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PubMed1988

Breast cancer in relation to the occurrence and time of induced and spontaneous abortion.

The authors evaluated whether an induced or spontaneous abortion during the first six months of gestation, particularly if it occurs before the first term pregnancy, increases the risk of breast cancer. Data from a case-control study of women under 70 years of age were used: 3,200 cases of breast cancer were compared with 4,844 controls with nonmalignant nongynecologic conditions. Among both nulliparous and parous women, the risk of breast cancer was not related to the number of induced or spontaneous abortions. After allowance for all identified potential confounding factors, the estimated relative risk for nulliparous women with an induced abortion relative to those who had never been pregnant was 1.3 (95% confidence interval (CI) 0.8-2.2), and for spontaneous abortion, the corresponding estimate was 0.9 (95% CI 0.5-1.5). Among parous women, the estimated relative risks were 1.2 (95% CI 0.9-1.6) for an induced abortion and 0.9 (95% CI 0.8-1.0) for a spontaneous abortion, relative to never having had an abortion of any type. The time of the abortion had little effect: The relative risk estimates were 0.9 (95% CI 0.5-1.4) for induced abortion before the first term birth, 1.4 (95% CI 1.0-1.9) for induced abortion first occurring after the first term birth, 0.9 (95% CI 0.7-1.2) for spontaneous abortion before the first term birth, and 0.9 (95% CI 0.7-1.0) for spontaneous abortion first occurring after the first term birth. Similar results were evident for women under age 40, among whom the frequency of induced abortion was relatively high. These data suggest that the risk of breast cancer is not materially affected by abortion, regardless of whether it occurs before or after the first term birth.

Abortion, Induced↗
PubMed1990

[A study of the auditory responses to intra-uterine sound in the first few months after birth].

The auditory responses of infants until 3 months after birth were examined using the doll "Nenkororin" which contains a tape recorder of the intrauterine sound (IUS). The purpose of this study was to assess the applicability of these responses to screening of infants with severe hearing impairment. The results are summarized as follows. 1. The IUS with 1/3-octaval audiofrequency of 400Hz-4kHz was presented to 152 neonates. Positive responses showing alert inactivity were obtained in 148 infants, but negative responses in 2 neonates. 2 infants were undetermined. The neonates showed negative responses had severe hearing impairment with comparison of ABR. ABR was also carried out in 69 of the 152 infants. The results of ABR well agreed with those of the IUS test. 2. A typical reaction of neonates who stopped crying and assumed a state of alert inactivity in responses to the IUS was demonstrated until approximately one month after birth. At the end of the first month after birth, the threshold of this reaction grew smaller than that of the one-week period after birth. The latent time of this reaction also tended to become shorter. 3. The infants mostly failed to respond to the 1/3-octaval noise consisting of 0.5, 1.0, 2.0, 4.0kHz extracted from the IUS. From the experiment using high and low pass noise components extracted from the IUS. High response were obtained at low frequency band components below 1kHz. 4. Public health nurses without experience of auditory test were requested to compare the reaction by the IUS test and an auditory reflex test using tongue-clicking, whistling and paper-crumpling sounds. The IUS test was found to be easier for evaluation of the reactions than the other method of test. From the above results it is concluded that the auditory response to the IUS was useful for screening of severe hearing impairment in neonates until one after birth.

Auditory Perception↗
PubMed1989

Mineral balance studies in sick preterm intravenously fed infants during the first week after birth. A guide to fluid therapy.

Mineral balance studies were performed in 61 sick preterm infants given parenteral fluids only. Their gestational ages varied from 24 to 35 weeks, and 50 required mechanical ventilation. Two consecutive balance studies were performed; the first from admission to 48 hours in all babies given maintenance fluids of 10% Dextrose, and the second from 48 hours to 7 days in those babies given intravenous feeding (IVN). At the beginning and end of each balance period, the baby was weighed and an arterial blood sample taken for blood gases, electrolyte, urea, creatinine and protein determinations. During the balance period all urine was collected and analysed for electrolyte, urea, and creatinine composition, and all fluid intake was recorded. The balance of a mineral was calculated as the difference between parenteral intake and urine output. Infants requiring IVN were allocated alternatively to regimen X or regimen Y, which had the same calcium content of 9.5 mmol/L, but different phosphate contents, regimen X containing 7.3 mmol/L and regimen Y 11.6 mmol/L. In those infants requiring prolonged IVN, 12-24 hour balance studies were performed at weekly intervals after day 10. 1. Phosphate deficiency developed in infants given regimen X, who had higher urine calcium excretion, lower percentage calcium retention and lower plasma phosphate levels than those given regimen Y. These differences were apparent by day 7 and persisted after day 10. In infants given regimen Y, mean calcium retention from admission to day 7 was 3.9 mmol/kg, and after day 10 was 0.9 mmol/kg/day. 2. In the first 48 hours, urine output and creatinine clearance varied widely and were lower in infants with higher oxygen requirements at 48 hours. Ten babies had severe oliguria with outputs less than 10 mL/kg/day. Creatinine clearance was directly related to gestational age, mean arterial blood pressure, and plasma protein concentrations on admission. After 48 hours, urine output and creatinine clearance increased considerably. 3. In the first 48 hours, metabolic acidosis was produced by increased plasma non-protein metabolisable acid concentrations, which were associated with low creatinine clearances, and were thought to be due to lactic acid accumulation in response to decreased tissue perfusion. At 7 days, metabolic acidosis was of similar severity but was produced by decreased plasma non-metabolisable base concentrations, caused by increased urine loss of net base, and not directly by IVN.(ABSTRACT TRUNCATED AT 400 WORDS)

Acidosis↗
PubMed1977

Measles immunity in the first year after birth and the optimum age for vaccination in Kenyan children. Collaborative study by the Ministry of Health of Kenya and the World Health Organization.

There is still controversy about the optimum age for measles vaccination in developing countries, where the incidence of measles infection is higher in the first few months of life than it is in developed countries. This study was undertaken to collect reliable data in order to determine the optimum age for mass vaccination programmes. Haemagglutination inhibition (HI) antibodies were titrated periodically from birth to one year of age in children who were given the vaccine at different ages, between 5 and 9 months. It was found that 90% of children no longer have their maternal antibodies at 7-8 months of age, precisely at the period that the incidence of measles begins to rise sharply. Almost all children showed HI seroconversion when vaccinated at 71/2 months (or later, but not before), even if a low level of maternal antibody still persisted when the vaccine was given. These data show that there is an advantage in carrying out measles vaccination at 71/2 months of age in countries with conditions similar to that of Kenya. The duration of post-vaccinal immunity beyond one year of age has not been studied, but it can reasonably be expected that immunity after one vaccination can last for at least 3-5 years, thus exceeding the period when African children are most exposed to malnutrition.

Antibodies, Viral↗
PubMed1992

[Unmarried, pre-nuptial and marital fertility: the family in process of change. An empirical analysis of Austrian women giving birth to their first child, 1950-1990].

"This analysis provides an outline of the changes in family formation behaviour in Austria in the years 1950 to 1990. Using vital statistical data and retrospective data of the 1981 census all women with their first confinement in the years 1950 to 1990 were classified into three distinct groups according to their form of family formation behaviour: 1. Mother is unmarried at date of birth...,2. mother marries during pregnancy, 3. mother is married at time of conception. Changes in family formation behaviour over time are discussed in detail, focussing on different age groups and on regional differences." (SUMMARY IN ENG)

Age Factors↗
PubMed2002

Reference values of the bioelectrical impedance vector in neonates in the first week after birth.

OBJECTIVE: To determine the reference, bivariate, tolerance intervals of the whole-body impedance vector for healthy white neonates, we performed an observational, cross-sectional study in two university hospitals. METHODS: The impedance vector (standard, tetrapolar analysis at 50-kHz frequency) was measured in 163 consecutive subjects (87 boys and 76 girls) with postnatal ages of 1 to 7 d. Bivariate vector analysis was conducted with the resistance-reactance (RXc) graph method. RESULTS: The age-specific 95% confidence intervals of mean vectors and the 95%, 75%, and 50% tolerance intervals for individual vector measurements were plotted using R and Xc components standardized by the subject's crown-to-heel length (height). Mean vectors from the groups (1, 2, and 3 to 7 d) with overlapping 95% confidence ellipses were considered representative of only one age class of 1 to 7 d. The impedance vector distribution of neonates also was compared with healthy white children (1014 boys and 1030 girls, age 2-15 y) and adult subjects (354 men and 372 women, age 15-85 y) from the same geographic area. There was a definite, progressive, vector shortening from birth, through ages 2 to 15 y, toward the adults' vector position. CONCLUSIONS: We established the reference, bivariate, 95%, 75%, and 50% tolerance intervals of the impedance vector in the first postnatal week for healthy white neonates, with which the vectors from infants with altered body composition can be tested (free software is available from apiccoli@ unipd.it).

Adolescent↗
PubMed1979

Problems in a 'creative marriage' following the birth of the first child -- an account of a conjoint marital therapy.

This description of the marital therapy of a couple treated conjointly by the authors illustrates the profound effects of the couple's childhood experiences of their respective parents' relationships on their own subsequent marriage. The precipitating effect of the birth of the child in the marriage in awakening dormant unconscious conflicts stemming from these early experiences also emerges in the history of the couple and in the material of the therapeutic sessions.

Adult↗
PubMedDate not supplied

Second pregnancies among teenage mothers.

An analysis of data from the National Survey of Family Growth (NSFG) finds that 82 percent of sexually active teenage mothers were using contraceptives in the year following the birth of their first child; the majority of those who practiced contraception used the pill. The proportion of black teenagers using no method of birth control was higher than that for white teenagers, and it increased over the course of the year. Rates of nonuse were particularly high among black women younger than 18, only 68 percent of whom practiced contraception (compared with 85 percent of whites the same age). Examination of the data by marital status shows that women who married while they were pregnant were the most likely to practice contraception in the year following their first birth, while those who were single at the time of first birth were the least likely to do so (89 versus 74 percent). Blacks constituted the majority of women who were not married at the time of first birth, and of all marital subgroups, single blacks had the highest rate of nonuse (29 percent). The probability of a pregnancy during the year following a first birth for all teenage mothers was 17 percent. Pregnancy rates among women with incomes less than 150 percent of poverty level were nearly twice as high as rates among women who had incomes above that level--21 percent vs. 11 percent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

[Assessment of orthopedic and sonographic hip examinations in the first days after birth based on research conducted in neonatal units and outpatient clinics].

The authors evaluated conformity between clinical and sonographical examinations in diagnosis of developmental dysplasia of the hip (DDH). The research was conducted on two groups of children: 750 newborn in neonatologic ward and 897 babies examined in outpatient clinic. The clinical signs of DDH was confirmed in 181 hips (12%) in the first group. The abnormality was sonographically detected only in 6 hips (0.4%). In the second group the orthopedic examination showed the signs of DDH in 101 hips (5.6%) and sonographic signs of DDH appeared in 54 hips (3%). It seems that clinical examinations of hip joints in newborn in the first days of life provides to many falsely positive diagnosis of DDH. Probably proper care spontaneously leads to normalization of the morphology of newborns' hip joint and eliminates the necessity of the treatment with the usage of abduction devices. Screening examination of newborn performed by neonatologist and the verification of such examinations conducted by the orthopedic surgeons in outpatient clinic seems to be the mean efficient enough in the prophylaxis of DDH.

Ambulatory Care Facilities↗
PubMed1994

The second-born twin: can we improve outcomes?

OBJECTIVE: Second-born twin outcome was compared with that of the first-twin birth mate to determine whether there were differences, the reason for the differences, if any, and the clinical decisions that could be made to eliminate or ameliorate these differences. STUDY DESIGN: Twin pregnancies from 1989 through 1992 were retrospectively reviewed. Charts demonstrating both twins stillborn, either twin weighing < 500 gm, or either twin with a serious congenital anomaly were excluded from evaluation. After these exclusions 200 twin pairs remained for analysis. Each twin was compared directly with its birth mate. The first twin is postulated as having the best possible outcome for the pregnancy involved, and second-twin outcomes are compared with these. RESULTS: The second-born twin was more likely to be intubated, have respiratory distress syndrome, need resuscitation, and have lower 5-minute Apgar scores. Second-born twins had more nursery complications. The < 1500 gm group appeared to be at special risk. In this group there were more second-born twin neonatal deaths and much higher rates of intubation and resuscitation. Nonvertex presentation in the second-born twin increased chances for resuscitation, intubation, respiratory distress syndrome, and nursery complications. These outcomes in the second-born were not affected by cesarean delivery. CONCLUSIONS: The second-born twin is at increased risk of untoward outcome compared with its birth mate. Some of this risk can be attributed to birth weight. The risk posed by nonvertex presentation is small. Cesarean section delivery does not appear to eliminate the difference between first- and second-twin outcome. Prospective studies are needed.

Birth Order↗
PubMed2000

Does the duration of postnatal stay influence breast-feeding rates at one month in women giving birth for the first time? A randomized control trial.

The aim of the study reported in this paper was to examine the effect of postnatal stay on breast-feeding rates at one month using a randomized control trial. Participants were recruited during parent-craft classes at a large teaching hospital in the north of England. Nulliparous women in the last trimester of pregnancy were randomly allocated to a short hospital postnatal stay (6-48 hours), or a longer stay (more than 48 hours). The mothers were contacted at one month following the birth to ask about the method of feeding. The study was approved by the hospital ethical committee, and participation was voluntary. The results demonstrated no significant effect of postnatal stay on breast-feeding rates at one month. The main limitation of the study was the reluctance of the mothers in the long stay group to stay in hospital for longer than three days. This resulted in only a small difference between the lengths of hospital stay of the two interventions. The overall breast-feeding rate for the study group had increased significantly when compared with local city wide rates. This increase may be as a result of a sampling bias or a Hawthorne effect.

Breast Feeding↗
PubMed1981

A prospective cohort study of oral contraceptives and breast cancer.

In 1970 a questionnaire was sent to 97,300 married women aged 25-50 years residing in eastern Massachusetts information was requested on use of oral contraceptives (OC), education, and gynecologic and reproductive histories. Subsequent questionnaires were sent in 1973 and 1979 to a subset of the original cohort (37,000) to obtain recent information. Surveillance of 34 hospitals disclosed 622 cases of breast cancer among respondents diagnosed in a 6 1/2-year period. The rate ratio of breast cancer associated with any use of OC was 0.84 (95% confidence limits: 0.7, 1.1). Although certain subgroups users experienced significantly lower rates of hospitalization for breast cancer than did nonusers (including users aged 25-29, those for whom less than or equal to 5 yr had passed since first use, women with ages at birth of first child either before 25 or after 30, and women who first used OC after the birth of the first child), the risk of breast cancer OC after the birth of the first child), the risk of breast cancer was not consistently lower among users of OC. Among nulliparous women, the rate ratio associated with use of OC was 2.1 (0.9, 5.0).

Adult↗
PubMedDate not supplied

Effect of a combined GnRH/hCG therapy in boys with undescended testicles: evaluated in relation to testicular localization within the first week after birth.

Among 509 boys referred with undescended testicles, 112 had true undescended testicles unilaterally and 62 bilaterally. Patients with true undescended testicles were offered hormonal treatment unless the condition was associated with hernia or previous operations. Boys less than 5 years old were primarily treated with gonadotrophin releasing hormone (GnRH), while boys more than 5 years old were primarily treated with human chorionic gonadotrophin (hCG). If the effect of the primary treatment was insufficient the other hormone was given. Testicular descent was obtained for 64% (23/36) of the intraabdominally located testicles in boys with bilaterally undescended testicles versus only 14% (3/21) in boys with unilaterally undescended testicles (p < .001). Treating 1 to 4 years old boys with GnRH resulted in descent in 16 of 95 testicles and secondary treatment with hCG yielded an additional 34, whereas secondary treatment of 5 to 13 years old boys with GnRH added only 10 descended testicles to 51 of 101 testicles. Reading the maternity records of 272 of the boys support other studies showing that testicles may reascend. Boys with endocrinological or "surgical" causes of incomplete testicular descent were relatively more likely to have had one or two undescended testicles during the first postnatal week compared with boys found to have only retractile testicles (p < .001). Treatment with hormones resulted in descent in 56% of boys whose testicles were both descended within one week after birth. Conversely, only 1 of 20 boys with unilateral testicular undescent postnatally was sufficiently treated with hormones (p < .001). The hormonal effect in boys with bilaterally undescended testicles at delivery did not differ significantly from boys with either one or none undescended testicle postnatally. In 35 of 51 boys (69%) in whom the hormonal effect was insufficient, operation revealed a "surgical cause" of the incomplete testicular descent.

Adolescent↗
PubMed1990

[The absorption of colostral immunoglobulins in newborn piglets. I. Effect of time from birth to the first feeding].

The effects of a delayed onset of feeding on the absorption of intact immunoglobulins from the small intestines was investigated in newborn piglets by using an automatic device ("artificial sow"). Fasting periods extended to a maximum of 24 hours and were followed by 12 hourly allotments of 25 ml of sow colostrum. The concentrations of immunoglobulins G, A and M were analyzed in plasma samples drawn before and after the onset of feeding. The capacity for Ig-absorption was not impaired by the fasting. The same plasma levels of 12 and 18 hours after the onset of feeding were obtained in piglets fed immediately after birth as observed with individual variations in all experimental groups, for which we could find no explanation. Our results indicate, that the absorptive ability of the intestinal epithelia for immunoglobulins is not timed from birth but rather from the onset of feeding.

Animals↗
PubMed1990

Skin blood flow changes, measured by laser Doppler flowmetry, in the first week after birth.

Changes in forehead skin blood flow were determined in 17 healthy, term newborns, using a fiberless diode laser Doppler flow meter (Diodopp). Measurements were carried out three times on each infant, at postnatal ages of 16.8 +/- 7.4 h, 58.9 +/- 6.2 h and 121.5 +/- 14.2 h (mean +/- S.D.), respectively. Skin blood flow, respiration, heart rate and skin temperature were recorded simultaneously, while the newborns were asleep. During the recordings, the behavioural state of the newborns was observed and environmental temperature and humidity were kept constant. Postocclusive hyperaemia of the skin blood flow was obtained by pressing the laser Doppler probe against the skull for 30 or 60 s. The following parameters changed significantly between the first and third measurements (t-test for paired samples): the basal skin blood flow during active and quiet sleep decreased, the average decrease being 29.4% (P = 0.002) and 25.9% (P = 0.01), respectively; skin blood flow during postocclusive hyperaemia also changed: the time taken to reach maximum hyperaemia increased from 17.3 to 22.7 s (P = 0.01), while the halftime recovery increased from 46.1 to 57.1 s (P = 0.02). The changes in skin blood flow between the first and second measurements and between the second and third measurements did not reach the level of statistical significance.

Blood Flow Velocity↗
PubMed2000

Predicting preeclampsia in the second pregnancy from low birth weight in the first pregnancy.

OBJECTIVE: To evaluate the effect of low birth weight adjusted for gestational age in first pregnancies on preeclampsia in second pregnancies and to estimate the proportion of preeclampsia in second pregnancies attributable to histories of LBW for gestational age. METHODS: We conducted a cohort study based on linked data from the Medical Birth Registry of Norway, which covered all births in 1967-1992. RESULTS: Women who delivered infants under the third percentile birth weight were three times more likely to have initial or recurrent preeclampsia in second pregnancies than those who delivered infants at or above the tenth percentile. After adjusting for maternal age, year of birth, interpregnancy interval, education, chronic hypertension, diabetes mellitus, and change of partner, the increased risk persisted. Birth weight below the tenth percentile in the first delivery accounted for 10% of the total cases of preeclampsia in the second pregnancy and 30% of recurrent cases. CONCLUSION: A history of low birth weight adjusted for gestational age is associated significantly with subsequent occurrence as well as recurrence of preeclampsia. These findings are consistent with the hypothesis of a shared etiologic factor or recurrent pathophysiologic mechanism for preeclampsia and fetal growth restriction. A history of fetal smallness for gestational age is found in a substantial proportion of all cases of preeclampsia and thus seems to be important in the etiology of preeclampsia.

Adult↗
PubMed1981

Electrophoretic mobility profiles of mouse leukemias: I. Electrophoresis of normal mouse thymus and lymph node cell populations.

Anodic electrophoretic mobility of thymocytes and lymph node cells from random-bred ICR Swiss mice was examined. Three cell populations were identified which differed in their surface charge as reflected in their distinct mean AEM and in their time of appearance during the course of life. The first electrophoretically slow-moving population with a mean AEM of 0.97 microns sec-1 V-1 cm was detected in the early postnatal period. In the first month after birth, the first population was replaced by a second, slower-moving population with a mean AEM of 0.83 microns sec-1 V-1 cm. In the second month after birth, a third, fast-moving population with a mean AEM value of 1.24 microns sec-1 V-1 cm appeared in addition to the second cell population. The third population constituted only a minority of thymus cells and continued to be present, as well as the second cell population, up to two years of age. Lymph node cells of ICR mice showed a typical bimodal electrophoretic distribution; fast LNC displayed a mean AEM of 1.18 microns sec-1 V-1 cm whereas slow LNC that of 0.76 microns sec-1 V-1 cm. The percentage of cells in the fast- and slow-moving LNC subpopulations was similar to the expected percentage of T and B LNC. Fractionation of the ICR LNC on nylon wool columns revealed that the majority of the fast-moving LNC corresponded to the nonadherent Thy 1.2+ lymphocytes and the majority of the slow-moving LNC to the nylon wool-adherent sIg+ lymphocytes.

Animals↗
PubMed1988

Selective fertility and the distortion of perinatal mortality.

Data from the Medical Birth Registry of Norway, covering more than one million births for the period 1967-1984, were used to study the magnitude and effects of selective fertility, which is the tendency for a woman to replace a perinatal loss. Variation in fertility after the first three births is studied, controlling for perinatal outcome of previous births, maternal age, and year of birth. Even after the first birth, fertility is higher after a perinatal loss. Selective fertility is more strongly present at each successive birth order, and at each birth order it is stronger among older women. As the average number of births per woman decreases, the force of selective fertility increases; that is, its importance has increased over time. Perinatal mortality at the third and fourth birth orders is particularly distorted by the mechanism of selective fertility in studies based on cross-sectional data. Mortality at second birth is exaggerated by 1%, at third birth by 8% to 20%, and at fourth birth by 18% to 27%, with the largest effects seen in the later periods. A major portion of the increase in perinatal mortality from the second to fourth birth seen in most studies based on cross-sectional data can be explained by the mechanism of selective fertility.

Adult↗