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PubMed1992

Reproductive factors and risk of myocardial infarction.

The relation of reproductive factors to risk of myocardial infarction in women aged 45-69 years was examined in a case-control interview study carried out in Massachusetts from 1986 to 1990. Each of 858 cases of first myocardial infarction was age-matched with a control from the same precinct of residence. Conditional logistic regression was used to control the matching factors and the major known and suspected risk factors for coronary heart disease. For parous women compared with nulliparous women, the estimated relative risk of myocardial infarction was 1.8 (95% confidence interval (CI) 1.0-3.3). Among parous women, the relative risk estimate for five or more births relative to fewer births was 1.4 (95% CI 1.0-2.0); the estimate for a first birth before age 20 relative to a later age at first birth was 1.7 (95% CI 1.1-2.6). The greatest increase in risk was observed for women who had both an early age at first birth and five or more children. However, confounding by factors related to socioeconomic status may have contributed to the results. Compared with women who had a natural menopause at age 50 or older, women who reached the menopause before age 45 were at increased risk regardless of type of menopause: The estimated relative risks were 2.1 (95% CI 1.3-3.2), 1.7 (95% CI 1.0-2.7), and 1.7 (95% CI 1.0-2.8) for early natural menopause, bilateral oophorectomy, and hysterectomy with retention of one or both ovaries, respectively. These results suggest that early cessation of ovulatory function, whether due to natural causes or to surgery, increases the risk of myocardial infarction. Age at menarche was not related to myocardial infarction risk.

Aged↗
PubMed2003

Determinants of women's fertility in Oman.

OBJECTIVE: International studies have the inverse relationship of women education and empowerment on fertility. Our aim is to study the association of women education, and empowerment with some of the fertility determinants in a community based survey. METHODS: A cross sectional survey of the health status of the Omani community was designed. Face to face interviews with 2037 women, who were or had been married including demographic data, fertility patterns, family planning, 2 women empowerment indices (decision making and freedom of movement), and other modules reproductive health, were carried out during the year 2000. RESULTS: About 31% of the sample was considered highly empowered in decision making and the mean number of decisions taken in the household was 4.46 for the overall sample. For freedom of movement, 29% of the sample was highly empowered with a mean number of 3.88 for the overall sample. The mean values of both indices varied significantly according to age, residence, level of education and work status. Higher freedom of movement score women were more likely to have less number of children in the first 20 years of marriage. Women of higher score of decision making index were more likely to have longer closed birth interval Those scored low in the decision making index were more likely to get a child at an earlier age. CONCLUSION: There is inverse relationship between both education and empowerment and fertility. However, the 2 indices of women empowerment; decision making and freedom of movement were not always predicting the same fertility indicator, as women's empowerment is multidimensional in nature.

Adolescent↗
PubMedDate not supplied

[Electrocardiogram of the healthy premature infant].

At the Hospital de Ginecobstetricia del Centro Médico "La Raza", were taken EKG to 30 healthy premature newborn during a six month period. The first EKG was recorded 3 hours after birth, the second in 8 hours, the third in 24 h, the fourth in 48 h, the fifth in 72 hours, the sixth at the end of the first week, the seventh at the fifteen days and the eighth at 30 days after birth. The mean heart rate was 135 +/- 10 beats/min in the first week. There were heart rate elevation for the first three days after birth. The QRS mean axis were + 130 +/- 25 degrees, without changes during the study time. The QTc interval in all cases was higher than 0.42 sec. The voltage of waves R and S at right and left precordial leads were similar. At this gestational age the ventricular masses are equals. The T waves changes reflected hemodynamic changes. It is concluded what the healthy premature newborn had a typical EKG as a reflex to the cardiocirculatory adaptations.

Adaptation, Physiological↗
PubMed1984

[Gentamycin dosage interval in premature infants].

The effect of dose interval on gentamicin serum concentrations in preterm babies (less than 35 weeks gestational age) was studied in the first week after birth. When gentamicin (2,5 mg/kg) was given intravenously every 12 hours, 53% of the babies had elevated pre dose serum concentrations (greater than 2,0 microgram/ml). This occurred in 27% of the babies when gentamicin was given every 18 hours (p less than 0.01). We recommend that 2.5 mg/kg/18 hours should be used in preterm babies in the first week after birth, although monitoring of gentamicin serum levels remains essential.

Bacterial Infections↗
PubMed1996

Racial disparities in outcomes of military and civilian births in California.

OBJECTIVE: To examine racial disparities in prenatal care utilization, birth weight, and fetal and neonatal mortality in a population for whom financial barriers to health care services are minimal. STUDY-DESIGN: Using linked birth, fetal death, and infant death certificate files, we examined prenatal care utilization, birth weight distribution, and fetal and neonatal mortality rates for all white and black births occurring in military hospitals in California from January 1, 1981, to December 31, 1985. These patterns were compared with the experience of their civilian counterparts during the same time period. RESULTS: Black mothers had higher percentages of births occurring in teenaged and unmarried mothers than did white mothers in military and civilian populations. First-trimester prenatal care initiation was lower for blacks in the military (relative risk, 0.79; 95% confidence interval, 0.75-0.82) and civilian (relative risk, 0.51; 95% confidence interval, 0.50-0.52) populations. However, the scale of the disparity in prenatal care utilization was significantly smaller (P < .001) in the military group. Rates of low birth weight and fetal and neonatal mortality among blacks were elevated in the military and civilian groups. However, the racial disparity in low birth weight was significantly smaller in the military group (P < .01 and P < .001, respectively). CONCLUSIONS: In populations with decreased financial barriers to health care, racial disparities in prenatal care use and low birth weight were reduced. However, the persistence of significant disparities suggests that more comprehensive strategies will be required to ensure equity in birth and neonatal outcome.

California↗
PubMed1989

[Quantification of heart rate variability in newborn infants and during the first 6 months of age].

We have registered, on 36 normal newborns at term, ECG recordings of sixty seconds at a speed of 100 mm/second, from birth tooth sixth month of postnatal life. The heart rate variability was measured on its double slope, short and long term by the numerical method that Yeh proposed, consistent with the "differential index" (DI) and the "interval index" (II). For the short term variability, we have obtained minimum values at birth and maximum values at 72 hours of postnatal life, with a tendency to drop up to the end of the first month and later to become stable until the end of six months of age. The changes found among different ages, could be related to modifications in basal heart rate under autonomic nervous system control. The variability values of the long term, do not show a clear age relation.

Age Factors↗
PubMed2006

Carpal and fetlock conformation of the juvenile Thoroughbred from birth to yearling auction age.

REASONS FOR PERFORMING STUDY: There is little information available about conformational changes in the forelimbs of growing foals. OBJECTIVES: To describe the conformation of the carpus and fetlock of Thoroughbred foals from birth to yearling sale age. METHODS: Subjective assessments of the fetlock and carpal conformation of 119 Thoroughbred foals were made within the first month of life and then at 30 day intervals until at least age 120 days. At least 70 subjects were examined further at 60 day intervals until September of their second year. Conformation grades are reported for 5 age groups: first 7 days and at a mean of 46, 176, 362 and 525 days. The conformation of all available sires and dams of subjects was also graded. RESULTS: All subjects demonstrated carpal deviations, such as valgus, outward rotation and offset, and approximately 30% had fetlock deviations. Heavier birth weights were associated with carpal offset and fetlock inward conformation at most ages, and heavier yearlings were more likely to be carpal valgus. The carpal conformation of the sire (offset and outward rotation) was associated with similar yearling carpal conformation. During the study period, the carpal conformation of Thoroughbred foals became less valgus and more offset. Fetlock conformation became more inwardly deviated during the first 6 months of the study. CONCLUSIONS: Carpal and fetlock conformation change greatly in Thoroughbred foals up to age 18 months. The phenotype of the sire can be associated with yearling carpal conformation and bodyweight, particularly at birth and as yearlings, is associated with yearling fetlock and carpal conformation. POTENTIAL RELEVANCE: New factors associated with forelimb conformational deviations have been identified that may help breeders better to manage young racing stock.

Aging↗
PubMed1992

Birth spacing and child health in urban Brazilian children.

The associations between birth interval and a range of child health outcomes were examined in a population-based cohort of approximately 3500 urban Brazilian children. The effects of several socioeconomic and maternal confounding factors were controlled for in the analyses. Children born after shorter birth intervals (less than 18 and 18 through 23 months) were disadvantaged with respect to most of the health outcomes when compared with children born after intermediate birth intervals (24 through 35, 36 through 47, and 48 through 71 months). Effects were particularly marked for birth weight, postneonatal mortality, and anthropometric status at mean age 19 months. Children born after a long birth interval (greater than 71 months) also showed some disadvantage for birth weight, perinatal mortality, and infant mortality. However, this group experienced lower risks of hospitalizations during the first 19 months of life and better anthropometric status at mean age 19 months. This study provides data that are scarce from such settings and contributes to the quantification of associations between birth spacing and child health. This information is important in the planning of appropriate intervention strategies.

Anthropometry↗
PubMed2004

Gestational age and birth weight in relation to n-3 fatty acids among Inuit (Canada).

Seafood consumption during pregnancy carries both benefits (high n-3 FA intake) and risks (exposure to environmental contaminants) for the developing fetus. We determined the impacts of marine n-3 FA and environmental contaminants on gestational age (GA) of Nunavik women and the anthropometric characteristics of their newborns. FA and contaminant (polychlorinated biphenyls and mercury) concentrations were measured in cord plasma of Nunavik newborns (n = 454) and compared with those of a group of newborns (n = 29) from southern Québec. Data were collected from hospital records and birth certificates. In Nunavik newborns, arachidonic acid (AA) was two times lower (P < 0.0001), whereas DHA concentration, the sigman-3 / sigman-6 ratio, and the percentage of n-3 highly unsaturated FA (HUFA) (of the total HUFA) were three times higher (P < 0.0001) compared with southern Québec newborns. After controlling for confounders, GA and birth weight were higher by 5.4 d [95% confidence interval (CI): 0.7-10.1] and 77 g (95% CI: -64 to 217) in the third tertile of percentage of n-3 HUFA (of the total HUFA) as compared with the first tertile. There was no evidence that contaminants had negative effects on GA or birth weight. In this seafood-eating population, an increase in the proportion of n-3 HUFA (of the total HUFA), measured in umbilical cord plasma phospholipids, was associated with a significantly longer GA.

Adolescent↗
PubMed2001

Recurrence of preterm birth in singleton and twin pregnancies.

OBJECTIVE: To assess recurrence of preterm birth and its impact on an obstetric population. METHODS: Women with consecutive births at our hospital beginning with their first pregnancy were identified (n = 15,945). The first pregnancy was categorized as delivered between 24 and 34 weeks' gestation or 35 weeks or beyond, singleton or twin, and spontaneous or induced. The risk of preterm delivery in these same women during subsequent pregnancies was then analyzed. RESULTS: Compared with women who delivered a singleton at or beyond 35 weeks' gestation in their first pregnancy, those who delivered a singleton before 35 weeks were at a significant increased risk for recurrence (odds ratio [OR] 5.6, 95% confidence interval [CI] 4.5, 7.0), whereas those who delivered twins were not (OR 1.9, 95% CI 0.46, 8.14). The OR for recurrent spontaneous preterm birth presenting with intact membranes was 7.9 (95% CI 5.6, 11.3) compared with 5.5 (95% CI 3.2, 9.4) with ruptured membranes. Of those women with a recurrent preterm birth, 49% delivered within 1 week of the gestational age of their first delivery and 70% delivered within 2 weeks. Among 15,863 nulliparous women with singleton births at their first delivery, a history of preterm birth in that pregnancy could predict only 10% of the preterm births that ultimately occurred in the entire obstetric population. CONCLUSION: In a population-based study at our hospital, women who initially delivered preterm and thus were identified to be at risk for recurrence ultimately accounted for only 10% of the prematurity problem in the cohort.

Adolescent↗
PubMed1996

Effects of space allocation and temperature on periparturient maternal behaviors, steroid concentrations, and piglet growth rates.

Preparturient sows were randomly assigned to either a farrowing crate (n = 12) or farrowing pen (n = 12) across cool and hot seasons (with or without drip cooling) to study space allocation and temperature effects on periparturient maternal behaviors, steroid concentrations, and piglet growth rates. Concentrations of estradiol-17 beta (E2 beta), progesterone (P4), and cortisol were quantified in blood collected from surgically implanted vena cava cannulas. Sows were videotaped from 2 h before to 2 h after farrowing. Similar periparturient behaviors were displayed by all sows, regardless of farrowing environment. Sows in pens had lower (P < .05) prepartum P4 concentrations from d -6 to the day preceding farrowing and a reduced (P < .05) piglet birth interval compared with sows in crates (12.95 +/- 1.35 min vs 18.31 +/- 2.21 min, respectively). Additionally, compared with multiparous sows in crates, multiparous sows in pens weaned heavier piglets (P < .05). Estradiol-17 beta concentrations were lower (P < .01) throughout lactation during hot weather for sows with or without drip cooling, averaging 9.30 pg/mL and 8.57 pg/mL, respectively, compared with 18.65 pg/mL for sows during cool weather. This decrease in E2 beta concentration in sows during hot weather was correlated with an extended (P < .05) interval from weaning to first estrus for the sows in hot weather compared to sows during cool weather. Cortisol concentrations decreased progressively during lactation and were not associated with litter weight gains or the interval between weaning and first estrus.

Animals↗
PubMedDate not supplied

The association of heparin exposure with intraventricular hemorrhage among very low birth weight infants.

To determine whether there is a relationship between exposure to heparin and an increased risk of intraventricular hemorrhage (IVH), we analyzed data from a cohort of infants who had been subjects in a randomized clinical trial of umbilical artery catheter placement. Data from 862 infants who survived the first 6 days of life were used for analysis. The incidence of IVH (grades 1 through 4) was 28.6%. The mean (SD) birth weight for infants with IVH was 954 gm (247 gm) compared with 1053 gm (253 gm) among infants without IVH (p < 0.01). The mean (SD) heparin intake among infants with an IVH was 83.5 units/kg/day (48.7) compared with 59.4 units/kg/day (48.7) among infants without an IVH (p < 0.01). With the use of logistic regression modeling to adjust for a number of potentially confounding variables, including fluid intake and birth weight, we observed an odds ratio for an IVH of 1.96 (95% confidence interval = 1.32, 2.91) for infants with second through fourth quartile intakes of heparin compared with that for infants with first quartile heparin intakes. Although we cannot rule out the possibility that the observations from this model may be confounded by factors associated with the severity of illness of the infant, these data support the findings of previous reports of an association between heparin exposure and the risk for an IVH.

Case-Control Studies↗
PubMed1987

A prospective study of age at menarche, parity, age at first birth, and coronary heart disease in women.

Reproductive events in women are associated with alterations in blood lipids and blood pressure and may therefore influence determinants of coronary heart disease. To investigate the risk of coronary heart disease in relation to age at menarche, parity, and age at first birth, the authors evaluated prospectively the experience of 119,963 US women aged 30-55 years who were free from coronary heart disease in 1976 and were followed through 1982. During 700,809 person-years of observation, 308 incident cases of nonfatal myocardial infarction or fatal coronary heart disease occurred. Younger age at menarche was weakly associated with coronary heart disease (age-adjusted rate ratio of 1.3 for menarche before age 11 years compared with menarche at age 13 years; chi, Mantel extension test for trend = -1.1, p = 0.2). Nulliparous women experienced only a slightly higher rate of coronary heart disease than parous women (rate ratio = 1.2, 95 per cent confidence interval 0.8-1.8). Among parous women, there was no alteration in risk with increasing number of births. Likewise, there was no significant association between age at first birth and coronary heart disease (chi, Mantel extension test for trend = -0.4, p = 0.4). Established risk factors for coronary heart disease nevertheless showed expected relations. These findings show no important association between reproductive experiences and risk of coronary heart disease.

Adult↗
PubMed2002

Worsening of V'maxFRC in infants with chronic lung disease in the first year of life: a more favorable outcome after high-frequency oscillation ventilation.

Little is known about the development of maximal flow at functional residual capacity, a measure of airway patency, in infants with chronic lung disease (CLD). In a follow-up study, we evaluated V'maxFRC in very low birth weight infants with CLD, treated with high-frequency oscillation ventilation (HFOV) or conventional mechanical ventilation. In 36 infants with CLD, V'maxFRC was evaluated at 6 and/or 12 months corrected age, and the relationship between perinatal factors and lung function was studied. Mean (SD) birth weight and gestational age were 837 (152) g and 26.8 (1.7) weeks, respectively. At 6 and 12 months, mean V'maxFRC was significantly below normal. Between 6 and 12 months, there was a mean (95% confidence interval) reduction in V'maxFRC (Z score) of 0.5 (0.2-0.7) (p < 0.001). At 12 months, the mean V'maxFRC (Z score) was higher for children initially treated with HFOV (n = 15), as compared with children treated with conventional mechanical ventilation (n = 16): mean (95% confidence interval) difference was 0.6 (0.2-1.0) (p = 0.008). We conclude that very low birth weight infants with CLD have decreased V'maxFRC that worsen during the first year of life. Initial treatment with HFOV was associated with a more favorable outcome of V'maxFRC at 12 months corrected age.

Chronic Disease↗
PubMed1992

Effect of maturation on the extrathoracic airway stability of infants.

The influence of maturation on extrathoracic airway (ETA) stability during quiet sleep was determined in 13 normal preterm infants of 1.41 +/- 0.14 (SD) kg birth weight and 32 +/- 2 wk estimated gestational age. Studies began in the first week of life and were performed three times at weekly intervals. A drop in intraluminal pressure within the ETA was produced by external inspiratory flow-resistive loading (60 cmH2O.l-1 x s at 1 l/min); an increase in intrinsic resistance, indicating airway narrowing, was sought as a measure of ETA instability. Baseline total pulmonary resistance was not significantly different between weeks 1, 2, and 3 (88 +/- 35, 65 +/- 24, and 61 +/- 17 cmH2O.l-1 x s, respectively) but increased markedly above baseline with loading to 144 +/- 45 cmH2O.l-1.s during week 1 (P < 0.001), 89 +/- 28 cmH2O.l-1 x s at week 2 (P < 0.01), and 74 +/- 25 cmH2O.l-1 x s at week 3 (n = 10). The increment with loading was significantly greater during week 1 than during weeks 2 or 3 (P < 0.02). Similar studies were also done in seven full-term infants in the first week of life to evaluate the influence of gestational maturity on ETA stability. Despite a relatively greater drop in intraluminal pressure within the ETA of term vs. preterm infants with loading (P < 0.001), total pulmonary resistance failed to increase (68 +/- 21 to 71 +/- 32 cmH2O.l-1.s). These data reveal that ETA instability is present in preterm infants at birth and decreases with increasing postnatal age. Full-term neonates, by comparison, display markedly greater ETA stability in the immediate neonatal period.

Aging↗
PubMed2001

In utero and perinatal complications preceding asthma.

BACKGROUND: It has been suggested that pregnancy and early life may influence the development of asthma in the offspring, but published studies have not carefully controlled for potential biases. METHODS: In a large British birth cohort of 4065 natural children of 2583 mothers, we investigated whether in utero and perinatal influences contribute to the development and the severity of asthma in childhood, allowing for possible confounders of the relationship, and considering the nonindependence of familial data. RESULTS: Child asthma (10.1%) was more frequently reported by mothers when there had been health complications during pregnancy (prevalence =14.3%; adjusted odds ratio [ORadj] =2.01; 95% confidence interval, 1.52-2.67), labor, or delivery (19.3%, ORadj =1.35, 1.01-1.81); child illness or health complications during the first week of life (22.6%, ORadj =1.35, 1.01-1.82); and birth weight of < 2.5 kg (7.0%, ORadj =1.57, 1.10-2.25). Specific causes of health complications during pregnancy which significantly related to asthma were early or threatened labor (ICD: 644) (4.8%, ORadj =1.58, 1.03-2.40) and the malposition or malpresentation of the fetus (ICD: 652) (1.6%, ORadj =3.63, 1.47-8.91). CONCLUSION: The results provide further evidence that in utero and perinatal factors may increase the risk of developing asthma.

Adolescent↗
PubMed2004

Associations of seafood and elongated n-3 fatty acid intake with fetal growth and length of gestation: results from a US pregnancy cohort.

Previous studies, mainly among populations with high consumption of seafood, have suggested that increased marine n-3 polyunsaturated fatty acid (PUFA) intake during pregnancy promotes longer gestation and higher birth weight. Few studies have isolated the contribution of fetal growth to birth weight. Using data from 2,109 pregnant women in Massachusetts enrolled in Project Viva from 1999 to 2002, the authors examined associations of marine n-3 PUFA and seafood intake with birth weight and birth-weight-for-gestational-age z value (fetal growth) using linear regression; length of gestation using median regression; and low birth weight, preterm delivery, and being small for gestational age using logistic regression. After adjustment for maternal and child factors, birth weight was 94 (95% confidence interval: 23, 166) g lower and fetal growth z value 0.19 (95% confidence interval: 0.08, 0.31) units lower in the highest compared with the lowest quartile of first-trimester n-3 PUFA intake. Results for the second and third trimesters were similar, and findings for seafood paralleled those for n-3 PUFA. Elongated n-3 PUFA intake and seafood intake were not associated with length of gestation or risk of preterm birth. Results from this US cohort support the conclusion that seafood intake during pregnancy is associated with reduced fetal growth.

Birth Weight↗