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Maternal Interviews (maternal + interview)
Selected AbstractsHypospadias and maternal exposures to cigarette smokePAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2005Suzan L. Carmichael Summary The few previous studies of hypospadias and smoking have suggested either no association or a reduced risk. This study, which uses data from the National Birth Defects Prevention Study, a multi-state, population-based case,control study, includes data on males born with severe hypospadias (i.e. the urethra opens at the penile shaft, scrotum or perineum) from 1997 to 2000. Non-malformed, liveborn male controls were selected randomly from birth certificates or from birth hospitals. Maternal interviews were completed by telephone with 453 case mothers and 1267 control mothers. Maternal smoking was not associated with hypospadias risk. For example, during the third month of pregnancy, smoking < 0.5 pack/day had an odds ratio (OR) of 1.1 [95% CI 0.6, 1.9]; 0.5 pack/day, 0.6 [0.4, 1.1]; and ,,1 pack/day, 0.8 [0.4, 1.6]. Exposure to any secondhand smoke at home during the third month of pregnancy showed an OR of 0.6 [95% CI 0.4, 1.0], and exposure at work or school, an OR of 0.7 [0.5, 1.1]. Similar risks were observed for other months during the periconceptional period, and adjustment for several potential confounders did not substantially alter results. This analysis does not confirm a recent report suggesting that maternal smoking is associated with a reduced risk of having offspring with hypospadias. [source] Risk factors for small-for-gestational-age babies: The Auckland Birthweight Collaborative StudyJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2001JMD Thompson Objective: This case-control study determined whether internationally recognized risk factors for small-for-gestational-age (SGA) term babies were applicable in New Zealand. Methodology: All babies were born at 37 or more completed weeks of gestation in one of three hospitals in Auckland. Cases weighed less than the sex specific 10th percentile for gestational age at birth, and controls (appropriate-for-gestational-age (AGA)) were a random selection of heavier babies. Information was collected by maternal interview and from obstetric databases. Results: Information from 1714 completed interviews (844 SGA and 870 AGA) was available for analysis. Computerized obstetric records were available for 1691 of the 1701 women who consented to such access. In a multivariate analysis allowing for sex, gestational age at birth, social class and other potential confounders, mothers who smoked had a significantly increased risk of an SGA baby (adjusted OR 2.41; 95% CI 1.78,;3.28), as did primiparous mothers (adjusted OR 1.34; 95% CI 1.03,;1.73), mothers of Indian ethnicity (adjusted OR 3.22; 95% CI 1.95,;5.30), women with pre-eclamptic toxaemia (adjusted OR 2.42; 95% CI 1.08,;5.40) and those with pre-existing hypertension toxaemia (adjusted OR 5.49; 95% CI 1.81,;16.71). Mothers of SGA infants were shorter (P < 0.001) and reported lower prepregnancy body weights (P < 0.001) than mothers of AGA infants. The population attributable fraction for smoking suggests that up to 18% of SGA infants born in the ABC Study could be related to maternal smoking. Conclusions: Risk factors associated with SGA births in other countries are also important in New Zealand. Smoking in pregnancy is an important and potentially modifiable behaviour, and efforts to decrease the number of women who smoke during pregnancy should be encouraged. [source] Interaction between maternal smoking and malnutrition in infant risk of gastroschisis,BIRTH DEFECTS RESEARCH, Issue 3 2006Phung K. Lam Abstract BACKGROUND Gastroschisis is a severe birth defect characterized by a tear in the infant's abdominal wall. Young mothers have the highest risk of having an infant with gastroschisis. In an animal model, the defect resulted from exposure of pregnant mice to carbon monoxide (CO) in combination with a low protein and low zinc diet. METHODS We evaluated this model in a study of 55 infants with gastroschisis and 94 age-matched controls that included maternal interview with a food frequency questionnaire. Smoking cigarettes (,1 pack/day) or marijuana (more than once) 3 months prior to pregnancy indicated CO exposure. Low protein or zinc intake and a low body mass index (BMI) indicated maternal malnutrition. RESULTS When assessed separately, high CO, low protein, low zinc, and low BMI were each significantly associated with an increased risk of gastroschisis. Although we observed significant CO-BMI and CO-zinc interactions after adjusting for income, only a combination of high CO exposure and low BMI yielded a synergistic adverse effect. Compared to the low risk of having an infant with gastroschisis for mothers who did not have low BMI and did not smoke, the risk of having an infant with gastroschisis was 16.3 times (95% CI, 2.49,113.4) higher for mothers who did not have low BMI but smoked, and 19.7 times (95% CI, 4.33,89.6) higher for mothers who did not smoke but had low BMI. However, the risk was 26.5 times (95% CI, 7.85,89.4) higher for mothers who had low BMI and smoked. CONCLUSIONS Our results suggest that young mothers are at increased risk of having an infant with gastroschisis if they smoke and are also malnourished. Birth Defects Research (Part A), 2006. © 2006 Wiley-Liss, Inc. [source] Birth Defects Cluster Study: A national approach to birth defects cluster investigations,,BIRTH DEFECTS RESEARCH, Issue 11 2008James E. Kucik Abstract BACKGROUND: Investigations of clusters of birth defects have been challenging endeavors that have had only modest success identifying causes or risk factors. Some of the challenges to individual cluster investigations have been small sample size and limited data collection. We describe a novel approach for investigating and analyzing pooled information from a series of birth defects cluster investigations. METHODS: The Birth Defects Cluster Study uses a case-control study design with standardized methods, including a case definition, control selection, data collection methods, and data collected (e.g., maternal interviews, blood samples, and environmental samples). Analyses of pooled data from several clusters of the same defect are conducted for specific hypotheses once a sufficient sample size has been achieved. The feasibility of conducting individual birth defect investigations was evaluated on a cluster of gastroschisis. RESULTS: The pilot investigation of a cluster of gastroschisis demonstrated success in recruiting participants and in collecting data and specimens for eventual inclusion in a pooled analysis. CONCLUSIONS: The Birth Defects Cluster Study offers a unique and effective approach to cluster investigations that improves the likelihood of identifying genetic and environmental causes of birth defects and provides a model for cluster investigations of other noninfectious health outcomes. Birth Defects Research (Part A), 2008. Published 2008 Wiley-Liss, Inc. [source] Evidence of placental haemorrhage and preterm deliveryBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2010JW Gargano Please cite this paper as: Gargano J, Holzman C, Senagore P, Reuss M, Pathak D, Williams M, Fisher R. Evidence of placental haemorrhage and preterm delivery. BJOG 2010;117:445,455. Objective, To evaluate evidence of placental haemorrhage (PH) obtained through maternal interviews, patient charts and placental pathology examinations as potential indicators of a ,bleeding pathway' to preterm delivery (PTD). Design, Prospective cohort. Setting, Fifty-two clinics in five communities in Michigan, USA (1998,2004). Population, A subset (n = 996) of cohort participants with complete placental pathology data. Methods, First-trimester bleeding and placental abruption were ascertained by mid-trimester interviews and chart review, respectively. Disc-impacting blood clot was defined as a gross placental examination finding of a blood clot impacting adjacent tissue. Microscopic haemorrhage was defined as ,high' (top quintile) scores on an aggregate measure of placental pathology findings suggestive of atypical maternal vessel haemorrhage. These four PH indicators were compared with one another and with risk of PTD assessed by logistic regression analyses. Main outcome measures, Preterm delivery and PTD subtypes (i.e. <35 weeks, 35,36 weeks; spontaneous, medically indicated) compared with term deliveries. Results, Placental abruption cases had 2.3-fold to 5.5-fold increased odds of the other three PH indicators. Disc-impacting blood clots and microscopic haemorrhage were associated with one another (odds ratio [OR] = 4.6), but not with first-trimester bleeding. In a multivariable model that included all four PH indicators and confounders, risk of PTD < 35 weeks was elevated with first-trimester bleeding (OR = 1.9 [1.0, 3.4]), placental abruption (OR = 5.2 [1.7, 16.2]), disc-impacting blood clots (OR = 2.3 [1.0, 5.0]) and microscopic haemorrhage (OR = 2.4 [1.4, 4.2]). Conclusions, Multiple clinical and subclinical PH indicators are associated with PTD, particularly early PTD. [source] Optic nerve hypoplasia in North America: a re-appraisal of perinatal risk factorsACTA OPHTHALMOLOGICA, Issue 5 2010Pamela Garcia-Filion Abstract. Purpose:, The purpose of this study is to describe and clarify the birth and prenatal characteristics of a large cohort of children with optic nerve hypoplasia. Methods:, This is a descriptive report of 204 patients aged , 36 months and enrolled in a prospective study at the Children's Hospital Los Angeles. Birth characteristics, including complications, were abstracted from study files and medical records. Systematic maternal interviews were conducted to obtain detailed prenatal histories. National birth data were used for comparison with birth findings. Results:, Birth characteristics were unremarkable for birthweight and gestation, but significant for increased frequency of caesarean delivery and fetal and neonatal complications. Young maternal age and primaparity were dominating maternal features. Preterm labour, gestational vaginal bleeding, low maternal weight gain and weight loss during pregnancy were prevalent. Conclusions:, These findings confirm young maternal age and primaparity as associated risk factors, challenge many other suggested factors such as alcohol and drug abuse, and introduce potentially significant prenatal characteristics such as maternal weight loss and early gestational vaginal bleeding as aetiological correlates. [source] | ||||||||||