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R L Goldenberg

Publications and source records attributed to R L Goldenberg.

At least 91 records · Page 5Linked to original sources
PubMed1997

Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. A randomized controlled trial. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.

CONTEXT: Intrauterine infection is thought to be one cause of preterm premature rupture of the membranes (PPROM). Antibiotic therapy has been shown to prolong pregnancy, but the effect on infant morbidity has been inconsistent. OBJECTIVE: To determine if antibiotic treatment during expectant management of PPROM will reduce infant morbidity. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: University hospitals of the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. PATIENTS: A total of 614 of 804 eligible gravidas with PPROM between 24 weeks' and 0 days' and 32 weeks' and 0 days' gestation who were considered candidates for pregnancy prolongation and had not received corticosteroids for fetal maturation or antibiotic treatment within 1 week of randomization. INTERVENTIONS: Intravenous ampicillin (2-g dose every 6 hours) and erythromycin (250-mg dose every 6 hours) for 48 hours followed by oral amoxicillin (250-mg dose every 8 hours) and erythromycin base (333-mg dose every 8 hours) for 5 days vs a matching placebo regimen. Group B streptococcus (GBS) carriers were identified and treated. Tocolysis and corticosteroids were prohibited after randomization. MAIN OUTCOME MEASURES: The composite primary outcome included pregnancies complicated by at least one of the following: fetal or infant death, respiratory distress, severe intraventricular hemorrhage, stage 2 or 3 necrotizing enterocolitis, or sepsis within 72 hours of birth. These perinatal morbidities were also evaluated individually and pregnancy prolongation was assessed. RESULTS: In the total study population, the primary outcome (44.1 % vs 52.9%; P=.04), respiratory distress (40.5% vs 48.7%; P=.04), and necrotizing enterocolitis (2.3% vs 5.8%; P=.03) were less frequent with antibiotics. In the GBS-negative cohort, the antibiotic group had less frequent primary outcome (44.5% vs 54.5%; P=.03), respiratory distress (40.8% vs 50.6%; P=.03), overall sepsis (8.4% vs 15.6%; P=.01), pneumonia (2.9% vs 7.0%; P=.04), and other morbidities. Among GBS-negative women, significant pregnancy prolongation was seen with antibiotics (P<.001). CONCLUSIONS: We recommend that women with expectantly managed PPROM remote from term receive antibiotics to reduce infant morbidity.

Adult↗
PubMed1997

Plasma and erythrocyte zinc concentrations and their relationship to dietary zinc intake and zinc supplementation during pregnancy in low-income African-American women.

OBJECTIVE: To evaluate the effects of usual dietary intake of zinc and of zinc supplementation during pregnancy on plasma and erythrocyte zinc concentrations. DESIGN: A randomized, double-blind, placebo-controlled trial. SUBJECTS: Low-income African-American women (n = 580) assigned randomly to groups at 19 weeks of gestation. INTERVENTION: A daily dose of zinc (25 mg) or a placebo until delivery. MAIN OUTCOME MEASURES: Plasma, erythrocyte, and dietary zinc levels. STATISTICAL ANALYSES: Multiple regression and repeated measures analysis of variance. RESULTS: In both the placebo and the supplemented groups, when all subjects were grouped by usual dietary zinc intake above or below the median (12 mg/day), results were the same: Women with high dietary zinc intake had higher erythrocyte zinc levels at the time of randomization and at all subsequent measurements during pregnancy than those who had low dietary zinc intake (P < or = .06; difference not significant for zinc-supplemented group); no difference was observed for plasma zinc levels. On the other hand, when the subjects were stratified at the median by total daily zinc intake (usual dietary zinc + 25 mg zinc supplement) during pregnancy, a significant difference in plasma zinc levels (P < .005) was found between women with high total zinc intake (mean = 38 mg/day) and low total intake (mean = 13 mg/day) at 26, 32, and 38 weeks of gestation; however, no such differences were found in erythrocyte zinc levels. APPLICATIONS: These results should help dietitians and other health professionals better understand the expected changes in plasma and erythrocyte zinc levels during pregnancy, and the relationship between dietary and supplemental zinc and zinc nutriture.

Adult↗
PubMed1997

Risk factors associated with preeclampsia in healthy nulliparous women. The Calcium for Preeclampsia Prevention (CPEP) Study Group.

OBJECTIVE: Our goal was to identify risk factors for the development of preeclampsia in nulliparous women enrolled in a multicenter trial comparing calcium supplementation to a placebo. STUDY DESIGN: A total of 4589 women from five centers was studied. Analysis of risk factors for preeclampsia was performed in 4314 who carried the pregnancy to > 20 weeks. Baseline systolic and diastolic blood pressure, demographic characteristics, and findings after randomization were examined for the prediction of preeclampsia. Preeclampsia was defined as hypertension (diastolic blood pressure > or = 90 mm Hg on two occasions 4 hours to 1 week apart) and proteinuria (> or = 300 mg/24 hours, a protein/creatinine ratio > or = 0.35, one dipstick measurement > or = 2+ or two dipstick measurements > or = 1+ at an interval as specified for diastolic blood pressure). RESULTS: Preeclampsia developed in 326 women (7.6%). The first analysis treated each risk factor as a categoric variable in a univariate regression. Maternal age, blood group and Rh factor, alcohol use, previous abortion or miscarriage, private insurance, and calcium supplementation were not statistically significant. Risk factors initially found to be significant were body mass index, systolic blood pressure, diastolic blood pressure, non-white race (African-American and other), clinical center, and smoking. Adjusted odds ratios computed with a logistic regression model revealed that body mass index (odds ratio 3.22 for > or = 35 kg/m2 vs < 19.8 kg/m2), systolic blood pressure (odds ratio 2.66 for > or = 120 vs < 101 mm Hg), diastolic blood pressure (odds ratio 1.72 for > or = 61 mm Hg vs < 60 mm Hg), and clinical center (odds ratio 1.85 for Memphis vs the other clinical centers) were statistically significant predictors of preeclampsia. Results of the final model fit revealed that preeclampsia risk increases significantly (p < 0.0001) with increased body mass index at randomization, as well as with increased systolic and diastolic blood pressure at randomization. Calcium supplementation had no effect on the risks posed by body mass index and blood pressure. Among risk factors developing after randomization, an abnormal results of a glucose screen (plasma glucose > or = 140 mg/dl 1 hour after a 50 gm glucose challenge) was not found to be associated with a significant risk of preeclampsia. CONCLUSION: These risk factors should be of value in counseling women regarding preeclampsia and should aid in understanding the pathophysiologic characteristics of this syndrome.

Adolescent↗
PubMed1997

The Preterm Prediction Study: association of cesarean delivery with increases in maternal weight and body mass index.

OBJECTIVE: Our purpose was to evaluate whether maternal weight and body mass index measured either before or during pregnancy are associated with an increased risk of cesarean delivery. STUDY DESIGN: Maternal weight and height were prospectively collected on 2929 women in the National Institutes of Health Maternal-Fetal Medicine Units Network Preterm Prediction Study. Prepregnancy and 27- to 31-week maternal weight and height were used to calculate the body mass index, and its contribution to the risk of cesarean delivery was determined. Women with prenatally diagnosed congenital anomalies (n = 89) and pregestational diabetes (n = 31) were excluded from analysis. RESULTS: Univariate analysis of risk factors for cesarean delivery in the 2809 eligible women revealed a decreased risk of cesarean delivery with maternal age < 18 years and multiparity; increased risk of cesarean delivery was noted with maternal age > 35 years and a male fetus. Increases in either prepregnancy or 27- to 31-week maternal weight (5-pound units) or body mass index (1.0 kg/m2 units) were significantly associated with an increased odds of cesarean delivery (p = 0.0001). Each unit increase in prepregnancy or 27- to 31-week body mass index resulted in a parallel increase in the odds of cesarean delivery of 7.0% and 7.8%, respectively. Multivariable stepwise logistic regression analysis confirmed the association of male fetus, age, nulliparity, and body mass index as significant variables contributing to cesarean delivery risk. CONCLUSIONS: The risk of cesarean delivery is associated with incremental changes in maternal weight and body mass index before and during pregnancy after adjustment for potential confounding factors. Prepregnancy counseling about optimizing maternal weight and monitoring weight gain during pregnancy to decrease the risk of cesarean delivery are supported by this study.

Adolescent↗
PubMed1997

The preterm prediction study: patterns of cervicovaginal fetal fibronectin as predictors of spontaneous preterm delivery. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.

OBJECTIVE: Our purpose was to determine how various temporal patterns of fetal fibronectin positivity from 24 to 30 weeks predict subsequent fetal fibronectin test results and spontaneous preterm delivery. STUDY DESIGN: A total of 2929 women had vaginal and cervical fetal fibronectin tests obtained at least once at 24, 26, 28, or 30 weeks, and 1870 women had tests performed at all four gestational ages. Fetal fibronectin values > or = 50 ng/ml were considered positive. Various patterns of positive and negative tests were evaluated for prediction of (1) whether the next fetal fibronectin test would be positive or negative and (2) the percent of women with a spontaneous preterm delivery > or = 4 weeks after the last fetal fibronectin test at < 30, < 32, < 35, and < 37 weeks' gestational age. RESULTS: Women with previous negative test results had only a 3% chance of a subsequent positive test result; however, if the last test result was positive, 29% of the next tests were positive. Of the 1870 women with tests at 24, 26, 28, and 30 weeks, 89% had all negative results, 8.4% had one positive result, 1.8% had two positive results, and 0.8% had three or four positive results. The higher the percent of positive tests at 24 to 26 weeks, at 28 to 30 weeks, or at 24 to 30 weeks, the greater the risk of subsequent spontaneous preterm birth. As an example, the risk of spontaneous preterm birth at < 30 weeks for women with two negative fetal fibronectin test results at 24 and 26 weeks was 0.3% versus 16% for women with two positive results. CONCLUSION: The presence of a positive cervical or vaginal fetal fibronectin test result predicts subsequent positive fetal fibronectin positivity and subsequent spontaneous preterm birth. The greater the percent of positive results, the higher is the risk of spontaneous preterm birth. After a positive test result, two negative results are required before the risk of spontaneous preterm birth returns to baseline.

Cervix Uteri↗
PubMed1997

Low pregravid body mass index as a risk factor for preterm birth: variation by ethnic group.

OBJECTIVE: To examine the association between pregravid body mass index (BMI) and preterm delivery among black, white, and Hispanic women. METHODS: Preterm deliveries among 12,459 women (43.2% black, 39.3% white, and 17.5% Hispanic) enrolled in a large multicenter trial of preterm birth prevention were examined by pregravid BMI category (very low, less than 16.5; low, 16.5-19.7; normal, 19.8-26.0; high, greater than 26) and by pathway (all, early, late, spontaneous preterm labor, and premature rupture of membranes [PROM]). RESULTS: More than one-fifth of both black (20.1%) and white (28.6%) women had low pregravid BMIs (less than 19.8), whereas only 11.7% of Hispanic women were under-weight. The overall prevalence of preterm delivery (gestational age less than 37 completed weeks) was 8.1% (10.3% in black, 7.3% in white, and 4.8% in Hispanic women). Among black and white women, bivariate analysis revealed an inverse linear association between pregravid BMI and the prevalence of all preterm deliveries (P < or = .001) and between pregravid BMI and the prevalence of late (33-36 weeks' gestation) preterm deliveries (P < .001). No such associations were observed for early (20-32 weeks' gestation) preterm delivery or among Hispanic women. Pregravid BMI was also associated inversely with spontaneous preterm labor among both black (P < or = .01) and white (P < .001) women, but not among Hispanic women. Logistic regression analysis (adjusting for the effects of maternal age, education, smoking, parity, previous preterm delivery, birth interval, and height) revealed that among black and white women, very low and low pregravid BMIs were associated with increased adjusted odds ratios for late (but not early) preterm delivery and for spontaneous preterm labor (but not PROM). CONCLUSIONS: These observations suggest that low pregravid BMI is associated with an increase in the prevalence of late preterm delivery and of spontaneous preterm labor among black and white, but not Hispanic, women.

Adolescent↗
PubMed1997

Determinants of poor pregnancy outcomes among teenagers in Sweden.

OBJECTIVE: To study pregnancy outcomes among teenagers and to determine whether age-related increases in risk are due to differences in socioeconomic conditions, maternal smoking, or anthropometric status. METHODS: All single births during 1990-1991 to mothers aged less than 25 years recorded in the Swedish Medical Birth Registry were studied (n = 62,433). The pregnancy outcomes analyzed were late fetal death, infant mortality, preterm birth, low birth weight, small for gestational age, and low Apgar scores. Information on maternal age, parity, family situation, maternal smoking, maternal height, and weight gain during pregnancy was recorded in the Medical Birth Registry. Information on socioeconomic characteristics was obtained from the Population Census. Logistic regression analysis was used to define the determinants of the adverse outcomes among teenagers. RESULTS: Compared with women aged 20-24 years, girls of 17 years or less were at higher risk for preterm birth (odds ratio [OR] 1.6), and this increased risk remained essentially unchanged after controlling for major confounding factors (OR 1.5). Teenagers also had a crude 50% higher risk of late fetal death and infant mortality, but this risk was reduced after controlling for the effect of socioeconomic characteristics (adjusted OR 1.2). CONCLUSIONS: The increase in risk of late fetal death and infant mortality associated with low maternal age is substantially an effect of teenagers' poorer socioeconomic situation. However, the increase in preterm birth among younger teenagers suggests that young maternal age may be a biologic risk factor for preterm birth.

Adolescent↗
PubMed1997

The pediatric costs of strategies for minimizing the risk of early-onset group B streptococcal disease.

OBJECTIVE: To estimate the pediatric costs associated with the Centers for Disease Control and Prevention (CDC) guidelines for the management of infants born to mothers receiving intrapartum antimicrobial prophylaxis for prevention of early-onset group B streptococcal disease. METHODS: For an annual United States birth cohort of 3.95 million infants, we estimated the cost of pediatric care provided to full-term asymptomatic infants when pediatricians followed the CDC algorithm for the management of infants exposed to intrapartum antimicrobial prophylaxis under culture-based and risk factor-based maternal care approaches. We calculated the relative contribution of pediatric costs to the total costs of preventing a case of early-onset group B streptococcal sepsis. RESULTS: Total pediatric costs were $41 million for a culture-based approach and $33 million for a risk factor-based approach. Hospital and physician costs accounted for more than 78% of this total. The majority (over 95%) of the pediatric costs were associated with vaginal deliveries. Incorporating pediatric costs into previous cost-effectiveness analyses increased the cost per sepsis case averted by as much as 51% for culture-based strategies and by as much as 112% for risk factor-based strategies. Pediatric costs varied with the average length of stay for full-term infants and with the average cost of a hospital day. CONCLUSION: Substantial pediatric costs are associated with the implementation of an obstetric strategy for minimizing the risk of early-onset group B streptococcal disease. Such costs should be included in future cost-effectiveness analyses of different strategies for minimizing the risk of group B streptococcal disease in newborns.

Algorithms↗
PubMed1997

Antenatal screening for factor V Leiden mutation: a critical appraisal.

Thromboembolic disease is a leading cause of maternal mortality in the United States. Recently, inherited resistance to activated protein C has been recognized as a major risk factor for thrombosis and has been demonstrated in 20-60% of patients with clinically evident thrombosis. The factor V Leiden mutation, which is readily detectable by molecular DNA techniques, is responsible for 90-95% of cases of activated protein C resistance. Because 5% of whites and 1% of blacks in the United States are heterozygous for the Leiden mutation, at least one group has suggested that screening of asymptomatic gravidas for the mutation should be considered. Therefore, we conducted a combined MEDLINE and bibliographic literature search for relevant data and evaluated screening for the factor V Leiden mutation in the context of well-elucidated desirable characteristics for a successful screening program. Based on this evaluation, we conclude that routine antenatal screening for the factor V Leiden mutation cannot be recommended at the present time.

Factor V↗
PubMed1997

Sexually transmitted diseases and adverse outcomes of pregnancy.

We emphasize again that the prevalence of maternal infections may vary in different populations, and others might arrive at different estimates about the percentage of infants colonized and, concerning those infants colonized, about the percentage with adverse outcomes. Additionally, many women are colonized or infected simultaneously with several of the organisms discussed in this review, and this may result in different projections of morbidity and mortality rates than those presented here. We realize also that new information is generated continually describing the relationship between various maternal colonizations and preterm birth, and that screening and treatment protocols for several diseases may reduce the prevalence of adverse outcomes reported here. Therefore, we emphasize that the prevalences of various adverse pregnancy outcomes, as presented in this article, are only approximations and may change as new information becomes available. Nevertheless, we believe it is reasonable to estimate the relative effect of various maternal sexually transmitted diseases on adverse pregnancy outcome as we have done in this article. By comparing the effect of direct transmission of sexually transmitted organisms on adverse outcomes with the effect on overall outcome through an increase in the rate of preterm births, we should be able to use this type of analysis to establish some basis for allocation of resources to future research as well as intervention programs aimed at reducing sexually transmitted disease-related adverse outcomes of pregnancy. Finally, the appreciation of the effect of bacterial vaginosis on outcomes of pregnancy associated with preterm birth gives bacterial vaginosis a greater public health importance than has been attributed to it in the past as the subject of sexually transmitted disease research and prevention.

Female↗
PubMed1997

The relationship between maternal characteristics and fetal and neonatal anthropometric measurements in women delivering at term: a summary.

BACKGROUND: We wanted to determine the relationship between a number of maternal characteristics and various fetal and neonatal anthropometric measurements determined by ultrasound and at birth. METHODS: A total of 1205 term singleton maternal-infant pairs were studied. Various ultrasound measurements obtained at 18, 24, 30 and 36 weeks' gestation and neonatal anthropometric measurements obtained at birth were studied in relationship to various maternal characteristics using univariate and multivariate techniques. RESULTS: Black race, female sex, cigarette smoking, drug use, having a previous low birthweight infant, maternal hypertension and being short or thin or failing to gain weight each resulted in a birthweight decrease of 100 to 300 g. The effect of each of these characteristics on each ultrasound measurement, the timing of the effect, and its ultimate effect on neonatal anthropometric measurements are described. CONCLUSION: The data presented in this paper provide a more complete understanding of the relationship between maternal characteristics, infant sex, and various fetal ultrasound and neonatal measurements.

Alabama↗
PubMed1997

Abbreviated scale for the assessment of psychosocial status in pregnancy: development and evaluation.

BACKGROUND: Data from five existing psychosocial scales were used to develop an abbreviated scale for the assessment of psychosocial status during pregnancy. METHODS: Scales were self-administered by 842 black and 381 white low-income multiparous women at risk for poor pregnancy outcome. Trait anxiety (Speilberger), self-esteem (Rosenberg), mastery (Pearlin), and depression (CES-D) were assessed at 24-26 weeks' gestation; subjective stress (Schar) was assessed at 30-32 weeks' gestation. The 59 pooled items were examined for redundancy and the discernment of primary factors using principal factor analysis. Regression analysis was used to determine if the resulting abbreviated scale (28 items) would provide information similar to that obtained with the 59 item pool (full scale) in predicting gestational age (GA), birth weight (BW), fetal growth restriction (FGR), and preterm delivery (PTD). RESULTS: The abbreviated scale was highly correlated (r = 0.97) with the 59-item pool and the six factors isolated were generally compatible with the major characteristics assessed by the five original scales. The distribution of FGR and PTD by scale quartile was similar for the abbreviated and the combined scales. Logistic regression analysis of scores for all women revealed that poor (high) scores on both the full (p = 0.0151) and the abbreviated scales (p = 0.0131) were positively associated with FGR, but not with PTD. In linear regression analysis poor (high) scores on both the full (p = 0.0024) and the abbreviated scale (p = 0.0019) were negatively related to BW, but not to GA. When data for black and white women were examined separately, the two scales provided comparable information. CONCLUSIONS: The abbreviated psychosocial scale provided information similar to that obtained with 59 pooled items in predicting GA, BW, FGR, and PTD.

Adult↗
PubMed1997

Maternal serum concentrations of human placental lactogen, estradiol and pregnancy specific beta 1-glycoprotein and fetal growth retardation.

BACKGROUND: To determine if maternal serum levels of human placental lactogen (hPL), estradiol, and pregnancy-specific beta 1-glycoprotein (SP1) measured at approximately 18 weeks' gestation were associated with fetal growth retardation (FGR) in infants delivered at or after 37 weeks. METHODS: Serum samples were obtained at a mean of 18 weeks' gestational age from 200 multiparous women with risk factors for FGR. Maternal serum concentrations of hPL, estradiol and SP1 were correlated with FGR. RESULTS: A total of 59 (29.5%) of the 200 infants were diagnosed postnatally with FGR. There were no significant differences in the prevalence of FGR among the lowest quartiles of estradiol, hPL or SP1. However, pregnancies in the highest quartile of estradiol levels at 18 weeks' (> 580 pg/ml) were associated with a significantly lower risk of FGR than those in the lower three quartiles, 8 out of 50 (16%) vs 51 of 150 (34%) (p = < 0.05). The prevalence of FGR associated with the highest quartile of hPL (> 1.73 micrograms/ml) was 12.2% compared to 35% in the lower three quartiles (p = 0.025) and the prevalence of FGR associated with the highest quartile of SP1 (> 43 ng/ml) was 14% compared to 34.7% in the lower three quartiles (p = 0.018). Only one out of 21 infants (4.5%) whose mothers had each value in the highest quartile of hPL, estradiol, and SP1 was diagnosed with FGR compared to 58 out of 178 (32.6%) of the remaining infants (p = 0.007). CONCLUSIONS: In pregnancies of women at high risk for FGR, higher levels of estradiol, hPL, and SP1 at 18 weeks are associated with a decreased prevalence of FGR. This finding indicates that high levels of these hormones are related to a lower risk of FGR, but that low levels do not predict FGR.

Alabama↗
PubMed1997

Serum concentrations of zinc, folate, vitamins A and E, and proteins, and their relationships to pregnancy outcome.

OBJECTIVE: To review the relationships between various laboratory measures relating to nutrition and pregnancy outcome. The data were obtained during the investigation entitled "Successive small-for-gestational-age births study". METHODS: A total of 289 pregnant women of the 1545 who participated in the study between 1986 and 1988 in Birmingham, Alabama, USA. The following determinations were done using the serum samples obtained at 18 and 30 weeks of gestation: zinc, folate, vitamins A and E, and proteins (alpha-2-macroglobulin, retinol-binding protein, prealbumin, and albumin). These laboratory values were correlated with various measures of pregnancy outcome including the incidence of fetal-growth retardation and maternal infections during the perinatal period and birth weight and Apgar score of infants. RESULTS: Serum folate concentrations showed positive relationships with the incidence of fetal-growth retardation as well as birth weight of infants, and alpha-2-macroglobulin was negatively correlated with birth weight. These relationships were significant after adjusting for factors previously known to affect the birth weight of infants. The concentrations of serum zinc, vitamins A and E, and proteins did not show significant correlation with measures of pregnancy outcome. CONCLUSION: Among the laboratory measures evaluated in this study, serum folate and alpha-2-macroglobulin concentrations correlated with pregnancy outcome. Further research is warranted to investigate the mechanism(s) of the relationship between serum alpha-2-macroglobulin and birth weight of infants.

Alabama↗
PubMed1997

The relationship between maternal dietary intake and infant birthweight.

BACKGROUND: Zinc and folate are important for fetal growth. However, the relationship between the dietary intake of these nutrients and pregnancy outcome is not settled. METHODS: A prospective study was conducted to ascertain the relationship between maternal dietary zinc and folate intake (n = 1398), serum zinc and folate levels (n = 289), and infant birthweight. Twenty-four hour recalls were used to measure energy, zinc, folate and other nutrient intakes at 18 and 30 weeks of gestation. Subjects in the study were offered daily folic acid (1.0 mg) and iron (60 mg as ferrous sulfate) at enrollment. RESULTS: Maternal zinc nutriture as assessed by serum and dietary intake was not associated with birthweight or length of gestation. There was a small but significant positive association between maternal folate intake and adjusted infant birthweight (beta = 0.05, p = 0.03). The indirect measures of maternal nutritional status including maternal pre-pregnancy weight (beta = 8.0, p = 0.0001) and weight gain during pregnancy (beta = 18.1, p = 0.0001) were stronger predictors of adjusted infant birthweight as compared to energy intake and intake of zinc and folate. An increase of 320, 290, and 48 g in infant birthweight was associated with the 90th-10th percentile difference for pre-pregnancy weight, weight gain during pregnancy, and folate intake respectively. CONCLUSION: These results indicate that pre-pregnancy weight and weight gain during pregnancy are both strong predictors of infant birthweight. Folate intake, although significantly associated with birthweight, was a weak predictor while maternal intake of zinc and other nutrients was not associated with birthweight.

Adult↗
PubMed1997

Growth and development during the first year in a cohort of low income term-born American children.

BACKGROUND: Infants born small for gestational age (SGA) are at risk for poor postnatal growth and development. This study evaluates biologic and environmental determinants of outcome during the first year of life in a cohort of low income term-born American infants. METHODS: Seven hundred and seventeen of 949 (76%) singleton births to women followed from early pregnancy were studied over their first year of life and measures of growth, home environment, physical and cognitive development were obtained. Infants were categorized as SGA or non-SGA based on birthweight < 15th percentile for gestational age. SGA and non-SGA children's outcomes were analyzed by race, gender and symmetry. RESULTS: SGA infants were demographically similar to non-SGA infants but significantly lower in mean maternal height, weight and education. Birthweight, crownheel length and head circumference were all significantly smaller in SGA infants. By age 1 year, the SGA children were still shorter, lighter and had smaller head circumferences than the non-SGA children though their rate of growth during the first year was significantly greater for length and head circumference. Cognitive functioning as measured by the Bayley Scales of Infant Development and the Fagan Test of Infant Intelligence did not differ significantly except for a lower Bayley Psychomotor Development Index (PDI) in SGA infants. Since most of these children live in economically disadvantaged households, any negative consequences of poor intrauterine growth may be influenced by postnatal environment and longer term follow-up will be necessary to assess this relationship.

Alabama↗