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PubMed1986

Heat loss from the skin of preterm and fullterm newborn infants during the first weeks after birth.

In 68 infants appropriate for gestational age, born after 25-41 weeks of gestation, the evaporation rate from the skin and ambient, skin and body temperatures were measured repeatedly during the first 4 weeks after birth, and the heat exchange due to evaporation, radiation and convection was calculated. All measurements were made at an ambient humidity of 50%, with the infants calm and quiet. High evaporative heat losses were found in preterm infants on their first days of life, with gradually decreasing values with increasing gestational and postnatal age. It was only during the 1st week of life in infants born at 25-27 weeks of gestation that evaporative heat loss was higher than radiative heat loss. The high evaporative heat losses in very preterm infants were balanced by low losses or even a gain through radiation and convection, because of the high ambient temperature needed to maintain a stable body temperature. Total heat loss increased with increasing gestational and postnatal age.

Aging↗

PubMed2001

Birth and first-year costs for mothers and infants attributable to maternal smoking.

Maternal smoking during pregnancy has been linked to high costs. This study estimates the magnitude of excess costs attributable to smoking during pregnancy for mothers and infants. The model estimates smoking-attributable costs for 11 infant and maternal conditions. From a claims database of 7784 mothers and 7901 infants who had deliveries during 1996, we estimated total cost over the infants' first year of life for each mother and infant and identified each complication of interest, based on ICD-9 codes. The average cost for smokers and non-smokers could not be computed directly because smoking status is not available in claims data. Therefore, the population attributable risk percentage (PAR%) due to smoking for each complication was identified from the literature. Multiple linear regression was used to provide estimates of the incremental cost associated with each smoking-related complication. The total cost attributable to smoking was computed as a function of the incremental cost of each complication and the PAR% for each complication. The conditions associated with the largest incremental costs compared to patients without those conditions were abruptio placenta ($23,697) and respiratory distress syndrome ($21,944). Because they were more common, the conditions with the largest smoking-attributable cost were low birth weight ($914) and lower respiratory infection ($428). The sum of the additional costs attributable to smoking for all conditions yielded a total in the first year after birth ranging from $1142 to $1358 per smoking pregnant woman. It was concluded that maternal smoking during pregnancy results in an economic burden to payers and society. These estimates may be useful in formal cost-effectiveness evaluations of individual smoking cessation strategies.

Child Health Services↗

PubMed2002

Parental emotions following the birth of the first child: gender differences in depressive symptoms.

This study addresses psychological issues that put first-time parents at risk for depressive disorders. In a community sample of 107 men and their wives, employment variables, marital quality, and personality attributes (fear of abandonment and loneliness) significantly explained 43% of the variance in men's, and almost 25% in women's, depressive symptoms. Men reported more symptoms than women. Men with heightened fear of loneliness were particularly at risk for depressive symptoms after birth of the first child.

Adult↗

PubMed1993

Experiences of primiparous breast-feeding mothers in the first days following birth.

This study describes the breast-feeding patterns of 59 neonates and the experiences of their primiparous mothers during the early postpartum period. The results showed that most mothers and babies in this group had significant difficulties during the first 2 days after birth and that 33% of the mother-baby pairs were still having problems latching or sucking on discharge from hospital (fourth to fifth postpartum days). Of the mothers who were still having problems on leaving the hospital, 84% had given up breast-feeding by 8 weeks, most of them by 2 weeks following hospital discharge.

Adaptation, Psychological↗

PubMed2006

Maternal age at the birth of the first child as an epistatic factor in polygenic disorders.

The identification of the genes for complex, polygenic disorders has proven difficult. This is due to the small effect size of each gene and genetic heterogeneity. An additional important factor could be the presence of unidentified epistatic factors. In the broad definition of epistasis, the effect of one unit is not predicable unless the value of another unit is known and one of the units may not be a gene. We have previously identified maternal age as an epistatic factor for the effect of the LEP gene on the age of onset of menarche. We report here the effect of maternal age and the age of the mother at the birth of her first child (maternal age 1st) as epistatic factors for the interaction of the dopamine D1 gene (DRD1) with obsessive-compulsive behaviors and with stuttering. The epistatic effects of maternal age 1st were stronger than maternal age. This type of epistatic factor may be generalizable to many other gene-trait interactions.

Adolescent↗

PubMed2006

Trans fatty acids and birth outcome: some first results of the MEFAB and ABCD cohorts.

Using data from two longitudinal pregnancy and birth cohorts in the Netherlands, the potential influence of trans fatty acids (TFA) on fetal development was investigated by multiple regression analysis. After adjustment for a large number of potential confounders, birth length (BL) and head circumference (HC) were significantly and negatively related to the C18:1trans concentration in phospholipids isolated from umbilical plasma (HC), umbilical arterial walls (HC and BL), or umbilical venous walls (BL). A significant and negative relationship was also observed between birth weight and the C18:1trans concentration in maternal plasma phospholipids at early pregnancy, but this attenuated upon correction for potential confounders. These results indicate that TFA may compromise fetal development.

Birth Weight↗

PubMed1992

The Royal Women's Hospital Family Birth Centre: the first 10 years reviewed.

In reviewing the first 10 years experience of the Royal Women's Hospital Family Birth Centre (FBC), we examined the outcomes of pregnancy and labour in a group of women who requested alternative birthing care and who were identified antenatally as being a 'low-risk' population. This study is a retrospective analysis of 5,365 women booked with the birth centre between 1980 and 1989. Over 16% of women developed antenatal complications precluding further care there, while a further 16% developed complications in labour requiring transfer out to conventional labour wards. Thus 67% of those originally booked delivered in the FBC. The instrumental delivery rate was 11%, and the Caesarean section rate was 4%. Of the women who delivered in the FBC, 3.1% had a postpartum haemorrhage and 1.8% required manual removal of placenta. Approximately 4% of babies born in the FBC required some resuscitation, and 0.8% needed admission to the neonatal nursery. Two perinatal deaths occurred in women admitted in labour to the FBC with a live baby, whilst 2 other women presented in labour with a fetal death in utero (perinatal mortality 0.89 per 1,000).

Birthing Centers↗

PubMed1996

Effects of the level of asphyxia during delivery on viability at birth and early postnatal vitality of newborn pigs.

Newborn pigs (n = 117) were used to provide information on the relationships of degree of asphyxia during delivery, viability at birth, and some striking aspects of postnatal vitality including survival, interval between birth and first udder contact and between birth and first suckling, rectal temperature at 24 h of life (RT24), and growth rate over the first 10 d of life. The degree of asphyxia at birth was estimated from cord blood pCO2, pH, and lactate levels. Onset of respiration, heart rate, skin color, and attempts to stand during the first minute after birth were used to estimate the viability score. Neonatal asphyxia, i.e., decreased blood pH and increased blood pCO2 and lactate, was associated with the production of unusually high levels of catecholamines. The degree of asphyxia increased with late position in the birth order (P < .01) and was higher in piglets born posteriorly (P < 0.5). Further, the average blood pCO2 within a litter increased (P < .05) with litter size. The was an inverse relationship between the degree of asphyxia and the viability score (P < .001). Highly viable piglets reached the udder more rapidly (P < .001) and had a higher RT24 (P < .001) than those of low viability. Plasma glucose concentrations increased with blood pCO2 and plasma epinephrine concentrations (P < .001). Neonatal asphyxia reduced postnatal vitality by delaying the first contact with the udder (P < .03) and was associated with a lower RT24 (P < .05), growth rate (P < .001), and survival over 10 d (P < 0.06). These variables, i.e., interval between birth and first udder contact, RT24, and growth rate, were correlated with birth weight (P < .001); RT24 was also shown to decrease (P < .001) with the time taken to reach the udder. Overall, results suggest that piglet suffering from asphyxia during delivery are less viable at birth and less prone to adapt to extrauterine life.

Animals↗

PubMed2003

Infrared thermography in newborns: the first hour after birth.

OBJECTIVE: It was the aim of this study to investigate the surface temperature in newborns within the first hour after delivery. Furthermore, the influence of different environmental conditions with regard to surface temperature was documented. METHODS: Body surface temperature was recorded under several environmental conditions by use of infrared thermography. 42 newborns, all delivered at term and with weight appropriate for date, were investigated under controlled conditions. RESULTS: The surface temperature immediately after birth shows a uniform picture of the whole body; however, it is significantly lower than the core temperature. Soon after birth, peripheral sites become cooler whereas a constant temperature is maintained at the trunk. Bathing in warm water again leads to a more even temperature profile. Radiant heaters and skin-to-skin contact with the mother are both effective methods to prevent heat loss in neonates. CONCLUSIONS: Infrared thermography is a simple and reliable tool for the measurement of skin temperature profiles in neonates. Without the need of direct skin contact, it may be helpful for optimizing environmental conditions at delivery suites and neonatal intensive-care units.

Age Factors↗

PubMed1977

Risk factors of breast cancer in Finland.

The risk of breast cancer in Finland is low (40.1/100,000) compared with the other Nordic countries. A case-control study was carried out on 122 cases of breast cancer and 534 controls between the ages of 41 and 60. It was found that age at first marriage and birth of the first child as well as the number of abortions and parity adjusted for age at first birth were associated with the breast cancer risk, whereas lactation was not. The results did not confirm the hypothesis (de Waard) that overweight and/or the size of the woman influence the risk of breast cancer.

Adult↗

PubMed1979

alpha-Melanocyte-stimulating hormone and adrenocorticotropin in the regulation of glucocorticoid secretion during the perinatal period in sheep.

To determine the role of other ACTH-like peptides in the regulation of glucocorticoid secretion in fetal sheep, we examined the responses of the adrenal gland of fetal and newborn sheep to comparable single doses of alpha MSH (75 micrograms) or ACTH (50 micrograms) during the last third of gestation and the first month of postnatal life. alpha MSH first increased the plasma glucocorticoid concentration at 121--130 days of gestation [from 16 +/- 1.5 to 36.9 +/- 9 (SE) ng/ml]; the response to alpha MSH persisted on days 131--140 of gestation and during the first month after birth. ACTH first increased the plasma glucocorticoid concentration at 131--140 days of gestation and increased it further in the first month after birth (from 18.9 +/- 3.6 to 97.0 +/- 10 ng/ml). The observations that the adrenal glands of fetuses and newborn lambs responded to alpha MSH at a dose comparable to that of ACTH and that the response to alpha MSH in the fetus preceded the response to ACTH may indicate that adrenal receptors mature during fetal development. These data also suggest that the regulation of the adrenal during fetal life may involve more than one tropic hormone.

Adrenocorticotropic Hormone↗

PubMed1994

Mothers' health after the birth of the first child: the case of employed women in an Italian city.

While the number of mothers resuming employment soon after the birth of a child is growing, knowledge about the effect that having both a baby and a job has on mental and physical health is still scarce. In this paper, we studied the health of 141 Italian first-time mothers, who were all employed during pregnancy. When their child was 15 months old, 84% were back at work; 24-36% suffered from lack of sleep, extreme tiredness and backache; more than half had experienced some feelings of depression since the birth. Considering the whole sample, poorly educated and unmarried mothers reported more physical health problems. Being employed per se showed no influence, but poorly educated mothers and those with a less qualified job reported more problems. On the basis of our results, we suggest that future research on new mothers, work and health should systematically include "domestic" variables and the characteristics of the paid job; and should analyze more thoroughly the influence of marriage status and educational level on health.

Adult↗

PubMed1983

Maternal "en face" orientation during the first hour after birth.

Data are presented on the amount of time that 97 mothers spent in the "en face" position in the first hour postpartum, during which time contact between mother and infant was uninterrupted. The mean times varied with cultural background, relationship with the child's father, attitude toward childbirth, and administration of oxytocics.

Attitude↗

PubMed1982

Plasma and adrenal aldosterone levels in premature mice at birth and during neonatal development.

The concentrations of aldosterone in the plasma and adrenal glands, the concentrations of sodium and potassium in the plasma and the hematocrit were estimated from birth to day 6 after birth in premature mice removed by Caesarean section on day 19 of pregnancy in comparison with newborn mice delivered spontaneously vaginally on day 20 of pregnancy. In premature mice, the plasma aldosterone concentrations increased twice: at birth after reanimation, then at 6 h after birth. The first increase at birth resulted probably from ACTH stimulation. Several factors could be involved in the peak at 6 h after birth: ACTH stimulation, the decrease in the level of sodium in the plasma and the increase in the hematocrit due to kidney immaturity of premature mice. The results suggest that the renin-angiotensin-aldosterone system is able to respond to stimulations in the first 6 h after birth in premature mice. The rise in the level of plasma aldosterone which has been found at birth in newborns delivered spontaneously vaginally on day 20 of pregnancy (control animals) did not result from variations of plasma electrolytes, plasma volume and ACTH; this rise has been induced by labor of the parturition which caused the aldosterone release from adrenal glands.

Adrenal Glands↗

PubMed1983

Auditory brainstem response in neonates during the first 48 hours after birth.

Auditory brainstem response (ABR) has been recorded in 20 neonates at three different time intervals during the first 48 hours after birth. The first recording was performed about 15 min after delivery, when the babies were in their first period of postnatal reactivity. During this period, we were unable to obtain reliable ABR data. During the second and third ABR test performed 2 and 48 hours after birth the babies revealed gradually better responses. Data from these recordings suggest no significant change in middle ear function during the time interval between 2 and 48 hours after birth. Observations of amplitude ratio wave V/wave I are presented. Finally, reservations regarding the interpretation of the results are discussed.

Audiometry↗

PubMed2004

Timing of depression recurrence in the first year after birth.

BACKGROUND: Women who have suffered from one episode of postpartum-onset major depression (PPMD) experience increased risk for recurrence in the year following another birth. METHODS: Non-depressed women (N=51) who had at least one past episode of PPMD were recruited during pregnancy. After birth, subjects were assessed prospectively each week for 20 weeks with the Hamilton Rating Scale for Depression and Research Diagnostic Criteria for recurrence of major depression. Evaluations were carried out at 24, 36, and 52 weeks to assess for episodes beyond 20 weeks postpartum. RESULTS: The data revealed a clustering of cases, with five of the 21 recurrences (24%) occurring in the first 2 weeks. Thirteen of the 21 recurrences (67%) and 19/21 recurrences (90%) occurred in the first 20 and 28 weeks following birth, respectively. LIMITATIONS: Although it is unusual for studies of this type to be prospective, the sample size is relatively small. CONCLUSIONS: The 1-year recurrence rate was 21/51 or 41%, with a clustering of cases near delivery. All recurrences except two occurred by 28 weeks postpartum.

Adult↗

PubMed1985

Toward providing parents the option of avoiding the birth of the first child with Cooley's anemia: response to hemoglobinopathy screening and counseling during pregnancy.

Will the development of safe, accurate prenatal diagnosis for Cooley's anemia result in a reduction in the unwanted birth of children with Cooley's anemia in the United States? Since detection of couples at risk only through the birth of an affected child will lead to a minimal reduction in the incidence of the disease, carrier screening will be necessary. A pilot project of prenatal hemoglobinopathy screening is being conducted in Rochester, New York, to answer the question "Should hemoglobinopathy carrier screening and genetic counseling of positives be part of routine prenatal care?" In the first 27 months of this study, 6,641 unselected pregnant women have been screened on the first prenatal visit, regardless of race and ethnic origin. Of these, 304 have been positive for some type of hemoglobinopathy. Of the 293 analyzed here, the proportion coming for counseling was 61% of the total group and 77% of the thalassemia trait subgroup. Of this number, the proportion wanting their mate tested was 98% of the total group and 100% of the thalassemia trait subgroup. The proportion of those counseled whose mate was actually tested was 60% for the total group and 70% for the thalassemia trait subgroup. The proportion of at risk couples wanting amniocentesis (mostly for detection of sickle cell disease) was 61%. We conclude that, when comprehensive hemoglobinopathy screening is incorporated into routine prenatal screening, the majority of positive women make an extra visit to receive an explanation, nearly all women coming for counseling want their mate tested, the majority of mates come for testing, and the majority of couples at risk want amniocentesis. Further, pregnant women with beta-thalassemia trait may be more inclined to act upon identification as a carrier than are positive women at large.

Abortion, Therapeutic↗

PubMed1986

Nutrient intake by breast-fed infants during the first five days after birth.

The intakes of milk and specific nutrients during the first 120 hours after birth were measured in 11 full-term, breast-fed infants. Infants were test weighed at all feeds using an electronic balance, and milk samples were obtained from both breasts one to three times daily. Milk was analyzed for levels of fat, protein, lactose, calcium, sodium, and potassium; energy content was calculated using the Atwater factors. The average (+/- SD) intake of milk in the first 24 hours after birth was 13 +/- 16 g/kg (range, 3 to 32 g/kg), increasing to 98 +/- 47 g/kg (50 to 163 g/kg) and 155 +/- 29 g/kg (110 to 196 g/kg) on days 3 and 5, respectively. Mean daily intakes of energy, lactose, calcium, and potassium were less than 12% of the mean day 5 intake on day 1 and less than 25% of the day 5 intake on day 2. In the first few days after birth, the nutrient intake of the solely breast-fed infant is highly variable and is frequently low.

Breast Feeding↗