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Biomedical subjects

J Golding

Publications and source records attributed to J Golding.

At least 91 records · Page 5Linked to original sources

Does the supine sleeping position have any adverse effects on the child? I. Health in the first six months. The ALSPAC Study Team.

OBJECTIVE: To assess whether the recommendations that infants sleep supine could have adverse health consequences. DESIGN: A prospective study of infants, delivered before, during, and after the Back to Sleep Campaign in the United Kingdom (UK), followed to 6 months of age. The children were part of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Subjects. Singletons born to mothers resident in the three former Bristol-based health districts of Avon in the period June 1991 to December 1992, and for whom questionnaires were completed on sleeping position at 4 to 6 weeks of age (n = 9777); for these infants 8524 questionnaires were also completed at 6 to 8 months of age. MAIN OUTCOME MEASURES: Subjective measures of health, the presence of specific signs and symptoms, duration of sleep at night, and calling the family doctor to the home. RESULTS: Of 43 outcomes considered, after adjustment for 12 factors using logistic regression only 2 were associated with raised risk among infants put to sleep on their back (diaper rash and cradle cap). Infants put to sleep prone had increased risk of a number of health outcomes, including cough and possibly pyrexia. CONCLUSIONS: There is no evidence that putting infants to sleep in the supine position results in increased morbidity, although changes in prevalence of rare disorders would not have been identified.

Adult↗

Sibship size and self-reported inhalant allergy among adult women. ALSPAC Study Team.

BACKGROUND: An association of allergic sensitization with small families and low birth order has been described and attributed to a protective effect of early infection. The influence of like-sex and unlike-sex siblings has not been investigated, although the severity of viral infections may be greater if acquired from unlike-sex siblings. OBJECTIVE: To investigate the association of self-reported inhalant allergy with family composition. METHODS: Reports of allergy to grass, dust or cats by 11042 pregnant women recruited to a longitudinal study of pregnancy and childhood in Avon, UK, were analysed in relation to respondent's age, maternal age and sibship composition (older and younger brothers and sisters) by multiple logistic regression. RESULTS: The prevalence of self-reported inhalant allergy decreased with increasing numbers of brothers (test for trend: P < 0.0001), but was unrelated to the number of sisters. The unadjusted prevalences for subjects with none, one, two and three or more brothers were 26%, 23%, 20% and 17%, respectively. The corresponding prevalences for numbers of sisters were 23%, 24%, 22% and 23%. After adjustment for total sibship size, offspring of older mothers were more likely to report allergy (test for trend: P < 0.001), but there was no association with position in the sibship. CONCLUSION: Although it is not possible to determine whether brothers specifically, or unlike-sex siblings in general, are inversely associated with inhalant allergy, these findings are consistent with the hypothesis that patterns of sibling interaction within young families influence the risk of future aeroallergen sensitization.

Adolescent↗

Getting to the bottom of nappy rash. ALSPAC Survey Team. Avon Longitudinal Study of Pregnancy and Childhood.

BACKGROUND: Nappy rash accounts for 20% of dermatology consultations in childhood, but its causes are poorly understood. AIM: To determine the incidence of nappy rash during the first four weeks of life in a geographically defined United Kingdom (UK) population, and to study the factors associated with developing the rash. METHOD: The data are derived from self-completed questionnaires of parents in the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). The response rate to a questionnaire about the child administered four weeks after delivery among parents of singleton infants was 87% (12103/13902). RESULTS: The incidence of nappy rash was 25%. Fourteen highly significant possible causal factors emerged, of which 10 were retained in a logistic regression model: dirtying of nappy, contact with doctor about other problems, history of rashes in joints or skin creases, type of nappy worn, being fed cereal, taken to mother's bed when waking at night, history of cradle cap, general state of health, previous stomach upset, and being only breast-fed. However, the relative risks were generally small. CONCLUSIONS: The likelihood of nappy rash increases with intercurrent illness and early introduction of cereals. Disposable nappies give little protection, and this finding helps to endorse a recently introduced hospital scheme arising from environmental concerns that encourages parents to use cotton nappies instead of disposables. For many babies, however, the causes of nappy rash remain unknown.

Analysis of Variance↗

Environment of infants during sleep and risk of the sudden infant death syndrome: results of 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers.

OBJECTIVE: To investigate the role of sleeping arrangements as risk factors for the sudden infant death syndrome after a national risk reduction campaign. DESIGN: Two year population based case-control study. Parental interviews were conducted for each infant who died and for four controls matched for age and date of interview. SETTING: Three regions in England with a total population of 17 million people. SUBJECTS: 195 babies who died and 780 matched controls. RESULTS: Prone and side sleeping positions both carried increased risks of death compared with supine when adjusted for maternal age, parity, gestation, birth weight, exposure to smoke, and other relevant factors in the sleeping environment (multivariate odds ratio = 9.00 (95% confidence interval 2.84 to 28.47) and 1.84 (1.02 to 3.31), respectively). The higher incidence of side rather than prone sleeping led to a higher population attributable risk (side 18.4%, prone 14.2%). More of the infants who died were found with bed covers over their heads (21.58; 6.21 to 74.99). The use of a dummy had an apparent protective effect (0.38; 0.21 to 0.70). Bed sharing for the whole night was a significant risk factor for infants whose mothers smoked (9.25; 2.31 to 34.02). No protective effect of breast feeding could be identified on multivariate analysis. CONCLUSIONS: This study confirms the importance of certain risk factors for the sudden infant death syndrome and identifies others-for example, covers over the head, side sleeping position-which may be amenable to change by educating and informing parents and health care professionals.

Bedding and Linens↗

Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers.

OBJECTIVE: To investigate the effects of exposure to tobacco smoke and of parental consumption of alcohol and illegal drugs as risk factors for the sudden infant death syndrome after a national risk reduction campaign which included advice on prenatal and postnatal avoidance of tobacco smoke. DESIGN: Two year population based case-control study. Parental interviews were conducted for each infant who died and four controls matched for age and date of interview. SETTING: Three regions in England with a total population of 17 million people. SUBJECTS: 195 babies who died and 780 matched controls. RESULTS: More index than control mothers (62.6% v 25.1%) smoked during pregnancy (multivariate odds ratio = 2.10; 95% confidence interval 1.24 to 3.54). Paternal smoking had an additional independent effect when other factors were controlled for (2.50; 1.48 to 4.22). The risk of death rose with increasing postnatal exposure to tobacco smoke, which had an additive effect among those also exposed to maternal smoking during pregnancy (2.93; 1.56 to 5.48). The population attributable risk was over 61%, which implies that the numbers of deaths from the syndrome could be reduced by almost two third if parents did not smoke. Alcohol use was higher among index than control mothers but was strongly correlated with smoking and on multivariate analysis was not found to have any additional independent effect. Illegal drug use was more common among the index parents, and paternal use of illegal drugs remained significant in the multivariate model (4.68; 1.56 to 14.05). CONCLUSIONS: This study confirms the increased risk of the sudden infant death syndrome associated with maternal smoking during pregnancy and shows evidence that household exposure to tobacco smoke has an independent additive effect. Parental drug misuse has an additional small but significant effect.

Alcohol Drinking↗

Detection of human viruses using primary cells immortalised by oncogene transfection, in comparison with primary cells and established cell lines.

No single established cell line was found capable of substituting for primary baboon kidney (PBK) or primary rhesus macacque kidney (PRK) cells for detection of human viruses. Although a panel of cell lines could detect influenza, parainfluenza, and enteroviruses, which are among the most important viruses encountered in routine diagnostic laboratories, the sensitivity of this panel was not as high as that of PBK or PRK cells. However, in a promising complementary approach, PBK and PRK cells have been immortalised successfully by oncogene transfection, and some of the resulting cell lines have retained susceptibility to human viruses, and may be suitable for routine diagnostic use.

Animals↗

Domestic magnetic field exposures in Avon.

To define a protocol for surrogate measurement of magnetic field exposure by questionnaire, a series of spot and 24-hour measurements was made at 50 houses in Avon, UK. Measurements were made with Emdex II equipment in the centres of rooms with the house power encountered at the start of the visit, and then with all power to the house isolated at the main switch. The mean spot magnetic field averaged over the 50 homes for each room varied between 0.011 and 0.023 microT with an overall mean (0.017 +/- 0.003) microT with the power 'on', and between 0.008 and 0.015 microT, giving an overall mean (0.012 +/- 0.002) microT with power 'off'. Measurements over 24 h in the three main occupancy rooms showed a distinct diurnal variation in the overall mean magnetic field of the 50 homes by a factor of three, giving a 24-hour mean of (0.044 +/- 0.06) microT; at the same time mean recorded personal exposure for the occupants monitored was (0.067 +/- 0.08) microT. These values appear low compared with, for example, USA domestic levels of magnetic field exposure demonstrated in several studies, but also show a wide variation in individual values, which could not be predicted from spot measurements.

Air Pollution, Indoor↗

The repeatability of self-reported exposure after miscarriage. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

BACKGROUND: The Avon Longitudinal Study of Pregnancy and Childhood is a prospective study of women who were resident in Avon and who were expected to deliver a baby between April 1991 and December 1992. METHODS: The study provided an opportunity to test the repeatability of responses from 220 women who experienced a miscarriage and who reported exposure to occupational substances and common household products and appliances in two questionnaires. The first questionnaire was completed in the early part of the pregnancy and the second after the miscarriage. Women were asked to score their frequency of exposure on a five-point scale from 'daily' to 'never'. Their responses were analysed to assess the degree of agreement between replies to identical questions in the two questionnaires using the kappa statistic. A new frequency variable was created which compared the replies for the two questionnaires; this was analysed for all exposures by cross-tabulation with possible explanatory variables (age of mother, social class, history of miscarriage and the time lag between questionnaires). RESULTS: In general there was good agreement in the reported exposures to 48 substances and products. The results showed a small and consistent pattern of reporting exposures less frequently in the second questionnaire, i.e. after miscarriage. This was not explained by the analysis of possible confounding variables. Given the literature, the authors had expected to find a shift in the opposite direction. CONCLUSION: The study reinforces the need to be cautious when using the results from single surveys of retrospective self-reported exposure.

Abortion, Spontaneous↗

Haemoglobin and ferritin concentrations in infants at 8 months of age.

AIM: To identify the optimum age to screen for iron deficiency, the normal distribution of haemoglobin and ferritin in a representative population sample was investigated. METHODS: Normal values for haemoglobin and ferritin were measured from heel prick capillary samples obtained from a representative cohort of 1175 infants at 8 months old who were randomly selected from children taking part in the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). RESULTS: Haemoglobin was normally distributed: mean (SD) 117 (11) milligrams, 95% confidence interval (CI) 116 to 118, and range 72-153 milligrams. Ferritin was log normally distributed: geometric mean 38.5 micrograms/l, 95% CI 37.0 to 39.9, range 7.1-224 micrograms/l. The 5th centile for haemoglobin was 97 milligrams and for ferritin 16.9 micrograms/l. No correlation was found between haemoglobin and ferritin. Multiple regression analysis showed ferritin concentrations to be positively related to birth weight (p < 0.0001) and the sex of the child (girls with higher concentrations) (p < 0.0001) but negatively with the child's weight at 8 months (p < 0.0001). Haemoglobin concentrations were positively related to the child's weight at 8 months (p = 0.04). Neither haemoglobin nor ferritin concentrations were related to social class as measured by maternal education level. CONCLUSION: These data define the normal range for haemoglobin and ferritin in capillary samples in the UK population, and suggest that anaemia is common in infancy. Using current recommendations, 23% of infants would be identified as anaemic. For British infants at 8 months of age, a more representative 'cut off' for anaemia would be haemoglobin concentration < 97 milligrams and for iron deficiency ferritin < 16 micrograms/l.

Age Factors↗

Methodology for a randomised controlled trial of preschool vision screening. A new approach with the 'ALSPAC' project.

We present the methodology of a population-based Randomised Controlled Trial, comparing an intensive programme of primary preschool vision screening by orthoptists with the usual non-specialist screening. The aims of the trial are to compare the effectiveness and costs of intensive orthoptic screening with non-specialist measures. The orthoptic screening programme will be evaluated both as a composite package and in terms of the screening value of the individual tests at specific ages. This trial is nested within a large population-based longitudinal study. Additional demographic and developmental data on the children in the trial are therefore available. The results of the trial will be used to help clarify which methods of preschool ophthalmic population screening are best in terms of disease detection and cost efficiency.

Amblyopia↗

Cognitive outcomes of multiple mild head injuries in children.

This study assessed cumulative effects of multiple mild head injuries on cognitive functioning in children. Subjects included 1586 children with one mild head injury, 278 with two, and 51 with three or more head injuries between birth and age 10 years and controls without head injuries matched on gender and total number of injuries. The number of head injuries and injuries not to the head was associated with decreasing performance on measures of intelligence (p < .01), reading (p < .01), and math (p = .02). There was no interaction between case-control status and number of injuries, indicating a similar relationship between cognitive outcomes and number of injuries in head-injured cases and controls. After adjustment for covariates, the relationship between number of injuries and cognitive outcomes became nonsignificant. This study suggests that cognitive deficits associated with multiple mild head injury are due to social and personal factors related to multiple injuries and not to specific damage to the head.

Achievement↗

Reproduction and caffeine consumption--a literature review.

Caffeine containing drinks are commonly consumed by pregnant women, but definitive studies concerning safety to the fetus are still awaited. This literature review highlights the methodological problems in mounting appropriate studies and assessing those publications that are available. Currently there is little to implicate caffeine consumption with congenital malformations or preterm delivery, but there may be associations with subfertility, miscarriage and intrauterine growth retardation. Definitive prospective studies are required.

Abnormalities, Drug-Induced↗

A survey of the administration of drugs to young infants. The Alspac Survey Team. Avon Longitudinal Study of Pregnancy and Childhood.

Medication which is given to young infants during the first months of life, an important period of development, may have effects on development which would not be observed in adults receiving the same drugs. The aim of this study was to estimate the numbers of children receiving various types of medication, including both prescription and non-prescription drugs, during the first 6 months of life. Self-completion questionnaires were posted to mothers participating in the Avon Longitudinal Study of Pregnancy & Childhood (ALSPAC) when their children were 6 months of age. These questionnaires included enquiries about the administration of drugs to the study children. The study was based in the three Bristol-based health districts of Avon in the United Kingdom. The study population comprised of 6973 children born in the 12 month period between the 1st July 1991 and the 30th June 1992. The majority of mothers, 96%, reported that their children had received medication, excluding vaccines, during the first 6 months of life. 35% had been given drugs from four or more different classes. Paracetamol had been given to 84% of the children, antibiotics to 30%. In view of potential effects of drug exposure on long term development, it is important that drugs which are administered to children are carefully assessed to ensure that they are not harmful.

Acetaminophen↗

Antecedents of schizophrenia and affective illness. Obstetric complications.

BACKGROUND: This exploratory study seeks to generate new hypotheses about the relationship between obstetric complications and schizophrenia. METHOD: The British Perinatal Mortality Survey represents 98% of all births during one week in March 1958 in Great Britain. Present State Examination (PSE), Catego diagnoses of narrowly defined schizophrenia (n = 49), broadly defined schizophrenia (n = 79), affective psychosis (n = 44) and neurosis (n = 93) were derived from case notes for all cohort members. The remainder of the cohort, surviving the perinatal period, acted as controls (n = 16 812). Variables in the British Perinatal Mortality Survey were grouped into five categories: the physique/lifestyle of the mother (including demographic characteristics), her obstetric history, the current pregnancy, the delivery and the condition of the baby. RESULTS: There were 7/17 significant differences in maternal physique/lifestyle and obstetric history between the births of schizophrenics and controls, compared to 4/40 comparisons of somatic variables relating to pregnancy, birth and the condition of the baby. This compares with 4/17 and 7/40 for affective psychotics and a total of 4/57 differences for all categories of variables when neurotics were contrasted with controls. CONCLUSIONS: The purported increased risk of obstetric complications in schizophrenics may result from the physique/lifestyle of their mothers.

Affective Disorders, Psychotic↗