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At least 1,243 records · Page 69Linked to original sources
PubMed2002

Growth pattern of low birth weight babies in the first year of life.

OBJECTIVE: The growth pattern of low birth weight (LBW) babies was studied prospectively in our hospital from September 1995 to august 1996. METHOD: Every baby <1.5 kg birth weight (B.Wt), every 2nd baby between 1.5 to 2 kg, every 6th baby between 2 to 2.5 kg and 120 term appropriate for gestation (AGA) babies ( as controls) were included in the study. Severe birth asphyxia, multiple gestation, major malformations or severe birth trauma formed exclusion criteria. Weight, length and head circumference were measured in all babies at birth and at 2 monthly intervals till 1 year of age. All babies completing 1 year follow-up were included for final analysis. Growth distance curves were constructed separately for each parameter for the six categories based on birth weight (Groups I-VI) and on gestational age (Divisions A-F). Comparison was made between the LBW babies and the controls for growth pattern among the babies who completed 1 year follow up (total of 220 babies). RESULT: The growth pattern for weight and length showed good catch up growth in babies >1.25 kg B.Wt. and >30 weeks gestation, reaching almost the same level as controls by 1 year of age. Babies with B.Wt <1.25 kg and <30 weeks gestation showed late and poor catch up growth, with considerable lag persisting at 1 year of age. Head circumference increased rapidly in all babies, with maximal growth rate initially followed by a steady decline. All babies showed catch up growth, although those <1.25 kg and <30 weeks gestation still lagged behind even at 1 year. CONCLUSION: It was seen that the smallest and least mature babies had late and poor catch up growth. Recognition of the factors influencing catch up growth and adequate measures to improve growth (like attention to feeding practices) may improve the overall outcome of these babies.

Anthropometry↗
PubMed1975

Lung growth and alveolar multiplication.

As the lung grows in volume from infancy to adult life, considerable amounts of tissue are added to the lung, mostly as a result of alveolar multiplication. Species differences may exist: at birth alveoli are absent in mice and rats but alveoli are generally thought to be present in humans at birth. Alveolar multiplication is brought about by the subdivision of the primitive terminal units, primary pulmonary saccules, by secondary alveolar crests, and by alveolarization of nonalveolated and partly alveolated airways. The exact method of alveolar development and the relative importance of the above modes of alveolar growth are not known. In the first few days of life in rats and mice, there is a phase of dilatation of the lung, followed by a phase of rapid cellular and tissue proliferation. Subsequently, remodeling of the lung occurs, during which stage lung tissue increases little and dilatation is more prominent; this leads to stretching of the alveolar walls. Alveolar multiplication may occur throughout life in the rat. In human subjects, alveolar multiplication is most rapid in the first few years of life. After this, it appears to slow and perhaps stop by age 8 years, although there is some suggestion that alveolar multiplication may continue until somatic growth stops. Pneumonectomy produces enlargement and increase in tissue of the contralateral lung by virtue of cellular hyperplasia. Alveolar multiplication likely does not occur. Diminution of intrathoracic volumes produces small lungs which, in the human, may also have too few alveoli if the chest wall deformity has its onset in infancy or in intrauterine life. High altitude produces large, heavy lungs which may have more alveoli than normal.

Adolescent↗
PubMed1994

Comparison of perinatal outcome in rural Tanzania as obtained from a prospective community-based survey and hospital data.

The objective of this study was to measure perinatal mortality rate (PMR), percentage of low birth weight (LBW) and twinning rate, as obtained from a prospective community-based survey and hospital data. The community survey was performed in five villages in North-western Tanzania recruiting 447 pregnant women, while the study in the local District Hospital included 3,056 hospital deliveries. PMR was 68/1,000 in the community survey and 96/1,000 births in hospital. Stillbirths accounted for 81% of perinatal mortality in hospital as compared to 41% in the community-based survey. Percentages of LBW were 9.9 and 14.6 and twinning rates were 14/1,000 and 39/1,000 births in the community study and hospital, respectively. Perinatal mortality, low birth weight and twinning rates in hospital were higher than in the community survey. Estimations of perinatal outcome in hospital cannot be extrapolated to the community concerned.

Birth Rate↗
PubMed2002

Errors in birth registrations and coding of twins and higher order multiples.

Dizygotic compared with monozygotic conceptions are at decreased risk of fetal and infant death and serious morbidity in surviving infants. Different sex twin maternities must be dizygotic but miscoding and incorrect registration of sex and number of fetuses may lead to an incorrect assignment of zygosity. The aim of the study was to validate the coding and registration of number and sex of births in multiple pregnancies. Fetal and infant death registrations from all multiple maternities in England and Wales 1993-1998 were examined. There were 51,792 twin, 1627 triplet and 51 higher order multiple maternities that were registered. Among these there were 1926 fetal deaths, 58 of which were registered as being of indeterminate sex but were coded as male in 56 and female in 2 cases. A fetus papyraceous was registered as male in 19 and as female in 19 cases. Other fetal deaths weighing >/= 100g, with no mention of papyraceous on the death certificate, nevertheless, likely to be of indeterminate sex, were registered as male in 26 and as female in 23 cases. In 13 maternities, the number of infants registered at birth was less than the number mentioned on the registration certificate. It cannot be assumed that multiple births of different registered sex are dizygotic. As surviving infants from a monozygotic multiple birth are at much greater risk of infant death and serious morbidity than dizygotic multiple births, incorrect assignment of sex has important implications for parental counselling and may have medico-legal relevance when attributing negligence as the cause of morbidity in a survivor from a multiple pregnancy.

Birth Certificates↗
PubMed2004

Neurodevelopmental outcome of very low birth weight infants after multiple courses of antenatal corticosteroids.

OBJECTIVE: To determine if two or more courses of antenatal corticosteroids are associated with neurodevelopmental impairment. METHODS: All infants born at Northwestern Memorial Hospital between 1995 and 1998, who met the following criteria, were identified: birth weight < or = 1500 g, gestational age between 24 and 34 weeks, recipient of antenatal corticosteroids, and subsequent neurodevelopmental evaluation in multidisciplinary developmental evaluation clinic. The outcomes of these infants were compared according to degree of corticosteroid exposure. This study had 80% power to detect a difference in the mental development index score of 10% or a relative risk of neurodevelopmental delay of 2.5 in the group receiving at least two courses of corticosteroids. RESULTS: Ninety-three infants were exposed to less than two full courses and 33 infants were exposed to at least two full courses of corticosteroids. The mean duration of follow-up was similar in the two groups (25 months vs 30 months, respectively, P >.05). The two groups had similar neonatal outcomes, and had no differences in any measures of neurodevelopmental outcome on follow-up. CONCLUSION: Repeated courses of antenatal corticosteroids are not associated with increased incidence of abnormalities on subsequent neurodevelopmental outcome measures.

Adrenal Cortex Hormones↗
PubMed2004

Safety of birth centre care: perinatal mortality over a 10-year period.

OBJECTIVE: To study perinatal mortality in women booked for birth centre care during pregnancy. DESIGN: Retrospective cohort study. SETTING: In-hospital birth centre and standard maternity care in Stockholm. POPULATION: Two thousand and five hundred and thirty-four women (3256 pregnancies) admitted to an in-hospital birth centre over 10 years (1989-2000) and 126818 women (180380 pregnancies) who gave birth in standard care during the same period and who met the same medical inclusion criteria as in the birth centre. Multiple pregnancies were excluded. METHODS: Data were collected from the Swedish Medical Birth Register. Information on all cases of perinatal death in the birth centre group was retrieved from the medical records. MAIN OUTCOME MEASURE: Perinatal mortality. RESULTS: No statistically significant difference in the overall perinatal mortality rate was observed between the birth centre group and the standard care group (odds ratio [OR] 1.5, 95% CI 0.9-2.4), but infants of primiparas were at greater risk (OR 2.2, 95% CI 1.3-3.9). Infants of multiparas tended to be at lower risk, but this difference was not statistically significant (OR 0.7, 95% CI 0.3-1.9). These figures were adjusted for maternal age and gestation in multiple regression analyses. CONCLUSION: Birth centre care may be less safe for infants of first-time mothers.

Adult↗
PubMed1982

[Prematurity and placental insufficiency in twin pregnancies. Results during the care of multiple pregnancies at a center for premature births].

An analysis was made of 151 twin pregnancies, in 1975, 1978 and 1979, to study the effectiveness of obstetrico-neonatological attention to bigeminal pregnancies in a premature infant centre. -- Significant rise in early detection of bigeminal pregnancy due to much wider use of ultrasonic diagnosis and intensification of hospital treatment have drastically reduced the number of extremely immature twin births by delaying delivery to somewhere between the 34th and 36th weeks of gravidity. With the use of tocolysis nearly unchanged throughout the period of observation, change in average gestational age at birth should be interpreted primarily as the result of more long-time prepartum hospitalisation, with attention being offered for periods of more than three weeks. This conclusion was supported by unsatisfactory results regarding average gestational age and birth weight, following exclusive outpatient attention to women with bigeminal pregnancies. Improvement of foetal prognosis was found to depend primarily on proper therapeutic approach to prematurity. -- The authors' own experience differed from reports of other workers, in that the rate of hypotrophy declined in the wake of intensive prepartum care. Substantial reduction of the gap between average birth weights of first multiple foetuses and those of second multiple foetuses as well as declining differences between average birth weights of heavier twins, on the one hand, and those of less heavy twins, on the other, were recorded from all gestational age groups and attributed to improvement in intra-uterine care for all multiple foetuses due to intensified treatment. -- Significant rise in survival rates (after deduction of all foetal loss up to the 28th day of age) of all premature twins is considered an expression of increasingly improving life chances of twins, in general. It was based on growing numbers of highly immature survivors, but even more on significant rise in the number of premature survivors between the 34th and 36th weeks of gestation.

Birth Weight↗
PubMed1998

Retinopathy of prematurity: evaluation of risk factors.

OBJECTIVES: The purpose of this study was to determine what risk factors play a role in the development of retinopathy of prematurity (ROP). STUDY DESIGN: Data were collected on 157 infants born and cared for in one institution between January 1991 and July 1994. Initially we evaluated all children enrolled in the study to determine potential risk factors for the development of ROP. We subsequently compared multiple variables for ROP positive singletons with ROP positive twins to determine ROP risk factors for each group and to determine if one group was more susceptible to a given risk factor. RESULTS: Of the 157 infants examined, 72 infants (46%) developed ROP. Infants who developed ROP had a lower gestational age, a lower birth weight, a higher number of days on oxygen/ventilator, more days in the intensive care unit (ICU), a greater need for steroids and a higher incidence of sepsis when compared to infants who did not develop ROP. There was no significant difference noted between singleton and twin gestation infants that developed ROP when comparing gestational age, weight, ventilator time or length of ICU stay. Total number of days on oxygen therapy was higher in the singleton group and this difference did reach statistical significance. CONCLUSIONS: Several risk factors are associated with a higher incidence of ROP. These variables may not be independent risk factors but may be a sign of the increased severity of illness associated with those infants who are born earlier with a lower birth weight. Multiple gestational births do not appear to increase the risk of developing ROP when compared to a similar group of singleton birth infants.

Female↗
PubMed2002

Effects of antenatal glucocorticoids on outcomes of very low birth weight multifetal gestations.

OBJECTIVE: The purpose of this study was to test the hypothesis that benefits of antenatal glucocorticoids to reduce death or major morbidities are similar in very low birth weight multiple and singleton infants. STUDY DESIGN: Infants with birth weight of 401 to 1500 g who were born from May 1991 through December 1999 were evaluated with the use of the National Institute for Child Health and Human Development Neonatal Research Network registry data. The generalized estimating equations approach to multivariable logistic regression was used, with interaction between multifetal gestation and antenatal glucocorticoids as the primary independent variable. RESULTS: Mothers of multiple infants were more likely to receive antenatal glucocorticoids than mothers of singleton infants (66% vs 56%; P <.01). No interaction between multifetal gestation and antenatal glucocorticoids was noted for any study outcomes. The odds of death or major morbidity was decreased by antenatal glucocorticoids, advancing gestational age, increasing birth weight, female gender, and nonwhite race. CONCLUSION: If exposed to antenatal glucocorticoids, very low birth weight infants of multifetal gestations and very low birth weight singleton infants have similar risks of death or major morbidity.

Female↗
PubMed1988

Law No. 99 amending Law No. 49 of 7 April 1947 on working conditions, as amended, 26 December 1987.

This Law includes substantive provisions dealing with occupational health aspects of work by minors and women in Japan. Section 65 lays down, in particular, that an employer must not employ a woman for six weeks (or 10 weeks, in the case of a multiple pregnancy) before childbirth, if she requests leave during this period. An employer must not, except as indicated, employ a woman within a period of eight weeks following childbirth. A woman nursing an infant under one year of age is entitled to two nursing breaks a day, each for a period of at least 30 minutes. Under Section 68, an employer may not require a woman to work if she suffers from dysmenorrhea and requests leave for that reason.

Asia↗
PubMed2003

Mind the gap: bridge methods to allocate multiple-race mothers in trend analyses of birth certificate data.

OBJECTIVES: To examine the effects of proposed methods of redistributing multiple-race mothers to single-race categories when computing trend data from birth certificates. METHODS: Low birthweight and multiple (twin and higher-order) birth rates for California were calculated for non-Hispanic mothers from birth certificate data for 2000. Births to the 1.9% of mothers identified as multiple-race were reassigned to single-race groups according to 12 "bridging" methods. Bridge methods utilized population-based whole allocation, fractional allocation, and other methods, primarily depending on first race listed. RESULTS: For large race groups, there was little difference in low birthweight and multiple birth rates regardless of the bridge method employed. For smaller groups such as Native Hawaiians and other Pacific Islanders and American Indians/Alaska Natives, there was substantial variation by bridge method in observed rates. CONCLUSIONS: Tracking trends in birth outcomes across the change in data collection will challenge public health researchers. This paper outlines advantages and disadvantages of various bridge methods.

Adolescent↗
PubMed1998

Space-time clustering of multiple sclerosis cases around birth.

OBJECTIVES: To investigate whether infectious events around birth and during early infancy are likely to be of relevance in MS pathogenesis. SUBJECTS AND METHODS: Data are available from two regions in The Netherlands: Groningen (n=320) and Rotterdam (n=226). Simultaneous clustering in birth date and birth location of MS cases is tested by the methods of Mantel, Knox and Jacquez. RESULTS: No evidence was found for a space-time interaction between place and time of birth. CONCLUSION: Perinatal infectious events are unlikely to be a major factor in determining MS susceptibility.

Age Distribution↗
PubMed2001

Multiple-race mothers on the California birth certificate, 2000.

OBJECTIVES: Several data systems are beginning to allow respondents to report more than one race. Implications of multiple race reporting for the tabulation of race-specific birth characteristics are largely unknown. This analysis reports selected demographic characteristics and birth outcomes for multiple-race mothers, using California birth certificate data for 2000. DESIGN: Descriptive study of birth records. METHODS: Data were drawn from 530,305 electronically registered births. Demographics and birth outcomes were analyzed by race of mother for six multiple-race/ethnic groups with >300 births. RESULTS: 1.7% of mothers reported more than one race on the birth certificate. The most common multiple-race group reported was non-Hispanic Asian/White, followed by Hispanic/American Indian or Alaska Native/White. Characteristics varied widely among multiple-race subgroups, as well as between multiple-race groups and their single-race counterparts. For example, among multiple-race mothers, the proportion of births to teenage mothers was lowest among non-Hispanic Asian/White mothers (9%); this was significantly higher than percentages for non-Hispanic Asian or non-Hispanic White mothers (4% and 6%, respectively). CONCLUSIONS: Understanding the influence of multiple-race reporting on trends and comparisons in birth outcomes will be a challenge for public health researchers.

Adolescent↗