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PubMed1994

Patterns of fantasy play engagement across the transition to becoming a sibling.

Patterns of spontaneous dyadic fantasy play among 30 3- to 5-year-old first-born children who were becoming siblings were evaluated at two pre- and three post-birth intervals for its length, thematic content and social quality. Children who interacted more positively with their sibling played longer, engaged in fantasy play that was thematically relevant to becoming a sibling and had more positive interactions with best friends than low-sibling acceptance children. High-sibling acceptance children also experienced a suppression in fantasy immediately following their sibling's birth; thus, a temporary disruption in fantasy play may indicate adaptive coping.

Adaptation, Psychological↗
PubMed2001

Modification of BRCA1- and BRCA2-associated breast cancer risk by AIB1 genotype and reproductive history.

Women who have inherited a germ-line mutation in the BRCA1 or BRCA2 (BRCA1/2) genes have a greatly increased risk of developing breast cancer compared with the general population. However, there is also substantial interindividual variability in the occurrence of breast cancer among BRCA1/2 mutation carriers. We hypothesize that genes involved in endocrine signaling may modify the BRCA1/2-associated age-specific breast cancer penetrance. We studied the effect of alleles at the AIB1 gene using a matched case-control sample of 448 women with germ-line BRCA1/2 mutations. We found that these women were at significantly higher breast cancer risk if they carried alleles with at least 28 or 29 polyglutamine repeats at AIB1, compared with women who carried alleles with fewer polyglutamine repeats [odds ratio (OR), 1.59; 95% confidence interval (CI), 1.03-2.47 and OR, 2.85; 95% CI, 1.64-4.96, respectively]. Late age at first live birth and nulliparity have been associated with increased breast cancer risk. We observed increases in BRCA1/2-associated breast cancer risk in women who were either nulliparous or had their first live birth after age 30 (OR, 3.06; 95% CI, 1.52-6.16). Women were at significantly increased risk if they were nulliparous or had a late age at first live birth and had AIB1 alleles no shorter than 28 or 29 or more AIB1 polyglutamine repeats (OR, 4.62; 95% CI, 2.02-10.56 and OR, 6.97; 95% CI, 1.71-28.43, respectively) than women with none of these risk factors. Our results support the hypothesis that pathways involving endocrine signaling, as measured through AIB1 genotype and reproductive history, may have a substantial effect on BRCA1/2-associated breast cancer risk.

Adult↗
PubMed1990

Proposals for epidemiological surveys of helminthoses aimed at the improvement of livestock production in the tropics.

As the major contagious epidemics in the tropics are today more or less under control, the most important diseases of livestock are due to parasitic infections. Precise knowledge concerning the biology of parasites and their seasonality is a prerequisite for any control strategy. Therefore, epidemiological investigations into the effect of helminths on ruminant livestock production must include I. A vertical section through the age dependent helminthic burden of a representative number of animals of a given population, i.e. the sampling of faeces at regular intervals during the first 18 months of life. II. Investigations into the horizontal development of the helminthic situation, whether soil-transmitted and/or vector-transmitted. a. The seasonal fluctuation of egg excretion from gastrointestinal nematodes. b. The seasonal incidence of nematode larvae on pastures. c. The seasonal survival time of nematodes larvae on pastures. III. The seasonal fluctuation of vector snails and their incidence of infection with trematode larvae. For the economic evaluation of control measures it is necessary that the following parameters should be recorded: The age dependent mortality rate, the development of the average body weight, the birth/slaughter weight, the age at first calving and the calving intervals.

Age Factors↗
PubMed1984

Studies of serum-transferrin and some hematologic parameters in vitamin E and selenium deficient pigs.

Sows of Swedish Landrace x Yorkshire breed were fed a diet extremely deficient in vitamin E, selenium (VESD) during the last six weeks of pregnancy and compared to sows of the same breed and age fed a normal commercial diet. The transferrin concentration in serum and different hematological parameters were estimated at regular intervals in the sows before and after partus and in their piglets at birth and during the first four weeks of life. The transferrin concentration in the serum of piglets from sows fed the VESD diet did not differ from the corresponding values in normal pigs whereas the VESD piglets showed significantly lower hemoglobin values at birth and higher MCV values during the first three weeks of life than the normal piglets. A disturbance of the erythropoesis in these piglets due to vitamin E/selenium deficiency is discussed.

Animals↗
PubMed1994

The use of intrapartum intrathecal narcotic analgesia in a community-based hospital.

OBJECTIVE: To evaluate the use of intrapartum intrathecal narcotic analgesia in the obstetric population of our community-based hospital. METHODS: A protocol to administer intrapartum intrathecal narcotic analgesia was established at our institution in December 1992. All patients consenting to this procedure received a single lumbar intrathecal injection of 25 micrograms fentanyl and 0.25 mg morphine sulfate through a 25-gauge spinal needle. Only those patients with singleton pregnancies in the vertex presentation were included in this study. The study group was matched by gravidity and parity with singleton pregnancies delivered during the study period. Patients in the study group were asked to complete an analgesia satisfaction survey using a five-point Likert scale ranging from 0 for total dissatisfaction to 5 for total satisfaction. RESULTS: A total of 75 patients were assigned to each group; the control and study groups were similar with respect to age, race, estimated gestational age, infant birth weight, interval between rupture of membranes and delivery, and mode of delivery. The length of the first and second stages of labor and the incidence of fetal malposition were not significantly different between the two groups. Frequent side effects of this analgesia included complaints of pruritus (81.3%), urinary retention (53.3%), and nausea and vomiting (44.0%). Headaches were less common (9.3%), with two (2.7%) of seven patients requiring an epidural blood patch for relief. Infrequent side effects included respiratory depression (1.3%) and oversedation (1.3%). Patients were generally satisfied with the degree of pain relief obtained, rating it highly during the first and second stages of labor and in comparison to their previous labor experience. CONCLUSION: The use of intrapartum intrathecal narcotic analgesia provides a satisfactory level of pain relief without disrupting the normal course of labor.

Analgesia, Obstetrical↗
PubMed2000

First intention high-frequency oscillation with early lung volume optimization improves pulmonary outcome in very low birth weight infants with respiratory distress syndrome.

OBJECTIVES: The lack of decline in chronic lung disease of prematurity despite the generalized use of surfactant and alternative modes of ventilation such as high-frequency oscillation (HFO) has been attributed to some misunderstanding of how HFO has to be used. We used a new ventilatory strategy in very low birth weight (VLBW) infants, by initiating HFO immediately after intubation and attempting early lung volume optimization before surfactant was administered. STUDY DESIGN: The outcome of 32 VLBW infants, managed with first intention HFO over a period of 24 months (September 1, 1996 and August 31, 1998) was compared by chart review with 39 historical controls, consecutively managed with conventional mechanical ventilation (CMV) over a period of 24 months (January 1, 1994 and December 31, 1995). SETTING: An 11-bed tertiary care pediatric and neonatal intensive care unit of a university teaching hospital. RESULTS: The 2 groups of patients were similar in demographic distribution of birth weight, gestational age, race, and gender. Patients on first intention HFO were ventilator-dependent (median [95% confidence interval]: 5 [3-6] vs 14 [6-23] days) and oxygen-dependent (12 [4-17] vs 51 [20-60] days) for a shorter time than patients on CMV. The incidence of chronic lung disease at 36 weeks of gestational age was significantly lower in the HFO group compared with the CMV group (0% vs 34%). CONCLUSIONS: First intention HFO with early lung volume optimization shortened the need for respiratory support and improved pulmonary outcome of VLBW infants with respiratory distress syndrome significantly.

Drug Combinations↗
PubMed1994

On some stochastic models of open birth interval.

"In this paper, a set of two probability models have been derived to describe the variation in the length of open birth interval of women having given birth to a child during the last 'T' years of their current reproductive age. The first model is derived by assuming the reproduction process as steady-state, the second is obtained by varying the fecundability parameter involved in the first model after the last birth. These models are applied to the three sets of data, one collected from [the Indian] Varanasi-survey, 1969-70 and the other two generated from the data on age-specific fertility rates using the life table technique. The biological parameters such as fecundability and secondary sterility have been estimated using some simple procedure of estimation."

Asia↗
PubMed2002

[Delayed interval delivery in multiple pregnancy--case report and review of the literature].

INTRODUCTION: The incidence of multiple pregnancies is increasing with concomitant increased risk in maternal and fetal complications. Premature rupture of membranes and consecutive premature delivery, especially that of immature babies with very low birth weight is accompanied by a high rate of perinatal morbidity and mortality. OBJECTIVES: This is a case report of a mother with twin pregnancy, who aborted the first fetus at 17 weeks and successfully delivered the second one at 29 weeks of gestation with an interval of 84 days following conservative treatment. METHODS: Review of the literature reports the possibilities of the management of delayed interval delivery. RESULTS: The authors conclude that by the use of tocolysis, antepartum steroid-, and antibiotic prophylaxis the life-expectancy of the retained fetus can be improved. CONCLUSION: After the birth of the first fetus delayed delivery in multiple pregnancies can be successful in selected cases. They advocate it only in well prepared perinatal centers for physically and psychologically balanced patients, who are well informed about the risks and benefits of this trial.

Adult↗
PubMed2006

Effect of pethidine administered during the first stage of labor on the acid-base status at birth.

OBJECTIVE: To evaluate the association between the use of pethidine during the first stage of labor and the presence, type and timing of acidosis in the newborn at birth. STUDY DESIGN: Secondary data analysis of a randomized controlled trial, which included term singleton pregnancies diagnosed with dystocia and requiring active management of labor. Women were randomized to receive either 100 mg of pethidine or placebo. Statistical analyses were performed using chi(2) or Fisher's exact tests for proportions and multiple linear regression for continuous outcomes. RESULTS: Three hundred and eighty-three pregnant women with a valid arterial blood cord sample were included in the final analysis. Lower pH and bicarbonate levels, as well as higher pCO(2) levels were found in the pethidide group. A higher incidence of acidosis was found in the pethidine group (pH<7.12 OR: 8.59 95% C.I. 3.29, 22.46). The highest frequency of acidosis was encountered when pethidine-delivery interval was 5 h. CONCLUSION: Pethidine use during the first stage of labor was associated with an increased risk of acidosis at birth.

Acid-Base Equilibrium↗
PubMed1998

Natural growth of the population of Plovdiv, Bulgaria for the period 1895-1995.

A study of the natural growth rate of the population using female cohorts by birth year has been carried out for the first time in our country. The study comprises 14 cohorts. The following characteristics are recorded: birth year, social group, educational level, number of live births, age of marriage, infant mortality rate, proto- and intergenetic intervals. Our report presents the key indicators of natural growth of population in the studied cohorts. A consistent trend of decreasing the number of livebirths is established. In the first studied cohort (1895-1899) the average number of offspring per woman is 3.94, reaching a level of 1.77 in the 1960-1964 cohort. The indicators for natural growth of population exhibit a similar trend. The summary fertility rate in the reference period decreases with more than 2 points--from 4.47 in 1895-1899 to 1.73 in 1960-1964. Likewise, the total reproduction rate goes down from 2.54 to 0.78 for the same period. Considerable changes have occurred in the indicators total period fertility rate and marriage fertility rate of women. For a period of 110 years the former has decreased 3.5 times, the latter--8 times. The drastic drop of the indicators of natural growth of the population is accounted for by an intricate complex of social, economic, psychological and biological factors. The marked aging of the population and the decrease of the percentage of women in active fertility age play a certain role in this process. The ascertained changes in the reproductive behavior and age structure of the female population are factors intensifying the unfavorable trends in the natural growth rate of the population in our country.

Adolescent↗
PubMed1994

Impaired prenatal and postnatal growth in Dutch patients with phenylketonuria. The National PKU Steering Committee.

OBJECTIVE: To assess whether physical growth is affected in early treated Dutch patients with phenylketonuria (PKU). METHODS: The birth weights of all 137 early detected patients with PKU born in the period from 1974 to 1988 in the Netherlands were compared with reference values. Height, head circumference, and weight were measured at the age at which treatment started (commonly about 2-3 weeks), at 6 months of age, and yearly from the child's first birthday up to the age of 10 years. These measurements were compared with reference values. RESULTS: The adjusted birth weight in patients with PKU was 141 g (95% confidence interval (CI) 66 to 216 g) less than Dutch reference values by Kloosterman and 103 g (95% CI 9 to 196 g) less compared with the birth weight of another reference group. At the age at which treatment started, z scores of patients for height by age were -0.23 (95% CI -0.44 to -0.02) and z scores for head circumference by the age were -0.25 (95% CI -0.44 to -0.06). From the age at which treatment started up to the age of 3 years z scores for height by age further decreased to -0.74 (95% confidence interval -0.93 to -0.56), after which no additional decrease occurred. In contrast, z scores for head circumference increased from -0.25 at the first visit to 0.08 (95% CI -0.14 to 0.30) at the age of 1 year, after which they remained close to zero. Weight by height was close to the expected centiles for all ages. CONCLUSION: Patients with PKU are growth retarded at birth and have smaller head circumferences than the normal population. In Dutch patients further growth retardation occurs in the first three years of life.

Anthropometry↗
PubMed2005

Supplementation of dextrose to the diet during the weaning to estrus interval affects subsequent variation in within-litter piglet birth weight.

Effects of supplementation of dextrose to the diet of sows during the weaning-to-estrus interval (WEI) on subsequent litter size and within-litter variation were investigated. After weaning, 223 sows (first to fifth parity) were fed 3.5 kg/d. Half of the sows additionally received 150 g of dextrose per day as topdressing on the feed. WEI and estrus duration were determined as well as subsequent pregnancy rate and litter size. Piglets were weighed individually at birth and at weaning (day 26.4; S.D.: 2.5). Supplementation of dextrose to the diet during the WEI did not affect WEI (106 h), pregnancy rate (88.2%), farrowing rate (84.2%), subsequent litter size (total born: 13.70), or birth weight (1599 g). The within-litter variation in birth weight was lower in sows on the dextrose treatment (CV: 17.5% versus 21.2% for the dextrose and control group, respectively, P=0.03). From this experiment, we concluded that addition of dextrose during the weaning to estrus interval did not increase litter size, but seems to affect the uniformity in birth weight of the litter.

Animals↗
PubMed2005

Early respiratory infections, asthma, and allergy: 10-year follow-up of the Oslo Birth Cohort.

OBJECTIVE: It has been hypothesized that early infections protect against the development of atopic disease, but there have been few long-term follow-up studies. We estimated the associations between early respiratory infections and doctor-diagnosed asthma, allergic rhinitis, and skin-prick sensitization in children at 10 years of age in the Oslo Birth Cohort, established in 1992-1993. We also considered birth order and attendance at a child care center as proxy measures of increased exposure to infections early in life. METHODS: A total of 2540 children were followed from birth to the age of 10 years. Experiences of respiratory infections were recorded in follow-up surveys at 6 and 12 months. At age 10, questions were asked about current symptoms of asthma and allergic rhinitis and about having ever received a doctor diagnosis for these diseases. A subsample (n = 1740) of the cohort was tested for skin-prick test reactivity. RESULTS: Current asthma was related to lower respiratory tract infection (adjusted odds ratio [OR]: 2.1; 95% confidence interval: 1.3-3.0) and croup (adjusted OR: 2.3; 95% confidence interval: 1.3-4.2) in the first year. ORs for allergic rhinitis and skin-prick sensitization were smaller but mainly positive. Birth order and child care attendance at age 1 year were not significantly associated with any of the studied outcomes. CONCLUSIONS: Early respiratory infections did not protect against the development of asthma, allergic rhinitis, or sensitization to common allergens during the first 10 years of life but increased the risk for asthma symptoms at age 10 in this population.

Allergens↗
PubMed1993

Resuscitation of the very immature infant: cerebral Doppler flow velocities in the first 20 minutes of life.

Blood flow velocity of the anterior cerebral artery was investigated by Doppler ultrasonography in five time intervals up to 20 min after birth in 16 non-asphyxiated very immature infants (median birth weight 1,058 g, range 720-1,930 g; median gestational age 30 weeks, range 27-32 weeks) delivered by caesarean section and intubated after birth. Heart frequency, oscillometric mean arterial blood pressure and blood gases were recorded as well. There was a transitory increase in both systolic and end-diastolic velocities (from 29 to 35 and from 1 to 10 cm/s) during the first 5 min after birth which occurred together with an increase in heart frequency. The overall incidence of intracranial haemorrhage was low (3/16, 19%). This observation study shows a transitory increase in cerebral blood flow velocity with a peak at about 5 min after birth in preterm infants < 33 weeks of gestation undergoing standard resuscitation.

Birth Weight↗
PubMedDate not supplied

Ontogeny of four cell types in fetal rat islets using histochemical techniques.

The pancreas of the fetal rat was collected from the first appearance of the pancreatic bud at 11 days of gestation, and every day thereafter until birth. After birth the neonatal pancreas was collected every day for one week, and at intervals thereafter. Fetal B-cells were stained with Gomori's aldehyde fuchsin at 16 1/2 days, and with the immunofluorescent technique for insulin at 14 days. The A-cells were stained as early as 13 days using the fluorescent antibody technique for glucagon. The D-cells first stained at 17 days with pseudoisocyanin. A 4th cell type was found which stained black with silver nitrate, using a method derived from the Grimelius technique for A-cells. This 4th cell type appeared at 15 days in the fetus, reaching its greatest abundance around 19 days, and then declined in numbers after birth until adulthood, when occasionally one or two cells were found.

Age Factors↗
PubMed1999

Does inadequate prenatal care contribute to growth retardation among second-born African-American babies?

The authors evaluated the relation between adequacy of prenatal care and risk of delivery of full term small-for-gestational-age (SGA) infants. Data were derived from maternally linked birth certificates for 6,325 African-American women whose first two pregnancies ended in singleton, full term live births in Georgia from 1989 through 1992. The authors used stratified analysis to assess the effect of prenatal care on the risk of having an SGA baby in the second pregnancy among women with and without an SGA baby in their first pregnancy. The group of women with a history of SGA birth may be more likely to include persons for whom SGA delivery is related to factors, such as genetics, that are not amenable to intervention by prenatal care. Inadequate prenatal care was not associated with the risk of SGA delivery among women who had previously delivered an SGA baby. In unadjusted analyses, inadequate prenatal care was associated with an increased risk of delivering a full term SGA baby in the second pregnancy among women whose first baby was not SGA (risk ratio = 1.28; 95% confidence interval: 1.05, 1.55). The association did not persist when data were adjusted for confounding variables (odds ratio = 1.11; 95% confidence interval: 0.89, 1.38). Regardless of outcome in the first pregnancy, adequate prenatal care did not reduce the risk of full term SGA birth among second pregnancies in this population.

Adolescent↗
PubMed1989

Reproductive factors and breast cancer: an overview.

Despite extensive research, there is still uncertainty on the separate effects of parity and age at first birth on breast cancer risk. Thus, information on these variables from formal epidemiological articles published in English since 1970 is reviewed in the present article. Among 26 studies considered, one found no significant association with either variable, seven showed an association between age at first birth but not parity and breast cancer risk, six an association with parity but not age at first birth, and in twelve studies both variables appeared to be independently related with breast cancer risk. Various reasons for these apparent differences can be considered, including heterogeneity between various populations (for instance, the proportion of multiparous women in studies showing no association with parity tended to be higher than in studies finding an inverse relation with parity), criteria for selection of cases and controls, influence of age and other covariates (among which the interval between pregnancies is of particular interest) and, of course, the role of chance. The data reviewed suggest, from an aetiological viewpoint, that both parity and age at first birth have some independent effect on breast carcinogenesis. From a public health viewpoint, however, it appears that the importance of age at first birth is greater, since the trend is linear across subsequent age levels, while the protection of parity seems to be quantitatively relevant only for women with four or five births or more.

Breast Neoplasms↗
PubMed2000

A maternal vegetarian diet in pregnancy is associated with hypospadias. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

OBJECTIVE: To investigate the possible role of the maternal diet, particularly vegetarianism and consumption of phytoestrogens, in the origin of hypospadias, which is reported to be increasing in prevalence. SUBJECTS AND METHODS: Detailed information was obtained prospectively from mothers, including previous obstetric history, lifestyle and dietary practices, using structured self-completed questionnaires during pregnancy. Previously recognized associations with environmental and parental factors were examined, focusing particularly on the hypothesized hormonal link. Multivariate logistic regression was used to identify independent associations. RESULTS: Of 7928 boys born to mothers taking part in the Avon Longitudinal Study of Pregnancy and Childhood, 51 hypospadias cases were identified. There were no significant differences in the proportion of hypospadias cases among mothers who smoked, consumed alcohol or for any aspect of their previous reproductive history (including the number of previous pregnancies, number of miscarriages, use of the contraceptive pill, time to conception and age at menarche). Significant differences were detected for some aspects of the maternal diet, i.e. vegetarianism and iron supplementation in the first half of pregnancy. Mothers who were vegetarian in pregnancy had an adjusted odds ratio (OR) of 4.99 (95% confidence interval, CI, 2.10-11.88) of giving birth to a boy with hypospadias, compared with omnivores who did not supplement their diet with iron. Omnivores who supplemented their diet with iron had an adjusted OR of 2.07 (95% CI, 1.00-4.32). The only other statistically significant association for hypospadias was with influenza in the first 3 months of pregnancy (adjusted OR 3.19, 95% CI 1.50-6.78). CONCLUSION: As vegetarians have a greater exposure to phytoestrogens than do omnivores, these results support the possibility that phytoestrogens have a deleterious effect on the developing male reproductive system.

Diet, Vegetarian↗