality

    PubMed Central

    Rohrer, Julia M.; Egloff, Boris; Schmukle, Stefan C.

    2015-01-01

    This study examined the long-standing question of whether a person’s position among siblings has a lasting impact on that person’s life course. Empirical research on the relation between birth order and intelligence has convincingly documented that performances on psychometric intelligence tests decline slightly from firstborns to later-borns. By contrast, the search for birth-order effects on personality has not yet resulted in conclusive findings. We used data from three large national panels from the United States (n = 5,240), Great Britain (n = 4,489), and Germany (n = 10,457) to resolve this open research question. This database allowed us to identify even very small effects of birth order on personality with sufficiently high statistical power and to investigate whether effects emerge across different samples. We furthermore used two different analytical strategies by comparing siblings with different birth-order positions (i) within the same family (within-family design) and (ii) between different families (between-family design). In our analyses, we confirmed the expected birth-order effect on intelligence. We also observed a significant decline of a 10th of a SD in self-reported intellect with increasing birth-order position, and this effect persisted after controlling for objectively measured intelligence. Most important, however, we consistently found no birth-order effects on extraversion, emotional stability, agreeableness, conscientiousness, or imagination. On the basis of the high statistical power and the consistent results across samples and analytical designs, we must conclude that birth order does not have a lasting effect on broad personality traits outside of the intellectual domain. PMID:26483461

  5. Examining the effects of birth order on personality.

    PubMed

    Rohrer, Julia M; Egloff, Boris; Schmukle, Stefan C

    2015-11-17

    This study examined the long-standing question of whether a person's position among siblings has a lasting impact on that person's life course. Empirical research on the relation between birth order and intelligence has convincingly documented that performances on psychometric intelligence tests decline slightly from firstborns to later-borns. By contrast, the search for birth-order effects on personality has not yet resulted in conclusive findings. We used data from three large national panels from the United States (n = 5,240), Great Britain (n = 4,489), and Germany (n = 10,457) to resolve this open research question. This database allowed us to identify even very small effects of birth order on personality with sufficiently high statistical power and to investigate whether effects emerge across different samples. We furthermore used two different analytical strategies by comparing siblings with different birth-order positions (i) within the same family (within-family design) and (ii) between different families (between-family design). In our analyses, we confirmed the expected birth-order effect on intelligence. We also observed a significant decline of a 10th of a SD in self-reported intellect with increasing birth-order position, and this effect persisted after controlling for objectively measured intelligence. Most important, however, we consistently found no birth-order effects on extraversion, emotional stability, agreeableness, conscientiousness, or imagination. On the basis of the high statistical power and the consistent results across samples and analytical designs, we must conclude that birth order does not have a lasting effect on broad personality traits outside of the intellectual domain.

  6. Differential cataract blindness by sex in India: Evidence from two large national surveys.

    PubMed

    Pant, Hira B; Bandyopadhyay, Souvik; John, Neena; Chandran, Anil; Gudlavalleti, Murthy Venkata S

    2017-02-01

    Women suffer disproportionately more from cataract blindness compared to males in low- and middle-income countries. Two large population-based surveys have been undertaken in India at an interval of 7 years and data from these surveys provided an opportunity to assess the trends in gender differentials in cataract blindness. Data were extracted from the surveys to discern sex differences in cataract blindness. Multivariate analysis was performed to adjust for confounders and their impact on gender differences in cataract blindness. Blindness was defined as presenting vision <20/400 in the better eye, and a cataract blind person was defined as a blind person where the principal cause of loss of vision was cataract. Prevalence of cataract blindness was higher in females compared to males in both surveys. The odds of cataract blindness for females did not change over time as observed in the surveys (1999-2001 and 2006-2007). Adjusted odds ratio from logistic regression analysis revealed that females continued to be at a higher risk of cataract blindness. Sex differences continued in India in relation to cataract blindness despite the gains made by the national program.

  7. Profiling National Board Certified Teachers in a Large Urban District in West Tennessee

    ERIC Educational Resources Information Center

    Simmons Nevels, LaShanda D.

    2013-01-01

    The purpose of this mixed-methods study was to investigate the factors associated with the successful achievement of National Board Certification. This study also aimed to identify common characteristics among teachers who have achieved National Board Certification, as perceived by National Board Certified Teachers (NBCTs). Through structured…

  8. Profiling National Board Certified Teachers in a Large Urban District in West Tennessee

    ERIC Educational Resources Information Center

    Simmons Nevels, LaShanda D.

    2013-01-01

    The purpose of this mixed-methods study was to investigate the factors associated with the successful achievement of National Board Certification. This study also aimed to identify common characteristics among teachers who have achieved National Board Certification, as perceived by National Board Certified Teachers (NBCTs). Through structured…

  9. Fitting parametric random effects models in very large data sets with application to VHA national data

    PubMed Central

    2012-01-01

    Background With the current focus on personalized medicine, patient/subject level inference is often of key interest in translational research. As a result, random effects models (REM) are becoming popular for patient level inference. However, for very large data sets that are characterized by large sample size, it can be difficult to fit REM using commonly available statistical software such as SAS since they require inordinate amounts of computer time and memory allocations beyond what are available preventing model convergence. For example, in a retrospective cohort study of over 800,000 Veterans with type 2 diabetes with longitudinal data over 5 years, fitting REM via generalized linear mixed modeling using currently available standard procedures in SAS (e.g. PROC GLIMMIX) was very difficult and same problems exist in Stata’s gllamm or R’s lme packages. Thus, this study proposes and assesses the performance of a meta regression approach and makes comparison with methods based on sampling of the full data. Data We use both simulated and real data from a national cohort of Veterans with type 2 diabetes (n=890,394) which was created by linking multiple patient and administrative files resulting in a cohort with longitudinal data collected over 5 years. Methods and results The outcome of interest was mean annual HbA1c measured over a 5 years period. Using this outcome, we compared parameter estimates from the proposed random effects meta regression (REMR) with estimates based on simple random sampling and VISN (Veterans Integrated Service Networks) based stratified sampling of the full data. Our results indicate that REMR provides parameter estimates that are less likely to be biased with tighter confidence intervals when the VISN level estimates are homogenous. Conclusion When the interest is to fit REM in repeated measures data with very large sample size, REMR can be used as a good alternative. It leads to reasonable inference for both Gaussian and non

  10. Standard Errors for National Trends in International Large-Scale Assessments in the Case of Cross-National Differential Item Functioning

    ERIC Educational Resources Information Center

    Sachse, Karoline A.; Haag, Nicole

    2017-01-01

    Standard errors computed according to the operational practices of international large-scale assessment studies such as the Programme for International Student Assessment's (PISA) or the Trends in International Mathematics and Science Study (TIMSS) may be biased when cross-national differential item functioning (DIF) and item parameter drift are…

  11. Spinal pain and co-occurrence with stress and general well-being among young adolescents: a study within the Danish National Birth Cohort.

    PubMed

    Stallknecht, Sandra Elkjær; Strandberg-Larsen, Katrine; Hestbæk, Lise; Andersen, Anne-Marie Nybo

    2017-06-01

    This study aims to describe the patterns in low back, mid back, and neck pain complaints in young adolescents from the Danish National Birth Cohort (DNBC) and to investigate the co-occurrence of spinal pain and stress and general well-being, respectively. Cross-sectional data from the 11-year follow-up of DNBC were used. As part of a web-based survey, a total of 45,371 young adolescents between 10 and 14 years old completed the Young Spine Questionnaire, the Stress in Children Questionnaire, and a one-item question on general well-being. Associations between spinal pain and, respectively, stress and general well-being were estimated by means of multiple logistic regression models. Almost one fifth of boys and one quarter of girls reported spinal pain. Compared with adolescents who reported no stress, adolescents reporting medium and high values of stress had odds ratios (OR) of 2.19 (95% CI 2.08-2.30) and 4.73 (95% CI 4.28-5.23), respectively, of reporting spinal pain (adjusted for age, gender, and maternal education). Adolescents who reported poor general well-being had an OR of 2.50 (95% CI 2.31-2.72) for reporting spinal pain compared to adolescents with good general well-being. Spinal pain is a common complaint among young adolescents and co-occurs with stress and poor general well-being. The mutual dependency between the factors remained to be explained. What is Known: • The prevalence of spinal pain increases rapidly during childhood and adolescence, but different measurement instruments result in great variation in the estimates of spinal pain in children and adolescents. • Some studies have shown that different psychosocial measures are associated with spinal pain in children and adolescents. What is New: • Spinal pain, as measured by the newly developed and validated Young Spine Questionnaire, is a common complaint in young adolescents aged 10-14 years. • Spinal pain in young adolescents co-occurs with stress and poor general well-being.

  12. Plasma Concentrations of Ferritin in Early Pregnancy Are Associated with Risk of Gestational Diabetes Mellitus in Women in the Danish National Birth Cohort.

    PubMed

    Bowers, Katherine A; Olsen, Sjurdur F; Bao, Wei; Halldorsson, Thorhallur I; Strøm, Marin; Zhang, Cuilin

    2016-09-01

    Evidence from experimental studies has demonstrated that higher than normal iron concentrations can lead to pancreatic β cell dysfunction and impaired glucose metabolism. Studies on body iron stores in early pregnancy and subsequent gestational diabetes mellitus (GDM) risk are sparse. Our objective was to determine whether biomarkers of body iron stores measured in early pregnancy are associated with GDM risk. A case-control study of 350 GDM cases and 349 non-GDM controls was conducted in participants from the Danish National Birth Cohort. Blood was collected at a mean ± SD gestational age of 9.4 ± 3.2 wk. Plasma biomarkers of iron stores, including ferritin and soluble transferrin receptor (sTfR), were measured. Logistic regression was used to estimate the OR of GDM associated with quintiles of plasma biomarkers of body iron stores, controlling for maternal age, family history of diabetes, exercise in pregnancy, parity, and prepregnancy body mass index (BMI). Cases were older (mean ± SD age: 32.2 ± 4.3 compared with 29.9 ± 4.2 y) and had a higher BMI (in kg/m(2); mean ± SD: 28.7 ± 6.0 compared with 24.1 ± 4.6) than controls. Plasma concentrations of both ferritin and sTfR in early pregnancy were significantly higher in GDM cases than in controls [means ± SDs: 80.6 ± 56.0 compared with 71.8 ± 50.1 μg/L (P = 0.03) and 1.5 ± 0.7 compared with 1.4 ± 0.6 mg/L (P = 0.002) for ferritin and sTfR, respectively]. Ferritin was positively and significantly associated with GDM risk even after adjustment for major risk factors of GDM, including prepregnancy BMI. ORs across increasing quintiles of ferritin were 1.00 (reference), 1.25 (95% CI: 0.70, 2.22), 1.89 (95% CI: 1.06, 3.37), 0.82 (95% CI: 0.46, 1.48), and 2.34 (95% CI: 1.30, 4.21) (P-linear trend = 0.02). These findings suggest that plasma ferritin measured in early pregnancy is significantly and positively associated with GDM risk. © 2016 American Society for Nutrition.

  13. Vital signs: Repeat births among teens - United States, 2007-2010.

    PubMed

    2013-04-05

    Teen childbearing has potential negative health, economic, and social consequences for mother and child. Repeat teen childbearing further constrains the mother's education and employment possibilities. Rates of preterm and low birth weight are higher in teens with a repeat birth, compared with first births. To assess patterns of repeat childbearing and postpartum contraceptive use among teens, CDC analyzed natality data from the National Vital Statistics System (NVSS) and the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2007-2010. Based on 2010 NVSS data from all 50 states and the District of Columbia, of more than 367,000 births to teens aged 15-19 years, 18.3% were repeat births. The percentage of teen births that represented repeat births decreased by 6.2% between 2007 and 2010. Disparities in repeat teen births exist by race/ethnicity, with the highest percentages found among American Indian/Alaska Natives (21.6%), Hispanics (20.9%), and non-Hispanic blacks (20.4%) and lowest among non-Hispanic whites (14.8%). Wide geographic disparities in the percentage of teen births that were repeat births also exist, ranging from 22% in Texas to 10% in New Hampshire. PRAMS data from 16 reporting areas (15 states and New York City) indicate that 91.2% of teen mothers used a contraceptive method 2-6 months after giving birth, but only 22.4% of teen mothers used the most effective methods. Teens with a previous live birth were significantly more likely to use the most effective methods postpartum compared with those with no prior live birth (29.6% versus 20.9%, respectively). Non-Hispanic white and Hispanic teens were significantly more likely to use the most effective methods than non-Hispanic black teens (24.6% and 27.9% versus 14.3%, respectively). The percentage of teens reporting postpartum use of the most effective methods varied greatly geographically across the PRAMS reporting areas, ranging from 50.3% in Colorado to 7.2% in New York State. Although the

  14. Data linkage between the National Birth Defects Prevention Study and the Occupational Information Network (O*NET) to assess workplace physical activity, sedentary behaviors, and emotional stressors during pregnancy.

    PubMed

    Lee, Laura J; Symanski, Elaine; Lupo, Philip J; Tinker, Sarah C; Razzaghi, Hilda; Pompeii, Lisa A; Hoyt, Adrienne T; Canfield, Mark A; Chan, Wenyaw

    2016-02-01

    Knowledge of the prevalence of work-related physical activities, sedentary behaviors, and emotional stressors among pregnant women is limited, and the extent to which these exposures vary by maternal characteristics remains unclear. Data on mothers of 6,817 infants without major birth defects, with estimated delivery during 1997 through 2009 who worked during pregnancy were obtained from the National Birth Defects Prevention Study. Information on multiple domains of occupational exposures was gathered by linking mother's primary job to the Occupational Information Network Version 9.0. The most frequent estimated physical activity associated with jobs during pregnancy was standing. Of 6,337 mothers, 31.0% reported jobs associated with standing for ≥75% of their time. There was significant variability in estimated occupational exposures by maternal age, race/ethnicity, and educational level. Our findings augment existing literature on occupational physical activities, sedentary behaviors, emotional stressors, and occupational health disparities during pregnancy. © 2015 Wiley Periodicals, Inc.

  15. The effect of maternal age and planned place of birth on intrapartum outcomes in healthy women with straightforward pregnancies: secondary analysis of the Birthplace national prospective cohort study

    PubMed Central

    Li, Yangmei; Townend, John; Rowe, Rachel; Knight, Marian; Brocklehurst, Peter; Hollowell, Jennifer

    2014-01-01

    Objectives To describe the relationship between maternal age and intrapartum outcomes in ‘low-risk’ women; and to evaluate whether the relationship between maternal age and intrapartum interventions and adverse outcomes differs by planned place of birth. Design Prospective cohort study. Setting Obstetric units (OUs), midwifery units and planned home births in England. Participants 63 371 women aged over 16 without known medical or obstetric risk factors, with singleton pregnancies, planning vaginal birth. Methods Log Poisson regression was used to evaluate the association between maternal age, modelled as a continuous and categorical variable, and risk of intrapartum interventions and adverse maternal and perinatal outcomes. Main outcome measures Intrapartum caesarean section, instrumental delivery, syntocinon augmentation and a composite measure of maternal interventions/adverse outcomes requiring obstetric care encompassing augmentation, instrumental delivery, intrapartum caesarean section, general anaesthesia, blood transfusion, third-degree/fourth-degree tear, maternal admission; adverse perinatal outcome (encompassing neonatal unit admission or perinatal death). Results Interventions and adverse maternal outcomes requiring obstetric care generally increased with age, particularly in nulliparous women. For nulliparous women aged 16–40, the risk of experiencing an intervention or adverse outcome requiring obstetric care increased more steeply with age in planned non-OU births than in planned OU births (adjusted RR 1.21 per 5-year increase in age, 95% CI 1.18 to 1.25 vs adjusted RR 1.12, 95% CI 1.10 to 1.15) but absolute risks were lower in planned non-OU births at all ages. The risk of neonatal unit admission or perinatal death was significantly raised in nulliparous women aged 40+ relative to women aged 25–29 (adjusted RR 2.29, 95% CI 1.28 to 4.09). Conclusions At all ages, ‘low-risk’ women who plan birth in a non-OU setting tend to experience

  16. HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.

    PubMed

    Chambers, Stephen T; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Fernández-Hidalgo, Nuria; Almirante, Benito; Bouza, Emilio; Forno, Davide; del Rio, Ana; Hannan, Margaret M; Harkness, John; Kanafani, Zeina A; Lalani, Tahaniyat; Lang, Selwyn; Raymond, Nigel; Read, Kerry; Vinogradova, Tatiana; Woods, Christopher W; Wray, Dannah; Corey, G Ralph; Chu, Vivian H

    2013-01-01

    The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34-9.65; p<0.01) and younger age (OR 0.62; CI 0.49-0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences.

  17. How Does Sex Influence Multimorbidity? Secondary Analysis of a Large Nationally Representative Dataset.

    PubMed

    Agur, Karolina; McLean, Gary; Hunt, Kate; Guthrie, Bruce; Mercer, Stewart W

    2016-03-31

    Multimorbidity increases with age and is generally more common in women, but little is known about sex effects on the "typology" of multimorbidity. We have characterized multimorbidity in a large nationally representative primary care dataset in terms of sex in ten year age groups from 25 years to 75 years and over, in a cross-sectional analysis of multimorbidity type (physical-only, mental-only, mixed physical and mental; and commonest conditions) for 1,272,685 adults in Scotland. Our results show that women had more multimorbidity overall in every age group, which was most pronounced in the 45-54 years age group (women 26.5% vs. men 19.6%; difference 6.9 (95% CI 6.5 to 7.2). From the age of 45, physical-only multimorbidity was consistently more common in men, and physical-mental multimorbidity more common in women. The biggest difference in physical-mental multimorbidity was found in the 75 years and over group (women 30.9% vs. men 21.2%; difference 9.7 (95% CI 9.1 to 10.2). The commonest condition in women was depression until the age of 55 years, thereafter hypertension. In men, drugs misuse had the highest prevalence in those aged 25-34 years, depression for those aged 35-44 years, and hypertension for 45 years and over. Depression, pain, irritable bowel syndrome and thyroid disorders were more common in women than men across all age groups. We conclude that the higher overall prevalence of multimorbidity in women is mainly due to more mixed physical and mental health problems. The marked difference between the sexes over 75 years especially warrants further investigation.

  18. Religion and the Unmaking of Prejudice toward Muslims: Evidence from a Large National Sample.

    PubMed

    Shaver, John H; Troughton, Geoffrey; Sibley, Chris G; Bulbulia, Joseph A

    2016-01-01

    In the West, anti-Muslim sentiments are widespread. It has been theorized that inter-religious tensions fuel anti-Muslim prejudice, yet previous attempts to isolate sectarian motives have been inconclusive. Factors contributing to ambiguous results are: (1) failures to assess and adjust for multi-level denomination effects; (2) inattention to demographic covariates; (3) inadequate methods for comparing anti-Muslim prejudice relative to other minority group prejudices; and (4) ad hoc theories for the mechanisms that underpin prejudice and tolerance. Here we investigate anti-Muslim prejudice using a large national sample of non-Muslim New Zealanders (N = 13,955) who responded to the 2013 New Zealand Attitudes and Values Study. We address previous shortcomings by: (1) building Bayesian multivariate, multi-level regression models with denominations modeled as random effects; (2) including high-resolution demographic information that adjusts for factors known to influence prejudice; (3) simultaneously evaluating the relative strength of anti-Muslim prejudice by comparing it to anti-Arab prejudice and anti-immigrant prejudice within the same statistical model; and (4) testing predictions derived from the Evolutionary Lag Theory of religious prejudice and tolerance. This theory predicts that in countries such as New Zealand, with historically low levels of conflict, religion will tend to increase tolerance generally, and extend to minority religious groups. Results show that anti-Muslim and anti-Arab sentiments are confounded, widespread, and substantially higher than anti-immigrant sentiments. In support of the theory, the intensity of religious commitments was associated with a general increase in tolerance toward minority groups, including a poorly tolerated religious minority group: Muslims. Results clarify religion's power to enhance tolerance in peaceful societies that are nevertheless afflicted by prejudice.

  19. Religion and the Unmaking of Prejudice toward Muslims: Evidence from a Large National Sample

    PubMed Central

    Shaver, John H.; Troughton, Geoffrey; Sibley, Chris G.; Bulbulia, Joseph A.

    2016-01-01

    In the West, anti-Muslim sentiments are widespread. It has been theorized that inter-religious tensions fuel anti-Muslim prejudice, yet previous attempts to isolate sectarian motives have been inconclusive. Factors contributing to ambiguous results are: (1) failures to assess and adjust for multi-level denomination effects; (2) inattention to demographic covariates; (3) inadequate methods for comparing anti-Muslim prejudice relative to other minority group prejudices; and (4) ad hoc theories for the mechanisms that underpin prejudice and tolerance. Here we investigate anti-Muslim prejudice using a large national sample of non-Muslim New Zealanders (N = 13,955) who responded to the 2013 New Zealand Attitudes and Values Study. We address previous shortcomings by: (1) building Bayesian multivariate, multi-level regression models with denominations modeled as random effects; (2) including high-resolution demographic information that adjusts for factors known to influence prejudice; (3) simultaneously evaluating the relative strength of anti-Muslim prejudice by comparing it to anti-Arab prejudice and anti-immigrant prejudice within the same statistical model; and (4) testing predictions derived from the Evolutionary Lag Theory of religious prejudice and tolerance. This theory predicts that in countries such as New Zealand, with historically low levels of conflict, religion will tend to increase tolerance generally, and extend to minority religious groups. Results show that anti-Muslim and anti-Arab sentiments are confounded, widespread, and substantially higher than anti-immigrant sentiments. In support of the theory, the intensity of religious commitments was associated with a general increase in tolerance toward minority groups, including a poorly tolerated religious minority group: Muslims. Results clarify religion’s power to enhance tolerance in peaceful societies that are nevertheless afflicted by prejudice. PMID:26959976

  20. Do Infant Birth Outcomes Vary Among Mothers With and Without Health Insurance Coverage in Sub-Saharan Africa? Findings from the National Health Insurance and Cash and Carry Eras in Ghana, West Africa

    PubMed Central

    Ibrahim, Abdallah; O’Keefe, Anne Marie

    2014-01-01

    Background: Beginning in the late 1960’s, and accelerating after 1985, a system known as “Cash and Carry” required the people of Ghana to pay for health services out-of-pocket before receiving them. In 2003, Ghana enacted a National Health Insurance Scheme (NHIS) (fully implemented by 2005) that allowed pregnant women to access antenatal care and hospital delivery services for low annual premiums tied to income. The objective of this study was to compare trends in low birth weight (LBW) among infants born under the NHIS with infants born during the Cash and Carry system when patients paid out-of-pocket for maternal and child health services. Methods: Sampled birth records abstracted from birth folders at the Tamale Teaching Hospital (TTH) were examined. Chi-squared tests were performed to determine differences in the prevalence of LBW. A p-value of ≤ 0.05 was considered statistically significant. Analyses were conducted for selected variables in each year from 2000 to 2003 (Cash and Carry) and 2008 to 2011(NHIS). Results: Higher birth weights were not observed for deliveries under NHIS compared to those under Cash and Carry. More than one-third of infants in both eras were born to first-time mothers, and they had a significantly higher prevalence of LBW compared to infants born to multiparous mothers. Conclusion and Global Health Implications: Understanding the factors that affect the prevalence of LBW is crucial to public health policy makers in Ghana. LBW is a powerful predictor of infant survival, and therefore, an important factor in determining the country’s progress toward meeting the United Nations Millennium Development Goal of reducing under-five child mortality rates (MDG4) by the end of 2015. PMID:27621973

  1. Teen Birth Rate. Facts at a Glance

    ERIC Educational Resources Information Center

    Franzetta, Kerry; Ikramullah, Erum; Manlove, Jennifer; Moore, Kristin Anderson; Terry-Humen, Elizabeth

    2005-01-01

    Preliminary data for 2003 from the National Center for Health Statistics show the teen birth rate continues to decline, reaching historic lows for teens in each age group. The 2003 rate of 41.7 births per 1,000 females 15-19 was 33 per cent lower than the 1991 peak rate of 61.8. The 2003 birth rate for teens aged 15-17 (22.4) was 42 per cent lower…

  2. Amelia: A Multi-Center Descriptive Epidemiologic Study in a Large Dataset from the International Clearinghouse for Birth Defects Surveillance and Research, and Overview of the Literature

    PubMed Central

    BERMEJO-SÁNCHEZ, EVA; CUEVAS, LOURDES; AMAR, EMMANUELLE; BAKKER, MARIAN K.; BIANCA, SEBASTIANO; BIANCHI, FABRIZIO; CANFIELD, MARK A.; CASTILLA, EDUARDO E.; CLEMENTI, MAURIZIO; COCCHI, GUIDO; FELDKAMP, MARCIA L.; LANDAU, DANIELLE; LEONCINI, EMANUELE; LI, ZHU; LOWRY, R. BRIAN; MASTROIACOVO, PIERPAOLO; MUTCHINICK, OSVALDO M.; RISSMANN, ANKE; RITVANEN, ANNUKKA; SCARANO, GIOACCHINO; SIFFEL, CSABA; SZABOVA, ELENA; MARTÍNEZ-FRÍAS, MARÍA-LUISA

    2015-01-01

    This study describes the epidemiology of congenital amelia (absence of limb/s), using the largest series of cases known to date. Data were gathered by 20 surveillance programs on congenital anomalies, all International Clearinghouse for Birth Defects Surveillance and Research members, from all continents but Africa, from 1968 to 2006, depending on the program. Reported clinical information on cases was thoroughly reviewed to identify those strictly meeting the definition of amelia. Those with amniotic bands or limb-body wall complex were excluded. The primary epidemiological analyses focused on isolated cases and those with multiple congenital anomalies (MCA). A total of 326 amelia cases were ascertained among 23,110,591 live births, stillbirths and (for some programs) elective terminations of pregnancy for fetal anomalies. The overall total prevalence was 1.41 per 100,000 (95% confidence interval: 1.26–1.57). Only China Beijing and Mexico RYVEMCE had total prevalences, which were significantly higher than this overall total prevalence. Some under-registration could influence the total prevalence in some programs. Liveborn cases represented 54.6% of total. Among monomelic cases (representing 65.2% of nonsyndromic amelia cases), both sides were equally involved, and the upper limbs (53.9%) were slightly more frequently affected. One of the most interesting findings was a higher prevalence of amelia among offspring of mothers younger than 20 years. Sixty-nine percent of the cases had MCA or syndromes. The most frequent defects associated with amelia were other types of musculoskeletal defects, intestinal, some renal and genital defects, oral clefts, defects of cardiac septa, and anencephaly. PMID:22002956

  3. Teenage abortion, birth and pregnancy statistics by state, 1988.

    PubMed

    Henshaw, S K

    1993-01-01

    The report provided updated estimates of teenage abortion by state in the United States for 1988 as well as pregnancy and birth rates. Teenagers were grouped at the age of pregnancy outcome. The findings revealed 400,000 women pregnant under the age of 18 years and 600,000 pregnant women aged 18-19 years. About 66% of the 1,034,000 teenagers were White. The national rate of teenage pregnancy in 1988 was 111/1000 women aged 15-19 years (53 births, 43 abortions, and 15 miscarriages), 113/1000 for all races, and 103/1000 for Whites, and 96/1000 without miscarriages. The highest rates were in California (154/1000) and the lowest in North Dakota (57/1000). Nevada (142/1000), Hawaii (134/1000), Florida (133/1000), and Maryland (129/1000) also had high rates. Low rates of 69/1000 were found in Utah, Minnesota, South Dakota, and Iowa. The rates among 15-17 year olds were 74/1000, and rates among those 18-19 years were 164/1000. About 50% of pregnancies had a birth outcome, and birth outcomes were higher among those aged 18-19 years. Abortion and birth rates did not follow the same pattern as pregnancy rates. For example, in Mississippi there was a 106/1000 pregnancy rate, a 73/1000 birth rate, and a 16/1000 abortion rate. Other states with a high birth rate and a low abortion rate were New Mexico, Arkansas, Arizona, Georgia, and Texas. Low birth rates were found in Minnesota, North Dakota, Massachusetts, Iowa, New Hampshire, and Vermont. The highest abortion rates were in California (76/1000), Hawaii (68/1000), New York (61/1000), Maryland (61/1000), and New Jersey (60/1000). Low abortion rates were in Utah (15/1000), Mississippi (16/1000), Idaho (17/1000), and West Virginia (17/1000). Birth and abortion rates by state followed similar patterns regardless of age, except among women 15-17 years compared to those 18-19 years in Missouri and Rhode Island, which have parental consent laws. Race data on abortion among teenagers was available for only 29 states. In general

  4. Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland.

    PubMed

    Klemetti, R; Gissler, M; Niinimäki, M; Hemminki, E

    2012-11-01

    Is the perinatal health of first-born children affected by the mother's previous induced abortion(s) (IAs)? Prior IAs, particularly repeat IAs, are correlated with an increased risk of some health problems at first birth; even in a country with good health care quality. A positive association between IA and risk of preterm birth or a dose-response effect has been found in some previous studies. Limited information and conflicting results on other infant outcomes are available. Nationwide register-based study including 300 858 first-time mothers during 1996-2008 in Finland. All the first-time mothers with a singleton birth (obtained from the Medical Birth Register) in the period 1996-2008 (n = 300 858) were linked to the Abortion Register for the period 1983-2008. Of the first-time mothers, 10.3% (n = 31 083) had one, 1.5% had two and 0.3% had three or more IAs. Most IAs were surgical (88%) performed before 12 weeks (91%) and carried out for social reasons (97%). After adjustment, perinatal deaths and very preterm birth (<28 gestational week) suggested worse outcomes after IA. Increased odds for very preterm birth were seen in all the subgroups and exhibited a dose-response relationship: 1.19 [95% confidence interval (CI) 0.98-1.44] after one IA, 1.69 (1.14-2.51) after two and 2.78 (1.48-5.24) after three IAs. Increased odds for preterm birth (<37 weeks) and low birthweight (<2500 g and <1500 g) were seen only among mothers with three or more IAs: 1.35 (1.07-1.71), 1.43 (1.12-1.84) and 2.25 (1.43-3.52), respectively. Observational studies like ours, however large and well-controlled, will not prove causality. In terms of public health and practical implications, health education should contain information of the potential health hazards of repeat IAs, including very preterm birth and low birthweight in subsequent pregnancies. Health care professionals should be informed about the potential risks of repeat IAs on infant outcomes in subsequent pregnancy. National

  5. Facts about Birth Defects

    MedlinePlus

    ... Button Information For… Media Policy Makers Facts about Birth Defects Language: English (US) Español (Spanish) Recommend ... having a baby born without a birth defect. Birth Defects Are Common Every 4 ½ minutes, a ...

  6. Birth control pills - combination

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000655.htm Birth control pills - combination To use the sharing features on ... contain both progestin and estrogen. What Are Combination Birth Control Pills? Birth control pills help keep you from ...

  7. Essure Permanent Birth Control

    MedlinePlus

    ... and Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Essure System Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

  8. Contraception and Birth Control

    MedlinePlus

    ... Birth Control > About Page Content ​About Contraception and Birth Control Contraception is the prevention of pregnancy. Contraception, or birth control, also allows couples to plan the timing of ...

  9. Birth weight in live births and stillbirths.

    PubMed

    Poon, L C Y; Tan, M Y; Yerlikaya, G; Syngelaki, A; Nicolaides, K H

    2016-11-01

    To establish a normal range of birth weights for gestational age at delivery and to compare the proportion of live births and stillbirths that are classified as small-for-gestational age (SGA) according to our normal range vs that of the INTERGROWTH-21(st) standard. The study population comprised 113 019 live births and 437 (0.4%) stillbirths. The inclusion criterion for establishing a normal range of birth weights for gestational age was the live birth of a phenotypically normal neonate ≥ 24 weeks' gestation and the exclusion criteria were smoking and prepregnancy hypertension, diabetes mellitus, systemic lupus erythematosus or antiphospholipid syndrome, pre-eclampsia, gestational hypertension, gestational diabetes mellitus or iatrogenic preterm birth for fetal growth restriction in the current pregnancy. Inclusion criteria were met by 92 018 live births. The proportions of live births and stillbirths with birth weights < 5(th) and < 10(th) percentiles of our normal range and those according to the INTERGROWTH-21(st) standard were determined and compared by the chi-square test and McNemar test. The proportions of live births and stillbirths with a birth weight < 5(th) percentile according to our standard were significantly higher than and discordant with the proportion according to the INTERGROWTH-21(st) standard (live birth: 5.6% vs 3.4%; stillbirth: 37.2% vs 22.7%). Similarly, the proportion of live births and stillbirths with a birth weight < 10(th) percentile according to our standard were significantly higher than and discordant with those according to the INTERGROWTH-21(st) standard (live birth: 11.2% vs 6.9%; stillbirth: 44.3% vs 32.6%). The INTERGROWTH-21(st) standard underestimates the proportion of SGA live births and stillbirths in our population. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  10. Trihalomethanes in public drinking water and stillbirth and low birth weight rates: an intervention study.

    PubMed

    Iszatt, Nina; Nieuwenhuijsen, Mark J; Bennett, James E; Toledano, Mireille B

    2014-12-01

    During 2003-2004, United Utilities water company in North West England introduced enhanced coagulation (EC) to four treatment works to mitigate disinfection by-product (DBP) formation. This enabled examination of the relation between DBPs and birth outcomes whilst reducing socioeconomic confounding. We compared stillbirth, and low and very low birth weight rates three years before (2000-2002) with three years after (2005-2007) the intervention, and in relation to categories of THM change. We created exposure metrics for EC and trihalomethane (THM) concentration change (n=258 water zones). We linked 429,599 live births and 2279 stillbirths from national birth registers to the water zone at birth. We used Poisson regression to model the differences in birth outcome rates with an interaction between before/after the intervention and EC or THM change. EC treatment reduced chloroform concentrations more than non-treatment (mean -29.7 µg/l vs. -14.5 µg/l), but not brominated THM concentrations. Only 6% of EC water zones received 100% EC water, creating exposure misclassification concerns. EC intervention was not associated with a statistically significant reduction in birth outcome rates. Areas with the highest chloroform decrease (30 - 65 μg/l) had the greatest percentage decrease in low -9 % (-12, -5) and very low birth weight -16% (-24, -8) rates. The interaction between before/after intervention and chloroform change was statistically significant only for very low birth weight, p=0.02. There were no significant decreases in stillbirth rates. In a novel approach for studying DBPs and adverse reproductive outcomes, the EC intervention to reduce DBPs did not affect birth outcome rates. However, a measured large decrease in chloroform concentrations was associated with statistically significant reductions in very low birth weight rates.

  11. Interrater Reliability in Large-Scale Assessments--Can Teachers Score National Tests Reliably without External Controls?

    ERIC Educational Resources Information Center

    Pantzare, Anna Lind

    2015-01-01

    In most large-scale assessment systems a set of rather expensive external quality controls are implemented in order to guarantee the quality of interrater reliability. This study empirically examines if teachers' ratings of national tests in mathematics can be reliable without using monitoring, training, or other methods of external quality…

  12. What Puts Women at Risk of Violence from Their Husbands? Findings from a Large, Nationally Representative Survey in Turkey

    ERIC Educational Resources Information Center

    Yuksel-Kaptanoglu, Ilknur; Turkyilmaz, Ahmet Sinan; Heise, Lori

    2012-01-01

    A large, nationally representative, cross-sectional survey was conducted in Turkey in 2008. In this survey, which used the WHO (World Health Organization) study module on violence, information about lifetime and current violence (past 12 months) was obtained using weighted, stratified, and multistage cluster sampling. This article describes…

  13. Examiners and Content and Site: Oh My! a National Organization's Investigation of Score Variation in Large-Scale Performance Assessments

    ERIC Educational Resources Information Center

    Sebok, Stefanie S.; Roy, Marguerite; Klinger, Don A.; De Champlain, André F.

    2015-01-01

    Examiner effects and content specificity are two well known sources of construct irrelevant variance that present great challenges in performance-based assessments. National medical organizations that are responsible for large-scale performance based assessments experience an additional challenge as they are responsible for administering…

  14. Examiners and Content and Site: Oh My! a National Organization's Investigation of Score Variation in Large-Scale Performance Assessments

    ERIC Educational Resources Information Center

    Sebok, Stefanie S.; Roy, Marguerite; Klinger, Don A.; De Champlain, André F.

    2015-01-01

    Examiner effects and content specificity are two well known sources of construct irrelevant variance that present great challenges in performance-based assessments. National medical organizations that are responsible for large-scale performance based assessments experience an additional challenge as they are responsible for administering…

  15. Interrater Reliability in Large-Scale Assessments--Can Teachers Score National Tests Reliably without External Controls?

    ERIC Educational Resources Information Center

    Pantzare, Anna Lind

    2015-01-01

    In most large-scale assessment systems a set of rather expensive external quality controls are implemented in order to guarantee the quality of interrater reliability. This study empirically examines if teachers' ratings of national tests in mathematics can be reliable without using monitoring, training, or other methods of external quality…

  16. Birth Patterns in Mentally Retarded Autistic Patients.

    ERIC Educational Resources Information Center

    Yeates-Frederikx, M. H. M.; Nijman, H.; Logher, E.; Merckelbach, H. L. G. J.

    2000-01-01

    Birth data for 1,031 Dutch patients with autism were compared to those of the national population. Separate analyses were performed on diagnostic subgroups (i.e., infantile autism vs. other psychoses with origin specific to childhood), gender, and intelligence. No evidence was found that autism is characterized by a deviant birth pattern.…

  17. Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study

    PubMed Central

    2013-01-01

    Background Pregnant women consume caffeine daily. The aim of this study was to examine the association between maternal caffeine intake from different sources and (a) gestational length, particularly the risk for spontaneous preterm delivery (PTD), and (b) birth weight (BW) and the baby being small for gestational age (SGA). Methods This study is based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. A total of 59,123 women with uncomplicated pregnancies giving birth to a live singleton were identified. Caffeine intake from different sources was self-reported at gestational weeks 17, 22 and 30. Spontaneous PTD was defined as spontaneous onset of delivery between 22+0 and 36+6 weeks (n = 1,451). As there is no consensus, SGA was defined according to ultrasound-based (Marsal, n = 856), population-based (Skjaerven, n = 4,503) and customized (Gardosi, n = 4,733) growth curves. Results The main caffeine source was coffee, but tea and chocolate were the main sources in women with low caffeine intake. Median pre-pregnancy caffeine intake was 126 mg/day (IQR 40 to 254), 44 mg/day (13 to 104) at gestational week 17 and 62 mg/day (21 to 130) at gestational week 30. Coffee caffeine, but not caffeine from other sources, was associated with prolonged gestation (8 h/100 mg/day, P <10-7). Neither total nor coffee caffeine was associated with spontaneous PTD risk. Caffeine intake from different sources, measured repeatedly during pregnancy, was associated with lower BW (Marsal-28 g, Skjaerven-25 g, Gardosi-21 g per 100 mg/day additional total caffeine for a baby with expected BW 3,600 g, P <10-25). Caffeine intake of 200 to 300 mg/day increased the odds for SGA (OR Marsal 1.62, Skjaerven 1.44, Gardosi 1.27, P <0.05), compared to 0 to 50 mg/day. Conclusions Coffee, but not caffeine, consumption was associated with marginally increased gestational length but not with spontaneous PTD risk. Caffeine intake was consistently

  18. HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort

    PubMed Central

    Chambers, Stephen T.; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Fernández-Hidalgo, Nuria; Almirante, Benito; Bouza, Emilio; Forno, Davide; del Rio, Ana; Hannan, Margaret M.; Harkness, John; Kanafani, Zeina A.; Lalani, Tahaniyat; Lang, Selwyn; Raymond, Nigel; Read, Kerry; Vinogradova, Tatiana; Woods, Christopher W.; Wray, Dannah; Corey, G. Ralph; Chu, Vivian H.

    2013-01-01

    The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34–9.65; p<0.01) and younger age (OR 0.62; CI 0.49–0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences. PMID:23690995

  19. Unsolicited Patient Complaints in Ophthalmology: An Empirical Analysis from a Large National Database.

    PubMed

    Kohanim, Sahar; Sternberg, Paul; Karrass, Jan; Cooper, William O; Pichert, James W

    2016-02-01

    The number of unsolicited patient complaints about a physician has been shown to correlate with increased malpractice risk. Using a large national patient complaint database, we evaluated the number and content of unsolicited patient complaints about ophthalmologists to identify significant risk factors for receiving a complaint. Retrospective cohort study. Ophthalmologists, nonophthalmic surgeons, nonophthalmic nonsurgeons. We analyzed 2087 unsolicited or spontaneous complaints reported about 815 ophthalmologists practicing in 24 academic and nonacademic organizations using the Patient Advocacy Reporting System (PARS). Complaints against 5273 nonophthalmic surgeons and 19487 nonophthalmic nonsurgeons during the same period were used for comparison. Complaint type profiles were assigned using a previously validated standardized coding system. We (1) described the distribution of complaints against ophthalmologists; (2) compared the distribution and rates of patient complaints about ophthalmologists with those of nonophthalmic surgeons and nonophthalmic nonsurgeons in the database; (3) analyzed differences in complaint type profiles and quantity of complaints by ophthalmic subspecialty, practice setting, physician gender, medical school type, and graduation date; and (4) identified significant risk factors for high numbers of unsolicited patient complaints after adjusting for other covariates. Unsolicited patient complaints. Ophthalmologists had significantly fewer complaints per physician than other nonophthalmic surgeons and nonsurgeons. Sixty-three percent of ophthalmologists had 0 complaints, whereas 10% of ophthalmologists accounted for 61% of all complaints. Ophthalmologists from academic centers, female ophthalmologists, and younger ophthalmologists had significantly more complaints (P < 0.01), and general ophthalmologists had significantly fewer complaints than subspecialists (P < 0.05). After adjusting for covariates using multivariable analysis, working

  20. Stories about ourselves: How national narratives influence the diffusion of large-scale energy technologies

    DOE PAGES

    Malone, Elizabeth L.; Hultman, Nathan E.; Anderson, Kate; ...

    2017-07-03

    Examining past examples of rapid, transformational changes in energy technologies could help governments understand the factors associated with such transitions. We used an existing dataset to assess government strategies to connect new energy technologies with national narratives. Analyzing the diffusion stories told by experts, we demonstrate how governments connected the new technologies with their national narratives. The United States government supported the development of nuclear power after World War II with the national narrative that the United States was destined to improve creation, increasing the potential of raw materials exponentially for the nation’s good (“atoms for peace,” electricity “too cheapmore » to meter”). In Brazil, the development of sugar cane ethanol was supported by the government’s invoking the national narrative of suffering leading to knowledge and redemption, coupled with the quest for improved societal well-being (technological development to produce ethanol and employment for farmers). In Sweden, biomass energy was tied to the national narrative of local control, as well as love of nature and tradition (the use of natural products). We found strong evidence that the pairing of technological transformations with national narratives facilitated the successful development and implementation of these major energy technologies in the three cases analyzed here.« less

  1. Birth weight and growth from infancy to late adolescence in relation to fat and lean mass in early old age: findings from the MRC National Survey of Health and Development

    PubMed Central

    Bann, D; Wills, A; Cooper, R; Hardy, R; Aihie Sayer, A; Adams, J; Kuh, D

    2014-01-01

    Objective: High birth weight and greater weight gain in infancy have been associated with increased risk of obesity as assessed using body mass index, but few studies have examined associations with direct measures of fat and lean mass. This study examined associations of birth weight and weight and height gain in infancy, childhood and adolescence with fat and lean mass in early old age. Subjects: A total of 746 men and 812 women in England, Scotland and Wales from the MRC National Survey of Health and Development whose heights and weights had been prospectively ascertained across childhood and adolescence and who had dual energy X-ray absorptiometry measures at age 60–64 years. Methods: Associations of birth weight and standardised weight and height (0–2 (weight only), 2–4, 4–7, 7–11, 11–15, 15–20 years) gain velocities with outcome measures were examined. Results: Higher birth weight was associated with higher lean mass and lower android/gynoid ratio at age 60–64 years. For example, the mean difference in lean mass per 1 standard deviation increase in birth weight was 1.54 kg in males (95% confidence interval=1.04, 2.03) and 0.78 kg in females (0.41, 1.14). Greater weight gain in infancy was associated with higher lean mass, whereas greater gains in weight in later childhood and adolescence were associated with higher fat and lean mass, and fat/lean and android/gynoid ratios. Across growth intervals greater height gain was associated with higher lean but not fat mass, and with lower fat/lean and android/gynoid ratios. Conclusion: Findings suggest that growth in early life may have lasting effects on fat and lean mass. Greater weight gain before birth and in infancy may be beneficial by leading to higher lean mass, whereas greater weight gain in later childhood and adolescence may be detrimental by leading to higher fat/lean and android/gynoid ratios. PMID:23779050

  2. Does Reading to Infants Benefit Their Cognitive Development at 9-Months-Old? An Investigation Using a Large Birth Cohort Survey

    ERIC Educational Resources Information Center

    Murray, Aisling; Egan, Suzanne M.

    2014-01-01

    This study uses a nationally representative sample of 9-month-old infants and their families from the Growing Up in Ireland (GUI) study to investigate if reading to infants is associated with higher scores on contemporaneous indicators of cognitive development independently of other language-based interactions between parent and infant, such as…

  3. Does Reading to Infants Benefit Their Cognitive Development at 9-Months-Old? An Investigation Using a Large Birth Cohort Survey

    ERIC Educational Resources Information Center

    Murray, Aisling; Egan, Suzanne M.

    2014-01-01

    This study uses a nationally representative sample of 9-month-old infants and their families from the Growing Up in Ireland (GUI) study to investigate if reading to infants is associated with higher scores on contemporaneous indicators of cognitive development independently of other language-based interactions between parent and infant, such as…

  4. Large systematic trend difference between national and regional homogenized datasets and global collections

    NASA Astrophysics Data System (ADS)

    Venema, Victor

    2016-04-01

    The global land temperature trend may be biased due to remaining inhomogeneities. Well-homogenized national datasets on average clearly show more warming than global collections when averaged over the region of common coverage. For this study we have collected a dataset with more than 40 national and regional average monthly temperature series (called "national" from now on). National datasets can be better homogenized than global ones. More data is available at national weather services to serve as a reference in the detection and correction of breaks. More stations and knowledge of the local climatology can help in selecting better references that are expected to have the same climate signal. More metadata is available nationally on network-wide breaks and to determine the right date of the statistically detected breaks. Furthermore, better homogenization methods are available for regional networks. Here we compare these national datasets to the global collections BEST, CRUCY, CRUTEM4, GHCNv3 and GISS. For all datasets the country average series have been computed. A subset of 10 well-homogenized national datasets shows a clearly stronger temperature trend, which is several tenths of a degree Celsius per century larger and mostly statistically significant. These differences are seen for the entire period between 1800 and now. The differences are smallest for CRUTEM4 and CRUCY, which include homogenized data from many of our national datasets. The differences are largest for BEST and GISS. GHCN represents a middle case. We are working on better understanding these differences by comparing all datasets, which range from raw data to data homogenized by various methods and which use a range of different methods to compute the national average. We look for relationships between the methods used for homogenization and averaging and the trend differences. In an accompanying poster, we i) review the literature on trend uncertainties due to remaining inhomogeneities, ii

  5. Factors associated with unintended pregnancy in Brazil: cross-sectional results from the Birth in Brazil National Survey, 2011/2012.

    PubMed

    Theme-Filha, Mariza Miranda; Baldisserotto, Marcia Leonardi; Fraga, Ana Claudia Santos Amaral; Ayers, Susan; da Gama, Silvana Granado Nogueira; Leal, Maria do Carmo

    2016-10-17

    Unintended pregnancy, a pregnancy that have been either unwanted or mistimed, is a serious public health issue in Brazil. It is reported for more than half of women who gave birth in the country, but the characteristics of women who conceive unintentionally are rarely documented. The aim of this study is to analyse the prevalence and the association between unintended pregnancy and a set of sociodemographic characteristics, individual-level variables and history of obstetric outcomes. Birth in Brazil is a cross-sectional study with countrywide representation that interviewed 23,894 women after birth. The information about intendedness of pregnancy was obtained after birth at the hospital and classified into three categories: intended, mistimed or unwanted. Multinomial regression analysis was used to estimate the associations between intendedness of a pregnancy, and sociodemographic and obstetric variables, calculating odds ratios and 95 % confidence intervals. All significant variables in the bivariate analysis were included in the multinomial multivariate model and the final model retaining variables that remained significant at the 5 % level. Unintended pregnancy was reported by 55.4 % of postpartum women. The following variables maintained positive and significant statistical associations with mistimed pregnancy: maternal age < 20 years (OR = 1.89, 95 % CI: 1.68-2.14); brown (OR = 1.15, 95 % CI: 1.04-1.27) or yellow skin color (OR = 1.56, 95 % CI: 1.05-2.32); having no partner (OR = 2.32, 95 % CI: 1.99-2.71); having no paid job (OR = 1.15, 95 % CI: 1.04-1.27); alcohol abuse with risk of alcoholism (OR = 1.25, 95 % CI: 1.04-1.50) and having had three or more births (OR = 2.01, 95 % CI: 1.63-2.47). The same factors were associated with unwanted pregnancy, though the strength of the associations was generally stronger. Women with three or more births were 14 times more likely to have an unwanted pregnancy, and complication

  6. Comparison of US population and live birth rates with poison exposures reported to the National Poison Data System (NPDS): children ages 0-5 years from 2000 to 2012.

    PubMed

    Spiller, H A; Spyker, D A; Casavant, M J

    2013-03-01

    Monitoring of poison control center data has provided an important public health surveillance tool. Previous work has identified the population with the greatest risk of poisoning as children of < 6 years. It follows that the size of the population at highest risk should be an important driver/factor of poison center volume. Therefore, one would expect population changes to be reflected in corresponding National Poison Data system (NPDS) call volume changes. We examined this relationship. This was a retrospective comparison of young children's poison exposures reported to NPDS with changes in US population as reported by the US Census Bureau and by live birth counts in the United States. We examined the relation of population and live birth counts to NPDS exposures in children of 0-5 years and for the total (children of 0-5 years). There was a statistically significant relation between exposures and population for the three of the seven age groups (1-3 years old) and between exposures and live birth counts for the five of the seven age groups (1-4 years old and total (0-5)). The highest correlation was seen with the age groups of 2-year olds (r = 0.815; slope, 4.7373; 95% CI, 2.36-7.11) and 1-year olds (r = 0.785; slope, 4.878; 95% CI, 2.163-7.592). Live birth count was more closely related than population for all but the 1-year-old age groups. Our study reports a number of interesting findings including 1) live birth counts and population are closely associated with each other, 2) poison exposures in NPDS were more strongly associated with live birth counts than with population, 3) the population at greatest risk is the 1- and 2-year-old age groups and the strongest associations between exposures and population and exposures and live birth counts occurred in these two age groups, and 4) changes occurring in the live birth counts, both positive and negative, were reflected in annual changes reported in NPDS human exposures in children < 6 years. These results mean

  7. Parent-reported prevalence of autism spectrum disorders in US-born children: an assessment of changes within birth cohorts from the 2003 to the 2007 National Survey of Children's Health.

    PubMed

    Schieve, Laura A; Rice, Catherine; Yeargin-Allsopp, Marshalyn; Boyle, Coleen A; Kogan, Michael D; Drews, Carolyn; Devine, Owen

    2012-04-01

    The prevalence of autism spectrum disorders (ASD) from the 2007 National Survey of Children's Health (NSCH) was twice the 2003 NSCH estimate for autism. From each NSCH, we selected children born in the US from 1990 to 2000. We estimated autism prevalence within each 1-year birth cohort to hold genetic and non-genetic prenatal factors constant. Prevalence differences across surveys thus reflect survey measurement changes and/or external identification effects. In 2003, parents were asked whether their child was ever diagnosed with autism. In 2007, parents were asked whether their child was ever diagnosed with an ASD and whether s/he currently had an ASD. For the 1997-2000 birth cohorts (children aged 3-6 years in 2003 and 7-10 years in 2007), relative increases between 2003 autism estimates and 2007 ASD estimates were 200-600 %. For the 1990-1996 birth cohorts (children aged 7-13 years in 2003) increases were lower; nonetheless, differences between 2003 estimates and 2007 "ever ASD" estimates were >100 % for 6 cohorts and differences between 2003 estimates and 2007 "current ASD" estimates were >80 % for 3 cohorts. The magnitude of most birth cohort-specific differences suggests continuing diagnosis of children in the community played a sizable role in the 2003-2007 ASD prevalence increase. While some increase was expected for 1997-2000 cohorts, because some children have later diagnoses coinciding with school entry, increases were also observed for children ages ≥ 7 years in 2003. Given past ASD subtype studies, the 2003 "autism" question might have missed a modest amount (≤ 33 %) of ASDs other than autistic disorder.

  8. Does famine influence sex ratio at birth? Evidence from the 1959-1961 Great Leap Forward Famine in China.

    PubMed

    Song, Shige

    2012-07-22

    The current study examined the long-term trend in sex ratio at birth between 1929 and 1982 using retrospective birth histories of 310 101 Chinese women collected in a large, nationally representative sample survey in 1982. The study identified an abrupt decline in sex ratio at birth between April 1960, over a year after the Great Leap Forward Famine began, and October 1963, approximately 2 years after the famine ended, followed by a compensatory rise between October 1963 and July 1965. These findings support the adaptive sex ratio adjustment hypothesis that mothers in good condition are more likely to give birth to sons, whereas mothers in poor condition are more likely to give birth to daughters. In addition, these findings help explain the lack of consistent evidence reported by earlier studies based on the 1944-1945 Dutch Hunger Winter or the 1942 Leningrad Siege.

  9. Exploring DSM-5 ADHD criteria beyond young adulthood: phenomenology, psychometric properties and prevalence in a large three-decade birth cohort.

    PubMed

    Vitola, E S; Bau, C H D; Salum, G A; Horta, B L; Quevedo, L; Barros, F C; Pinheiro, R T; Kieling, C; Rohde, L A; Grevet, E H

    2017-03-01

    There are still uncertainties on the psychometric validity of the DSM-5 attention deficit hyperactivity disorder (ADHD) criteria for its use in the adult population. We aim to describe the adult ADHD phenotype, to test the psychometric properties of the DSM-5 ADHD criteria, and to calculate the resulting prevalence in a population-based sample in their thirties. A cross-sectional evaluation using the DSM-5 ADHD criteria was carried out in 3574 individuals from the 1982 Pelotas Birth Cohort. Through receiver operator curve, latent and regression analyses, we obtained parameters on construct and discriminant validity. Still, prevalence rates were calculated for different sets of criteria. The latent analysis suggested that the adult ADHD phenotype is constituted mainly by inattentive symptoms. Also, inattention symptoms were the symptoms most associated with impairment. The best cut-off for diagnosis was four symptoms, but sensitivity and specificity for this cut-off was low. ADHD prevalence rates were 2.1% for DSM-5 ADHD criteria and 5.8% for ADHD disregarding age-of-onset criterion. The bi-dimensional ADHD structure proposed by the DSM demonstrated both construct and discriminant validity problems when used in the adult population, since inattention is a much more relevant feature in the adult phenotype. The use of the DSM-5 criteria results in a higher prevalence of ADHD when compared to those obtained by DSM-IV, and prevalence would increase almost threefold when considering current ADHD syndrome. These findings suggest a need for further refinement of the criteria for its use in the adult population.

  10. Large-Scale Testing and High-Fidelity Simulation Capabilities at Sandia National Laboratories to Support Space Power and Propulsion

    SciTech Connect

    Dobranich, Dean; Blanchat, Thomas K.

    2008-01-21

    Sandia National Laboratories, as a Department of Energy, National Nuclear Security Agency, has major responsibility to ensure the safety and security needs of nuclear weapons. As such, with an experienced research staff, Sandia maintains a spectrum of modeling and simulation capabilities integrated with experimental and large-scale test capabilities. This expertise and these capabilities offer considerable resources for addressing issues of interest to the space power and propulsion communities. This paper presents Sandia's capability to perform thermal qualification (analysis, test, modeling and simulation) using a representative weapon system as an example demonstrating the potential to support NASA's Lunar Reactor System.

  11. Cloning, Stem Cells, and the Current National Debate: Incorporating Ethics into a Large Introductory Biology Course

    ERIC Educational Resources Information Center

    Fink, Rachel D.

    2002-01-01

    Discussing the ethical issues involved in topics such as cloning and stem cell research in a large introductory biology course is often difficult. Teachers may be wary of presenting material biased by personal beliefs, and students often feel inhibited speaking about moral issues in a large group. Yet, to ignore what is happening "out there"…

  12. Cloning, Stem Cells, and the Current National Debate: Incorporating Ethics into a Large Introductory Biology Course

    ERIC Educational Resources Information Center

    Fink, Rachel D.

    2002-01-01

    Discussing the ethical issues involved in topics such as cloning and stem cell research in a large introductory biology course is often difficult. Teachers may be wary of presenting material biased by personal beliefs, and students often feel inhibited speaking about moral issues in a large group. Yet, to ignore what is happening "out there"…

  13. [Transforming the Peruvian birth information system].

    PubMed

    Curioso, Walter H; Pardo, Karim; Loayza, Manuel

    2013-04-01

    The On-Line Registration of Certificates of Live Births was developed in conjunction with the Ministry of Health of Peru and the National Registry of Identification and Civil Status. It is a free system that registers newborns in the delivery room itself which generates a real time certificate of live birth. This simplifies the procedures required to obtain the birth certificate and the National Identity Document for the newborn. This system has been implemented in 114 health centers in 21 regions from March 2012 to March 2013, and has registered 113,917 live births, providing accurate, timely and quality information about these births. This system is the main cornerstone of the health information system which helps obtain real time statistics for adequate and timely decision making in public health.

  14. Evaluating the use of questions and responses in a large national dietary data collection instrument

    USDA-ARS?s Scientific Manuscript database

    The USDA Automated Multiple Pass Method (AMPM) Blaise instrument collects 24-hour dietary recall data for the What We Eat In America, National Health and Nutrition Examination Survey. AMPM contains more than 2,500 questions and 25,000 responses about foods. Each year it is used in approximately 10,0...

  15. [Revelation of purchase system of developed nation to large medical equipment group purchase in our country].

    PubMed

    Tao, Lin; Guan, Bing; Liu, Shan

    2011-01-01

    There were some features of purchase system in developed nation, such as clear purchase objectives flexible methods, standard programming, emphasis on competition and open process. The measures suggested include playing the role of competition purchasing; establishing the e-business modern purchasing information system; establishing legislation system; and completing business purchasing.

  16. Using National Coastal Assessment Data to Model Estuarine Water Quality at Large Spatial Scales

    EPA Science Inventory

    Background/Question/MethodThe water quality of the Nation’s estuaries is attracting increasing scrutiny in light of burgeoning coastal population growth and enhanced delivery of nutrients via riverine flux. The USEPA has evaluated water quality in US estuaries in the Nation...

  17. Maternal stress and preterm birth.

    PubMed

    Dole, N; Savitz, D A; Hertz-Picciotto, I; Siega-Riz, A M; McMahon, M J; Buekens, P

    2003-01-01

    This study examined a comprehensive array of psychosocial factors, including life events, social support, depression, pregnancy-related anxiety, perceived discrimination, and neighborhood safety in relation to preterm birth (<37 weeks) in a prospective cohort study of 1,962 pregnant women in central North Carolina between 1996 and 2000, in which 12% delivered preterm. There was an increased risk of preterm birth among women with high counts of pregnancy-related anxiety (risk ratio (RR) = 2.1, 95% confidence interval (CI): 1.5, 3.0), with life events to which the respondent assigned a negative impact weight (RR = 1.8, 95% CI: 1.2, 2.7), and with a perception of racial discrimination (RR = 1.4, 95% CI: 1.0, 2.0). Different levels of social support or depression were not associated with preterm birth. Preterm birth initiated by labor or ruptured membranes was associated with pregnancy-related anxiety among women assigning a high level of negative impact weights (RR = 3.0, 95% CI: 1.7, 5.3). The association between high levels of pregnancy-related anxiety and preterm birth was reduced when restricted to women without medical comorbidities, but the association was not eliminated. The prospective collection of multiple psychosocial measures on a large population of women indicates that a subset of these factors is associated with preterm birth.

  18. A dearth of short-period massive binaries in the young massive star forming region M 17. Evidence for a large orbital separation at birth?

    NASA Astrophysics Data System (ADS)

    Sana, H.; Ramírez-Tannus, M. C.; de Koter, A.; Kaper, L.; Tramper, F.; Bik, A.

    2017-03-01

    Aims: The formation of massive stars remains poorly understood and little is known about their birth multiplicity properties. Here, we aim to quantitatively investigate the strikingly low radial-velocity dispersion measured for a sample of 11 massive pre- and near-main-sequence stars (σ1D= 5.6 ± 0.2 km s-1) in the very young massive star forming region M 17, in order to obtain first constraints on the multiplicity properties of young massive stellar objects. Methods: We compute the radial-velocity dispersion of synthetic populations of massive stars for various multiplicity properties and we compare the obtained σ1D distributions to the observed value. We specifically investigate two scenarios: a low binary fraction and a dearth of short-period binary systems. Results: Simulated populations with low binary fractions () or with truncated period distributions (Pcutoff > 9 months) are able to reproduce the low σ1D observed within their 68%-confidence intervals. Furthermore, parent populations with fbin > 0.42 or Pcutoff < 47 d can be rejected at the 5%-significance level. Both constraints are in stark contrast with the high binary fraction and plethora of short-period systems in few Myr-old, well characterized OB-type populations. To explain the difference in the context of the first scenario would require a variation of the outcome of the massive star formation process. In the context of the second scenario, compact binaries must form later on, and the cut-off period may be related to physical length-scales representative of the bloated pre-main-sequence stellar radii or of their accretion disks. Conclusions: If the obtained constraints for the M 17's massive-star population are representative of the multiplicity properties of massive young stellar objects, our results may provide support to a massive star formation process in which binaries are initially formed at larger separations, then harden or migrate to produce the typical (untruncated) power-law period

  19. No Time for Complacency: Teen Births in California.

    ERIC Educational Resources Information Center

    Constantine, Norman A.; Nevarez, Carmen R.

    California's recent investment in teen pregnancy prevention has contributed to the largest decline in teen birth rates and the second largest percentage reduction of all 50 states. California's annual teen birth rate is now similar to the national rate. This occurred while the highest teen birth rate group, Latinas, increased as a proportion of…

  20. Birth weight is not associated with risk of fracture: results from two Swedish cohort studies.

    PubMed

    Byberg, Liisa; Michaëlsson, Karl; Goodman, Anna; Zethelius, Björn; Koupil, Ilona

    2014-10-01

    Development and growth in utero has been suggested to influence bone health. However, the relationship with risk of fracture in old age is largely unknown. Using Cox proportional hazards regression, we studied the association between birth weight and fractures at ages 50-94 among 10,893 men and women (48% women) from the Uppsala Birth Cohort Study (UBCoS, born 1915-29) and 1334 men from the Uppsala Longitudinal Study of Adult Men (ULSAM, born 1920-24). Measured birth weight was collected from hospital or midwives' records and fractures from the Swedish National Patient Register. We observed 2796 fractures (717 of these were hip fractures) in UBCoS and 335 fractures (102 hip fractures) in ULSAM. In UBCoS, the hazard ratio (HR) per 1 kg increase in birth weight, adjusted for sex and socioeconomic status at birth, was 1.01 [95% confidence interval (CI), 0.94-1.09] for any fracture and 1.06 (95% CI, 0.91-1.23) for hip fracture. Estimates in ULSAM were similar. We did not observe a differential association of birth weight with fractures occurring before age 70 or after age 70 years. Neither birth weight standardized for gestational age nor gestational duration was associated with fracture rate. In linear regression, birth weight was not associated with bone mineral density among 303 men who were 82-years-old in ULSAM but showed positive associations with total body bone mineral content (β per kg increase in birth weight, adjusted for social class and age, 133; 95% CI, 30-227). This association was attenuated after further adjustment for body mass index and height (β, 41; 95% CI, -43-126). We conclude that birth weight is associated with bone mineral content but this association does not translate into an association with risk of fracture in men and women aged 50-94 years.

  1. Milk consumption during pregnancy is associated with increased infant size at birth: prospective cohort study.

    PubMed

    Olsen, Sjurdur F; Halldorsson, Thorhallur I; Willett, Walter C; Knudsen, Vibeke K; Gillman, Matthew W; Mikkelsen, Tina B; Olsen, Jørn

    2007-10-01

    Cow milk contains many potentially growth-promoting factors. The objective was to examine whether milk consumption during pregnancy is associated with greater infant size at birth. During 1996-2002, the Danish National Birth Cohort collected data on midpregnancy diet through questionnaires and on covariates through telephone interviews and ascertained birth outcomes through registry linkages. Findings were adjusted for mother's parity, age, height, prepregnant BMI, gestational weight gain, smoking status, and total energy intake; father's height; and family's socioeconomic status The analyses included data from 50,117 mother-infant pairs. Mean (+/-SD) consumption of milk was 3.1 +/- 2.0 glasses/d. Milk consumption was inversely associated with the risk of small-for gestational age (SGA) birth and directly with both large-for-gestational age (LGA) birth and mean birth weight (P for trend < 0.001). In a comparison of women drinking >or=6 glasses/d with those drinking 0 glasses/d, the odds ratio for SGA was 0.51 (95% CI: 0.39, 0.65) and for LGA was 1.59 (1.16, 2.16); the increment in mean birth weight was 108 g (74, 143 g). We also found graded relations (P < 0.001) for abdominal circumference (0.52 cm; 0.35, 0.69 cm), placental weight (26 g; 15, 38 g), birth length (increment: 0.31 cm; 0.15, 0.46 cm), and head circumference (0.13 cm; 0.04, 0.25 cm). Birth weight was related to intake of protein, but not of fat, derived from milk. Milk intake in pregnancy was associated with higher birth weight for gestational age, lower risk of SGA, and higher risk of LGA.

  2. National Weatherization Assistance Program Impact Evaluation: Energy Impacts for Large Multifamily Buildings

    SciTech Connect

    Blasnik, Michael; Dalhoff, Greg; Carroll, David; Ucar, Ferit

    2015-10-01

    This report estimates energy savings, energy cost savings, and cost effectiveness attributable to weatherizing large multifamily buildings under the auspices of the Department of Energy's Weatherization Assistance Program during Program Year 2008.

  3. The 2006 Canadian Birth-Census Cohort.

    PubMed

    Bushnik, Tracey; Yang, Seungmi; Kramer, Michael S; Kaufman, Jay S; Sheppard, Amanda J; Wilkins, Russell

    2016-01-20

    Evidence on socioeconomic and ethnocultural disparities in perinatal health in Canada tends to be limited to analyses by neighbourhood or for selected provinces. In 2010, the Canadian Institutes of Health Research awarded funding for a project on perinatal outcomes. This article describes the resulting 2006 Canadian Birth-Census Cohort Database. From the Canadian Live Birth, Infant Death and Stillbirth Database, 687,340 records of children born in Canada from May 16, 2004 through May 15, 2006 to mothers whose usual place of residence was Canada were selected as in-scope births. Deterministic rules were applied to link each person on the birth record-child, mother, father-to 2006 Census data.The cohort was restricted to records linked to a long-form questionnaire, and a cohort weight was developed. Cohort rates (unweighted and weighted) for five birth outcomes-preterm birth, small-for-gestational age, large-for-gestational age, stillbirth, and infant mortality-were compared with rates for all in-scope births across birth characteristics. Cohort rates for these birth outcomes were examined across selected census characteristics. Linkage rates were 91% for births surviving to age 1, 76% for stillbirths, and 80% for infant deaths matched to a birth registration. The cohort estimates were similar to those for all in-scope births, particularly after the cohort weight was applied. The cohort data produced plausible estimates of selected birth outcomes across maternal ethnocultural categories and levels of education. The 2006 Canadian Birth-Census Cohort data can help inform perinatal surveillance and research in Canada.

  4. Febrile convulsions in a national cohort followed up from birth. I--Prevalence and recurrence in the first five years of life.

    PubMed Central

    Verity, C M; Butler, N R; Golding, J

    1985-01-01

    Of 13 135 children followed up from birth to the age of 5 years, 303 (2.3%) had febrile convulsions. Prior neurological abnormality had been noted in 13. Of the 290 remaining children, 57 (20%) presented with a complex convulsion, and 103 children (35%) went on to have further febrile convulsions. The risk of further febrile convulsions varied with the age at first convulsion and the presence of a history of convulsive disorders in relatives. There were no significant differences between the sexes. PMID:3922469

  5. Monitoring The Water Quality of the Nation's Large Rivers Colorado River NASQAN Program

    USGS Publications Warehouse

    Hart, Robert J.; Hooper, Richard P.

    2000-01-01

    Since 1995, the National Stream Quality Accounting Network (NASQAN) of the U. S. Geological Survey (USGS) has focused on monitoring the water quality of the Nation's largest rivers including the Colorado, Columbia, Mississippi, and Rio Grande. The NASQAN program in the Colorado River Basin consists of eight stations that span seven basin States including Colorado, Wyoming, Utah, New Mexico, Arizona, Nevada, and California. Data collected from these stations are used to quantify the transport of chemical constituents and evaluate trends in water quality of the river. Currently, the NASQAN program in the Colorado River Basin is providing necessary data and information required by resource managers of the river who are responsible for meeting longstanding legal agreements that regulate the flow and quality of the river water.

  6. U.S. National Science Foundation Slated for Large Budget Increase

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2010-03-01

    Although the Obama administration has promoted its proposed $3.8 trillion federal budget for fiscal year (FY) 2011 as one that works toward reining in budget deficits and living within the nation's means, research is among the areas slated for increases. The National Science Foundation (NSF) would receive $7.42 billion, an 8% increase above the FY 2010 enacted level of $6.87 billion, which pleases NSF administrators. This proposal would keep the agency on track for doubling its budget between about 2007 and 2017. “The president sees science as a way to build our economy. It’s a way to make the nation strong in the future. It’s a way of bringing change in society, and in addressing some of the global challenges that we are facing,” NSF director Arden Bement Jr. explained at a 1 February briefing. Bement, who has been at the helm of the agency for more than 6 years, announced in early February that he is leaving later this year to head up the Global Policy Research Institute at Purdue University.

  7. Forced Marriage and Birth Outcomes.

    PubMed

    Becker, Charles M; Mirkasimov, Bakhrom; Steiner, Susan

    2017-08-01

    We study the impact of marriages resulting from bride kidnapping on infant birth weight. Bride kidnapping-a form of forced marriage-implies that women are abducted by men and have little choice other than to marry their kidnappers. Given this lack of choice over the spouse, we expect adverse consequences for women in such marriages. Remarkable survey data from the Central Asian nation of Kyrgyzstan enable exploration of differential birth outcomes for women in kidnap-based and other types of marriage using both OLS and IV estimation. We find that children born to mothers in kidnap-based marriages have lower birth weight compared with children born to other mothers. The largest difference is between kidnap-based and arranged marriages: the magnitude of the birth weight loss is in the range of 2 % to 6 % of average birth weight. Our finding is one of the first statistically sound estimates of the impact of forced marriage and implies not only adverse consequences for the women involved but potentially also for their children.

  8. Diabetes mellitus and birth defects

    PubMed Central

    Correa, Adolfo; Gilboa, Suzanne M.; Besser, Lilah M.; Botto, Lorenzo D.; Moore, Cynthia A.; Hobbs, Charlotte A.; Cleves, Mario A.; Riehle-Colarusso, Tiffany J.; Waller, D. Kim; Reece, E. Albert

    2016-01-01

    OBJECTIVE The purpose of this study was to examine associations between diabetes mellitus and 39 birth defects. STUDY DESIGN This was a multicenter case-control study of mothers of infants who were born with (n = 13,030) and without (n = 4895) birth defects in the National Birth Defects Prevention Study (1997–2003). RESULTS Pregestational diabetes mellitus (PGDM) was associated significantly with noncardiac defects (isolated, 7/23 defects; multiples, 13/23 defects) and cardiac defects (isolated, 11/16 defects; multiples, 8/16 defects). Adjusted odds ratios for PGDM and all isolated and multiple defects were 3.17 (95% CI, 2.20–4.99) and 8.62 (95% CI, 5.27–14.10), respectively. Gestational diabetes mellitus (GDM) was associated with fewer noncardiac defects (isolated, 3/23 defects; multiples, 3/23 defects) and cardiac defects (isolated, 3/16 defects; multiples, 2/16 defects). Odds ratios between GDM and all isolated and multiple defects were 1.42 (95% CI, 1.17–1.73) and 1.50 (95% CI, 1.13–2.00), respectively. These associations were limited generally to offspring of women with prepregnancy body mass index ≥25 kg/m2. CONCLUSION PGDM was associated with a wide range of birth defects; GDM was associated with a limited group of birth defects. PMID:18674752

  9. Institutional and Cultural Perspectives on Home Birth in Israel

    PubMed Central

    Meroz, Michal (Rosie); Gesser-Edelsburg, Anat

    2015-01-01

    ABSTRACT This study exposes doctors’ and midwives’ perceptions and misperceptions regarding home birth by examining their views on childbirth in general and on risk associated with home births in particular. It relies on an approach of risk communication and an anthropological framework. In a qualitative-constructive study, 19 in-depth interviews were conducted with hospital doctors, hospital midwives, home-birth midwives, and a home-birth obstetrician. Our findings reveal that hospital midwives and doctors suffer from lack of exposure to home births, leading to disagreement regarding norms and risk; it also revealed sexist or patriarchal worldviews. Recommendations include improving communication between home-birth midwives and hospital counterparts; increased exposure of hospital doctors to home birth, creating new protocols in collaboration with home-birth midwives; and establishing a national database of home births. PMID:26937159

  10. Development and application of a large scale river system model for National Water Accounting in Australia

    NASA Astrophysics Data System (ADS)

    Dutta, Dushmanta; Vaze, Jai; Kim, Shaun; Hughes, Justin; Yang, Ang; Teng, Jin; Lerat, Julien

    2017-04-01

    Existing global and continental scale river models, mainly designed for integrating with global climate models, are of very coarse spatial resolutions and lack many important hydrological processes, such as overbank flow, irrigation diversion, groundwater seepage/recharge, which operate at a much finer resolution. Thus, these models are not suitable for producing water accounts, which have become increasingly important for water resources planning and management at regional and national scales. A continental scale river system model called Australian Water Resource Assessment River System model (AWRA-R) has been developed and implemented for national water accounting in Australia using a node-link architecture. The model includes major hydrological processes, anthropogenic water utilisation and storage routing that influence the streamflow in both regulated and unregulated river systems. Two key components of the model are an irrigation model to compute water diversion for irrigation use and associated fluxes and stores and a storage-based floodplain inundation model to compute overbank flow from river to floodplain and associated floodplain fluxes and stores. The results in the Murray-Darling Basin shows highly satisfactory performance of the model with median daily Nash-Sutcliffe Efficiency (NSE) of 0.64 and median annual bias of less than 1% for the period of calibration (1970-1991) and median daily NSE of 0.69 and median annual bias of 12% for validation period (1992-2014). The results have demonstrated that the performance of the model is less satisfactory when the key processes such as overbank flow, groundwater seepage and irrigation diversion are switched off. The AWRA-R model, which has been operationalised by the Australian Bureau of Meteorology for continental scale water accounting, has contributed to improvements in the national water account by substantially reducing accounted different volume (gain/loss).

  11. Methods used for successful follow-up in a large scale national cohort study in Thailand

    PubMed Central

    2011-01-01

    Background Ensuring successful follow-up is essential when conducting a prospective cohort study. Most existing literature reviewing methods to ensure a high response rate is based on experience in developed nations. Findings We report our 4-year follow-up success for a national cohort study examining the health transition underway in Thailand. We began the cohort study in 2005 with a baseline postal questionnaire sent to all 200,000 Thais enrolled as distance learning students at Sukhothai Thammathirat Open University and residing all over Thailand; 87,134 or 44% of the students responded. Subsequently we used University and national media to inform cohort members of study progress. Also, we prepared a health book with study results and health advice which was distributed to all cohort members. After 4 years we repeated the survey and achieved a 71% response rate. In this paper we report the methods used to achieve this response The initial follow-up mail-out generated a response rate of about 48% reflecting the extensive preparatory work between baseline and follow-up. After 4 rounds of telephone contact (more than 100,000 phone calls) and 4 related mail-out rounds progressively over 16 months an overall response rate was achieved of just over 71% (n = 60,774). The total cost was US$4.06/respondent - 19% for printing, 21% for postage, 14% for tape measures (included in mail-out), 18% for data processing 22% for prizes and 6% for telephone. Conclusions Many of the methods reported as effective for mail questionnaire and cohort response rates held true for Thailand. These included being associated with a university, incentivating cooperation, follow-up contact, providing a second copy of questionnaire where necessary, and assurance of confidentiality. Telephone contact with the cohort and the small prizes given to responders were particularly important in the Thai context as was Thai leadership of the research team. PMID:21615963

  12. Teen Birth Rates for Urban and Rural Areas in the United States, 2007-2015.

    PubMed

    Hamilton, Brady E; Rossen, Lauren M; Branum, Amy M

    2016-11-01

    Data from the National Vital Statistics System •Birth rates for teenagers aged 15-19 declined in urban and rural counties from 2007 through 2015, with the largest declines in large urban counties and the smallest declines in rural counties. •From 2007 through 2015, the teen birth rate was lowest in large urban counties and highest in rural counties. •Declines in teen birth rates in all urban counties between 2007 and 2015 were largest in Arizona, Massachusetts, Connecticut, Minnesota, and Colorado, with 17 states experiencing a decline of 50% or more. •Declines in teen birth rates in all rural counties between 2007 and 2015 were largest (50% or more) in Colorado and Connecticut. •In 2015, teen birth rates were highest in rural counties and lowest in large urban counties for non-Hispanic white, non-Hispanic black, and Hispanic females. Teen birth rates have demonstrated an unprecedented decline in the United States since 2007 (1). Declines occurred in all states and among all major racial and Hispanic-origin groups, yet disparities by both geography and demographic characteristics persist (2,3). Although teen birth rates and related declines have been described by state, patterns by urban-rural location have not yet been examined. This report describes trends in teen birth rates in urban (metropolitan) and rural (nonmetropolitan) areas in the United States overall and by state from 2007 through 2015 and by race and Hispanic origin for 2015. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  13. Large, Wetland-associated mayflies (Ephemeroptera) of glacier national park, Montana

    USGS Publications Warehouse

    Newell, R.L.; Hossack, B.R.

    2009-01-01

    We describe species richness and habitat associations of mayflies (Ephemeroptera) collected during amphibian surveys of 355 water bodies in Glacier National Park (NP), Montana, in 20062008. We collected 9 taxa (in 7 genera) of mayflies that were identifiable to species. Callibaetis jerrugineus hageni was collected most frequently, followed by Siphlonurus occidentalis, S. phyllis, Ameletus celer, A. similior, Parameletus columbiae, Ephemerella dorothea infrequens, Baetis bicaudatus, and Leptophlebia cupida. Siphlonurus phyllis had not been reported in the western United States prior to our surveys, and P. columbiae is a species of concern in the region. The identifications of 4 additional taxa were uncertain due to the poor condition of specimens found at only one site (Centroptilum sp. and Paraleptophlebia sp.) or because nymphal specimens could not be confidently identified (Cinygma sp. and Cinygmula sp.). Species richness of mayflies in wetlands seems low compared to that in streams and lakes in Glacier National Park. We found the most species of mayflies in beaver ponds, where we detected some species not commonly associated with lentic water bodies. Our survey was the first extensive survey of wetland invertebrates in Glacier NP and only the second that we are aware of in western Montana.

  14. Prevalence of household food poverty in South Africa: results from a large, nationally representative survey.

    PubMed

    Charlton, Karen E; Rose, Donald

    2002-06-01

    Household food insecurity is a major determinant of undernutrition, yet there is little information on its prevalence in the South African population. This paper assesses household food insecurity in South Africa using a quantitative and objective measure, known as food poverty, and provides prevalence estimates by geographic area and socio-economic condition. Secondary data analysis combining two sources: Statistics South Africa's household-based 1995 Income and Expenditure Survey; and the University of Port Elizabeth's Household Subsistence Level series, a nationally-conducted, market-based survey. South Africa. A nationally representative sample of the entire country - stratified by race, province, and urban and non-urban areas - consisting of 28 704 households. A household is defined to be in food poverty when monthly food spending is less than the cost of a nutritionally adequate very low-cost diet. The prevalence of food poverty in South Africa in 1995 was 43%. Food poverty rates were highest among households headed by Africans, followed by coloureds, Indians and whites. Higher food poverty rates were found with decreasing income, increasing household size, and among households in rural areas or those headed by females. The widespread nature of household food insecurity in South Africa is documented here. Prevalence rates by geographic and socio-economic breakdown provide the means for targeting of nutritional interventions and for monitoring progress in this field. The corroboration of these findings with both internal validation measures and external sources suggests that food poverty is a useful, objective measure of household food insecurity.

  15. Maternal Diabetes, Birth Weight, and Neonatal Risk of Congenital Heart Defects in Norway, 1994-2009.

    PubMed

    Leirgul, Elisabeth; Brodwall, Kristoffer; Greve, Gottfried; Vollset, Stein E; Holmstrøm, Henrik; Tell, Grethe S; Øyen, Nina

    2016-11-01

    To investigate the association between pregestational or gestational diabetes and offspring risk of congenital heart defects and the association between large-for-gestational-age birth weight and risk of cardiac defects in offspring of diabetic women. Information on pregestational and gestational diabetes, cardiac defects, and birth weight among all births in Norway in 1994-2009 was ascertained from the Medical Birth Registry of Norway, national health registries, and the Cardiovascular Disease in Norway project. The relative risk (RR) compared offspring risk of cardiac defects for maternal diabetes with offspring risk in nondiabetic mothers adjusted for year of birth, maternal age, and parity. Among 914,427 births (live births, stillbirths, terminated pregnancies), 5,618 (0.61%) were complicated by maternal pregestational diabetes and 9,726 (1.06%) by gestational diabetes. Congenital heart defects were identified in 10,575 offspring. The prevalence of cardiac defects differed between groups: 344 of 10,000 births to women with pregestational diabetes, 172 of 10,000 to women with gestational diabetes, and 114 of 10,000 in women without diabetes (adjusted RRs 2.92, 95% confidence interval [CI] 2.54-3.36 and 1.47, 95% CI 1.26-1.71). During the study period, the adjusted RRs for congenital heart defects did not change. The risk of cardiac defects in neonates very large for gestational age (birth weight greater than 3 standard deviations above the mean) was compared with neonates with birth weight appropriate for gestational age. For pregestational diabetes, the prevalences of offspring cardiac defects were 561 compared with 248 per 10,000 births (adjusted RR 2.23, 95% CI 1.39-3.59) and for gestational diabetes 388 compared with 132 per 10,000 (adjusted RR 2.73, 95% CI 1.53-4.85). The increased risk of having a child with a congenital heart defect has not changed for diabetic women in Norway since 1994. Among women with pregestational or gestational diabetes, having a

  16. Midwife-attended births in the United States, 1990-2012: results from revised birth certificate data.

    PubMed

    Declercq, Eugene

    2015-01-01

    Data on attendance at birth by midwives in the United States have been available on the national level since 1989, allowing for the documentation of long-term trends. New items on payer source and prepregnancy body mass index (BMI) from a 2003 revision of the birth certificate provide an opportunity to examine additional aspects of US midwifery practice. The data in this report are based on records on birth attendant gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), which allows users to create and download specialized tables. Analysis of new items on prepregnancy BMI and birth payer source are limited to the 38 states (86% of US births) that adopted the revised birth certificate by 2012. Between 1989 and 2012, the proportion of all births attended by certified nurse-midwives (CNMs) increased from 3.3% to 7.9%. The proportion of vaginal births attended by CNMs reached an all-time high of 11.9%. Births attended by "other midwives" (typically certified professional midwives) rose to a peak of 28,343, or 0.7% of all US births. The distribution of payer source for CNM-attended births (44% Medicaid; 44% private insurance; 6% self-pay) is very similar to the national distribution, whereas the majority (53%) of births attended by other midwives are self-pay. Women whose births are attended by other midwives are less likely (13%) to have a prepregnancy BMI in the obese range than women attended by CNMs (19%) or overall (24%). The total number of births attended by CNMs and other midwives has remained steady or grown at a time when total US births have declined, resulting in the largest proportions of midwife-attended births in the quarter century that such data have been collected. © 2015 by the American College of Nurse-Midwives.

  17. Folic acid supplements in pregnancy and birth outcome: re-analysis of a large randomised controlled trial and update of Cochrane review.

    PubMed

    Charles, Deborah H M; Ness, Andy R; Campbell, Doris; Smith, George Davey; Whitley, Elise; Hall, Marion H

    2005-03-01

    Periconceptual folic acid prevents neural tube defects. The effect of folic acid taken throughout pregnancy is unclear, however. We re-analysed data from a large randomised controlled trial performed between 1966 and 1967 and combined the results with those from trials included in a Cochrane review. A total of 2928 women were randomised: 1977 were allocated to placebo, 466 to folic acid 200 microg/day and 485 to folic acid 5 mg/day. Folic acid supplementation was not associated with any difference in mean birthweight, placental weight or gestational age. When combined with trials in the Cochrane review folic acid at high doses was associated with reduced risk of low birthweight (pooled relative risk 0.73 [95% CI 0.53, 0.99]). We found no conclusive evidence of benefit for folic acid supplementation in pregnant women given from time of booking onwards.

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

    PubMed Central

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

    2015-01-01

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

  19. The sex ratio at birth in France was unchanged 9months after the 1998 FIFA World Cup.

    PubMed

    Masukume, Gwinyai; Grech, Victor

    2016-08-01

    Positive psychological phenomena such as increased feelings of belonging linked to hosting the FIFA World Cup were observed in France 1998 and South Africa 2010. Approximately nine months after South Africa hosted the 2010 World Cup the sex ratio at birth increased significantly. Given the similarity of positive psychological phenomena between the two countries, this study sought to determine if the sex ratio at birth increased in France circa nine months after the 1998 World Cup. Anonymized publicly available live birth data from 1994 to 2004 inclusive was obtained from the Insee (Institut National de la Statistique et des Etudes/Économiques - National Institute of Statistics and Economic Studies). For statistical analysis, chi-squared tests were used. The sex ratio at birth for March and April 1999 did not differ significantly from that of the rest of same period from 1996 to 2000 (p=0.558), there was also no significant difference for February and March 1999. The sex ratio at birth did not increase in France after it hosted the 1998 World Cup. Possible reasons why the sex ratio at birth did not increase as it did in South Africa include a higher French prevalence of modern contraceptive use and a different kind/level of excitement for the World Cup in France since it has previously hosted large international sports tournaments. The influence of the World Cup on the sex ratio at birth depends on the context of a specific country. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Large Cross-National Differences in Gene × Socioeconomic Status Interaction on Intelligence.

    PubMed

    Tucker-Drob, Elliot M; Bates, Timothy C

    2016-02-01

    A core hypothesis in developmental theory predicts that genetic influences on intelligence and academic achievement are suppressed under conditions of socioeconomic privation and more fully realized under conditions of socioeconomic advantage: a Gene × Childhood Socioeconomic Status (SES) interaction. Tests of this hypothesis have produced apparently inconsistent results. We performed a meta-analysis of tests of Gene × SES interaction on intelligence and academic-achievement test scores, allowing for stratification by nation (United States vs. non-United States), and we conducted rigorous tests for publication bias and between-studies heterogeneity. In U.S. studies, we found clear support for moderately sized Gene × SES effects. In studies from Western Europe and Australia, where social policies ensure more uniform access to high-quality education and health care, Gene × SES effects were zero or reversed. © The Author(s) 2015.

  1. Masters Swimmers Use More Dietary Supplements Than a Large National Comparison Population in the United States.

    PubMed

    Guthrie, Sally K; Erickson, Steven R

    2016-04-01

    The use of dietary supplements was compared between a cohort of committed exercisers, U.S. Masters Swimming (USMS) members (n = 1,042), and the general U.S. population, exemplified by respondents to the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2010 (n = 6,209). USMS swimmers were significantly more likely to take dietary supplements (62%) than the general U.S. adult population, as represented by the NHANES population (37%). Those taking dietary supplements were older, more likely to be female and Caucasian, and more highly educated and affluent than those not taking supplements (p < .001 for all). When adjusted for age, race, gender, annual income, and education, masters swimmers were still more likely (p < .001) to use dietary supplements than the NHANES cohort. In addition, masters swimmers were significantly more likely (p < .001) to use either creatine or dehydroepiandrosterone or testosterone than those in the NHANES cohort.

  2. Problematic Social Media Use: Results from a Large-Scale Nationally Representative Adolescent Sample

    PubMed Central

    Bányai, Fanni; Zsila, Ágnes; Király, Orsolya; Maraz, Aniko; Elekes, Zsuzsanna; Griffiths, Mark D.; Andreassen, Cecilie Schou

    2017-01-01

    Despite social media use being one of the most popular activities among adolescents, prevalence estimates among teenage samples of social media (problematic) use are lacking in the field. The present study surveyed a nationally representative Hungarian sample comprising 5,961 adolescents as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Using the Bergen Social Media Addiction Scale (BSMAS) and based on latent profile analysis, 4.5% of the adolescents belonged to the at-risk group, and reported low self-esteem, high level of depression symptoms, and elevated social media use. Results also demonstrated that BSMAS has appropriate psychometric properties. It is concluded that adolescents at-risk of problematic social media use should be targeted by school-based prevention and intervention programs. PMID:28068404

  3. The Big Five Personality Traits and Intimate Partner Violence: Findings From a Large, Nationally Representative Sample.

    PubMed

    Ulloa, Emilio C; Hammett, Julia F; O'Neal, Danielle N; Lydston, Emily E; Leon Aramburo, Leslie F

    2016-12-01

    Intimate partner violence (IPV) is a major public health concern. Thus, it is vital to identify factors, such as individuals' personality traits, that may place men and women at risk for experiencing IPV. This study used data from Wave 4 of the National Longitudinal Study of Adolescent Health (N = 7,187), to examine the association between the Big Five personality traits and IPV perpetration and victimization among men and women. High openness, extraversion, and neuroticism emerged as the three most important risk factors associated with IPV. Although risk factors were found to be relatively similar for IPV perpetratio