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PubMed2005

A feeling of well-being accompanied by a period of prosperity and birthweight in Chile: a possible link?

The aims of the study were to describe the trend in birthweight from 1985 to 2000 in Chile and ascertain the possible factors that may explain the changes in birthweight during the period. We used time series of birthweight and length at birth of all live births (n > 4,000,000). Multivariable regression analyses were carried out to assess whether the gender of the newborn, maternal education, maternal age and marital status could explain the trend in the total time series and by period. Birthweight adjusted for gestational age was analysed in terms of grams and Z scores. There was an increase in birthweight of 100 g between 1989 and 1994 that coincided with the re-establishment of democracy and economic growth in Chile. The changes in birthweight were not explained by the available independent variables and trends of caesarean section, maternal obesity and post-mature deliveries over the period. The birthweight difference between mothers with university education and those with primary education was 0.2 Z scores (equivalent to 110 g) in 1985 and was greatly reduced by 2000 (equivalent to 40 g). A positive sense of social well-being and economic growth may have influenced an increase in birthweight between 1989 and 1994 as socio-economic growth preceded and continued after the period of increasing birthweight. Our study showed a remarkable decrease in the differences in birthweight by educational level not shown in other countries of similar wealth.

Adolescent↗
PubMed1966

[Aplasia of the umbilical artery].

A study was undertaken at St-François d'Assise Hospital, Quebec City, to determine the incidence of single umbilical artery. During a two-year period the umbilical cord was examined in 4138 consecutive deliveries. Thirty-three cases of aplasia of an umbilical artery were found, an incidence of 0.79%, which is almost identical to that reported in previous studies. Five of the 33 newborn infants with this vascular anomaly had other congenital malformations; this incidence of associated malformations is 10 times higher than that found in a control series. In studying the weight of the infants in relation to the period of gestation, it was found that many of the 33 infants with aplasia of the umbilical artery had a lower weight at birth than normal infants. The possibility that the absence of one umbilical artery might be responsible for intrauterine malnutrition is advanced by the authors.

Abnormalities, Multiple↗
PubMed1991

Epidemiological aspects of Mendelian syndromes in a Spanish population sample: II. Autosomal recessive malformation syndromes.

From April, 1976, to December, 1988, the Spanish Collaborative Study of Congenital Malformations (ECEMC) monitored a total population of 710,815 liveborn infants in 16 of 17 Spanish Regions and identified 14,439 (2.0%) with congenital defects. Among the malformed children, we identified 73 with well recognized autosomal recessive syndromes, for an overall prevalence rate of 10.3 per 100,000 livebirths and a total carrier frequency of 1/49. Considering the Spanish Regions (Comunidades Autónomas), we analyzed the geographical distributions of these syndromes that were homogeneous. We studied the place of birth of the grandparents to determine the distribution of the gene as well as the gene flow.

Abnormalities, Multiple↗
PubMed2002

Generalised infantile myofibromatosis with intracranial involvement: imaging findings in a newborn.

Infantile myofibromatosis is a disorder of infancy and early childhood characterised by single or multiple nodular lesions localised to bone, muscle, viscera, subcutaneous tissue or central nervous system. These pseudotumours contain smooth muscle and fibroblasts. The prognosis depends on the amount, as well as location, of the lesions. We present the radiological findings on plain films, US and MRI of a newborn who presented at birth with multiple organ involvement, including the CNS. To our knowledge, the comprehensive imaging features of such severe and multifocal involvement have not previously been reported.

Biopsy↗
PubMed2002

Motherhood and dental disease.

OBJECTIVE: To investigate whether motherhood is associated with tooth mortality, dental caries or destructive periodontal disease. DESIGN: An analytical cross-sectional study. SETTING: The Magomeni mother and child health clinic in Dar es Salaam, Tanzania. PARTICIPANTS: An age stratified total sample consisting of 500 mothers and pregnant women. Outcome measures Loss of a tooth, caries in a tooth or loss of periodontal attachment on a tooth. RESULTS: Controlling for current age and age at first child birth using multiple logistic regression and fitting cluster-specific models, no association was found between the number of children a woman had and loss of teeth [OR: 0.7-0.8 (95% CI: 0.3, 1.5)]. Nor was there any association with caries [OR: 1.0-1.1 (95% CI: 0.4, 1.9)]. Attachment loss among women having given birth to four or more children was, however more common than among women with fewer children [OR: 1.5-1.7 (95% CI: 1.0, 2.7)]. CONCLUSIONS: No evidence supporting the hypothesis that the more children a woman has the more teeth she loses was found. Nor was an association between the number of children and caries found. There may, however, be an association between motherhood and periodontal destruction.

Adult↗
PubMed2000

Arthritis prevalence and place of birth: findings from the 1994 Canadian National Population Health Survey.

This paper describes the prevalence of arthritis in Canadians by ethnic origin, including Asians, Europeans/Australians, and North American-born Canadians. Data for this study were derived from the 1994 Canadian National Population Health Survey, a cross-sectional survey with a sample of 39,240 persons aged 20 years and older. Arthritis was defined as a long-term health condition of "arthritis or rheumatism" diagnosed by a health professional. Place of birth was determined according to self-reported country of birth. Unconditional multiple logistic regression models were used to adjust for potential confounding effects. The crude prevalence of self-reported arthritis and rheumatism diagnosed by a health professional as a long-term condition for those aged 20 years and older in Canada was 14.2%. The age-sex adjusted prevalence by place of birth was 6.9% in Asians, 14.2% in Europeans/Australians, and 14.5% in North American-born Canadians. In the multivariate analyses using North America-born Canadians as baseline, the risk for arthritis (odds ratio = 0.56) was significantly lower in Asian-born Canadians after adjustment for age, sex, education, income, occupation, and body mass index.

Adult↗
PubMed1997

Hirschsprung-associated congenital anomalies.

Between 1976-1993, 302 patients were diagnosed to have Hirschsprung's disease (HD) in Hacettepe University Children's Hospital. All patients have been searched for the occurrence of associated anomalies and other parameters including 1) sex, 2) gestational age, 3) birth weight, 4) length of aganglionic segment, 5) familial occurrence, 6) consanguinity. Forty-nine of 302 patients were proved to have 83 associated congenital anomalies together with HD. Distribution of anomalies was as follows; central nervous system and special senses 28.92%, genitourinary system 26.51%, skeletal 24.09%, gastrointestinal 12.05%, cardiovascular 8.43%. In eleven patients more than one anomaly involving different systems were detected; only one of these patients was female and six of them have shown short segment disease. Down's syndrome was present in 5 patients. Female: male ratio was 1:4.2 for the whole series and 1:6 for the patients with Hirschsprung associated congenital anomalies (HACA). In the HACA group the percentage increased in favor of long-segment and extensive aganglionosis without statistical significance (p>0.05). The majority of patients were term babies and their birth weights were between 2500g < 3500g. Consanguinity was present in 36 families. No affected parents were detected but two sisters and four brothers were proved to have HD. Three pairs of twins, one of which was monozygotic, and all showing discordance were detected. There was no difference between HACA group and HD without HACA in terms of sex, birth weight, length of aganglionic segment and consanguinity. Although HD seemed to be genetically heterogeneous HACA did not have a genetically different origin from that of HD.

Abnormalities, Multiple↗
PubMed1989

Transient bullous dermolysis of the newborn: two additional cases.

Two cases of transient bullous dermolysis of the newborn are reported. The first patient, a white boy, had normal skin at birth, but multiple blisters soon developed. The oral mucous membranes were not affected. All lesions healed within 4 months without scars but with many milia. At the age of 17 months the boy was reexamined and was found to have no blisters or milia. The second patient, a Japanese baby girl, had extensive denudation of her hands at birth. Generalized blisters and involvement of the oral mucous membrane developed. Blistering stopped within 1 1/4 months, and all lesions healed without scars. Histologically the blisters were subepidermal in both cases. Some lesional basal cells contained periodic acid-Schiff-positive inclusions. Electron microscopy revealed collagenolysis, diminution or loss of anchoring fibrils, and stellate inclusions in dilated rough endoplasmic reticulum in the keratinocytes of the lower epidermis. These stellate inclusions consisted of filamentous bundles with 25 to 33 nm cross-striations.

Female↗
PubMed1989

Nosocomial sepsis in the neonatal intensive care unit.

During a 12-month study of the causes of and risk factors for nosocomial sepsis in a neonatal intensive care unit (NICU), we detected 23 episodes of nosocomial sepsis in 20 of the 155 infants at risk who were hospitalized in the NICU for at least one week. The associated mortality was 20%. Gram-positive organisms accounted for 15 (65%) of the episodes. Low birth weight, multiple gestation, and prolonged hospitalization were significant risk factors for nosocomial sepsis by univariate analysis; together, these three factors correctly predicted 80% of the infants with sepsis and 82% of the control subjects. By logistic regression analysis, however, length of stay was not a significant risk factor, but rather a confounding variable that was highly associated with birth weight. Analysis of risk factors for nosocomial sepsis showed that previous antibiotic therapy placed an infant at risk for candidemia; assisted ventilation was a risk factor for sepsis caused by group D Streptococcus and Candida albicans. Sepsis was related to infected or malfunctioning intravascular catheters in nine of the 20 infants with sepsis. Further investigation to determine strategies for preventing nosocomial septicemia in the low birth weight infant is warranted.

Analysis of Variance↗
PubMed1977

A case of focal dermal hypoplasia (Goltz syndrome) with some new aspects.

A case of Focal Dermal Hypoplasia (Goltz syndrome), diagnosed at birth, is reported. Some findings not formerly described (hemimelia, schizis of the palatum molle and the absence of one umbilical artery) are reported. Normal findings in chromosome studies with banding techniques are discussed.

Abnormalities, Multiple↗
PubMed1996

Statistical evidence for shared transient causes of anatomically distinct birth defects.

Certain pairs of anatomically distinct birth defects co-occur in the same baby more often than predicted under independence. Such an excess might reflects either the fact that some subpopulations of parents have inherently increased risk for both, or that certain pregnancies are at increased risk for both, even within the same couple, perhaps, due to transient exposures specific to the pregnancy. We focus on the latter possibility in the context of a large birth registry and two relatively common types of defects, by testing the null hypothesis that within sibships the two defects occur independently. Focusing on sibships where both defects occurred, we propose a test based on the total number of 'co-incidences', sibships where both occurred in the same baby. Such a test can be carried out either with or without allowance for possible dependence of risk on birth order. Applying this to club foot and sex organ defects among sibships from the Medical Birth Registry of Norway, we find strong evidence for excess within-family co-incidence, suggesting that there are shared, time-varying (hence perhaps modifiable) causal components in their aetiology.

Abnormalities, Multiple↗
PubMed2006

Blood pressure in non-critically ill preterm and full-term neonates.

The neonatal period is a time of extensive hemodynamic changes. It is expected that these changes are most prominent in premature infants during the first week of life. The aim of this study was to examine arterial blood pressure (BP) measured by an oscillometric device in the first month of life in a stable premature population admitted to our neonatal intensive care unit (NICU), and to evaluate the influence of gestational age, postnatal age, birth weight, gender, and sleep state on BP. This prospective study was conducted over 27 months. The study population consisted of 373 hemodynamically stable infants (292 preterm and 81 full-term infants). Overall 12,552 BP measurements were carried out using a non-invasive oscillometric blood pressure monitor. Both systolic and diastolic blood pressure progressively increased during the first month of life. BP increased more rapidly in preterm infants than in full-term infants, and was higher in groups with higher birth weight. Multiple regression analysis showed that mean BP during the first week and on the 30th day increased with gestational age, and also that it was higher in the awake than in the sleep state.

Birth Weight↗
PubMed2001

[Mortality in patients with esophageal atresia: influence of birth weight and cardiac anomaly].

BACKGROUND: Waterston's prognostic classification of esophageal atresia has been used in most hospitals throughout the world. A number of technical advances, mainly in neonatal intensive care units have contributed to a reduction in mortality. Although the Waterston classification continues to be widely used, increased survival in the highest risk groups in this classification has led to new classifications being described in the last few years. OBJECTIVE: To determine the influence of birth weight and cardiac anomaly on the outcome of patients with esophageal atresia. MATERIAL AND METHODS: The outcome of 100 infants with esophageal atresia was analyzed. The patients were divided chronologically into two groups according to advances in ICUs and surgical techniques: 45 patients treated in the first period (1971-1982) and 55 in the second (1983-2000). The influence of birth weight in the groups described by Waterston and Spitz and the association with cardiac malformation were compared between both periods. RESULTS: Mortality in the birth weight groups described by Waterston decreased significantly between periods but this decrease was lower when the birth weight groups at highest risk described by the Spitz (1,500 g) were compared. Survival in patients with esophageal atresia improved from the first period (57.8 %) to the second (80 %) but mortality was still high when an associated major cardiac anomaly was present (80 % vs 75 %). CONCLUSIONS: Although advances in the medical and surgical management of neonates have rendered birth weight less important to prognosis than previously, mortality continues to be high in patients with very low weight and major cardiac malformation.

Abnormalities, Multiple↗
PubMed1996

Influence of mode of delivery on twin births.

The mode of delivery and outcome in 158 twin births in a Nigerian sub-urban hospital are reviewed. Apgar scores at one minute were significantly higher for twin 1 compared to twin 2 in vertex deliveries only. There was no significant difference in Apgar scores at 5 minutes between the twins for the various modes of delivery. Apgar scores were generally higher for the controls (a set of singleton births) compared to twin births for all the modes of delivery except breech births. Birth weights were also significantly higher for controls compared to twin births although no significant difference occurred between the twins. Perinatal mortality rates were generally higher for twin 2 compared to twin 1, and for the twins compared to controls irrespective of mode of delivery. Better outcome could not be ascribed to any particular mode of delivery in twin births and would depend on the judgement and expertise of the labour attendant.

Apgar Score↗
PubMed1988

[Social and health care factors and perinatal mortality in Spain--ecological study].

The results of the multiple regression and correlation analysis between perinatal mortality and social and health care variables in Spanish provinces between 1975 and 1979 are presented. Although the perinatal mortality rates of Spanish provinces correlate significantly with a series of socioeconomic variables (family income available per capita, percentage of active population in primary sector, educational level of women at childbearing age) and health care variables (active obstetricians per 1000 live births and active pediatricians per 1000 live births), the multiple correlation and regression analysis has shown that the most important variable is the family income available per capita: 44% of the variability of perinatal mortality in Spanish provinces can be accounted for by this factor. By regression analysis, it is also possible to predict a decrease of 0.065 points in perinatal mortality for every additional 1000 pesetas in the family income available per capita.

Child Health Services↗
PubMed1975

Fetal effects of regular salicylate ingestion in pregnancy.

The babies of 144 mothers who took salicylates regularly in pregnancy are described. These babies had a significantly reduced birth-weight compared with controls; many of them had a raised cord-blood salicylate level but had no clinical evidence of bleeding or hypoglycaemia. Their perinatal mortality was increased, but the incidence of congenital anomalies was not significantly raised.

Abnormalities, Multiple↗
PubMed2003

Orofacial cleft malformations: associations with maternal and infant characteristics in Washington State.

BACKGROUND: To characterize the prevalence of orofacial cleft malformations and investigate variations in prevalence according to maternal and infant characteristics, we analyzed a cohort of 298,138 live births delivered between 1987 and 1990 to residents of Washington State. METHODS: Infants with cleft defects were identified using a statewide, population-based birth defects registry. Information on infant and maternal characteristics was obtained from Washington State birth certificates. Multiple logistic regression analysis was used to measure the association between potential risk factors and orofacial clefts. Cleft lip with or without cleft palate (CL +/- CP) and cleft palate (CP) were analyzed separately, depending on the presence or absence of other defects. RESULTS: We identified 608 infants with cleft defects. The prevalences of isolated and non-isolated CL +/- CP were 0.87 and 0.30 per 1,000 live births, respectively. The prevalences of isolated and non-isolated CP were 0.34 and 0.54 per 1,000 live births, respectively. Compared with mothers aged 25-29 years, mothers aged < 20 years were twice as likely to have an infant with isolated CL +/- CP (RR = 2.0; 95% CI 1.3, 2.9). Compared to white mothers, black mothers were more likely to have an infant with non-isolated CL +/- CP (RR = 2.8; 95% CI 1.2, 6.6). CONCLUSIONS: The prevalences of orofacial clefts in Washington State in 1987-90 were similar to those of other states. This study is among the first to report a greater relative risk for isolated CL +/- CP among the infants of mothers < 20 years compared to older mothers.

Birth Certificates↗
PubMed2006

Pattern and factors affecting management outcome of spina bifida cystica in Ile-Ife, Nigeria.

BACKGROUND AND OBJECTIVE: There is paucity of data on the pattern and factors affecting the management outcome of patients with spina bifida cystica in the Ife-Ijesa zone, Nigeria. This study was designed to address this research question. METHOD: One hundred and six consecutive cases of spina bifida cystica who presented in our hospital from January 1990 to December 2004 were reviewed. We obtained information on sociodemographic factors, medical history and management as well as clinical outcome. SPSS was used to analyze the data. RESULT: Males constituted 54.7% and females 45.2% of cases. Mortality was high in those presented after the 4th week of life (p = 0.04). The malformation occurred in the lumbar and lumbosacral regions in 77.4%. Myelomeningocele was the most common type (86.8%). Hydrocephalus was recorded in 53.8% of patients. Surgical closure was done for 91.5% of the patients. About 77% of all the patients were discharged while 22.7% died. This was significantly related to age at presentation (p = 0.04) and infection before surgery (p = 0.045). Postoperative complications were more frequent in patients with ruptured lesions (p = 0.025), a larger size of defect (p = 0.028) and a lower birth weight (p = 0.006). CONCLUSION: Myelomeningocele is the most common type of spina bifida cystica in our environment. Late presentation and preoperative infection are associated with high mortality in our patients.

Abnormalities, Multiple↗