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PubMedDate not supplied

Blood pressure levels of preterm infants in the first year of life.

Systolic blood pressure was measured in 36 infants with median gestational age of 29 weeks (range 24-35 weeks) and birth weight of 1160 g (range 642-1500 g). Measurements were made at 1, 6 and 12 weeks, and subsequently at 12-weekly intervals during the first year of life. No infant developed chronic lung disease. Systolic blood pressure increased over the first 24 weeks (p < 0.001) to a mean value of 95 mmHg, but did not change significantly over the next 24 weeks. These data provide a reference range of blood pressure levels during the first year of life for infants born at an early gestational age.

Blood Pressure↗
PubMed2003

Trends in the incidence of testicular germ cell tumors in the United States.

BACKGROUND: Recent reports have suggested that the increasing rates of testicular germ cell tumors in some populations have begun to plateau. This study was conducted to examine whether rates among white men in the United States have begun to stabilize and whether rates among black men in the United States have remained low. METHODS: Testicular germ cell tumor incidence data from in the Surveillance, Epidemiology, and End Results Program were analyzed for the years 1973-1998. Trends were examined separately for seminoma and nonseminoma. Using age-period-cohort analyses with 5-year age intervals and 5-year calendar-period intervals, changes in the slope of the trends in birth-cohort and calendar-period effects were examined. RESULTS: Among white men, rates of seminoma continued to increase, but the rate of increase steadily declined throughout the 26-year time span. Nonseminoma rates among whites increased more slowly during the first three time intervals, then plateaued in the final interval. Rates of both seminoma and nonseminoma in black men fluctuated throughout the first three time intervals. In the final interval, the rates of seminoma increased almost 100%, whereas the rates of nonseminoma increased more modestly. Age-period-cohort modeling of the incidence data in white men found that, whereas the dominant effect was that of birth cohort, there also was a period effect. CONCLUSIONS: Among white men in the United States, the incidence of testicular germ cell tumors varied by histology, with a continuing increase in risk only for seminoma. Among black men in the United States, the surprising increases seen between 1988 and 1998 were likely to be a calendar-period effect.

Adolescent↗
PubMed2002

Preliminary results on pregnancy outcomes in women using lamotrigine.

PURPOSE: In 1992, the International Lamotrigine Pregnancy Registry was initiated to enroll prospectively and to monitor pregnancies exposed to lamotrigine (LTG) for the occurrence of major birth defects. This study presents results as of September 2001 on 168 outcomes exposed to LTG monotherapy and 166 outcomes after pregnancies exposed to LTG polytherapy during the first trimester. METHODS: LTG pregnancy exposures are voluntarily reported to the registry by health care providers before they are aware of each pregnancy outcome. Pregnancy-outcome ascertainment is obtained through subsequent follow-up with the reporting health care provider, and each reported birth defect is reviewed by an expert pediatrician. The percentage with major birth defects in pregnancies with known birth defect status was calculated for LTG monotherapy and for polytherapy stratified by trimester of exposure. RESULTS: The registry identified 334 first-trimester LTG pregnancy outcomes exposed to LTG monotherapy or polytherapy during the first trimester and involving either a live birth with or without a major birth defect or an abortion with a major birth defect. After exposure to LTG monotherapy, the percentage with major birth defects exposed to LTG monotherapy was three (1.8%) of 168 [95% confidence interval (CI), 0.5-5.5%]. There were five (10%) major birth defects observed in 50 outcomes after LTG polytherapy involving valproic acid (VPA; 95% CI, 3.7-22.6%) during the first trimester. The observed proportion of major defects after LTG polytherapy without VPA during the first trimester was five (4.3%) of 116 (95% CI, 1.6-10.3%). No specific patterns of major birth defects in any subgroup or within the registry as a whole were observed. CONCLUSIONS: The sample sizes for individual regimens are too small to rule out small increases in frequency of all major birth defects or even large increases in frequency of rare major birth defects. However, the percentage of outcomes with major birth defects after LTG monotherapy in this study and in another similar pregnancy registry in the United Kingdom did not differ from that reported in the recent literature for women with epilepsy receiving antiepileptic drug monotherapy (4%). The frequency of major malformations after exposures of LTG-VPA is higher than that after the LTG monotherapy or LTG polytherapy regimens without VPA. Although there are published data on frequency of major malformations after VPA exposures in pregnancy, between-study differences in methods and source populations and the wide confidence intervals around the estimate for LTG and VPA limit the utility of comparison with such data, and no conclusions are made at this time about this combination. The continued registration of exposed pregnancies to an exposure registry as early as possible in the pregnancy before any knowledge of the outcome, and before any prenatal testing, will enhance the power of such data.

Abnormalities, Drug-Induced↗
PubMed2006

Effect of age on reference intervals of serum biochemical values in kittens.

OBJECTIVE: To determine the effect of age on reference intervals of serum biochemical values in kittens. DESIGN: Prospective clinical trial. ANIMALS: 55 kittens from 12 specific-pathogen-free queens. PROCEDURE: Kittens were allocated at birth into colostrum-fed (n = 27) and colostrum-deprived (28) groups. Blood was collected at birth and on days 1, 2, 4, 7, 14, 28, and 56. Serum samples were analyzed for activities of alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, gamma-glutamyltransferase, amylase, and lipase and for concentrations of albumin, total protein, bilirubin, urea nitrogen, creatinine, cholesterol, glucose, calcium, phosphorus, and triglycerides by use of an automated analyzer. Total serum solids concentrations were determined by use of refractometry. Serum IgG concentrations were quantified by use of radial immunodiffusion. RESULTS: For several analytes, reference intervals changed rapidly, most notably during the first few days of life. Reference intervals for alkaline phosphatase, creatine kinase, lactate dehydrogenase, and triglycerides were higher from birth to 8 weeks than adult reference intervals. Aspartate aminotransferase, bilirubin, urea nitrogen, and creatinine were higher than in adults at birth but were similar to or lower than adult reference intervals by 8 weeks. Compared with adult reference intervals, reference intervals for calcium and phosphorus concentrations were higher and for albumin and total protein concentrations were lower throughout the study period. CONCLUSIONS AND CLINICAL RELEVANCE: Important differences exist between reference intervals for serum biochemical values of neonatal and adult cats. Age-appropriate reference intervals should be used for accurate assessment of serum biochemical test results in cats.

Aging↗
PubMed2002

Increased interleukin-8 and monocyte chemoattractant protein-1 concentrations in mechanically ventilated preterm infants with pulmonary hemorrhage.

Pulmonary hemorrhage (PH) is a serious complication causing acute respiratory distress in the premature infant, and it is associated with significant mortality and morbidity. The role of inflammatory mediators in this condition is largely undefined. Serial tracheal aspirates (TA) were obtained at intervals from 65 mechanically ventilated infants with birth weights less than 1,250 g during the first 21 days of life. Clinically significant PH developed in 15 infants. TA concentrations of interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) were determined by enzyme-linked immunosorbent assay (ELISA).PH was associated with an increased risk of death, bronchopulmonary dysplasia, intraventricular hemorrhage, and prolonged need for mechanical ventilation and supplemental oxygen. TA aspirate concentrations of IL-8 and MCP-1 (P = 0.001, ANOVA) were significantly increased in infants with PH compared to infants who did not develop this condition. TA cytokine concentrations were also significantly increased in infants who developed bronchopulmonary dysplasia (BPD). Peak TA concentrations of IL-8 and MCP-1 were significantly higher in infants with poor outcome (BPD or death). TA MCP-1 but not IL-8 concentrations were significantly higher in infants who were oxygen-dependent at 36 weeks postconceptional age. These data suggest a pathogenic role for IL-8 and MCP-1 in the development of adverse pulmonary outcome in preterm infants with clinically significant PH.

Chemokine CCL2↗
PubMed1987

Menstrual and reproductive factors and the risk of myocardial infarction in women under fifty-five years of age.

The relationship between menstrual and reproductive factors and subsequent risk of coronary heart disease was investigated in a hospital-based case-control study of 202 women with acute myocardial infarction and 374 control subjects admitted for a wide spectrum of acute conditions unrelated to any of the established risk factors for ischemic heart disease. No consistent association was observed with age at menarche or menopausal status, but women with a lifelong irregular menstrual cycle pattern were at significantly elevated risk of myocardial infarction (relative risk = 1.8, 95% confidence interval = 1.1 to 2.9). No clear trend in risk was evident with the number of livebirths, miscarriages, or induced abortions. However, women whose first pregnancy or livebirth occurred before age 20 years showed elevated risks of subsequent myocardial infarction compared with nulliparous ones (relative risks = 2.3; 95% confidence interval = 1.1 to 4.9), and there was a significant trend of increasing risk with earlier first birth. These associations were evident in both younger and middle-age women and were not explained by allowance for several identified potential confounding factors.

Adult↗
PubMed2002

Pregnancy related protection against breast cancer depends on length of gestation.

In a prospective study of 694 657 parous women in Norway, 5474 developed breast cancer after their first birth. If the first pregnancy lasted less than 32 weeks, the risk was 22% (95% confidence interval, -3% to 53%) less than after a pregnancy of 40 weeks or more, with a significant declining trend in risk (P for trend=0.02).

Adult↗
PubMed1998

Reproductive risk factors for breast cancer in Hispanic and non-Hispanic white women: the New Mexico Women's Health Study.

The authors conducted a population-based case-control study of breast cancer in Hispanic women in New Mexico. Hispanic and non-Hispanic white women with incident breast cancer, aged 30-74 years and diagnosed between 1992 and 1994, were identified by the New Mexico Tumor Registry. Controls were selected using random digit dialing and frequency matched by ethnicity, age, and region. Information on reproductive history, lactation, and other risk factors was collected through in-person interviews; 719 Hispanics and 836 non-Hispanic whites were included in the analysis. Conditional logistic regression was used to estimate relative risk of breast cancer for reproductive factors and to assess ethnic differences in effects. Older age at first full-term birth was associated with breast cancer among Hispanics; the odds ratio for women aged 27 years and older at first full-term birth compared with women 18 years or younger was 2.26 (95% confidence interval 1.17-4.38) compared with 1.60 (95% confidence interval 0.86-3.01) for non-Hispanic whites. Higher parity was associated with reduced risk of breast cancer for non-Hispanic whites, but not Hispanics (p < 0.008). Longer lactation was associated with reduced risk in premenopausal Hispanic women and premenopausal and postmenopausal non-Hispanic white women. Reproductive factors explained 17% of the ethnic difference in breast cancer incidence for postmenopausal women and none of the difference for premenopausal women.

Adult↗
PubMed1990

Reproductive factors, smoking, and the risk for rheumatoid arthritis.

Risk factors for rheumatoid arthritis were examined in a cohort of 121,700 female nurses aged 30-55, followed in the Nurses' Health Study. Baseline information on reproductive variables, cigarette smoking, obesity, and other variables was obtained in 1976 and updated every 2 years. Cases of rheumatoid arthritis were defined by standardized questionnaire and review of medical records. During 883,187 person-years of follow-up, 217 new cases of rheumatoid arthritis were identified (115 had definite rheumatoid arthritis and 102 had "undifferentiated polyarthritis"). When compared with women who experienced menarche at age 13 years, the age-adjusted relative risk of rheumatoid arthritis among women with early menarche was 1.9 (95% confidence interval, 0.9-2.4). There were, however, no significant associations between parity, age at birth of the first child, menopause, or obesity and the incidence of rheumatoid arthritis. Cigarette smokers had a slight apparent increase in the risk of rheumatoid arthritis. Among current smokers, the age-adjusted relative risk for RA rheumatoid arthritis was 1.3 (0.9-2.1); among former smokers, the relative risk was 1.5 (0.9-2.3).

Adult↗
PubMed2003

Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancouver, Canada.

The association between ambient air pollution and adverse health effects, such as emergency room visits, hospitalizations, and mortality from respiratory and cardiovascular diseases, has been studied extensively in many countries, including Canada. Recently, studies conducted in China, the Czech Republic, and the United States have related ambient air pollution to adverse pregnancy outcomes. In this study, we examined association between preterm birth, low birth weight, and intrauterine growth retardation (IUGR) among singleton live births and ambient concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone in Vancouver, Canada, for 1985-1998. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for such effects. Low birth weight was associated with exposure to SO2 during the first month of pregnancy (OR = 1.11, 95% CI, 1.01-1.22, for a 5.0 ppb increase). Preterm birth was associated with exposure to SO2 (OR = 1.09, 95% CI, 1.01-1.19, for a 5.0 ppb increase) and to CO (OR = 1.08, 95% CI, 1.01-1.15, for a 1.0 ppm increase) during the last month of pregnancy. IUGR was associated with exposure to SO2 (OR = 1.07, 95% CI, 1.01-1.13, for a 5.0 ppb increase), to NO2 (OR = 1.05, 95% CI, 1.01-1.10, for a 10.0 ppb increase), and to CO (OR = 1.06, 95% CI, 1.01-1.10, for a 1.0 ppm increase) during the first month of pregnancy. In conclusion, relatively low concentrations of gaseous air pollutants are associated with adverse effects on birth outcomes in populations experiencing diverse air pollution profiles.

Adult↗
PubMed2004

Performance and individual feed intake characteristics of group-housed sows fed a nonstarch polysaccharides diet ad libitum during gestation over three parities.

The objective of this experiment was to study the effects of feeding group-housed gestating sows a diet with a high level of fermentable nonstarch polysaccharides (NSP; approximately 45% sugar beet pulp as fed) ad libitum on the development in individual feed intake characteristics and reproductive performance during three successive reproduction cycles. Performance of the ad libitum-fed sows was compared to the performance of sows that were fed a conventional diet restrictedly. Feed intake characteristics during gestation were only measured in the ad libitum-fed sows. One hundred and nineteen sows were assigned to one of two gestation feeding regimens. Gestating sows were fed a conventional Dutch diet restrictedly or a diet with a high level of fermentable NSP ad libitum. During lactation, sows were given free access to a commercial lactation diet from d 6 after parturition onward. The ad libitum-fed sows ate 1.3 kg/d more during gestation than the restrictedly fed sows (P < 0.001), resulting in higher body weight and backfat gains during gestation (P < 0.05). Sows that were fed ad libitum during gestation lost more body weight and backfat during lactation (P < 0.001) than sows that were fed restrictedly during gestation. Feed intake during lactation, however, did not differ between sows that were fed restrictedly or ad libitum during gestation. The numbers of total piglets born, live-born and stillborn piglets, piglet birth weight, weaning-to-estrus interval, and percentage of sows that returned to estrus after first insemination were not affected by gestation feeding regimen. Mean daily voluntary feed intake (as-fed basis) over the three reproduction cycles in the ad libitum-fed gestating sows was 4.2 kg/d. Depending on the number of preceding reproduction cycles during which a sow was fed ad libitum, the maximum voluntary feed intake was reached in Parity 3, 4, or 5 and then remained stable in subsequent parities. Mean daily feed intake of the ad libitum-fed sows increased from wk 2 to 6 of gestation and then decreased to wk 15 of gestation. The mean number of daily visits with feed intake over the three reproduction cycles was 13.8. On average, ad libitum-fed sows spent 90 min/d on eating. This study shows that it is possible to feed gestating sows a diet with a high level of fermentable NSP ad libitum during three successive reproduction cycles without negative effects on reproductive performance.

Animal Feed↗
PubMed1991

[Management of preterm breech presentation].

At the department for Obstetrics and Gynecology in Zagreb we analyzed 342 preterm singleton breech deliveries during three different periods of time: the first from 1975-1978, the second from 1982-1986, and the most recent one from 1987-1989. All studied cases were infants with birth weight of 1.200 gr or more. Out of 135 infants born in the first time interval, the Bracht maneuver was employed in 90 (66.6%) cases; 13.3% of vaginal deliveries from the same time interval were managed by partial extraction, and total etraction was applied in 3.7% of vaginal deliveries. The cesarean delivery rate was 16.3% in the first analyzed period. From 1982-1986, 79 (67.5%) out of a total of 117 infants were delivered vaginally by the Bracht maneuver, 3.4% by partial extraction, and only one child was delivered by total extraction. In this time interval, 28.2% of all deliveries were terminated by cesarean section. In the most recent interval from 1987-89, our attitude towards preterm breech delivery has completely changed. The Bracht maneuver was applied in only 32.2% out of a total of 90 born infants, and partial extraction in 3.3%. None of the infants were delivered by total extraction. The cesarean section rate doubled and amounted to 64.4%. Nevertheless, the best indicator of results is the perinatal mortality of infants according to the observed time intervals. Perinatal mortality in the first period was 20%, in the second period it was 12% and 5.6% in the third period.(ABSTRACT TRUNCATED AT 250 WORDS)

Breech Presentation↗
PubMedDate not supplied

Comparative length and weight growth in Khartoum infants.

First-year postnatal growth of supine length and body weight of a group of Khartoum infants is analysed in terms of the correlation coefficients between birth dimension on the one hand and (1) subsequent distance growth at monthly intervals and (2) the 11-monthly increments on the other. It is shown that the whole of the first-year length growth is dominated by catch-up/catch-down processes which must equally affect the infants. Weight growth is similarly affected, but to a lesser degree and for a shorter time. After 6 months of age some of the influences that determined prenatal weight growth reappear. Using data extracted from fitting growth curves to each individual the correlational analysis suggests a growth pulse in both length and weight, which is responsible for distance catch-up.

Age Factors↗
PubMed2001

Is air pollution a risk factor for low birth weight in Seoul?

Environmental factors contributing to reduced birth weight are of great concern because of the well-known relation of birth weight to infant mortality and adverse effects in later life. We examined the associations between air pollution exposures during pregnancy and low birth weight among all full-term births (gestational age 37-44 weeks) for a 2-year period (January 1996 through December 1997) in Seoul, South Korea. We evaluated these associations with a generalized additive logistic regression adjusting for gestational age, maternal age, parental educational level, parity, and infant sex. We used smoothing plots with generalized additive models to analyze the exposure-response relation for each air pollutant. The adjusted relative risk of low birth weight was 1.08 [95% confidence interval (CI) = 1.04-1.12] for each interquartile increase for carbon monoxide concentrations during the first trimester of pregnancy. The relative risks were 1.07 (95% CI = 1.03-1.11) for nitrogen dioxide, 1.06 (95% CI = 1.02-1.10) for sulfur dioxide, and 1.04 (95% CI = 1.00-1.08) for total suspended particles also for interquartile increase in exposure. Carbon monoxide, nitrogen dioxide, sulfur dioxide, and total suspended particle concentrations in the first trimester of pregnancy period are risk factors for low birth weight.

Adult↗
PubMed1998

Narghile (hubble-bubble) smoking, low birth weight, and other pregnancy outcomes.

Narghile smoking, a common habit among women in many non-Western societies, is assumed by the public to be minimally harmful. This study aims at identifying the effect of smoking narghiles during pregnancy on the weight of the newborn and other pregnancy outcomes. Three groups of pregnant women were interviewed in several hospitals in Lebanon between 1993 and 1995: 106 who smoked narghiles during their pregnancy, 277 who smoked cigarettes, and 512 who did not smoke. The adjusted mean birth weight of babies born to women who smoked one or more narghiles a day during pregnancy and to women who started smoking in the first trimester was more than 100 g less than that of babies born to nonsmokers (p < 0.1). The adjusted odds ratio of having babies with low birth weight (<2,500 g) among the narghile smokers was 1.89 (95% confidence interval (CI) 0.67-5.38). The risk increased to 2.62 (95% CI 0.90-7.66) among those who started smoking narghiles in the first trimester. A stronger association and a dose-response relation were found among cigarette smokers. The association between narghile smoking and other pregnancy outcomes, especially Apgar score and respiratory distress, was also noticeable. Further research and a policy action to fight the misperception that narghile smoking is safe are both recommended.

Adult↗
PubMed2000

Delivery of breech first twins: a multicenter retrospective study.

OBJECTIVE: To assess the risk of vaginal birth of breech first twins by Apgar scores and mortality. METHODS: We did a retrospective case-control analysis of data from 13 centers that allow vaginal birth for breech first twins. We used depressed 5-minute Apgar scores and neonatal mortality as main outcome measures between vaginal (n = 239) and cesarean (n = 374) deliveries of pairs with breech first twins, stratified by parity, birth weights of first twins, and types of cesarean. The 95% power of our sample size (alpha = .05) was sensitive enough to detect differences of 5% of the overall sample and 25-30% of subgroups. RESULTS: Vaginal birth was attempted in 61% of 613 pairs. There were significantly more depressed Apgar scores (P = .008, odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2, 4.7) and neonatal deaths (P < .001, OR 9.5, 95% CI 4.0, 23.4) among vaginal births of pairs in whom first twins weighed less than 1500 g but not among the higher-birth-weight cohort (for depressed Apgar scores: P = .76, OR 1.1, 95% CI 0.6, 2.1). Multiparity and elective cesarean seemed to have little influence on outcome measures. Neonatal mortality was associated with extremely preterm twins. CONCLUSION: There was no evidence that vaginal birth is unsafe, in terms of depressed Apgar scores and neonatal mortality, for breech first twins that weighed at least 1500 g.

Apgar Score↗
PubMed1982

Growth in the first four years: I. The relative effects of gender and weight for gestational age at birth.

The growth of 238 small-for-dates (SFD), 246 average-for-dates (AFD) and 241 large-for-dates (LFD) babies was assessed at regular intervals from birth to four years. At all ages, and for both sexes, the mean weight, length or height, and head circumference values for the two extreme groups differed significantly from the AFD group (P less than 0.001). During the first six months actual and relative growth was highest in the SFD group and lowest in the LFD group. With the exception of length in the LFD group it was higher for boys than for girls. Thereafter differences in actual values were slight, while the proportional increases for the three groups were almost identical. Differences from the AFD mixed-sex mean value were plotted for each group and sex combination. Stabilization of the mean trajectories in the two extreme groups occurred at six months for weight and head circumference, but not until 12 months for length. For each child a straight line was fitted on a log scale to these differences from six months (12 months for length) to four years, and analyses of variance of the slopes and intercepts obtained. The sex difference for weight and height gradually decreased, but for head circumference held constant. Estimates of the difference in intercepts of the birthweight groups and sexes showed that within the LFD group the difference in height between boys and girls was much less than in the other two groups. The sex difference for head circumference was slightly larger than the difference between SFD and AFD groups, and twice the difference between the LFD and AFD groups. At the age of four years the mean value for AFD boys was higher than LFD girls (P less than 0.01), and those for SFD boys and AFD girls were almost identical.

Birth Weight↗