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Maternal History (maternal + history)

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Medical Sciences	93%

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Maternal history, sensitization to allergens, and current wheezing, rhinitis, and eczema among children in Costa Rica

PEDIATRIC PULMONOLOGY, Issue 4 2002
Manuel E. Soto-Quiros MD
Abstract Little is known about the factors associated with asthma, allergic rhinitis, and eczema in Latin American countries. We investigated the relation between potential risk factors and current wheezing, allergic rhinitis, and eczema among 208 Costa Rican children aged 10,13 years participating in phase II of the International Study of Asthma and Allergies in Childhood (ISAAC). The geometric mean (,±,SD) serum total IgE level of children with current wheezing was significantly higher than that of children without current wheezing (533.8,±,5.2 vs. 144.7,± 6.0 IU/mL, P,<,0.01). In a multivariate analysis, a maternal history of asthma, skin test reactivity (STR) to house dust mites, and STR to Alternaria were significantly associated with current wheezing. Children who had a maternal history of asthma had 2.4 times higher odds of current wheezing than those without maternal history of asthma (95% CI for OR,=,1.1,5.3). Sensitization to either house dust mite or Alternaria was associated with 3.3 times increased odds of current wheezing (95% CI for OR for STR to dust mite,=,1.6,6.7; 95% CI for OR for STR to Alternaria,=,1.1,11.0). In a multivariate analysis, STR to house dust mite and STR to cat dander were significantly associated with allergic rhinitis, and a maternal history of eczema and STR to dog dander were associated with eczema in the child. The interaction between familial factors and lifestyle changes resulting from social reforms implemented 60 years ago may explain the high prevalence of atopic diseases in Costa Rica. Pediatr Pulmonol. 2002; 33:237,243. © 2002 Wiley-Liss, Inc. [source]

First trimester exposure to cefuroxime: a prospective cohort study

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2000
Matitiahu Berkovitch
Aims There are no published studies on the safety of cefuroxime use during pregnancy. We therefore investigated prospectively the possible teratogenic effect of intrauterine exposure to cefuroxime. Methods One hundred and six women who received cefuroxime during the first trimester of pregnancy were recruited from three teratogen information centres in Israel. Exposed women were paired for age, smoking habits and alcohol consumption with references being exposed to nonteratogenic antibiotics administered for the same indications. Results Maternal history, birthweight, gestational age at delivery, rates of live births, spontaneous abortions and fetal distress were comparable among the two groups. Rates of major malformations in the cefuroxime group (3.2%) did not differ from references (2%) (P = 0.61, relative risk = 1.56, 95% confidence interval 0.27,9.15). There was a significantly higher rate of induced abortions among the cefuroxime exposed women as compared to the references (P = 0.04, relative risk = 3.33, 95% confidence interval 0.94,11.77). Conclusions Our data may suggest that exposure to cefuroxime during the first trimester is probably not associated with an increased risk for malformations or spontaneous abortions; however, in light of the small sample size and the broad confidence limits, larger studies are needed to confirm these findings. [source]

Prevalence and clinical characteristics of maternally inherited diabetes and deafness caused by the mt3243A > G mutation in young adult diabetic subjects in Sri Lanka

DIABETIC MEDICINE, Issue 3 2008
P. Katulanda
Abstract Aims The maternally inherited mt3243A > G mutation is associated with a variable clinical phenotype including diabetes and deafness (MIDD). We aimed to determine the prevalence and clinical characteristics of MIDD in a large South Asian cohort of young adult-onset diabetic patients from Sri Lanka. Methods DNA was available from 994 subjects (age of diagnosis 16,40 years, age at recruitment , 45 years). Mutation screening was performed using a QRT-PCR method on an ABI 7900HT system using sequence-specific probes. Samples with heteroplasmy , 5.0% were considered positive. Results Nine (four males) mutation-positive subjects were identified (prevalence 0.9%). They were diagnosed at a younger age (25.9 ± 4.8 years vs. 31.9 ± 5.6 years, P = 0.002) and were lean (body mass index [BMI] 18.7 ± 2.7 kg/m2 vs. 24.7 ± 4.0 kg/m2, P < 0.001) compared to NMCs. One mutation-positive subject (11.1%) had metabolic syndrome, compared to 633 (64.3%) of NMCs. Insulin therapy within 6 months of diagnosis was used in four (44.0%) carriers compared to 6.9% of NMCs (P = 0.002). Combined screening criteria of any two of maternal history of diabetes, personal history of hearing impairment and family history of hearing impairment only identified five (55%) of the carriers, with a positive predictive value of 7.4%. Conclusions The prevalence of mt3243A > G mutation among young adult-onset diabetic subjects from Sri Lanka was 0.9%. Our study demonstrates that a maternal family history of diabetes and either a personal and/or family history of deafness only distinguish half of patients with MIDD from Sri Lankan subjects with young-onset diabetes. [source]

Association of the VDR Translation Start Site Polymorphism and Fracture Risk in Older Women,,

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2007
Susan P Moffett PhD
Abstract We evaluated the association between the VDR translation start site polymorphism and osteoporotic phenotypes among 6698 older white women. Women with the C/C genotype had lower wrist BMD and an increased risk of wrist and all non-spine/low-trauma fractures. The high frequency of this variant confers a population attributable risk that is similar to several established risk factors for fracture. Introduction: The vitamin D receptor (VDR) is a nuclear receptor that regulates bone formation, bone resorption, and calcium homeostasis. A common C to T polymorphism in exon 2 of the VDR gene introduces a new translation start site and a protein that differs in length by three amino acids (T = 427aa, C = 424aa; rs10735810). Materials and Methods: We conducted genetic association analyses of this polymorphism, BMD, and fracture outcomes in a prospective cohort of 6698 white American women ,65 years of age. Incident fractures were confirmed by physician adjudication of radiology reports. There were 2532 incident nontraumatic/nonvertebral fractures during 13.6 yr of follow-up including 509 wrist and 703 hip fractures. Results: Women with the C/C genotype had somewhat lower distal radius BMD compared with those with the T/T genotype (CC = 0.358 g/cm2, CT = 0.361 g/cm2, TT = 0.369 g/cm2, p = 0.003). The C/C genotype was also associated with increased risk of non-spine, low traumatic fractures (HR: 1.18; 95% CI: 1.04, 1.33) and wrist fractures (HR: 1.33; 95% CI: 1.01, 1.75) compared with the T/T genotype in age-adjusted models. Further adjustments for distal radius BMD only slightly attenuated these associations. The VDR polymorphism was not associated with hip fracture. The population attributable risk (PAR) of the C/C genotype for incident fractures was 6.1%. The PAR for established risk factors for fracture were: low femoral neck BMD (PAR = 16.3%), maternal history of fracture (PAR = 5.1%), low body weight (PAR = 5.3%), corticosteroid use (PAR = 1.3%), and smoking (PAR = 1.6%). Similar PAR results were observed for wrist fractures. Conclusions: The common and potentially functional VDR translation start site polymorphism confers a modestly increased relative risk of fracture among older white women. However, the high frequency of this variant confers a population attributable risk that is similar to or greater than several established risk factors for fracture. [source]

The reproductive health of daughters of pregestational diabetic women: Medical Birth Registry of Norway

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2002
Grace M. Egeland
Summary Maternal diabetes may have an impact upon a daughter's reproductive health through genetic influences, an altered fetal metabolic environment or both. We examined the reproductive health of daughters of diabetic women using linked generation data from the Medical Birth Registry of Norway. Among all female births between 1967 and 1982 (n = 459 182), 739 had a mother with registered pregestational diabetes, a rate of 1.6 per 1000 deliveries. A total of 142 904 daughters delivered at least one child by 1998. After taking into account differences in survival, we observed no differences in the percentage of childbearing and in the average number of children born by 1998 between daughters with and without a diabetic mother in age-stratified analyses. In analyses limited to singleton deliveries and stratified by mothers' and daughters' diabetic status, we found a threefold excess stillbirth delivery rate among women who had either a mother with pregestational diabetes (2.6%) or pregestational diabetes themselves (2.6%) compared with the stillbirth delivery rate observed in non-diabetic women with no maternal history of diabetes (0.8%). These findings were unaltered in multivariable analyses adjusting for daughters' maternal age and registered obstetric risk factors. Our results indicate that pregestational diabetes remains a health care challenge in Norway and that further evaluation of the reproductive health of daughters of diabetic pregnancies is warranted. [source]

Cross-sectional study of allergic disorders associated with breastfeeding in Japan: The Ryukyus Child Health Study

PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 5 2007
Yoshihiro Miyake
Uncertainties remain as to whether breastfeeding is protective against childhood allergic disorders. Positive relationships of breastfeeding with asthma and atopic eczema were observed in two previous Japanese studies. This cross-sectional study investigated the association between the feeding pattern after birth and the prevalence of allergic disorders during the past 12 months in Japanese schoolchildren. Study subjects were 24,077 children aged 6,15 yr in Okinawa. The outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Allowance was made for age, sex, number of siblings, smoking in the household, paternal and maternal history of asthma, atopic eczema, and allergic rhinitis, and paternal and maternal educational level. Breastfeeding, regardless of exclusivity, for 13 months or longer and exclusive breastfeeding for 4,11 months were independently associated with a higher prevalence of atopic eczema, particularly among children without a parental allergic history. A clear positive dose,response relationship was observed between prolonged duration of breastfeeding, regardless of exclusivity, but not exclusive breastfeeding, and the prevalence of atopic eczema. We found a significant positive trend for atopic eczema across the three categories (formula milk, partial and exclusive breastfeeding) in the first 4 months of life although the odds ratio for exclusive breastfeeding was not statistically significant. No material association was found between the feeding pattern after birth and the prevalence of wheeze or allergic rhinoconjunctivitis. Prolonged breastfeeding may be associated with a higher prevalence of atopic eczema in Japanese children. [source]

Cutis Marmorata Telangiectatica Congenita and Neonatal Lupus

PEDIATRIC DERMATOLOGY, Issue 3 2007
CAROLINE E. HEUGHAN M.D.
We describe a female infant with vascular lesions consistent with this entity who was born to a mother with previously diagnosed systemic lupus erythematosus. Antinuclear antibodies and anti-Ro/SSA antibodies were detected in both mother and infant, supporting a diagnosis of neonatal lupus. This presentation is consistent with the rarely reported association between neonatal lupus and cutis marmorata telangiectatica congenita that suggests the latter is part of the cutaneous spectrum of the former. A thorough maternal history and laboratory investigations should be considered for infants with cutis marmorata telangiectatica congenita and their mothers in order to rule out the presence of an underlying autoimmune disease. [source]

Risk factors of bronchial hyperresponsiveness in children with wheezing-associated respiratory infection

PEDIATRIC PULMONOLOGY, Issue 1 2005
Sitthivuddhi Futrakul MD
Abstract The objectives of this study were to identify possible risk factors of bronchial hyperesponsiveness (BHR) in children up to 5 years of age with wheezing-associated respiratory infection (WARI), and to study the prevalence of BHR. Children up to 5 years of age with WARI were enrolled in the study. The parents or caregivers of children were asked about their demographic data and clinical histories. Physical examination and clinical score assessment were performed. Pulmonary function tests, i.e., tidal breathing flow volume (TBFV), were performed to measure tidal breathing parameters before and after salbutamol nebulization. If volume at peak tidal expiratory flow/expiratory tidal volume and time to peak expiratory flow/total expiratory time increased ,20%, or tidal expiratory flow at 25% of tidal volume/peak tidal expiratory flow increased ,20% after nebulization therapy, BHR was diagnosed. The number in the positive BHR group was used to calculate the prevalence of BHR, and clinical features were compared with those of the negative BHR group. Categorical data were analyzed for statistical significance (P,<,0.05) by chi-square test or Fisher's exact test, or Student's t -test, as appropriate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for those with statistical significance. One hundred and six wheezing children underwent pulmonary function tests before and after salbutamol nebulization. With the aforementioned criteria, 41 cases (38.7%) were diagnosed with BHR. History of reactive airway disease, (OR, 6.31; 95% CI, 1.68,25), maternal history of asthma (OR, 3.45; 95% CI, 1.34,9), breastfeeding less than 3 months (OR, 3.18; 95% CI, 1.26,8.12), and passive smoking (OR, 3; 95% CI, 1.15,7.62) were significant risk factors of BHR. The eosinophil count was significantly higher in the BHR (+) group particularly, in children 1,5 years of age (P,,,0.01). Patchy infiltrates were more commonly found in patients with negative BHR but not statistically significant. In conclusion, a history of reactive airway disease, maternal history, breastfeeding less than 3 months, and passive smoking were significant risk factors for BHR. Pediatr Pulmonol. © 2005 Wiley-Liss, Inc. [source]

Maternal history, sensitization to allergens, and current wheezing, rhinitis, and eczema among children in Costa Rica

Association of tobacco smoke exposure and respiratory syncitial virus infection with airways reactivity in early childhood

PEDIATRIC PULMONOLOGY, Issue 6 2001
Alan Adler MD
Abstract Exposure to infectious agents and environmental tobacco smoke are thought to induce bronchial hyperresponsiveness (BHR). This study was undertaken to determine the effects of passive exposure to tobacco smoke and respiratory syncitial virus (RSV) lower respiratory infection (LRI) during infancy on the occurrence of BHR in the first 2 years of life. Eighty-six cases of documented RSV (mean age, 188 days) and 78 controls (mean age, 162 days) were enrolled from the clinic and in-patient service of a single hospital. None had a history of prior LRI. Subjects were studied at 6-month intervals up to 19 months of age with a standardized respiratory illness and parental smoking questionnaire, partial expiratory flow-volume curves by the "hug" (rapid thoracic compression) technique, and methacholine challenge. Exposure to maternal and paternal cigarette smoking, maternal history of asthma, and mold exposure were associated with decreased levels of length-corrected maximal flow at functional residual capacity (V,maxFRC). RSV-LRI was not related to V,maxFRC. After adjustment of V,maxFRC for these factors, V,maxFRC was a significantly and positively correlated with a methacholine concentration provoking a 40% fall in V,maxFRC (PC40) and negatively correlated with dose-response slope. After adjustment for V,maxFRC, there were no independent effects of tobacco smoke exposure or RSV-LRI on methacholine responses. These data do not support a role for RSV as a risk factor for airways reactivity in childhood and indicate that exposure to tobacco smoke affects airways reactivity through its effects on airways. Pediatr Pulmonol. 2001; 32:418,427. © 2001 Wiley-Liss, Inc. [source]

A population-based study of coarctation of the aorta: Comparisons of infants with and without associated ventricular septal defect

BIRTH DEFECTS RESEARCH, Issue 5 2001
Dana Swartzberg Wollins
Background Coarctation of the aorta (CoA) is a congenital cardiovascular malformation (CCVM) sometimes associated with ventricular septal defect (VSD). Although the phenotypic association is well documented, little research exists on the epidemiological features distinguishing CoA with and without VSD. Methods The Baltimore,Washington Infant Study (1981,1989), a population-based study of CCVM, evaluated 126 infants with "pure" CoA (free of associated cardiac defects) and 67 infants with CoA and VSD (COA/VSD) in comparison to 3,572 controls. Results The proportion of infants with associated extracardiac anomalies was greater among CoA/VSD than among pure CoA (31% versus 11%). Infants with CoA/VSD were twice as likely as those with pure CoA to be born small for gestational age (23% versus 12%, respectively, compared with 6% of controls). All-cause mortality during the first year of life was higher in CoA/VSD than in pure CoA (21% vs. 7%). Multiple logistic regression models revealed that family history of CCVM was associated with pure CoA (adjusted case-control odds ratio [OR] = 4.6; 99% confidence interval [CI] = 1.5,13.9) and with CoA/VSD (OR = 5.9, CI = 1.2,23.5); maternal history of organic solvent exposures early in pregnancy was also associated with pure CoA (OR = 3.2, CI = 1.0,10.2) and with CoA/VSD (OR = 3.7, CI 0.9,14.9). Additional risk factors, including maternal epilepsy (OR = 5.3, CI = 0.9,30.6), and use of macrodantin (OR = 6.7, CI = 1.4,31.8) were associated only with pure CoA. Conclusions These findings highlight possible genetic and environmental differences between pure CoA and CoA/VSD and may stimulate further investigations of the etiology of CoA. Teratology 64:229,236, 2001. © 2001 Wiley-Liss, Inc. [source]

Assessment of risk for the development of pre-eclampsia by maternal characteristics and uterine artery Doppler

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2005
Aris T. Papageorghiou
Objective To develop a method for the estimation of patient-specific risk for the development of pre-eclampsia by combining maternal history and uterine artery Doppler. Design Prospective multicentre observational study. Setting Antenatal clinics in seven hospitals in the UK and three overseas centres. Population Unselected women with singleton pregnancies attending for routine antenatal care. Methods Doppler studies of the uterine arteries were performed using colour flow mapping and pulsed wave Doppler at 23 weeks of gestation. The mean pulsatility index (PI) of the two uterine arteries was calculated. Doppler and maternal history variables were combined to develop a model for risk assessment. The incidence of pre-eclampsia was used to derive the prior risk for this complication. The posterior risk was derived by multiplying the prior odds with likelihood ratios (LRs) derived from independent risk factors identified from the maternal history, and the LR estimated from the heights of the frequency distributions of mean PI in affected and unaffected pregnancies. Main outcome measure Pre-eclampsia. Results There were 17,480 women recruited to the study, in which 17,319 (99.1%) of these Doppler examination of both uterine arteries were completed, and outcome data were available in 16,806 (97.0%). Pre-eclampsia occurred in 369 (2.20%) cases. Significant independent prediction of pre-eclampsia was provided by mean PI, ethnic origin, body mass index (BMI), parity, cigarette smoking, history of hypertension and family or personal history of pre-eclampsia. Models were derived allowing calculation of patient-specific risk for development of pre-eclampsia. For a false-positive rate of 25%, the detection rate of pre-eclampsia by screening using maternal history was 45.3%, with uterine artery Doppler it was 63.1% and with combined assessment it was 67.5%. Conclusions Combining risk factors in the mother's history with Doppler of the uterine arteries allows calculation of patient-specific risk for the development of pre-eclampsia. [source]

Maternal cardiovascular disease risk in relation to the number of offspring born small for gestational age: national, multi-generational study of 2.7 million births

ACTA PAEDIATRICA, Issue 6 2009
Peter M Nilsson
Abstract Aim: To investigate the risk of small for gestational age (SGA) births in relation to maternal history of cardiovascular disease (CVD) across two generations and additionally to analyse maternal CVD risk based on number of SGA offspring. Methods: We used register data from 1.4 million women and 2.7 million offspring. The outcome measures were risk of being SGA in relation to maternal total CVD (n = 10 436) across two generations, as well as risk of CVD in mothers in relation to the number of their SGA offspring, stratified by educational level. Results: Compared to no family history of CVD (reference) the hazard ratio (HR) for being SGA in female offspring was 1.11 (95% confidence interval (CI) 1.09,1.13) for a positive maternal history of CVD. The highest risk was shown in daughters when both the mother and the grandmother had a history of CVD (HR 1.32, 95% CI 1.24,1.39). There was a stepwise increased risk of CVD events in mothers in relation to the number of their SGA offspring (HR 1.41,1.86) when ,no SGA offspring' was used as reference. The risk of CVD in relation to SGA status was increased in the least educated group (HR 2.7,5.0) compared to the group with the highest level of education with no SGA offspring. Conclusion: The risk of SGA offspring and the risk of maternal CVD are mutually interdependent and both conditions increased in women with a low level of education. [source]

Risk factors and characteristics associated with severe and difficult to treat asthma phenotype: an analysis of the ENFUMOSA group of patients based on the ECRHS questionnaire

CLINICAL & EXPERIMENTAL ALLERGY, Issue 7 2005
M. Gaga
Summary Background Severe and difficult to treat asthma impairs health status and accounts for about half of asthma expenditure. In 1994, a European Network For Understanding Mechanisms of Severe Asthma (ENFUMOSA) was formed. A large group of patients from nine European countries has been selected. Objective To examine the risk factors and symptoms associated with a phenotype of severe/difficult to treat asthma. Methods The present report presents data assessed through the use of the European Community Respiratory Health Survey (ECRHS) Questionnaire in 148 mild,moderate controlled and 155 severe asthmatics from the ENFUMOSA group. Results There is a negative association of severe asthma with reported allergy and with a family history of allergy (Odds ratio (OR)=0.45). Sharing a bedroom before the age of five is associated with a higher risk of severe asthma (OR=1.5) while childhood infections, play school attendance and exposure to allergens or animals are not. A larger proportion of severe asthma patients report symptoms at work (OR=2.7) or have to change jobs (OR=4.3) and fewer severe than mild patients are currently employed (OR=0.39). Smoking and exposure to smoke is similar in mild and severe asthma. Dietary habits do not differ between the groups, but severe asthmatics report eating less savoury snacks and there is a trend for lower intake of sweets. Conclusions Analysis of the ECRHS questionnaire in the ENFUMOSA study shows that severe asthma patients experience more symptoms and their health status is impaired by their inability to work and perhaps eat freely. Personal and maternal history of allergy is associated with mild but not severe asthma. Other than sharing a bedroom before the age of 5 years, no childhood exposure risk factors associated with severe asthma could be identified from this analysis. [source]