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Biomedical subjects

V A Moar

Publications and source records attributed to V A Moar.

31 records · Page 2Linked to original sources
PubMed1983

Small-for-dates babies at the age of four years: health, handicap and developmental status.

221 small-for-dates (SFD) and 244 average-for-dates (AFD) children were personally examined at birth, and seen thereafter at regular intervals up to 4 years, when a thorough assessment was made. There was an excess of SFD children with major congenital abnormalities; but no difference between the groups in the number of children who were handicapped without congenital abnormality. Their general health was good, and the prevalence of specific disease or major ill-health did not differ. SFD girls seemed to have less acute hearing than AFD girls; but there was not difference for boys. The prevalence of squint, impaired vision, speech defects, and abnormalities of gross and fine motor movements were equally low in both groups. At 4 years the mean scores for five sectors of development were significantly lower in the SFD than the AFD group. Within group analyses of 16 variables and their effects on developmental scores showed no associations in either group according to maternal height and weight, birthweights of previous siblings, the presence or not of hypertension and pre-eclampsia, bleeding during pregnancy, asphyxia and injury at birth, or birth order. Within each group the net effect of the remaining eight factors was assessed; adjustment being made for the other seven variables. In the SFD group social class and method of delivery made a significant contribution to total scores. In the AFD group significant differences were found according to social class, sex, gestational age at birth and smoking. Method of infant feeding just failed to achieve significance. When all the children were considered together, and birthweight group included as an additional variable, no significant differences remained between the SFD and AFD groups for any sector of development.

Breast Feeding↗
PubMed1983

Large-for-dates babies at the age of four years: health, handicap and developmental status.

236 Average-for-dates (AFD) and 212 large-for-dates (LFD) children were personally examined at birth, and seen thereafter at regular intervals up to 4 yr, when a thorough assessment was made. No differences were found in the prevalence of handicap, health problems, speech and hearing defects, impaired vision or squint; and abnormalities of gross and fine-motor movements were equally low in both groups. At 4 yr the mean scores for five sectors of development were slightly higher in the LFD group, and the difference in total scores was significant; but when adjustment was made for sex and social class the difference became insignificant. Within group analyses of 16 variables and their effects on developmental scores showed no associations in either group according to maternal weight, height and siblings birthweight; hypertension, pre-eclampsia or bleeding during pregnancy; asphyxia or injury at birth. Within each group the net effect of eight factors was assessed; adjustment being made for the other seven variables. In the AFD group significant differences in total scores were found according to sex, social class, smoking, and method of infant feeding. In the LFD group social class and method of delivery made a significant contribution to total scores.

Analysis of Variance↗
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

Growth in the first year of life: how early can one predict size at twelve months among small-for-dates and large-for-dates babies?

Within groups of small-for-dates (SFD) and large-for-dates (LFD) babies there is great diversity in their postnatal growth patterns. We analysed our data to find out how soon, and for which dimensions, could predictions of size at one year be reasonably made. Among LFD babies a strong correlation (r=0.644) was found between head circumference at birth and 12 months. Comparable values for weight and length were present by 3 months. In the SFD group, correlations of the same order were achieved for all three dimensions at the age of 4 months.

Birth Weight↗
PubMed1980

Hypertension during pregnancy with and without specific treatment; the development of the children at the age of four years.

In a controlled trial pregnant women who were hypertensive before the 28th week of gestation were randomly allocated to treatment with methyldopa or no anti-hypertensive treatment. The children from these pregnancies have been re-examined at four years of age and their development compared with a random sample from the same maternity hospital population. Their health, height, weight, and the incidence of sight, hearing and speech problems did not differ. None had gross neurological abnormalities. Boys in the treated hypertensive group had significantly smaller heads than in the other two groups, but there was no correlation between head circumference and developmental score in this group (r = 0.020). On average the children in the random sample were the most advanced when assessed by a global score of development. In each developmental sector the mean score for the treated hypertensive group was consistently higher than the untreated hypertensive group. We conclude that maternal hypertension is associated with slight developmental delay in early childhood. There are some indications that treatment with methyldopa may reduce this effect.

Child Development↗
PubMed1978

Neonatal head circumference and the treatment of maternal hypertension.

In a random controlled trial of methyldopa for the treatment of hypertension in pregnancy presenting before 28 weeks gestation, the newborn in the treated group had relatively smaller head circumferences. This difference persisted at two months of age when correction had been made for birth weight, gestation and sex, but was no longeer detectable at six or twelve months. Within the treated group no relationship was found between neonatal head circumference and the total amount or duration of methyldopa received during pregnancy. Comparison of treated and untreated groups according to the time of entry to the study showed that significant differences in neonatal head circumference were only present in patients who entered between 16 and 20 weeks gestation. It is possible that this could be a sensitive period for the interaction of fetal head growth and the onset of specific treatment in hypertensive pregnancy.

Clinical Trials as Topic↗
PubMed1977

Hypertension during pregnancy, with and without specific hypotensive treatment. I. Perinatal factors and neonatal morbidity.

In a prospective study, women who were hypertensive before the 28th wk of gestation were randomly allocated into two groups: those who received specific hypotensive therapy (Ht) and those who did not (Hu). The outcome was compared with a random sample of the hospital population (S) ascertained after delivery. In both hypertensive groups there was a higher incidence of clinical signs of possible fetal distress and instrumental delivery. Although there was no difference between the groups in the distribution of birthweight above and below the mean for gestational age, the treated hypertensive group had an excess of infants with relatively smaller head circumferences for their gestational age compared with both the untreated hypertensive group and the hospital sample. Tube-feeding was also more frequent in the treated hypertensive group. In the untreated hypertensive group there were more infants whose neurological status was categorized as questionable or abnormal in the neonatal period, compared with the sample. The different problems encountered by infants in the two hypertensive groups emphasized the need for further study of these babies. Their development during the first year of life will be examined in a subsequent paper.

Female↗
PubMed1977

Hypertension during pregnancy, with and without specific hypotensive treatment. II. The growth and development of the infant in the first year of life.

The growth and development of three groups of infants were prospectively assessed from birth to 12 mth. In two groups the mothers had been hypertensive before the 28th wk of gestation; one group was randomly allocated to specific hypotensive therapy, the other group was allocated to no specific treatment. The third group was a sample of the hospital population. General health, and the incidence of sight and hearing problems did not differ. Infants in the treated hypertensive group had had more perinatal problems, and there was an excess of infants with relatively small heads for their gestational age at birth. At 6 mth their heads were still smaller than the hospital sample, but by the age of 1 yr the difference was no longer present. The neurological status of infants in the untreated hypertensive group was less favourable in the neonatal period, and there was still an excess of infants in this group rated questionable on neurological assessment at the age of 12 mth. In both hypertensive groups there was an excess of infants with delayed fine-motor function at 6 mth, and in the untreated group there was an excess with delayed gross-motor function at 12 mth compared with the hospital sample. Our varied findings draw attention to the dangers of assessing the effects of different pregnancy conditions in terms of neonatal mortality and morbidity alone. Our date indicate that follow-up should extend for longer than 12 mth when the effects of adverse pregnancy factors and their management are under consideration. Further evaluation will be made when these children are 4 yr old.

Child Development↗
PubMedDate not supplied

Constrained and unconstrained fetal growth: associations with some biological and pathological factors.

Data are presented on the birthweights of 1092 siblings and 5207 maternal and paternal relatives of 986 probands. Previous analyses had demonstrated the potency of a maternal regulator constraining fetal growth. Different patterns of birthweights were found in families ascertained, respectively, through very large and very small babies (Ounsted, Scott and Ounsted 1986). When the data were reanalyzed in respect of other biological and pathological factors affecting fetal growth rate the following findings emerged: (1) When pathological factors were associated with the proband pregnancy the typical patterns of pedigree birthweights were not so clearly manifest; (2) general associations were found between the mothers' own birthweights and their size as adults; (3) low maternal birthweight was the biological factor showing the highest risk associated with small babies. When the babies were large the risks associated with high maternal adult weight and parity were similar to those associated with high birthweight. Paternal factors also made a contribution to fast fetal growth rate when pathological factors were absent. These findings confirm our hypothesis that at the lower extreme of fetal growth rate maternal constraint is pre-potent. At the upper extreme, relaxation of constraint allows other biological factors to take up more of the variance.

Adult↗