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PubMed1997

Effects of three nematode anthelmintic treatment regimes on flock performance of sheep and goats under extensive management in semi-arid Kenya.

A study was undertaken in a semi-arid area of Kenya between August 1991 and June 1993 to evaluate the effects of anthelmintic treatment using ivermectin before or during the rains, on performance of mixed sheep and goat flocks, in comparison with an untreated flock. Performance parameters measured included age and weight of dams at first parturition, parturition intervals, body weights of dams and offspring, and birth weights, growth rates, and mortality rates of offspring. Among these parameters, birth weights and growth rates of offspring were found to be significantly improved by the treatment administered before the rains compared with the other two treatments. Mortality was lower in lambs and kids with high birth weights. Treatment, either before or during the rains, significantly reduced the faecal egg output and improved body weight, packed cell volume and flock fertility. Liveweight was confirmed to be a better measure of sexual maturity than age. It was further shown that lambs and kids, born of dams at their first lambing or kidding, experienced higher mortality rates than lambs and kids born of dams in their second and subsequent parturitions. Overall, treatment with ivermectin before the onset of rains was equal to or better, in terms of the performance parameters measured, than treatment during the rains, whilst treatment compared with no treatment increased performance in almost all of the parameters measured.

Albendazole↗
PubMed2005

Birth order and delivery interval: analysis of twin pair perinatal outcomes.

OBJECTIVE: To determine whether second-born twins (B) have higher morbidity and mortality than first-born twins (A), using a paired analysis. STUDY DESIGN: We conducted a retrospective analysis of birth certificates and fetal and infant death certificates for 5138 twin pairs selected from those born in Washington State from 1989 to 2001. Twin A was vertex and delivered vaginally. Pairs were not size-discordant (< 20%) and had no malformations. Matched-pair odds ratios were calculated. RESULTS: Twin B had more fetal distress (OR=6.0) and more low 5-min Apgar scores (OR=2.1) than Twin A, except at short delivery intervals. Pairs had relatively high rates of combined vaginal plus cesarean deliveries at delivery intervals 15 min. CONCLUSION: If prompt vaginal delivery of Twin B does not occur, the benefits of vaginal delivery for Twin A might not outweigh the risks of distress and low Apgar scores in Twin B and vaginal plus cesarean delivery for the mother.

Apgar Score↗
PubMed1978

Validation and aplication of an interval factor in estimating age at onset of Huntington's disease.

The time interval between the first appearance of signs in the transmitting parent and the birth of the subsequently affected child has been shown by Brackenridge and Telscher (1975) to influence the age at onset of Huntington's disease. The cirticism by Burke (1976) that the interval factor offers no predictive advantage over parental onset age is refuted. The advantage of small sibship sizes in familial correlation studies is noted and an equation to estimate onset age is derived to control for ascertainment bias. The interval factor is shown to surpass parental onset age as a determinant of offspring onset age. When applied to Queensland material, reasonable agreement is obtained between predicted and reported onset ages. Evidence for the desirability for parents at risk who intend to have families to plan them early is discussed.

Age Factors↗
PubMed2000

Infant mortality and early postpartum discharge.

OBJECTIVE: To assess additional risk of newborn death owing to early discharge. METHODS: This was a historical cohort study using Washington State linked birth certificates, death certificates, and hospital discharge records that covered 47,879 live births in 1989 and 1990. Logistic regression was used to assess risk of death within the first year of life after early discharge (less than 30 hours after birth) compared with later discharge (30-78 hours after birth). RESULTS: Newborns discharged early were more likely to die within 28 days of birth (odds ratio [OR] 3.65; 95% confidence interval [CI] 1.56, 8.54), between 29 days and 1 year (OR 1.61; 95% CI 1.10, 2.36), and any time within the first year (OR 1.84; 95% CI, 1.31, 2.60) of life than newborns sent home later. Newborns discharged early also were more likely to die of heart-related problems (OR 3.72; CI 1.25, 11.04) and infections (OR 4.72; CI 1.13, 19.67) within 1 year of birth than newborns discharged later. CONCLUSION: Newborns discharged within 30 hours of birth are at increased risk of death within the first year of life.

Cohort Studies↗
PubMed1990

Power spectral analysis of the EEG of term infants following birth asphyxia.

The aim of this pilot study was to perform power spectral analysis of the EEGs of term infants following birth asphyxia, to establish its value as a prognostic indicator. 16 term infants were studied over an 18-month period. Power spectral analysis was performed on the EEGs of babies with signs of hypoxic-ischaemic encephalopathy at regular intervals during the first five days of life. It showed distinct changes following birth asphyxia, which were related to the eventual outcome of the babies. Absolute power was significantly reduced in the babies with poor outcome compared with those with good outcome, particularly in the delta bands.

Asphyxia Neonatorum↗
PubMed2001

Higher risk of pre-eclampsia after change of partner. An effect of longer interpregnancy intervals?

Epidemiologic studies have shown that pre-eclampsia is mainly a disease of first pregnancy, possibly associated with primipaternity. The interpregnancy interval, which is strongly associated with change of partner, has received little attention. In this study, based on Danish hospital records, we evaluated whether the interpregnancy interval may confound or modify the paternal effect on pre-eclampsia. We studied the outcome of the second birth in a cohort of Danish women with pre-eclampsia in the previous birth (8,401 women) and in all women with pre-eclampsia in second (but not first) birth together with a sample of women with two births (26,596 women). A long interpregnancy interval was associated with a higher risk of pre-eclampsia in women with no previous pre-eclampsia when the father was the same. We estimated the risk of pre-eclampsia in second birth according to paternal change in different models. Although partner change was associated with an increased risk of pre-eclampsia in women with no history of pre-eclampsia, this effect disappeared after adjustment for the interpregnancy interval. We saw, however, different results when we stratified on the length of the interval. Our results indicate that the interval between births should be taken into consideration when studying the effect of changing partner on pre-eclampsia.

Adult↗
PubMed1979

Short-term variations in plasma LH and testosterone in bull calves from birth to 1 year of age.

LH and testosterone levels in bull calves were studied in the plasma samples collected sequentially at 15-min intervals every month during the first year of life. An episodic pattern of LH release occurred after birth and the frequency and magnitude of the LH peaks increased up to 4 months of age and decreased thereafter. A testicular response was not observed before this age. It is suggested that this episodic LH activity is responsible for the testicular development which then initiates puberty.

Aging↗
PubMed1985

Birth spacing and fertility limitation: a behavioral analysis of a nineteenth century frontier population.

Our analysis of changing birth interval distributions over the course of a fertility transition from natural to controlled fertility has examined three closely related propositions. First, within both natural fertility populations (identified at the aggregate level) and cohorts following the onset of fertility limitation, we hypothesized that substantial groups of women with long birth intervals across the individually specified childbearing careers could be identified. That is, even during periods when fertility behavior at the aggregate level is consistent with a natural fertility regime, birth intervals at all parities are inversely related to completed family size. Our tabular analysis enables us to conclude that birth spacing patterns are parity dependent; there is stability in CEB-parity specific mean and birth interval variance over the entire transition. Our evidence does not suggest that the early group of women limiting and spacing births was marked by infecundity. Secondly, the transition appears to be associated with an increasingly larger proportion of women shifting to the same spacing schedules associated with smaller families in earlier cohorts. Thirdly, variations in birth spacing by age of marriage indicate that changes in birth intervals over time are at least indirectly associated with age of marriage, indicating an additional compositional effect. The evidence we have presented on spacing behavior does not negate the argument that parity-dependent stopping behavior was a powerful factor in the fertility transition. Our data also provide evidence of attempts to truncate childbearing. Specifically, the smaller the completed family size, the longer the ultimate birth interval; and ultimate birth intervals increase across cohorts controlling CEB and parity. But spacing appears to represent an additional strategy of fertility limitation. Thus, it may be necessary to distinguish spacing and stopping behavior if one wishes to clarify behavioral patterns within a population (Edlefsen, 1981; Friedlander et al., 1980; Rodriguez and Hobcraft, 1980). Because fertility transition theories imply increased attempts to limit family sizes, it is important to examine differential behavior within subgroups achieving different family sizes. It is this level of analysis which we have attempted to achieve in utilizing parity-specific birth intervals controlled by children ever born.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1980

Nutrition and age at first birth in breast-cancer risk.

Urban/rural breast-cancer incidence ratios in the state of Iowa for 1950 and 1969-71 were contrasted with corresponding urban and rural distributions of age-at-first-birth and population nutrition, variable measured approximately 15 years before each morbidity survey and putatively related to breast-cancer incidence. Over the study interval, the decline in the urban/rural breast-cancer incidence ratio correlated better with changing nutritional patterns than with changing age-at-first-birth.

Adult↗
PubMed2002

Perinatal predictors of respiratory symptoms and lung function at a young adult age.

A longitudinal cohort of 2,957 babies, born in 1975-1978, was used to investigate whether perinatal factors predict respiratory morbidity at a young adult age. In 1997, the presence of asthmatic (wheeze, nocturnal dyspnoea) and bronchitic (cough, phlegm, dyspnoea grade 3) symptoms and the level of lung function was determined in this cohort. The independent association between smoking during pregnancy, being first-born, birth weight and respiratory symptoms and lung function at young adult age was investigated using multiple regression models, taking other potential risk factors into account. Of 1,568 responders, 608 (39%, aged 18-22 yrs) had at least one respiratory symptom. The young adults who had a mother that smoked during pregnancy had a significantly lower level of lung function than their nonintra-uterine exposed peers (regression coefficient (B) (standard error): peak expiratory flow (PEF) -0.257 (0.131) L x s(-1); forced expiratory flow when 25% of the forced vital capacity has been exhaled (FEF25) -0.290 (0.129) L x s(-1)), although they were not at increased risk of having respiratory symptoms. Young adults who were first-born had better levels of lung function (B (SE): forced expiratory volume in one second (FEV1) 0.090 (0.042) L) and were less likely to have asthmatic symptoms (odds ratio (95%, confidence interval): 0.58 (0.35-0.95)) than those not first-born. Low birth weight (FEV1 -0.013 (0.004) L for a reduction of 100 g) was also predictive of reduced achieved levels of lung function at young adult age, independent of other potential risk factors, e.g. current smoking habits or familial predisposition. This study adds to the knowledge of the role of perinatal factors, such as smoking during pregnancy, as important predictors of respiratory morbidity.

Adolescent↗
PubMed2000

Induced abortion and low birthweight in the following pregnancy.

BACKGROUND: To examine whether induced abortion increases the risk of low birthweight in subsequent singleton live births. METHODS: Cohort study using the Danish Medical Birth Registry (MBR), the Hospital Discharge Registry (HDR), and the Induced Abortion Registry (IAR). All women who had their first pregnancy during 1980-1982 were identified in the MBR, the HDR, and the IAR. We included all 15,727 women whose pregnancy was terminated by a first trimester induced abortion in the induced abortion cohort and 46,026 women whose pregnancy was not terminated by an induced abortion were selected for the control cohort. All subsequent pregnancies until 1994 were identified by register record linkage. RESULTS: Low birthweight (<2500 g) in singleton term live births occurred more frequently in women with one, two, three or more previous induced abortions, compared with women without any previous induced abortion of similar gravidity, 2.2% versus 1.5%, 2.4% versus 1.7%, and 1.8% versus 1.6%, respectively. Adjusting for maternal age and residence at time of pregnancy, interpregnancy interval, gender of newborn, number of previous spontaneous abortions and number of previous low birthweight infants (control cohort only), the odds ratios (OR) of low birthweight in singleton term live births in women with one, two or more previous first trimester induced abortions were 1.9 (95% CI: 1.6, 2.3), and 1.9 (95% CI: 1.3, 2.7), respectively, compared with the control cohort of similar gravidity. High risks were mainly seen in women with an interpregnancy interval of more than 6 months. CONCLUSIONS: The findings suggest a positive association between one or more first trimester induced abortions and the risk of low birthweight in subsequent singleton term live births when the interpregnancy interval is longer than 6 months. This result was unexpected and confounding cannot be ruled out.

Abortion, Induced↗
PubMed1994

Birth order, interpregnancy interval and birth outcomes among Filipino infants.

This study examines the effects of birth order and interpregnancy interval on birthweight, gestational age, weight-for-gestational age, infant length, and weight-for-length in a sample of 2063 births from a longitudinal study in the Philippines. First births are the most disadvantaged of any birth order/spacing group. The risks associated with short intervals (< 6 months) and high birth order (fifth or higher) are confined to infants who have both attributes; there is no excess risk associated with short previous intervals among lower-order infants, nor for high birth order infants conceived after longer intervals. This pattern is observed for all five birth outcomes and neonatal mortality, and persists in models that control for mother's age, education, smoking, family health history and nutritional status. Since fewer than 2% of births are both short interval and high birth order, the potential reduction in the incidence of low birthweight or neonatal mortality from avoiding this category of high-risk births is quite small (1-2%).

Adult↗
PubMed1995

Effects of menstrual and reproductive factors on the risk of breast cancer: meta-analysis of the case-control studies in Japan.

To elucidate the magnitude of the effect of menstrual and reproductive factors on breast cancer occurrence among Japanese women, we reviewed eight case-control studies previously conducted in Japan and used a quantitative method (meta-analysis) to summarize the data. While individual studies have different methods and populations, the estimated odds ratios (ORs) in the studies were statistically homogeneous for all study variables. It was confirmed that early age at menarche, late age at first birth, and premenopausal status are significantly associated with risk of breast cancer; an estimated combined OR of 0.68 (95% confidence interval (CI): 0.59-0.77) was obtained for women with onset of menstruation after age 16 compared to those before age 14. Nulliparous women had higher risk than women with first birth before age 25 (OR = 1.56 95%, CI: 1.27-1.91). The OR for women with first birth after age 35 was 2.26 (95% CI: 1.85-2.77) compared to women at first birth before age 25. Premenopausal women had a higher risk than women with menopause before age 50 (OR = 2.21, 95% CI: 1.53-3.20). We also found a significant protective effect of high parity after controlling for age at first birth and the other menstrual factors. The OR estimate for 3 or more births compared to nulliparity was 0.68 (95% CI: 0.54-0.86). The meta-analysis provided quantitative estimates of breast cancer risk among Japanese women with improved precision.

Age Factors↗
PubMed2000

Determinants of birth interval in a rural Mediterranean population (La Alpujarra, Spain).

The fertility pattern, in terms of birth intervals, in a rural population not practicing contraception belonging to La Alta Alpujarra Oriental (southeast Spain) is analyzed. During the first half of the 20th century, this population experienced a considerable degree of geographical and cultural isolation. Because of this population's high variability in fertility and therefore in birth intervals, the analysis was limited to a homogenous subsample of 154 families, each with at least five pregnancies. This limitation allowed us to analyze, among and within families, effects of a set of variables on the interbirth pattern, and to avoid possible problems of pseudoreplication. Information on birth date of the mother, age at marriage, children's birth date and death date, birth order, and frequency of miscarriages was collected. Our results indicate that interbirth intervals depend on an exponential effect of maternal age, especially significant after the age of 35. This effect is probably related to the biological degenerative processes of female fertility with age. A linear increase of birth intervals with birth order within families was found as well as a reduction of intervals among families experiencing an infant death. Our sample size was insufficient to detect a possible replacement behavior in the case of infant death. High natality and mortality rates, a secular decrease of natality rates, a log-normal birth interval, and family-size distributions suggest that La Alpujarra has been a natural fertility population following a demographic transition process.

Adult↗
PubMedDate not supplied

Birth spacing, breastfeeding, and early child mortality in a traditional Indian society: a hazards model analysis.

There are few studies of the interrelationships among breastfeeding, child spacing, and child mortality in traditional societies that incorporate extensive controls for social and demographic characteristics of the mother and child. In this paper, we investigate the impact of breastfeeding and the length of the preceding birth interval on early child mortality (defined as a death in the first two years of life) using data from a traditional society of India. Multivariate hazards models are used to analyze the data. Most prior analyses related the impact of breastfeeding duration to the duration of child survivability by taking breastfeeding as a fixed covariate. The present study has a methodological focus in the sense that breastfeeding information from retrospective survey data is treated as a time-dependent covariate both as a status variate as well as a duration--with empirical findings compared across the two specifications. The effects of postpartum amenorrhoea and various other demographic and socioeconomic characteristics of mother and child are also studied. The results suggest that breastfeeding duration has a strong impact in reducing the relative risk of early child mortality; but it does not explain the effect of the length of the preceding birth interval on early child mortality.

Birth Intervals↗
PubMed1994

Breast cancer incidence before age 55 in relation to parity and age at first and last births: a prospective study of one million Norwegian women.

We examined the relation between breast cancer, parity, and age at first and last births in a large national cohort of young women in Norway. We estimated relative incidence rates by Poisson regression analyses of person-years at risk with parity and age at last (most recent) birth as time-dependent variables. A total of 1,071,795 women were included in follow-up, contributing a total of 16,643,883 person-years in the age range 20-54 years. Follow-up times ranged from 1 month to 34.5 years. A total of 4,302 women were diagnosed with breast cancer during follow-up. With adjustment for age at first and last births, high parity was associated with an overall reduced risk of breast cancer (incidence rate ratio = 0.46; 95% confidence interval = 0.36-0.59 for women with five or more children vs uniparous women). Among women age 20-29 years, however, the results suggested an increase in risk with increasing parity (incidence rate ratio = 1.25; 95% confidence interval = 0.64-2.45 for women with three children vs uniparous women). The protective effect of high parity was particularly strong among women with first birth before the age of 20 years and rather weak among those with first birth at age 30 years or more. Low ages at first and last births were both associated with reduced breast cancer risk in analyses with adjustment for the other factor, with the association with age at last birth being slightly stronger.

Adult↗
PubMed2001

[Delayed birth of the second child in multiple gestation].

Five case histories illustrate the issue of delayed interval deliveries. In the first two cases, the first child was born at a gestational age of 20 and 18 weeks, respectively. The first woman (40 years old) gave birth to the second child after successful prolongation of pregnancy to a gestational age of 38 weeks. In the second case (28 years old), the attempt to delay delivery failed and the second child was born at 19 weeks of gestation. The third case (32 years old), illustrates the enormous differences in neonatal course between a child born at 26 weeks of gestation, who had to be treated at length for respiratory distress syndrome, hypotension and patent ductus arteriosus, and his twin brother born two weeks later and who recovered more quickly. The fourth case (24 years old) describes delayed delivery to allow administration of antenatal glucocorticoids. The last case (32 years old) deals with a serious maternal complication of placental abruption during an attempt to delay the birth of the second twin. Early tocolytic and antibiotic therapy may delay delivery and, in combination with antenatal glucocorticoids to stimulate lung maturation, may thereby improve the condition of the second twin. The role of cervical cerclage remains controversial. There is an important publication bias in the literature due to under-reporting of the failed attempts of delayed deliveries. In multiple gestation with imminent very preterm birth, delayed delivery of the second child is a feasible management option.

Adult↗
PubMed2006

Increased plasma concentrations of activin a predict intraventricular hemorrhage in preterm newborns.

BACKGROUND: Intraventricular hemorrhage (IVH) is a major cause of neurologic disabilities in preterm newborns. We evaluated the use of plasma activin A concentrations to predict the development of perinatal IVH. METHODS: We measured nucleated erythrocyte (NRBC) counts, plasma activin A, hypoxanthine (Hyp), and xanthine (Xan) in arterial blood samples obtained from 53 preterm infants during the first hour after birth. Cerebral ultrasound was performed within 48 h of birth and repeated at 5- or 6-day intervals until the age of 4 weeks. RESULTS: Grade I or II IVH was detected during the first 10 days of life in 11 of 53 patients (21%). Activin A, Hyp, and Xan concentrations and NRBC counts were higher in preterm newborns who subsequently developed IVH than in those who did not (P<0.0001, except P=0.019 for Xan). Neonatal activin A was correlated (P<0.0001) with Hyp (r=0.95), Xan (r=0.90), and NRBC count (r=0.90) in newborns without later IVH and in those who developed IVH (Hyp, r=0.89, P=0.0002; Xan, r=0.95, P<0.0001; NRBC count, r=0.90, P=0.0002). At a cutoff of 0.8 microg/L activin A, the sensitivity and specificity were 100% [11 of 11; 95% confidence interval (CI), 71%-100%] and 93% (39 of 42; 95% CI, 81%-98%), and positive and negative predictive values were 79% (95% CI, 61%-100%) and 0% (95% CI, 0%-2%), respectively. The area under the ROC curve was 0.98. CONCLUSIONS: Activin A concentrations at birth are increased in preterm newborns who later develop IVH and may be useful for early identification of infants with hypoxic-ischemic brain insults who are at high risk for IVH.

Activins↗