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PubMed2002

Leg and trunk length at 43 years in relation to childhood health, diet and family circumstances; evidence from the 1946 national birth cohort.

BACKGROUND: This is a study of the associations of adult leg and trunk length with early life height and weight, diet, socioeconomic circumstances, and health, and parental height, divorce and death. METHOD: The data used were collected in a longitudinal study of the health, development and ageing of a British national birth cohort (N = 2879 in this analysis) studied since birth in 1946. Multiple regression models were used to investigate the relationships. RESULTS: Adult leg and trunk length were each positively associated with parental height, birthweight, and weight at 4 years. Leg length was associated positively with breastfeeding and energy intake at 4 years. Trunk length was associated negatively with serious illness in childhood and possibly also parental divorce, but not with the dietary data. CONCLUSION: Adult leg length is particularly sensitive to environmental factors and diet in early childhood because that is the period of most rapid leg growth. Trunk growth is faster than leg growth after infancy and before puberty, and may be associated with the effects of serious illness and parental separation because of the child's growing sensitivity to stressful circumstances, as well as the result of the biological effects of illness.

Adult↗
PubMedDate not supplied

[The importance of children for the elderly and changes in reproductive behavior (a study of three rural communities in Mexico)].

"This study analyzes the importance of children in the care of elderly populations in rural communities [in Mexico].... In particular, the perception of elders about the value of their children is analyzed, especially the role children play in their economic contribution to the household or their instrumental value to it at different stages of their lives.... With respect [to] the condition in which children support their parents in their old age the economic assistance given was studied too. Finally, the preference regarding family size of those 60 years or older [is] given, as well as the view points of women on the need to control fertility and reduce family size. Three different types of cost are studied: the economic cost of supporting and caring for children, the emotional cost of their upbringing and the health cost of multiple pregnancies and births." (SUMMARY IN ENG)

Adult↗
PubMed2003

Birth defects ascertainment in the Philippines.

In the Philippines, congenital anomalies rank among the top 20 causes of death across the life span and are already the third leading cause of death in the infancy period (Philippine Department of Health, 1996). Despite the magnitude of the problem, no formal systematic registration of birth defects has been done in the country up until 1999. Various attempts have been made by different study groups to gather data but there was never a formal effort to consolidate the information and establish a centralized registry. Data from various modes of ascertainment are hereby presented: 1) Philippine Birth Defects Registry Project, 2) Hospital In-Patient and Out-Patient Registries, 3) Prenatal Inventory and Neonatal Outcome Study Group, 4) Hospital Pathology Reports, and 5) Community Outreach Programs. Birth Defects Registry Project had the largest reporting of the different methods presented here. The most common birth defects were multiple congenital anomalies, congenital malformations of the tongue, mouth, and pharynx (ankyloglossia), cleft palate with cleft lip, Down Syndrome, congenital deformities of the feet (talipes equinovarus), anencephaly, other congenital malformations of the face and neck, congenital malformations of the musculoskeletal system (diaphragmatic hernia, gastroschisis), hypospadias, congenital hydrocephalus, polydactyly, syndactyly, and cleft lip.

Congenital Abnormalities↗
PubMed1988

The expression of viral and cellular genes in papillomas of the choroid plexus induced in transgenic mice.

A line of transgenic mice that carry the SV40 gene for the large Tumor antigen express this protein during the first two weeks of life in brain tissue. By 30-40 days after birth, independently derived multiple foci of abnormal cells appear throughout the choroid plexus. After 90 days, higher levels of T antigen and rapid tumor growth are detected and all these animals die in a narrow time span, between 100-120 days. In situ hybridization with tissue sections and Northern blot analysis have been employed to follow the steady state levels of SV40 RNA and the p53 oncogene RNA levels in normal and tumor tissues. The level of SV40 RNA is quite variable between tumor cells in a section. This heterogeneity of T antigen mRNA levels could permit the selection of cells (from the multiple foci) expressing higher levels of T antigen and growing more rapidly. The increased levels of p53 RNA observed in tumor cells could then result from the active growth state of these cells or a more direct transcriptional activation. Two cellular genes, transthyretin and the 5-HT1C serotonin receptor, both of which are preferentially expressed in normal choroid plexus cells, were also examined for RNA production in these tumors of the choroid plexus. Both of these genes produced high levels of RNA in tumor tissue indicating the retention of well differentiated gene expression in these tumor tissues. This reflects, at the level of gene expression, the well differentiated morphology of these papillomas of the choroid plexus. Interestingly, as cell lines have been derived from these tumors, both the choroid plexus specific RNA species (for 5-HT1C receptor) and characteristic morphology were lost and an increase in T antigen levels was observed.

Animals↗
PubMed1983

Empiric recurrence risk for neural tube defects (NTD) in Krakow region.

A sample of 347 families in the Krakow region of Southern Poland with at least one child with anencephaly and/or myelomeningocele or encephalomeningocele were ascertained by multiple selection. The birth prevalence of neural tube defects in this population was 75/80, 584 (0.93/1000). The risk of affected individuals among the probands' sibs was 3.3% (+/- 1.6), about 38 times the population prevalence at birth. The empiric risk was higher for female than for male sibs of the proband. Also, the probability of occurrence was higher for sibs of male probands. The differences were nonsignificant. The heritability calculated on the regression of siblings on propositi was 76% (+/- 7).

Genetic Counseling↗
PubMed1980

[A new case of pentasomy X].

Cytogenetic investigations of children with psychomotor retardation gave evidence of pentasomia X in a twelve-month-old girl. The chromosome analysis made on the basis of lymphocyte cultures showed a 49,XXXXX caryotype; up to four X-chromatin masses were found. Total ridge count (TRC) was diminished to the very low value of 15. The clinical symptoms of our case were compared with the others published in earlier papers. In accordance with the other authors we found a low birth weight, oligophrenia, multiple abnormalities of the craniofacial skeleton (hypertelorism, epicanthus, broad root of the nose, oblique axis of the eyelids), and some minor deformities of the fingers and toes. Less common signs of the syndrome are malformations of the heart and probably the hemiatrophy, especially of the face, a rather pronounced finding in our case.

Chromosome Aberrations↗
PubMed1994

[Colorectal cancer in Denmark 1943-1988].

Nation-wide incidence rates are presented of colorectal cancer in Denmark from 1943 to 1988. In Denmark notification of malignant and related diseases is mandatory. The percentage of histologically confirmed tumours is now 95. The annual incidence rate of colon cancer in Denmark has been increasing among men and women combined from 684 cases in 1943-1947 to 2020 cases in 1988. In the same period the incidence of rectal cancer has increased from 762 cases in 1943-1947 to 1108 cases in 1988. We analyzed the effects of age, calender time, and birth cohort with multiplicative Poisson models. We did not find consistent period effects in the models. We suggest an etiologic distinction between carcinoma of the rectum, the left colon and the right colon.

Colonic Neoplasms↗
PubMed1996

Does periconceptional multivitamin use reduce the risk of neural tube defects associated with other birth defects? data from two population-based case-control studies.

The role of periconceptional folic acid in the prevention of neural tube defects (NTDs) is well established. However, it is not clear whether a protective effect exists for the subset of nonsyndromic NTD with other "unrelated" major structural birth defects (NTD-multiples). This question is important to investigate because of shared pathogenetic mechanisms between NTD and other types of birth defects, and because of the epidemiologic differences that have been shown between NTD-multiples and NTD-singles. We analyzed data from two population-based case-control studies of NTDs, Atlanta 1968-1980, and California 1989-1991, to assess whether periconceptional multivitamin use reduces the risk of NTD-multiples. Maternal vitamin histories were assessed for 47 and 65 NTD-multiples cases and 3,029 and 539 control babies in Atlanta, and California, respectively. There was a substantial risk reduction associated with periconceptional multivitamin use (-3 to +3 months) for NTD-multiples (pooled odds ratio = 0.36, 95% C.I. 0.18-0.72) that persisted after adjustment for maternal race/ethnicity and education. Also, no specific types of NTDs or NTDs with specific defects explained the risk reduction with vitamin use. These data suggest that multivitamins reduce the risk of nonsyndromic NTD cases associated with other major birth defects. The implication of this finding for the role of vitamins in the prevention of non-NTD birth defects should be further explored.

Abnormalities, Multiple↗
PubMed1991

Perinatal mortality rate in a south Indian population.

Perinatal mortality rate was assessed for 13964 consecutive births in SAT Hospital, Trivandrum, South India, during a period of one year. The overall perinatal mortality rate was 42.75, stillbirth rate 24.41 and early neonatal mortality rate 18.79. The perinatal mortality rate in multiple pregnancy was 156.65. Preventable causes of perinatal mortality still make a major contribution to perinatal deaths in developing countries.

Female↗
PubMed2005

Preimplantation genetic diagnosis for aneuploidy screening in women older than 37 years.

OBJECTIVE: To provide background information about the average aneuploidy and implantation rates of older patients after IVF with preimplantation genetic diagnosis for aneuploidy screening (PGD-AS) when the patients are subdivided into age categories; and to compare pregnancy outcome data after PGD-AS in this group of patients with a similar control group. DESIGN: Retrospective clinical study. SETTING: Patients in an academic reproductive medicine unit. PATIENT(S): All patients 37 years or older who had PGD-AS between October 1999 and December 2003 and all pregnant patients 37 years or older who had IVF/intracytoplasmic sperm injection without PGD-AS during the same period of time. INTERVENTION(S): IVF with PGD-AS. MAIN OUTCOME MEASURE(S): Aneuploidy rate, miscarriage rate, live birth rate, implantation rate, multiple pregnancy rate, and prenatal testing. RESULT(S): Three hundred ninety-four PGD-AS cycles of patients between 37 and 46 years of age were analyzed. The aneuploidy rate gradually increased with age. The implantation rate remained similar over all age groups. There was a trend to a lower miscarriage and multiple pregnancy rate in the PGD-AS group and a higher delivery/live birth rate. There were five elective terminations of pregnancy after prenatal testing and three late miscarriages due to prenatal testing in the control group. CONCLUSION(S): Preimplantation genetic diagnosis for aneuploidy screening can give valuable information to older patients concerning the reason why their IVF cycles are unsuccessful and whether it is worthwhile to continue IVF treatment, and it can help patients to avoid the emotional trauma that can occur after prenatal testing during the second trimester of pregnancy.

Adult↗
PubMed1993

Patterns of infant weight gain in developing countries.

Data relating to weight of infants from 23 developing countries and two western industrialized populations taken from the literature were compared. Growth in the developing countries was extremely variable, but was poor compared to western standards such that by 12 months of age mean weight in all 23 populations was below the NCHS 50th percentile (P < 0.001) and in 11 populations mean weight was below the 10th percentile. Birth weight was not related to growth increment in the first 3 months. Multiple regression analysis showed birth weight and growth increments in the first four 3-month periods post-partum to be highly significantly related to weight at 12 months (P < 0.0001 in all cases). Growth increment in the first 3 months had the greatest effect out of these variables; the effect of the other four variables was similar. These patterns demonstrate the variable impact of environmental factors on growth in the first year of life.

Age Factors↗
PubMed1996

The surveillance of birth defects: the usefulness of the revised US standard birth certificate.

To assess the sensitivity and positive predictive value of birth defects reported on the 1989 revision of the US Standard Birth Certificate, a population of 76,862 Atlanta-area births during 1989 and 1990 was used as the basis for comparing 771 birth certificates that reported birth defects with 2428 live-born infant records in a birth defects registry that uses multiple sources of case ascertainment. Only 14% of birth defects in the registry records were reported on birth certificates. After the analysis was restricted to defects recognizable at birth, the sensitivity and positive predictive value of the birth certificates were 28% and 77%, respectively. Birth certificates underestimate birth defect rates and should be used cautiously for birth defect surveillance and epidemiological studies.

Birth Certificates↗
PubMed2002

Birth outcomes and need for hospitalization after delivery among women with multiple sclerosis.

OBJECTIVE: The purpose of this study was to determine whether women with multiple sclerosis who deliver singleton infants are more likely to have pregnancy or delivery complications or to have infants with low birth weight, preterm gestation, or malformations than women without multiple sclerosis and to compare their need for rehospitalization during the 2 years after delivery. STUDY DESIGN: This was a population-based cohort study that used Washington State linked birth certificate-hospital discharge records for singleton births from 1987 through 1996. Pregnancy course, birth outcomes, and need for rehospitalization within 2 years after delivery were compared for 198 women with multiple sclerosis and a comparison group of 1584 women. RESULTS: With the exception of maternal anemia, women with multiple sclerosis were no more likely to have pregnancy or delivery complications, nor were their infants more likely to be low birth weight or preterm or to have malformations. Affected women were, however, twice as likely to be rehospitalized during the 3 months after delivery. CONCLUSION: The increased risk of rehospitalization emphasizes a need for strong support systems and close monitoring during the 3 months after delivery.

Adult↗
PubMed1996

The outcome of multiple pregnancy.

The incidence of multiple pregnancy and delivery has increased dramatically over the past 10-15 years in many developed countries of the world. Data for England and Wales show that between 1980 and 1993 the twin maternity rate increased by approximately 25% and the triplet and higher order maternity rate more than doubled. Similar trends have been reported elsewhere. The majority of these increases have been linked to the use of ovarian stimulants and assisted reproduction techniques, and multiple pregnancy must be considered to be one of the most important adverse outcomes in current methods of infertility treatment. Obstetric complications associated with multiple pregnancy include prenatal screening problems and increased incidence of pregnancy-induced hypertension, antepartum haemorrhage, preterm labour and assisted or surgical delivery. Neonatal problems include low birthweight and increased prevalence of congenital malformations. Compared with singletons, neonatal mortality was seven times higher in twins and > 20 times higher in triplets and higher order births in England and Wales in 1991. Survivors also suffer higher rates of cerebral palsy and other neurological impairments. Most studies of pregnancies and babies resulting from assisted reproduction have demonstrated similar, if not higher, risks of adverse obstetric and neonatal outcomes for multiple births compared with national expectations. A poorer outcome in multiple pregnancy, especially in triplet and higher order pregnancy, supports the replacement of two good quality embryos in assisted reproduction treatment cycles.

Female↗
PubMed2004

Cord blood cardiac troponin T and troponin I levels in multiple-gestation neonates.

The increased mortality and morbidity rates in multiple-gestation neonates are not completely understood. Troponin measurements have a role in situations where the evaluation of the cardiac damage is difficult, such as in cases of unexplained intrauterine fetal growth restriction or death. These conditions, along with perinatal hypoxic risk and in utero ischemic damage, are frequently found in multiple gestations. In this context, a myocardial damage could be expected more frequently in multiple than in singleton births. We hypothesized that cord blood cardiac troponin T and troponin I, markers of myocardial damage, could be different between singleton and multiple pregnancies and, among twins, between the first- and the second-born twin. Troponins T and I and creatine kinase MB concentrations were not increased in twins at birth and were not different between the first- and the second-born twin. These data suggest that myocardial damage, evaluated by cardiac troponin T, troponin I, and creatine kinase MB measurements, does not seem to be a relevant problem in multiple-gestation neonates.

Birth Order↗
PubMed2005

Prediction of death for extremely low birth weight neonates.

OBJECTIVE: To compare multiple logistic regression and neural network models in predicting death for extremely low birth weight neonates at 5 time points with cumulative data sets, as follows: scenario A, limited prenatal data; scenario B, scenario A plus additional prenatal data; scenario C, scenario B plus data from the first 5 minutes after birth; scenario D, scenario C plus data from the first 24 hours after birth; scenario E, scenario D plus data from the first 1 week after birth. METHODS: Data for all infants with birth weights of 401 to 1000 g who were born between January 1998 and April 2003 in 19 National Institute of Child Health and Human Development Neonatal Research Network centers were used (n = 8608). Twenty-eight variables were selected for analysis (3 for scenario A, 15 for scenario B, 20 for scenario C, 25 for scenario D, and 28 for scenario E) from those collected routinely. Data sets censored for prior death or missing data were created for each scenario and divided randomly into training (70%) and test (30%) data sets. Logistic regression and neural network models for predicting subsequent death were created with training data sets and evaluated with test data sets. The predictive abilities of the models were evaluated with the area under the curve of the receiver operating characteristic curves. RESULTS: The data sets for scenarios A, B, and C were similar, and prediction was best with scenario C (area under the curve: 0.85 for regression; 0.84 for neural networks), compared with scenarios A and B. The logistic regression and neural network models performed similarly well for scenarios A, B, D, and E, but the regression model was superior for scenario C. CONCLUSIONS: Prediction of death is limited even with sophisticated statistical methods such as logistic regression and nonlinear modeling techniques such as neural networks. The difficulty of predicting death should be acknowledged in discussions with families and caregivers about decisions regarding initiation or continuation of care.

Female↗
PubMed1992

Prevalence of congenital anomaly syndromes in a Spanish gypsy population.

We analysed the sample of gypsies included in the Spanish Collaborative Study of Congenital Malformations (ECEMC), a hospital based, case-control study and surveillance system. Special emphasis was placed on the birth prevalence of recessive multiple congenital anomaly syndromes, comparing their frequency in the gypsy population with that observed among non-gypsies. We observed an increased prevalence of birth defects, mostly because of groups of children with patterns of multiple anomalies and with autosomal recessive syndromes. The latter were approximately seven times more frequent in gypsies than in non-gypsies. We also estimated the carrier frequency in both groups (gypsy and non-gypsy). We consider that the frequent occurrence of the conditions observed reflects the high rate of consanguineous couples among the Spanish gypsy population.

Abnormalities, Multiple↗
PubMed2003

First-year survival of infants born with congenital heart defects in Arkansas (1993-1998): a survival analysis using registry data.

BACKGROUND: In the United States and other developed nations, birth defects are the leading cause of infant mortality. Congenital heart defects (CHDs) are among the most prevalent and fatal of all birth defects. Here we report the survival probability of infants born with CHDs in Arkansas and examine the impact of multiple malformations on survival. METHODS: Birth and death certificate records were linked to birth defects registry data for infants born with CHDs from January 1993 through December 1998 in Arkansas. Both neonatal and first-year survival probabilities were estimated. These were computed non-parametrically using Kaplan-Meier's product limit method. A Cox proportional-hazards model was used to evaluate the relative importance of additional malformations on survival. RESULTS: A total of 1,983 infants with CHDs were included in this study. The neonatal survival probability for this cohort was 94.0% (95% CI: 93.0%, 95.1%), and the first-year survival probability was 88.2% (95% CI: 86.8%, 89.6%). The presence of hypoplastic left heart syndrome conferred the greatest reduction in survival, whereas infants with pulmonic valve stenosis and infants with ventricular septal defects had the highest first-year survival. Infants with multiple CHDs had decreased survival compared to those with isolated heart defects. Survival was also adversely affected by the presence of congenital abnormalities in other body systems. CONCLUSIONS: Neonatal and first-year survival of infants with CHDs varies by both the type of cardiac malformation and the presence of additional cardiac and non-cardiac malformations. Further work will focus on the effects of maternal and infant characteristics on survival.

Abnormalities, Multiple↗

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