BACKGROUND: There have been suggestions that when two or three unexpected unexplained infant deaths occur within a family they are more likely to be unnatural than natural. We aimed to estimate the probability that a second infant death is natural versus unnatural. METHODS: The Care of Next Infant programme (CONI) supports parents who have previously had an unexpected and apparently unexplained infant death and is currently available in over 90% of health districts in England, Wales, and Northern Ireland. We studied all deaths in 6373 infants who had completed the CONI programme by December, 1999. After a CONI death, we made detailed enquiries into the previous death and the CONI death, including a family interview, a review of autopsies, and case discussion. FINDINGS: 57 (8.9 per 1000) CONI infants died. Nine deaths were inevitable, and 48 were unexpected. 44 families lost one child, and two families lost two children. Of the 46 first CONI deaths, 40 were natural; the other six were probable homicides, five committed by one or both parents (two criminally convicted). The ratio of 40 natural to six unnatural deaths is 6.7 (95% CI 2.8-19.4). Enquiries identified 18 families with two SIDS(sudden infant death syndrome) deaths and two families with probable covert double homicides (ratio 9.0 [2.2 to 80.0]). There were no convictions in 13 incomplete cases. Families with three deaths are reported. INTERPRETATION: Repeat unexpected infant deaths are most probably natural.

Humans↗

PubMedDate not supplied

Obesity in schoolchildren and their parents.

The height, weight and left triceps skinfold thickness of 2190 schoolchildren were measured and the heights and weights of their parents obtained from a postal questionnaire. Power-type obesity indices were used to correct weight for height in parents and children. Preliminary analysis of the distribution of obesity using arbitrarily chosen cut-off points to define the obese, normal and lean parent indicated the presence of a group of 'super-obese' families. The spline technique was used to analyse these data as continuous variables, and showed that the 'super-obese' group of families was too small to be of any practical importance. The relationship between obesity in parents and their children has also been investigated using the spline regression technique. The results show that the relationship is linear but that only 6% of the total variation of observed obesity in children is attributable to variation in the parents' reported obesity. However, a structural analysis indicates a direct relationship between obesity of parents and children. This is obscured in the regression analysis by the large within-subject variability of observed obesity in both parents and children.

Adolescent↗

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Growth of school children of southern Iran in relation to the NCHS standard.

Height and weight of school children aged 6-12 years in Shiraz (Iran) are reported. The smooth centile values have been derived from the raw data by Healy's nonparametric method. Median heights and weights of children in Shiraz lie approximately on the 25th centile of US children, but are above most groups of children from the developing world. The spread of the data is similar to that observed in US, and there is no evidence of widespread malnutrition. These observations suggest that local growth standards should be used in clinical work.

Anthropometry↗

PubMedDate not supplied

Height, weight, BMI and weight-for-height of adults in southern Iran: how should obesity be defined?

Height, weight, body mass index (BMI) and weight for height are reported for 2210 parents of a random sample of school children in Shiraz, Iran. Weight for age and weight for height centiles have been computed by the Healy, Rasbash and Yang's nonparametric method and are presented graphically. The Iranian adults are taller and heavier than previously reported for people in the region but are smaller than European and US white adults. The distribution of BMI is broadly similar to that reported for UK adults but curves corresponding to BMI-constant, i.e. weight proportional to height, cut across the centiles of weight for height.

Adult↗

PubMedDate not supplied

Growth charts for Iran.

Growth charts for children aged 2-18 years old in Iran are presented. The charts are based on a random cluster sample survey of 3301 children living in urban Tehran, whose heights and weights were measured during the 1990-1992 National Health Survey of Iran. Because of differences between the data from the different provinces, these data were used as a representative subset of the total data. Charts were constructed using Healy's method, as modified by Pan, Goldstein and Yang, and are shown to fit the data well. Simulations show that the structure of the data does not affect the centile estimates. These charts may be used for all urban children in Iran and modifications are suggested to enable them to be used for rural children, who are generally smaller than urban children.

Adolescent↗

PubMedDate not supplied

Growth of children in Iran.

Weights and Heights of 22,349 children and adolescents aged 2 to 18 in Iran are reported. Data are from the 1990-1992 National Health Survey, a random cluster sample survey of 1 in 1000 families in all provinces of Iran. Multilevel models (Goldstein 1995) which take account of the survey design, reveal significant differences between provinces and between urban and rural children. Differences between urban and rural children, like differences between girls and boys, persist across all provinces and are certainly real. Differences between provinces may be partly due to differences in calibration. Charts based on the homogeneous subset of children living in urban Tehran may be used for all urban children, and in modified form, for all rural children. All the centiles of these charts are substantially below those of the NCHS charts, but the spread is similar so that there is no suggestion that the difference is due to the prevalence of gross malnutrition. The difference shows that the use of locally based growth charts are essential for assessing the growth of children in Iran.

Adolescent↗

PubMedDate not supplied

Body mass index reference curves for Iran.

Body Mass Index (BMI) charts for boys and girls aged 2-18 years in Iran are presented. The charts are based on a random cluster sample survey of 1702 boys and 1599 girls living in urban Tehran, whose height and weights were measured in the 1990-1992 National Health Survey of the whole country. Charts were constructed using Healy's method as modified by Pan, Goldstein and Yang (1990), and for boys at one point were smoothed manually. The resulting charts are shown to fit the data well and adequately describe raw BMI centiles of urban and rural children elsewhere in Iran. Comparison of these BMI charts with corresponding UK charts showed substantial differences at every age and emphasizes the necessity for the use of locally based BMI norms for assessing body mass of Iranian children.

Adolescent↗

PubMedDate not supplied

Weight-for-height of children in Iran.

Weight and height data were obtained from the 1990-1992 National Health Survey, a random cluster sample survey of 1 in 1000 families in Iran. Weight-for-height centiles of children and adolescents aged 2 to 18 in Tehran have been computed from relationships between weight for age and height for age Z-scores. The resulting centiles are compared to weight-for-height centiles based on BMI (weight/height2) charts. Investigation of the data points age by age revealed that there are very few observations between the two sets of 3rd and 97th centiles, so that the normal range of BMI for age is effectively equivalent to the normal range of weight-for-height by age. Further analysis shows that BMI charts based on the subset of children living in urban Tehran may be reliably used for all children in Iran to determine the normal range of weight-for-height except for short children aged 2 to 5 for whom a table of the upper centiles is given.

Adolescent↗