Search PubMed⌕ Search

Biomedical subjects

C J Stevenson

Publications and source records attributed to C J Stevenson.

At least 19 recordsLinked to original sources
PubMed1999

Longitudinal study of behaviour disorders in low birthweight infants.

AIM: To compare the prevalence of childhood and adolescent behavioural problems in low birthweight infants with matched controls. METHODS: A cohort study of a geographically defined population of survivors of </=1500 g birthweight born in 1980 and 1981 and age, sex, and school matched controls was undertaken. Children with a clinical disability were excluded. Data from Rutter questionnaires, completed by parents and teachers when the children were aged 8 and again at age 14 years, were assessed. RESULTS: From an initial 40 321 births in 1980-81 there were 399 of birthweight </=1500 g, of whom 219 survived to age 8. After exclusion of the 42 children with clinical disability, 177 cases comprised the sample. Of these, 10 (6%) refused or could not be contacted, leaving 167 cases for each of whom a matched control was obtained. At age 14 years, both parent and teacher questionnaires showed an increased prevalence of behavioural problems in cases compared with controls. The presence of a pervasive behavioural problem, when the responses of parents and teachers were concordant, was present in 9% of cases and 3% of controls. There were 132 pairs where the cases and controls were the same at ages 8 and 14 years and provided longitudinal data. The parental questionnaire showed there was a significant decrease in the prevalence of behavioural problems for cases and controls between the ages of 8 and 14 years. There was almost no longitudinal change in the prevalence of behavioural problems as shown by the teacher questionnaires. CONCLUSION: Although low birthweight infants are at increased risk of behavioural problems, because they comprise only a small proportion of all births, their population attributable risk for behavioural disorder is around 2-3%.

Adolescent↗
PubMed1998

Association of blood pressure in adolescence with birthweight.

AIMS: To compare the blood pressure of very low birthweight infants with that of normal birthweight controls in adolescence. METHODS: A cohort of all infants of birthweight < or = 1500 g born to women resident in the county of Merseyside in 1980-1 was followed up at age 15 years with age, sex, and school matched controls. Growth indices and blood pressures were measured under standard conditions. The smoking history of mothers and children and their status for several socioeconomic variables were documented. In a matched pairs analysis systolic and diastolic blood pressures were compared for cases and controls before and after adjusting for height, weight, and body mass index. RESULTS: There were 172 singleton 15 year old survivors of birthweight < 1500 g out of 40,321 live births of Merseyside residents in 1980-1. Of the 172 survivors, 128 (74%) who had no clinical disability and 11 (6%) with a clinical disability but attending normal schools, were assessed with individually matched age, sex, and school controls. Twenty three (13%) had a clinical disability and were attending special schools; these were assessed without controls. Ten (6%) children refused or were unavailable for assessment. The systolic blood pressure was significantly higher in cases than in controls; the mean of the difference was 3.2 mm Hg. The diastolic blood pressure was also higher in the cases, but the difference was not significant. The controls were significantly heavier (4.4 kg), taller (4.0 cm), with larger head circumference (1.5 cm) than the cases. The difference in body mass index was not significant. Adjusting for height, weight, or body mass index increased the difference in systolic blood pressure between cases and controls. There were no significant differences in the socioeconomic variables, but what differences did exist favoured the controls. There was also a higher prevalence of smoking among the children and the mothers of the cases than the controls. CONCLUSIONS: The study supports the hypothesis that in adolescents variation in systolic blood pressure has its origins in fetal development. Some of the variation could be attributed to socioeconomic differences.

Adolescent↗
PubMed1997

Cerebral palsy--the transition from youth to adulthood.

Service provision for those with cerebral palsy (CP) becomes fragmented after adolescence. Young people with CP in two age groups, their carers and associates, were interviewed, and use of health and social services was investigated. Leisure activities were also compared with a matched control group of able-bodied young people. Use of health and social services decreased when the children with CP left school, thereby increasing the demands upon carers. Carers expressed anxieties about the provision of services, and frustration in obtaining information about help. Findings from the questionnaires showed the young people with CP in both age groups to be socially less active than the controls. Among the subjects, the older age group was socially less active than the younger age group. Communication is poor both between the agencies providing care and between the agencies and the young person or carer. There is a need to identify those with responsibility for coordinated-care planning for adolescents with CP.

Activities of Daily Living↗
PubMed1996

Cost of care for a geographically determined population of low birthweight infants to age 8-9 years. II. Children with disability.

AIM: To determine the cost of health and educational service provision for low birthweight children with a clinical disability. METHODS: Cohort study of a geographically defined population in five health districts that comprise the County of Merseyside was undertaken. All children with a clinical disability born in 1980 and 1981 to mothers resident in the County of Merseyside were followed up to age 8-9 years. The cost of care associated with the initial admission to the neonatal special/intensive care unit and subsequent use of hospital, family practitioner, and special education services was assessed. RESULTS: There were 52 children with a disability; the disability rate in children of birthweight < or = 2000 g was estimated at 7.7%. Of the total expenditure to age 8-9 years, special education was the largest category (52%) and neonatal care accounted for 35%. The disabled children accounted for 38% of the cost of the whole cohort of 693 disabled and non-disabled children who weighed < or = 2000 g at birth. CONCLUSION: In a cohort of low birthweight children, those who are disabled account for a disproportionate amount of the total expenditure to age 8-9. The cost of long term care for disabled young persons and adults will increasingly dominate the cost of care for the whole cohort of low birthweight children.

Child Care↗
PubMed1994

Clinical and subclinical deficits at 8 years in a geographically defined cohort of low birthweight infants.

OBJECTIVE: To determine the prevalence of subclinical deficits in cognitive and motor function in low birthweight infants. DESIGN: Children of birth weight < or = 2000 g born to mothers resident in Merseyside in 1980-1 assessed using the Wechsler Intelligence Scale for Children (WISC), the Neale analysis of reading ability, and the Stott-Moyes-Henderson test of motor impairment (TOMI). Children attending normal schools assessed with controls matched for age, sex, and class in school. Children attending special schools were assessed unmatched. SUBJECTS: 233 matched index case-control pairs attending normal primary schools and 46 unmatched children attending special schools. SETTING: Primary and special schools. MAIN OUTCOME MEASURES: IQ score, reading age in months, and TOMI score. RESULTS: Index cases when compared with controls had a lower WISC score (mean IQ difference 8.8; 95% confidence interval (CI) 6.8 to 10.7), a lower reading age (mean difference 6.5 months; 95% CI 4.0 to 9.0), and poorer motor performance as shown by the TOMI score (mean difference 1.4; 95% CI 1.1 to 1.8). Of the children attending special schools, 23/46 (50%) had a WISC score < or = 50. CONCLUSIONS: Low birthweight children have significant subclinical deficits of cognitive and motor function and extra resources, especially in education, may be required to meet their needs.

Birth Weight↗
PubMed1994

Prevalence of behaviour disorders in low birthweight infants.

OBJECTIVE: To determine the prevalence of behaviour disorders in low birthweight infants. DESIGN: Children of birth weight < or = 2000 g born to mothers resident in Merseyside in 1980-1 assessed using the Rutter parent and teacher behaviour questionnaires and the Conner modification of the Rutter teacher questionnaire. Children attending normal schools were assessed with controls matched for age, sex, and class in school. Children attending special schools were assessed unmatched. SUBJECTS: 233 matched case-control pairs attending normal primary schools and 46 unmatched children attending special schools. SETTING: Primary and special schools. MAIN OUTCOME MEASURES: Emotional, conduct, and undifferentiated behaviour disorders and hyperactivity. RESULTS: On the parental questionnaire screen, 36% of the cases and 22% of the controls had a behaviour disorder and on the teacher questionnaire the proportions were 27% and 12% respectively. Hyperactivity was significantly more common among male cases than their controls (21% v 5.0%) but differed little among female cases and controls (9% v 7%). CONCLUSIONS: Improving neonatal survival of low birthweight infants is accompanied by a higher prevalence of behaviour disorders. The long term implications for psychiatric morbidity and other adult disease must be monitored.

Behavior↗
PubMed1990

Carbamazepine-induced lichenoid eruption.

Carbamazepine-induced skin eruptions are common but lichenoid skin rashes associated with this drug are not well documented. We report here a patient with a lichenoid drug eruption secondary to carbamazepine.

Carbamazepine↗
PubMed1981

Screening for occupational vitiligo in workers exposed to hydroquinone monomethyl ether and to paratertiary-amyl-phenol.

Two men reported previously with vitiligo after occupational exposure to hydroquinone monomethyl ether (HMME) have been reviewed after eight years. Repigmentation of significant degree was found in one man and of limited degree in the other. One hundred and sixty-nine men in the same works have been screened with Wood's light for evidence of vitiligo. No cases were found in the 148 men exposed to HMME (colleagues who screened 100 men exposed to HMME in two other factories also found no case) or in the 129 who had been exposed to paratertiary-amyl-phenol. Loss of light reflection on Wood's light examination was observed in 13 men due to scars or to other skin disorders.

Adult↗