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At least 127 records · Page 7Linked to original sources
PubMed1999

Outcomes of post-term births: the role of fetal growth restriction and malformations.

OBJECTIVE: To evaluate the risks of adverse pregnancy outcomes among term and post-term small for gestational age (SGA) and appropriate for gestational age (AGA) births, before and after excluding infants with congenital malformations. METHODS: We did a population-based study of 510,029 singleton term (37-41 completed weeks) and post-term (at or after 42 weeks) births recorded in the Swedish Birth Register. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the risks of stillbirth, infant death, convulsions, meconium aspiration, and Apgar score less than 4 at 5 minutes. RESULTS: Among term births, 2.2% were SGA; among post-term births, 3.8% were SGA. Compared with term AGA births, term SGA births were at increased risk of stillbirth (OR 8.02; 95% CI 6.57, 9.80) and infant death (OR 7.57; 95% CI 6.39, 8.96). Among post-term SGA births, the ORs were 10.56 (95% CI 6.95, 16.05) for stillbirth and 5.00 (95% CI 3.04, 8.22) for infant death. When births with congenital malformations were excluded, the risk of infant death decreased considerably. Risks of convulsions and Apgar score less than 4 were higher in SGA than AGA infants. Post-term AGA infants had no significant increase in the risks of stillbirth or infant death but did have increased risks of convulsions, meconium aspiration, and Apgar score less than 4. CONCLUSION: The increased risk of stillbirth in post-term pregnancies is partly explained by an increased rate of SGA infants. The increased risk of death among SGA infants is caused to a large extent by congenital malformations.

Adolescent↗
PubMed2001

Birthweight, early environment, and genetics: a study of twins discordant for acute myocardial infarction.

BACKGROUND: Epidemiological studies that used birthweight as a crude marker of fetal growth have suggested that low birthweight is associated with increased risk of coronary heart disease. Through investigation of this association within same-sexed twin pairs, confounding by genetic and early environmental factors can be greatly decreased. We undertook a case-control study in twins discordant for acute myocardial infarction (AMI). METHODS: The case-control study was nested within the population-based Swedish Twin Registry and linked with the national cause-of-death and hospital-discharge registries. We manually retrieved birth records containing information on birth and maternal characteristics for 132 same-sexed twin pairs discordant for AMI and 118 individually matched control twin pairs. FINDINGS: In comparisons between AMI cases and external matched control twins, cases had significantly lower birthweight (mean 2556 [SD 500] vs 2699 [530] g, p=0.04), birth length (47.1 [2.8] vs 47.9 [2.7] cm, p=0.04), and head circumference (33.0 [1.8] vs 33.5 [2.0] cm, p=0.03) than controls. In within-pair comparisons between AMI cases and healthy co-twins, no significant differences in birth measurements were found (birthweight 2458 [510] vs 2534 [530] g, p=0.73; birth length 47.1 [2.8] vs 47.2 [2.8] cm, p=0.91; head circumference 33.0 [1.7] vs 33.0 [1.8] cm, p=0.92). INTERPRETATION: The lack of an association between birth characteristics and AMI within twin pairs suggests that previously reported associations may be influenced by genetic and early environmental factors, or possibly, by unmeasured maternal factors that operate independently of birthweight.

Birth Weight↗
PubMed2001

Birth weight and school-age disabilities: a population-based study.

Mortality rates have declined for low birth weight and extremely low birth weight infants. Yet, the consequences of survival for these children may be adverse developmental outcomes. Few studies to date have examined school-age outcomes for these children. The participants in this study represented a population-based cohort of Florida children who were born between 1982 and 1984 and who were receiving a public school education in 1996-1997. Linkage methodology was used to establish a cohort of 267,213 children aged 12-15 years with both birth certificate and school records. Birth weights were stratified into 500-g increments beginning with <or=999 g; 17% of the population had some school-identified disability. Risk ratios for specified school-identified disabilities increased as birth weight decreased for all birth weight strata of <or=3,499 g. Narrow increments of birth weights may better portray a more accurate estimate of risk for infants born at extremes than the conventional definition of <2,500 g.

Adolescent↗
PubMed2001

Audiologic aspects of the search for DFNA20: a gene causing late-onset, progressive, sensorineural hearing loss.

OBJECTIVE: The purpose of this research was to identify the gene responsible for a novel form of nonsyndromic, late-onset, bilateral, progressive, sensorineural hearing loss in a Michigan family of English descent. This report describes the audiologic aspects of the search. DESIGN: Fifty-eight members of the family served as subjects for the study. Family pedigree information was gathered from family interviews, family records, birth and death registration records and census data. Audiologic evaluation was used to describe the hearing loss (phenotype) and classify family members as affected or unaffected based on hearing status. These data then were used in a linkage analysis, a process in which the inheritance of a trait is compared with the inheritance of genetic markers and statistically significant associations are sought. RESULTS: The team mapped the hearing loss to the long arm of chromosome 17 at band 17q25. The pattern of inheritance is autosomal dominant. The search for the gene is continuing using a candidate gene approach. CONCLUSIONS: The hearing loss demonstrated by this mid-Michigan family is a novel form of nonsyndromic, genetic, late-onset, bilateral, progressive, sensorineural hearing loss. The locus of the gene, the 20th for autosomal dominant hearing loss, is at band 17q25 of chromosome 17.

Adolescent↗
PubMed1985

The heritability of smoking behaviour in pregnancy, and the birth weights of offspring of smoking-discordant twins.

Questionnaire information on smoking habits in pregnancy was collated in 341 monozygotic (MZ) and 321 dizygotic (DZ) female twin pair cases from a population-based Norwegian Twin Panel. In a multifactorial model, the intra-pair correlation in smoking was 0.797 (+/- 0.042) in monozygotic (MZ) and 0.443 (+/- 0.075) in dizygotic (DZ) twin pairs, indicating a substantial genetic influence on liability to smoke in pregnancy. The questionnaire information was linked with birth records in the Medical Birth Registry of Norway, and birth weights of offspring of 62 MZ and 100 DZ smoking-discordant twin pairs were studied. Offspring of smoking MZ twins weighed 127 g less than birth order matched offspring of the non-smoking co-twins. This finding is additional evidence that smoking is a direct cause of reduced birth weight in offspring.

Birth Weight↗
PubMed1991

Comparison of newborn screening records and birth certificates to estimate bias in newborn HIV serosurveys.

Implicit in the New York State Newborn HIV Seroprevalence Study is the assumption that newborns of all New York State residents are tested for human immunodeficiency virus (HIV) antibodies. We examined this assumption by describing that part of the 1988 New York newborn population not tested in the HIV seroprevalence study and assessing any bias contributed by this group. Of the expected total HIV specimens 1.5 percent were never received by the Newborn Screening Program, 0.5 percent were invalid specimens for which no repeat specimen could be obtained, and 1.7 percent were unsuitable or of insufficient quantity to be tested for HIV antibody. Thus 96.3 percent of all 1988 New York newborns were tested for HIV antibody. Black infants from New York City and low-birthweight infants were represented disproportionately among those not tested. Assignment of all untested newborn to HIV-positive status increased the seroprevalence rate 17 percent (0.64 percent to 0.75 percent).

Bias↗
PubMed1989

[Obstetric problems of newborn infants with a birth weight over 4,500 g].

Analysis of birth records of neonates a birth weight of 4,500 g or more (n = 83) has been made in order to compare the course of pregnancy and delivery to a normal birth weight of 3,000-3,500 (n = 100) among 14,193 newborns observed from 1983 to 1987 in Obstetric department of district hospital Berlin-Friedrichshain. On both groups mortality rate amounted to nil. Maternal morbidity is mainly caused by delivery injuries and postpartal atony. The perinatal morbidity which accounts for 7.2% is caused to increased acidosis rate (9.6%), complications of birth traumas such as shoulder dystocia (4.8%), fractures (2.4%) and paresis of nerve plexes (2.4%). The antenatal ultrasound assessment of fetal weight has been emphasized. Caesarean section is advised in cases of a fetal weight of 5,000 g, or more malpresentation and in a primipara with a history of previous caesarean section and with fetal weight more than 3,500-4,000 g. The problems of shoulder dystocia are being discussed.

Birth Weight↗
PubMed1987

Declining prevalence of anemia among low-income children in the United States.

To determine the anemia trends among low-income US children, hematologic measurements obtained from children aged 6 to 60 months who were enrolled in public health programs in six states that were consistently monitored by the Centers for Disease Control Pediatric Nutrition Surveillance System were studied. Overall, the prevalence of anemia has declined steadily from 7.8% in 1975 to 2.9% in 1985. The prevalence of anemia declined significantly among children seen at preenrollment screening visits, as well as those seen at follow-up visits, suggesting a generalized improvement in childhood iron nutritional status in the United States, as well as a positive impact of public health programs. To ensure that the declining trend of anemia was not a function of a change in the population of children enrolled in the surveillance system, Tennessee nutrition surveillance records were further analyzed; these records were linked with birth records to obtain detailed socioeconomic status (SES) information. Even though the SES composition remained stable from 1975 to 1984, the prevalence of anemia has declined significantly within each SES group. These findings indicate a true decline in the prevalence of anemia among low-income children that is likely the result of improvements in childhood iron nutrition.

Anemia↗
PubMedDate not supplied

Parental compliance with home apnea monitoring.

Until now, compliance with home apnea monitoring (HAM) has been assessed by parental recall. The availability of monitors with electronic memory allows a more objective evaluation of HAM. Fourteen premature infants discharged home from the hospital and receiving theophylline and 15 infants not receiving medication were studied. Medical and birth records, parent questionnaires, and 1 month of electronically recorded data were analyzed. Birth weights of the infants ranged from 850 to 2400 gm and gestational age from 26 to 34 weeks. Of 26 parents who recalled never leaving their infants unmonitored, 70% missed at least one night, 30% three or more. During the first month, treated infants were left unmonitored 21% of the days and 9% of the nights, and untreated babies were unmonitored 32% of the days and 15% of the nights. Average daily HAM use was 18 hours for treated and 16 hours for untreated (p = 0.19). Two weeks after discharge, the decline in use for treated babies was 5% (day and night), whereas for untreated infants the decrease was 20% during the day and 15% at night. Lead-related alarms occurred with similar frequency (one to two times per day) in both groups. Non-lead-related alarms were somewhat more frequent for treated (four times per day) than for untreated infants (twice daily). Parents' perception of the likelihood of severe apnea at the time of discharge influenced HAM use. Little risk prompted 13 hr/day use and moderate risk 16 hr/day, whereas great perceived risk resulted in 18 hr/day of monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)

Apnea↗
PubMed1999

Teenage pregnancies and risk of late fetal death and infant mortality.

OBJECTIVE: To estimate the effect of low maternal age on late fetal death and infant mortality and to estimate the extent of any increase in infant mortality attributable to higher rates of preterm birth among teenagers. DESIGN: Population-based cohort study. SETTING: Births recorded in the nationwide Swedish Medical Birth Registry. POPULATION: All single births to nulliparous women aged 13-24 years (n = 320,174) during 1973-1989. METHODS: Using information recorded in the medical birth registry, linked to a national education register, the effect of low maternal age on adverse outcomes was estimated using logistic regression analysis. MAIN OUTCOME MEASURES: Late fetal death, neonatal and postneonatal mortality and preterm birth. RESULTS: Compared with mothers aged 20-24 years, adjusted risks of neonatal and postneonatal mortality were significantly increased among mothers aged 13-15 years (odds ratios = 2.7 and 2.6, respectively) and among those aged 16-17 years (odds ratios = 1.4 and 2.0, respectively), while mothers aged 18-19 years had a significant increase in risk of postneonatal mortality only (odds ratio = 1.4). Rates of very preterm birth (< or = 32 weeks), according to maternal age, were: 13-15 years, 5.9%; 16-17 years, 2.5%; 18-19 years, 1.7%; and 20-24 years, 1.1%. The high rates of very preterm birth among young teenagers almost entirely explained the increased risk of neonatal mortality in this group. CONCLUSIONS: The increased risks of neonatal and postneonatal mortality among young teenagers may be related to biological immaturity. The increase in risk of neonatal mortality is largely explained by increased rates of very preterm birth.

Adolescent↗
PubMedDate not supplied

Annual and sub-annual rhythms in human conception rates. I. Effective correction and use of public record LMP dates.

Most studies of rhythms in human conception rates have used monthly total births back-dated 9 months. Such data are of little use for studying any pattern less than a few months in length. Even at that level, they are poor material for studying the possibility of altered conception rhythms in anomalous births. The high frequency of premature delivery in such births makes a simple 9-month offset simplistic and misleading. Dates of last normal menses (LMP) provide appropriate detail, but have generally been dismissed as unreliable. In a large public birth record dataset, we have identified a clear artifact of poor LMP recall, highly correlated with passage of time between conception and onset of prenatal care. The majority of the variation in daily LMP counts due to this recall artifact can be corrected statistically to yield population data suitable to more detailed analyses.

Female↗
PubMedDate not supplied

[Rate of prematurity and perinatal mortality in the Yaoundé (Cameroon) University Gynecologic Clinic 1982-1992> An analysis of 680 cases].

The authors made an analysis of perinatal mortality on 680 cases of premature births recorded between 1982 and 1992 in the CHU maternity, Yaoundé (Cameroon). During this period, 13,555 births were recorded. The frequency of premature births stood at 5%. The most important etiological factors responsible for these 680 premature cases were depicted as malaria infection and anemia (22.2%), premature rupture of the membranes (13%), multiple pregnancies (11.9%), preeclampsia (10.2%), antepartnal bleeding (5.7%), and urogenital infections (5.0%). The perinatal mortality rate was 16.7% (114 cases). There were 37 cases of antepartual foetal deaths (5.4%), 24 cases of intrapartual foetal deaths (3.2%) and 31 cases of neonatal deaths (4.5%). Perinatal mortality reduced with an increase in the gestation period and the weight of the foetus. The authors noted with astonishment that perinatal mortality was twice as high in cases of non ruptured membranes (19.5%) when compared to premature ruptures of the membrane (10.2%). A plus 30 minutes duration of the expulsion phase was estimated to be a factor that increases perinatal mortality. Breech presentation with a 32.8% perinatal mortality, when compared to cephalic presentation (7.5%), portrays an important risk factor in premature births. Perinatal mortality of premature babies in cases of spontaneous births is two time higher (16.2%) than in cases of caesarean section (7.8%).

Adult↗