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Lower Birthweight (lower + birthweight)
Selected AbstractsPrenatal polychlorinated biphenyl exposures in eastern Slovakia modify effects of social factors on birthweightPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2008Dean Sonneborn Summary Polychlorinated biphenyls (PCB) were widely used for industrial purposes and consumer products, but because of their toxicity, production was banned by most industrialised countries in the late 1970s. In eastern Slovakia, they were produced until 1985. During 2002,04, a birth cohort of mothers (n = 1057) residing in two Slovak districts was enrolled at delivery, and their specimens and information were collected after birth. Congeners of PCBs were measured in maternal serum by high-resolution gas chromatography with electron capture detection. In this study, we used multiple linear regression to examine the effects of prenatal PCB exposure on birthweight adjusted for gestational age, controlling for inter-pregnancy interval, and maternal smoking, age, education, ethnicity, pre-pregnancy body mass index and height. The association between total maternal serum PCB levels and birthweight was not statistically significant. However, an interaction model indicated that maternal PCB concentrations were associated with lower birthweight in Romani boys. Based on the fitted regression model, the predicted birthweight of Romani boys at the 90th percentile of maternal PCBs (12.8 ng/mL) was 133 g lower than the predicted birthweight at the 10th percentile of maternal PCBs (1.6 ng/mL). This is a similar magnitude of effect to that observed for maternal smoking and birthweight. These results suggest that higher levels of PCBs in maternal blood sera may inhibit growth in boys, particularly in those already affected by social factors related to ethnicity. This study is consistent with previous findings that boys are more susceptible than girls to growth restriction induced by in utero organochlorine exposures, and further indicates that high PCBs may magnify the influence of social disadvantage in this vulnerable group of boys. [source] Studies of twins: what can they tell us about the fetal origins of adult disease?PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2005Ruth Morley Summary There has been much interest in evidence that people with lower birthweight have higher risk of adult cardiovascular disease, but the causal pathways underlying such observations are uncertain. Study of twins offers an opportunity to shed light on the underlying causal pathways, in particular by investigating the role of ,shared' factors vs. factors affecting each individual fetus. This involves comparing results of within-cohort vs. within-pair analyses. Twins share many factors during gestation but birthweight discordance (difference in birthweight within a twin pair) cannot be determined by these shared factors and must relate to factors affecting growth of each individual fetus. If associations seen in a cohort of twins remain in within-pair analyses, then factors specific to each individual must be involved in the underlying causal pathways. Conversely, if the relationships disappear or substantially diminish in within-pair analyses, then factors common to the pair must be involved. Comparison of findings in monozygotic vs. dizygotic twins may provide insights into the role of genetic factors, although issues related to chorionicity need to be taken into account. We tabulate published data and conclude that differences in methodology and analyses preclude informative meta-analysis, and that analysis of pooled data would provide more useful information. [source] Lung function and exhaled nitric oxide levels in infants developing chronic lung diseasePEDIATRIC PULMONOLOGY, Issue 2 2007Olivia Williams MRCPCH Abstract Chronic lung disease (CLD) is a common outcome of neonatal intensive care. To determine whether the results of serial exhaled nitric oxide (eNO) measurements during the perinatal period differed between infants who did and did not develop CLD. In addition, we wished to assess whether eNO results were more predictive of CLD development than lung function test results or readily available clinical data (gestational age and birthweight). The patients were 24 infants with a median gestational age of 27 (range 25,31) weeks. Measurements of eNO levels, functional residual capacity (FRC), and compliance of the respiratory system (CRS) were attempted on postnatal days 1, 3, 5, 7, 14, and 28 days. The 12 infants who developed CLD were of significantly lower birthweight and gestational age than the rest of the cohort; in addition, they had lower median FRC (P,<,0.02) and CRS (P,<,0.02) results, but not higher eNO levels, in the first week after birth. Construction of receiver operator characteristic (ROC) curves demonstrated that the CRS and FRC results on Day 3 were the best predictors of CLD development; the areas under the ROC curves were 0.94 and 0.91, respectively. Early lung function test results, but not eNO levels, are useful in predicting CLD development, but are not significantly better than birthweight. Pediatr Pulmonol. 2007; 42:107,113. © 2006 Wiley-Liss, Inc. [source] Mothers without Companionship During Childbirth: An Analysis within the Millennium Cohort StudyBIRTH, Issue 4 2008Holly N. Essex MSc ABSTRACT: Background: Studies have highlighted the benefits of social support during labor but no studies focused on women who choose to be unaccompanied or who have no companion available at birth. Our goals were, first, to identify characteristics of women who are unaccompanied at birth and compare these to those who had support and, second, to establish whether or not being unaccompanied at birth is a risk marker for adverse maternal and infant health outcomes. Methods: The sample comprised 16,610 natural mother-infant pairs, excluding women with planned cesarean sections in the Millennium Cohort Study. Multivariable regression models were used to examine, first, sociodemographic, cultural, socioeconomic, and pregnancy characteristics in relation to being unaccompanied and, second, being unaccompanied at birth in relation to labor and delivery outcomes, maternal health and health-related behaviors, parenting, and infant health and development. Results: Mothers who were single (vs not single), multiparous (vs primiparous), of black or Pakistani ethnicity (vs white), from poor households (vs nonpoor), with low levels of education (vs high levels), and who did not attend antenatal classes (vs attenders) were at significantly higher risk of being unaccompanied at birth. Mothers unaccompanied at birth were more likely to have a preterm birth (vs term), an emergency cesarean section (vs spontaneous vaginal delivery) and spinal pain relief or a general anesthetic (vs no pain relief), a shorter labor, and lower satisfaction with life (vs high satisfaction) at 9 months postpartum. Their infants had significantly lower birthweight and were at higher risk of delayed gross motor development (vs normal development). Conclusions: Being unaccompanied at birth may be a useful marker of high-risk mothers and infants in need of additional support in the postpartum period and beyond. (BIRTH 35:4 December 2008) [source] Explaining differences in birthweight between ethnic populations.BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2007The Generation R Study Objective, To examine whether differences in birthweight of various ethnic groups residing in the Netherlands can be explained by determinants of birthweight. Design, Population-based birth cohort study. Setting, Data of pregnant women and their partners in Rotterdam, the Netherlands. Population, We examined data of 6044 pregnant women with a Dutch, Moroccan, Turkish, Capeverdean, Antillean, Surinamese-Creole, Surinamese-Hindustani and Surinamese-other ethnic background. Methods, Regression analyses were used to assess the impact of biomedical, socio-demographic and lifestyle-related determinants on birthweight differences. Main outcome measure, Birthweight was established immediately after delivery in grams. Results, Compared with mean birthweight of offspring of Dutch women (3485 g, SD 555), the mean birthweight was lower in all non-Dutch populations, except in Moroccans. Differences ranged from an 88-g lower birthweight in offspring of the Turkish women to a 424-g lower birthweight in offspring of Surinamese-Hindustani women. Differences in gestational age, maternal and paternal height largely explained the lower birthweight in the Turkish, Antillean, Surinamese-Creole and Surinamese-other populations. Differences in birthweight between the Dutch and the Capeverdean and Surinamese-Hindustani populations could only partly be explained by the studied determinants. Conclusions, These results confirm significant differences in birthweight between ethnic populations that can only partly be understood from established determinants of birthweight. The part that is understood points to the importance of determinants that cannot easily be modified, such as parental height. Further study is necessary to obtain a fuller understanding. [source] Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweightBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2000Christian Lodberg Hvas Research Fellow Objective To investigate the impact of epilepsy and antiepileptic drugs on length of gestation and anthropometric measures of the newborn. Design Cohort study based on questionnaires mailed to all pregnant women who attended for prenatal care at our department from August 1989 to January 1997. Setting Department of Obstetrics and Gynaecology at Aarhus University Hospital, Denmark. Participants One hundred and ninety-three singleton pregnancies in women with epilepsy were compared with 24,094 singleton pregnancies in women without epilepsy. Main outcome measures Preterm delivery, small for gestational age, mean gestational age, gestational age-adjusted birthweight, head circumference, and body length. Results Children of women with epilepsy who smoked had lower gestational age and were at increased risk of preterm delivery (OR 3.4; 95% CI 1.8,6.5), compared with children born by nonepileptic women who smoked. Birthweight adjusted for gestational age was reduced by 102 g (95% CI 40,164) in women with epilepsy, and the risk of delivering a child who was small for gestational age was increased (adjusted OR 1.9, 95% CI 1.3,2.7), compared with women without epilepsy. Newborn babies of women with epilepsy treated by drugs had a reduced adjusted birthweight (208 g, 95% CI 116,300), head circumference (0.4 cm, 95% CI 0.0.0.7), and body length (0.5 cm, 95% CI 0.1,1.0), compared with the newborn infants of women without epilepsy. Conclusions Women with epilepsy who smoked were at increased risk of preterm delivery compared with healthy smokers. Children of women with drug treated epilepsy had lower birthweight, length, and head circumference than children of women without epilepsy. [source] The influence of maternal cigarette smoking, snuff use and passive smoking on pregnancy outcomes: the Birth To Ten StudyPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2006Krisela Steyn Summary Steyn K, de Wet T, Saloojee Y, Nel H, Yach D. The influence of maternal cigarette smoking, snuff use and passive smoking on pregnancy outcomes: the Birth To Ten Study. Paediatric and Perinatal Epidemiology 2006; 20: 90,99. This article describes the patterns and effects of maternal snuff use, cigarette smoking and exposure to environmental tobacco smoke during pregnancy on birthweight and gestational age, in women living in Johannesburg and Soweto in 1990. A cohort of 1593 women with singleton live births provided information about their own and household members' usage of tobacco products during pregnancy. The women completed a questionnaire while attending antenatal services. Data on gestational age and birthweight were obtained from birth records. Women who smoked cigarettes or used snuff during pregnancy accounted for 6.1% and 7.5% of the study population respectively. The mean birthweight of non-tobacco users was 3148 g [95% CI 3123, 3173] and that of the smokers 2982 g [95% CI 2875, 3090], resulting in a significantly lower mean birthweight of 165 g for babies of smoking mothers (P = 0.005). In contrast, women using snuff gave birth to infants with a mean birthweight of 3118 g [95% CI 3043, 3192], which is a non-significant (P = 0.52) decrease (29.4 g) in their infants' birthweights compared with those not using tobacco. A linear regression analysis identified short gestational age, female infant, a mother without hypertension during pregnancy, coloured (mixed racial ancestry), and Asian infants compared with black infants, lower parity, less than 12 years of education and smoking cigarettes as significant predictors of low birthweight, while the use of snuff during pregnancy was not associated with low birthweight. The snuff users, however, had a significant shorter gestational age than the other two groups of women. The birthweight reduction adjusted for possible confounders was 137 g [95% CI 26.6, 247.3 (P = 0.015)] for cigarette smokers and 17.1 g [95% CI ,69.5, ,102.7, P = 0.69] for snuff users respectively, compared with the birthweight of non-tobacco users. Among women who did not smoke cigarettes or use snuff, exposure to environmental tobacco smoke did not result in significant effects on the birthweight of their infants. In conclusion, infants of cigarette smokers had significantly lower birthweights than those of non-tobacco users or snuff users who are exposed to nicotine during pregnancy. Passive smoking did not affect birthweight significantly in this population. [source] The influence of maternal and child characteristics and paternal support on interactions of mothers and their medically fragile infants,RESEARCH IN NURSING & HEALTH, Issue 1 2007Tzu-Ying Lee Abstract The influences of maternal characteristics, infant characteristics, and paternal support on maternal positive involvement and developmental stimulation were examined over time in 59 mothers and their medically fragile infants using an ecological framework. Higher maternal education was associated with greater maternal positive involvement. More maternal depressive symptoms, more infant technological dependence, and lower birthweights were associated with less maternal positive involvement at 6 months but greater involvement at 12 months. Higher paternal helpfulness facilitated positive involvement in mothers with low depressive symptoms but not in those with elevated symptoms. Higher maternal education and more depressive symptoms were associated with more developmental stimulation. Thus, maternal interactive behaviors are affected by maternal, infant, and environment factors, and these effects change over time. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 17,30, 2007 [source] Effects of twin pregnancy and periconceptional undernutrition on maternal metabolism, fetal growth and glucose,insulin axis function in ovine pregnancyTHE JOURNAL OF PHYSIOLOGY, Issue 5 2008C. W. H. Rumball Although twins have lower birthweights than singletons, they may not experience the increased disease risk in adulthood reportedly associated with low birthweight. In contrast, another periconceptional event, maternal undernutrition, does not reduce birthweight but does affect fetal and postnatal physiology in sheep. We therefore studied maternal and fetal metabolism, growth and glucose,insulin axis function in late gestation in twin and singleton sheep pregnancies, either undernourished from 60 days before until 30 days after conception or fed ad libitum. We found that twin-bearing ewes had decreased maternal food intake in late gestation and lower maternal and fetal plasma glucose and insulin levels. Twin fetuses had fewer everted placentomes, grew slower in late gestation, and had a greater insulin response to a glucose challenge, but lesser response to arginine. In contrast, periconceptional undernutrition led to increased maternal food intake and a more rapid fall in maternal glucose levels in response to fasting. Periconceptional undernutrition increased the number of everted placentomes, and abolished the difference in insulin responses to glucose between twins and singletons. Thus, the physiology of twin pregnancy is quite different from that of singleton pregnancy, and is probably determined by a combination of factors acting in both early and late gestation. The inconsistency of the relationships between low birthweight and postnatal disease risk of twins may lie in their very different fetal development. These data suggest that twin pregnancy may be another paradigm of developmental programming, and indicate that twins and singletons must be examined separately in any study of fetal or postnatal physiology. [source] Small for gestational age preterm infants and relationship of abnormal umbilical artery Doppler blood flow to perinatal mortality and neurodevelopmental outcomesAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Antonia W. SHAND Aim: To determine the outcomes of preterm small for gestational age (SGA) infants with abnormal umbilical artery (UA) Doppler studies. Methods: A retrospective cohort study of SGA singleton infants delivered between 24 and 32 weeks gestation at King Edward Memorial Hospital, Perth, who had UA Doppler studies performed within seven days of birth. Main outcomes assessed were perinatal mortality and morbidity, and neurodevelopmental outcomes at , 1 year of age. Outcomes were compared by normality of UA blood flow. Results: There were 119 infants in the study: 49 (41%) had normal UA Doppler studies, 31 (26%) had an increased systolic,diastolic ratio , 95th centile, 19 (16%) had absent end diastolic blood flow (AEDF) and 20 (17%) had reversed end-diastolic flow (REDF). Infants in the AEDF and REDF groups were delivered significantly more preterm (P = 0.006) and had lower birthweights (P < 0.001). Ninety four per cent (110 of 117) of live born infants survived. Neurodevelopmental follow-up at 12 months of age or more (median 24 months) was available on 87 of 108 (81%) of live children. Twenty-eight per cent (11 of 39) of fetuses who had had AEDF or REDF died or were classified with moderate or severe disability. There was no significant association between abnormality of UA blood flow, perinatal morbidity, perinatal mortality and neurodevelopmental disability after correction for gestational age. Conclusion: Fetuses that are SGA with abnormal UA Doppler studies remain at significant risk of perinatal death, perinatal morbidity and long-term neurodevelopmental disability, associated with their increased risk of preterm birth. [source] Transient hyperthyroidism of hyperemesis gravidarumBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2002Jackie Y.L. Tan Objective To characterise the clinical, biochemical and thyroid antibody profile in women with transient hyperthyroidism of hyperemesis gravidarum. Design Prospective observational study. Setting Hospital inpatient gynaecological ward. Population Women admitted with hyperemesis gravidarum and found to have hyperthyroidism. Methods Fifty-three women were admitted with hyperemesis gravidarum and were found to have hyperthyroidism. Each woman was examined for clinical signs of thyroid disease and underwent investigations including urea, creatinine, electrolytes, liver function test, thyroid antibody profile and serial thyroid function test until normalisation. Main outcome measures Gestation at which thyroid function normalised, clinical and thyroid antibody profile and pregnancy outcome (birthweight, gestation at delivery and Apgar score at 5 minutes). Results Full data were available for 44 women. Free T4 levels normalised by 15 weeks of gestation in the 39 women with transient hyperthyroidism while TSH remained suppressed until 19 weeks of gestation. None of these women were clinically hyperthyroid. Thyroid antibodies were not found in most of them. Median birthweight in the infants of mothers who experienced weight loss of >5% of their pre-pregnancy weight was lower compared with those of women who did not (P= 0.093). Five women were diagnosed with Graves' disease based on clinical features and thyroid antibody profile. Conclusions In transient hyperthyroidism of hyperemesis gravidarum, thyroid function normalises by the middle of the second trimester without anti-thyroid treatment. Clinically overt hyperthyroidism and thyroid antibodies are usually absent. Apart from a non-significant trend towards lower birthweights in the infants of mothers who experienced significant weight loss, pregnancy outcome was generally good. Routine assessment of thyroid function is unnecessary for women with hyperemesis gravidarum in the absence of any clinical features of hyperthyroidism. [source] | ||||||||||