Biomedical subjects

M Ounsted

Publications and source records attributed to M Ounsted.

At least 37 records · Page 2Linked to original sources

PubMed1985

Children of deviant birthweight: the influence of genetic and other factors on size at seven years.

138 small-for-gestational age (SGA), 138 average-for-gestational age (AGA) and 136 large-for-gestational age (LGA) children who had been followed up from birth were measured at the age of seven years. Parental measurements were also obtained. Significant differences for weight, height and head circumference of the children and their parents were found between the three groups. There were highly significant parent-child correlations for most somatic measures in all groups. Within each group the parental contribution to the variance in children's somatic measures was large; so also was the effect of sex on head circumference. Other biological and pathological factors made only a small contribution in any group.

Adult↗

PubMed1985

Head circumference charts updated.

Head circumference measurements from birth to 7 years, obtained from longitudinal data on children born between 1970 and 1977, are set against those from studies made in the United Kingdom earlier this century. A positive secular trend is shown. The children's heads were significantly larger than those born in the same locality 25 years earlier. Growth charts should be updated, as necessary, with each succeeding generation.

Aging↗

PubMed1985

Hand preference: its provenance, development, and associations with intellectual ability at the age of 7.5 years.

The development of 199 children was studied at regular intervals from birth to 7.5 years. On each occasion hand preference was recorded. Their preferred hand was evident in 89.4% right and 85.7% left-handers by 4 years. Analyses on 242 children seen at birth and 7.5 years showed no associations between left-handedness and nine factors representing different aspects of "birth stress." For 12 of 15 aspects of ability at 7.5 years left-handed children had slightly higher scores than right-handers. Pathological factors do not seem to feature in the provenance or consequences of left-handedness in a normal healthy population.

Age Factors↗

PubMed1984

Factors associated with the intellectual ability of children born to women with high risk pregnancies.

The intellectual abilities of 242 children born to women who had been hypertensive during pregnancy were assessed at the age of 7 1/2 years. Associations between 15 maternal, fetal, perinatal, postnatal and environmental factors, and test scores were investigated. After adjustment for confounding variables children in the upper social classes, born to non-smokers, who were first born, breast fed, and with birth weights above the 10th centile had significantly higher scores in some aspects of ability than the rest. Children whose mothers had developed superimposed pre-eclampsia had higher scores than those whose mothers had not suffered preeclampsia; and children delivered by elective caesarean section had lower scores than those delivered spontaneously. In a small subgroup of women with particularly high risk pregnancies perinatal mortality had been 10 times greater than in the rest of the sample. At 7 1/2 years the intellectual ability of the survivors in this subgroup did not differ from that of the rest. These findings do not support the notion that there is a quantitative continuum of "reproductive casualty" from mortality to morbidity.

Birth Weight↗

PubMed1984

Associations between size and development at four years among children who were small-for-dates and large-for-dates at birth.

Associations were sought between somatic measures and developmental status at 4 years among groups of children who had been small-for-dates (SFD), average-for-dates (AFD) and large-for-dates (LFD) at birth. When the three groups were combined, and adjustment made for sex, social class and series, a significant correlation was found between head circumference and total scores. Within the SFD and AFD groups no correlations were found between any somatic measures and aspects of development; and the only significant finding in the LFD group was a negative correlation between weight-for-height and total developmental scores. The somatic measures were then divided into three subgroups comprising children who had small, average, and large values for that measure, and developmental scores for each subgroup were computed. Within all three birthweight groups significant differences were found for head circumference: those with relatively small heads having lower scores than the rest.

Birth Weight↗

PubMed1983

Maternal hypertension with superimposed pre-eclampsia: effects on child development at 71/2 years.

Children born to women participating in a prospective study of hypertension during pregnancy were followed up from birth. Data on growth and development at the age of 71/2 years of 56 children whose mothers had superimposed pre-eclampsia are compared with results of 176 children whose mothers had only hypertension. Perinatal mortality in the hypertension-only group was similar to that for the hospital population in general at the time of their birth; but in the group who developed preeclampsia it was significantly higher. At the age of 71/2 years no differences were found in the frequency of health, handicap, sight and hearing problems, weight, height, head circumference, and standing and supine blood pressures. For six aspects of intellectual development children in the pre-eclampsia group had slightly higher mean scores; and in one of these, "perceptual matching' the difference was significant after adjustment had been made for confounding variables. Pre-eclampsia superimposed on hypertension does not increase the likelihood of impaired growth and development among children who survive the perinatal period.

Child↗

PubMed1983

Developmental assessment at four years: are there any differences between children who do, or do not, cooperate?

Among preschool children failure to cooperate in a developmental assessment is not uncommon, but many reports do not mention this awkward situation. Can such children be ignored? The abilities of 203 children were assessed at age 4 years and 7 1/2 years. At 4 years 37 (18%) did not cooperate fully and an overall developmental score could not, therefore, be calculated. For those sections in which they did achieve a score, the mean values, in all areas of development, were lower than those of complete cooperators and the differences were significant for visuomotor function, language, and comprehension. At 7 1/2 years children in the lower social classes who had been uncooperative at age 4 years had lower scores in all six areas of ability tested than those who had cooperated fully at 4 years. No differences were found for upper class children. Refusal to cooperate may in some cases indicate inability to perform and such children should not be ignored or discarded from follow up analyses.

Aptitude↗

PubMed1982

Final report of study on hypertension during pregnancy: the effects of specific treatment on the growth and development of the children.

195 (97.5%) children born to hypertensive women participating in a trial of methyldopa treatment during pregnancy were followed from birth and were extensively examined at the age of 7 1/2 years. The frequency of problems with health, physical or mental handicap, sight, hearing, and behaviour was the same in children of treated and untreated women. Sons of the untreated women were heavier and taller than those of treated women, as were their mothers. Among children of women who entered the trial between 16 and 20 weeks' gestation, sons of untreated women had larger heads than sons of treated women, but there was no difference in mean intelligence quotients. There were no significant differences between the children in the treated and untreated groups in standing and supine blood pressures, or fourteen tests of ability. Methyldopa therefore seems safe to use in pregnancy and is probably preferable to other drugs from the point of view of the neonate and child.

Antihypertensive Agents↗

PubMed1982

The relative contribution of different maternal factors in large-for-gestational-age pregnancies.

Relative and attributable risks were calculated to assess the potency of different maternal factors associated with large-for-gestational age (LGA) babies in individuals and in the population as a whole. In multiparous women the most important factor was the fast fetal growth rate demonstrated in previous pregnancies. Non-smoking also made a large contribution to the LGA population (43.65%) and the risk to individual patients was doubled. The relative risk for height steadily rose with increasing stature, but the effect was much more marked for weight. Heavy women made a considerable contribution to the LGA population (26%) and the effect of increasing weight is such that very heavy women (more than +2 SD) are nine times more likely to have an LGA baby than those of average weight. The relative risk also rose sharply with increasing parity. Nevertheless, 27.5% women in our LGA group were having their first baby. The possibility that a very obese non-smoking primiparous woman may be bearing a very large baby should not be overlooked.

Birth Weight↗

PubMed1982

Growth in the first four years: I. The relative effects of gender and weight for gestational age at birth.

The growth of 238 small-for-dates (SFD), 246 average-for-dates (AFD) and 241 large-for-dates (LFD) babies was assessed at regular intervals from birth to four years. At all ages, and for both sexes, the mean weight, length or height, and head circumference values for the two extreme groups differed significantly from the AFD group (P less than 0.001). During the first six months actual and relative growth was highest in the SFD group and lowest in the LFD group. With the exception of length in the LFD group it was higher for boys than for girls. Thereafter differences in actual values were slight, while the proportional increases for the three groups were almost identical. Differences from the AFD mixed-sex mean value were plotted for each group and sex combination. Stabilization of the mean trajectories in the two extreme groups occurred at six months for weight and head circumference, but not until 12 months for length. For each child a straight line was fitted on a log scale to these differences from six months (12 months for length) to four years, and analyses of variance of the slopes and intercepts obtained. The sex difference for weight and height gradually decreased, but for head circumference held constant. Estimates of the difference in intercepts of the birthweight groups and sexes showed that within the LFD group the difference in height between boys and girls was much less than in the other two groups. The sex difference for head circumference was slightly larger than the difference between SFD and AFD groups, and twice the difference between the LFD and AFD groups. At the age of four years the mean value for AFD boys was higher than LFD girls (P less than 0.01), and those for SFD boys and AFD girls were almost identical.

Birth Weight↗

PubMed1982

Growth in the first four years: II. Diversity within groups of small-for-dates and large-for-dates babies.

238 small-for-dates (SFD), 246 average-for-dates (AFD) and 241 large-for-dates (LFD) infants were personally examined at birth, and measured thereafter in their own homes at the ages of 2, 6, 12 and 18 months, 2, 3 and 4 years. At each age weight, length or height, and head circumference measures in the SFD and LFD groups were distributed around the appropriate sex AFD mean values. In both extreme groups major shifts towards the mean occurred in the first six months for all three measures. From one year onwards only small within group fluctuations were seen. Correlations between one and four year values for weight, height and head circumference were high. At four years about 50% SFD children were within 1 S.D. of the mean, and 10% were still very small. Slightly more LFD children (55-60%) were near to the mean at this age, particularly for their head circumference values (70%), and only about 8% LFD children had very large heads. Trajectories of individual SFD and LFD children illustrate the great diversity of growth patterns within and between groups.

Birth Weight↗

PubMed1982

Growth in the first four years: III. The effects of maternal factors associated with small-for-dates and large-for-dates pregnancies.

Relationships between maternal factors associated with very slow and very fast fetal growth rate, and the postnatal growth patterns within groups of 238 small-for-dates (SFD) and 241 large-for-dates (LFD) children were examined. Within the SFD group significant differences were found in their weight, height, and to a lesser extent head circumference, according to maternal weight, height, parity, social class, and the birthweights of previous siblings. In the LFD group no differences were found according to maternal weight or the birthweights of previous siblings. Maternal height affected only weight and height; first-born were heavier, and children in the upper social classes had larger heads than the rest. After adjustment for sex, the proportion of the variance in size between one and four years accounted for by all these factors was: SFD group 16% for weight and height, and 10% for head circumference; LFD group 6% for all three measures.

Adult↗

PubMed1982

Growth in the first four years: IV. Correlations with parental measures in small-for-dates and large-for-dates babies.

Parent-child correlations for weight, height and head circumference on eight occasions between birth and 4 years were estimated within groups of 212 small-for-dates (SFD), 208 average-for-dates (AFD) and 221 large-for-dates (LFD) children. For mothers and fathers in the SFD and AFD groups, and fathers in the LFD group, correlations for weight were generally low in the first year, with moderate increases up to 4 years. No correlations for weight at any age were found between mothers and LFD children. There was a gradual rise in correlations for length in all three groups for both mothers and fathers between birth and 4 years. Head circumference correlations in the AFD and LFD groups were relatively high at birth and showed little change thereafter. Mother-child correlations for head circumference in the SFD group were absent at birth, but then rose sharply to a value comparable with the AFD parents' correlations at 18 months, with the little change thereafter. No SFD father-child correlations for head circumference were found at any age. Children's standards of weight and head circumference adjusted for mid-parental measures would, in some cases, be misleading.

Adult↗

PubMed1982

Social class and birthweight: a new look.

The effects of social class on birthweight, and its interactions with other maternal factors, were examined in groups of women bearing small-for-dates (SFD), average-for-dates (AFD) and large-for-dates (LFD) babies. The relative risk of a lower social class woman having an SFD baby steadily decreased from 1.75 to 1.20 as adjustment was cumulatively made for smoking, hypertension, maternal age and height. The subsequent addition of weight and weight-for-height made little change. The unadjusted risk of a lower social class woman having a LFD baby was very close to unity (0.99). Adjustment for other maternal factors, in the same order as at the other extreme, showed a steady rise to a significant level (1.45) when height was included; but there was a sharp reversal to a non-significant risk of 1.12 when weight was added. The large contribution of obesity in the lower classes seems to counterbalance those for height, age and smoking in the upper classes in the LFD group. The interactional effects of other maternal factors and social class are not operating to an equal and opposite degree at the two extremes of the birthweight range.

Birth Weight↗

PubMed1982

Growth in the first year of life: effects of sex and weight for gestational age at birth.

Fifty-five small-for-dates (SFD), 56 average-for-dates (AFD) and 55 large-for-dates (LFD) babies were weighed and measured at regular intervals from birth to 12 months. Within the SFD and AFD groups weight gain was greater for boys than for girls so that by one year there were highly significant differences between the two sexes. Within the LFD group the sex difference was slight at all ages. Gain in length was similar to that for weight within each group; but head circumference showed a different pattern. Absolute increase in head circumference respectively for boys and girls between birth and one year was greatest in the SFD group and least in the LFD group. Within all three groups it was greater for boys than girls. By the age of six months AFD boys had larger heads than LFD girls and SFD boys had larger heads than AFD girls. At 12 months the head-circumference values for LFD girls and SFD boys did not significantly differ.

Birth Weight↗

PubMed1982

Smoking during pregnancy. Its association with other maternal factors and birthweight.

Data on 293 small-for-dates (SFD), 274 average-for-dates (AFD) and 338 large-for-dates (LFD) pregnancies are analyzed. 60.7% mothers in the SFD group smoked compared with AFD 29.2% and LFD 15.7%. Mean maternal height, weight and weight gain was lowest in the SFD group and highest in the LFD group. The mean weight-for-height index was the same in the SFD and AFD groups and higher in the LFD group. Within each group no differences were found between smokers and non-smokers for height, weight and weight-for-height indices. In the AFD group net pregnancy weight gain was higher for smokers than non-smokers. Feto-placental ratios were similar in all three groups and no differences were found between smokers and non-smokers. More infarcted placentas were found in the SFD group, but the proportions for smokers and non-smokers were alike. The incidence of bleeding during pregnancy and pre-eclampsia was the same for all groups, and between smokers and non-smokers. Hypertension during pregnancy occurred more often in the SFD group, and was more prevalent amongst non-smokers than smokers. The reduction in birthweight of infants born to smoking mothers appear to be a direct effect.

Birth Weight↗

PubMed1981

The relative contributions of different maternal factors in small-for-gestational-age pregnancies.

Relative and attributable risks were calculated to assess the potency of different maternal factors associated with intrauterine growth retardation in individual pregnancies and in the population as a whole. In multiparous women the most important factor for the total population was the slow fetal growth rate demonstrated in previous pregnancies. Moderate or severe preeclampsia gave a higher individual risk, but because of its low prevalence the contribution to small-for-gestational-age (SGA) pregnancies as a whole was low. Smoking and hypertension without preeclampsia each trebled the individual risk, and made a substantial contribution to the overall population of SGA babies. Other less potent factors were low maternal height, weight, and weight gain in pregnancy. When adjustment had been made for maternal size, smoking, pathological factors, and siblings' birthweight, the effect of social class became insignificant. The remaining "causes' of SGA pregnancies are likely to be single factors of large effect such as major congenital abnormalities and uterine abnormalities. If the pathological factors of smoking, hypertension and preeclampsia could be prevented, the number of SGA pregnancies in this population would be reduced by about 50%.

Female↗

PubMed1981

Perinatal morbidity and mortality in small-for-dates babies: the relative importance of some maternal factors.

Data on 538 mothers and their small-for-dates babies were analysed to ascertain whether any specific maternal factors were associated with increased perinatal risks. There were 34 deaths; 21 (62%) of these babies had major congenital abnormalities. Among the survivors perinatal morbidity was also markedly increased when the baby was abnormal. No direct associations were found between abnormal babies and any maternal factors. Few differences were found in the incidence of mortality and morbidity factors according to maternal height, weight, weight gain in pregnancy, social class and smoking habits. There was a significantly higher death rate when the mother was pre-eclamptic, and the incidence of seven other morbidity factors was also increased. The only adverse effects of maternal hypertension without pre-eclampsia was a higher instrumental delivery rate, and more of these babies were tube-fed. There were only significantly more perinatal deaths among multiparous women whose previous babies had been of average birthweight. This was due to an excess of congenitally abnormal babies in this group. Only 35% small-for-dates babies escaped any perinatal problems.

Birth Weight↗