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PubMed2006

Trends in female circumcision between 1933 and 2003 in Osun and Ogun States, Nigeria (a cohort analysis).

The international movement against female circumcision gained momentum in the past two decades. Although recent studies report decline in the practice none has studied the cohort effect or provided plausible explanation for such decline. Changes in female circumcision occurring in two southwestern States of Nigeria between 1933 and 2003 were tracked in a cross-sectional survey using cohort analysis. 1174 female live births to 413 women were included in the analysis. About fifty-three percent of all females were circumcised. The prevalence dropped from 64.9% during the period 1933-60 to 25.7% for the period 2000-2003. For first order births, the corresponding rates were 58.8% and 25.0%. The decline for first-born females comes a decade before other birth orders. Age and education of mother are two main factors of the decline. Global consensus or legal enforcement plays secondary roles. Understanding how modernisation affects the decline in female circumcision should receive greater attention.

Age Factors↗
PubMed1989

Down syndrome at birth not detected by first-trimester chorionic villus sampling.

A case of a false-negative first-trimester diagnosis following chorionic villus sampling is reported that ended with the birth of a child with Down syndrome. Chromosome analysis of 30 metaphases from 24 h-cultured chorionic villi obtained in week 12 of gestation showed a normal chromosome constitution. However, the newborn showed manifestations of Down syndrome, and 99 of 100 metaphases analysed from cultured lymphocytes showed 47, XY, + 21. The remaining metaphase was normal (46, XY).

Chorionic Villi Sampling↗
PubMedDate not supplied

Factors influencing first intercourse for teenage men.

Analyses of a nationally representative survey of 1,880 15- to 19-year-old men were conducted to examine factors associated with (a) the age when first sexual intercourse occurred and (b) whether a condom or other contraceptive method was used at first intercourse. Discrete time-event history models assessed factors influencing their age until first intercourse. Black males began sexual activity significantly earlier than white or Hispanic males. Males who had been held back in school also began sexual activity earlier. If a respondent's mother had been a teenager when she first gave birth, or if his mother was employed during his childhood, he was more likely to initiate intercourse early. A variety of combinations of AIDS and sex education topics were examined for their association with one's age at the time of first intercourse: two topics were associated with earlier intercourse, and one was associated with delays in first intercourse. Logistic regression models examined correlates of using a condom or any effective male or female method of contraception at first intercourse: having received education about birth control was marginally associated with increased probability of using a condom or any effective male or female contraceptive method at first intercourse. These findings indicate the relevance of integrated approaches to school-based sex and AIDS education in delaying intercourse and promoting use of contraceptive methods.

Adolescent↗
PubMed2001

The relationship between hematocrit and bleeding time in very low birth weight infants during the first week of life.

OBJECTIVES: The bleeding time is a measurement of platelet and capillary interaction following a small standardized cutaneous incision. In adults, anemia causes a prolongation of the bleeding time, and we hypothesized that the same would be true in very low birth weight (VLBW) infants during their first week of life. STUDY DESIGN: Template bleeding times, using the Surgicutt Newborn device, were performed on 20 VLBW weight infants 0.28 l/l had no significant reduction in bleeding time following transfusion. CONCLUSIONS: In VLBW infants, during their first week of life (the time when their risk of intraventricular hemorrhage is greatest), a low hematocrit is associated with a significant prolongation in the bleeding time.

Bleeding Time↗
PubMed1989

Physical growth of Swiss children from birth to 20 years of age. First Zurich longitudinal study of growth and development.

Physical growth from birth to adulthood in healthy Swiss children born 1954-1956 is described. The data are based on the First Zurich Longitudinal Study in which 137 individuals of each sex have been followed from birth to adulthood between 1954 and 1976. Distance standards of 20 anthropometric measurements such as weight, height and head circumference are presented as mean values and standard deviations or as median values (for weight and skinfold thickness) with smoothed empirical centiles. Velocity standards are provided for seven anthropometric parameters. The following standard growth charts for clinical use are presented: weight, length/height and head circumference in the perinatal period, in the age range of 0-48 months and in the age range of 1-18 years (including some data on puberty), as well as weight for length/height and height velocity (cross-sectional and peak height centered). Comparison of the growth standards with those of previous Swiss studies and of recent foreign studies revealed only minor differences. Various aspects relevant for the clinical use of growth standards, such as measurement error or secular trend, are discussed.

Adolescent↗
PubMed2005

Physical activity and breast cancer incidence in middle-aged women: a prospective cohort study.

Many reports suggest that physically active women have a somewhat lower breast cancer incidence than physically inactive women. We hypothesized that indices of physical activity are associated inversely with breast cancer incidence after adjustment for confounders. The sample comprised 7994 women, aged 45-64, who participated in the Atherosclerosis Risk in Communities (ARIC) Study. Baseline physical activity was assessed by the Baecke questionnaire. Over an average follow-up of 13.1 yrs, 342 incident breast cancer cases were ascertained. After adjustment for age, race, study center, age at first live birth, age at menopause, and family history of breast cancer in a first-degree relative, there was no statistically significant association of breast cancer incidence with baseline physical activity levels for leisure, sport or work indices. Compared with the lowest quartile of physical activity, women in the highest quartile had a multivariate-adjusted hazard ratio (HR) of 1.00 (95% confidence interval (CI)=0.64-1.54) for the leisure index, 1.31 (95% CI=0.87-1.96) for the sport index and 0.87 (95% CI=0.61-1.24) for the work index. Our findings do not corroborate the majority of previous reports, which implicated physical inactivity as a risk factor for breast cancer.

Aged↗
PubMed2000

Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly?

In this paper, we review the evidence bearing on socio-economic disparities in pregnancy outcome, focusing on aetiological factors mediating the disparities in intrauterine growth restriction (IUGR) and preterm birth. We first summarise what is known about the attributable determinants of IUGR and preterm birth, emphasising their quantitative contributions (aetiological fractions) from a public health perspective. We then review studies relating these determinants to socio-economic status and, combined with the evidence about their aetiological fractions, reach some tentative conclusions about their roles as mediators of the socio-economic disparities. Cigarette smoking during pregnancy appears to be the most important mediating factor for IUGR, with low gestational weight gain and short stature also playing substantial roles. For preterm birth, socio-economic gradients in bacterial vaginosis and cigarette smoking appear to explain some of the socio-economic disparities; psychosocial factors may prove even more important, but their aetiological links with preterm birth require further clarification. Research that identifies and quantifies the causal pathways and mechanisms whereby social disadvantage leads to higher risks of IUGR and preterm birth may eventually help to reduce current disparities and improve pregnancy outcome across the entire socio-economic spectrum.

Canada↗
PubMed1996

Dairy operation management practices and herd milk production.

A national US survey collected data on herd milk production and management of Holstein herds. Step-wise selection identified management practices that were related to herd milk production using only operations that calculated herd milk production as well as using data from all operations. Results were similar. Milk production was highest in the West. Operations with < 100 dairy cows had lower production than did larger operations. Operations with > 25% registered cattle had higher production than operations with no registered cattle. Dairy operations that reported a mean BW > 545 kg at first calving had higher mean milk production than operations with a mean BW < or = 545 kg at first calving. Operations that reported mean age at first calving < 27 mo had higher mean milk production than operations with a mean age > or = 27 mo at first calving. In addition, use of the following management practices was associated with higher rolling herd average milk production: calves born in individual areas in buildings, calves hand-fed first colostrum, starter grain fed to preweaned calves, ionophores fed to heifers from birth to first calving, DHIA record-keeping system used, computerized records, and no new cattle introduced in the previous 12 mo.

Animal Feed↗
PubMed1989

Blood pressure in low birth weight infants in the first eleven weeks of life.

The enhanced diagnostic significance of blood pressure during the earliest period of human life is already well known. The present study, performed in the Special Care Unit for Preterm Infants, First City Hospital, Sofia Bulgaria, concerns a longitudinal follow-up of blood pressure values of 400 newborn low birth weight infants who were appropriate and small for their gestation age during the first eleven weeks of life. A steady increase in blood pressure was observed, which advanced with maturity and age of the preterm infants, particularly for systolic blood pressure. Some changes in blood pressure also progressed after intravenous infusion of bioproducts such as plasma and packed erythrocyte cells. There is a relation between systolic blood pressure prior to and after transfusion. The information available so far in almost all literature sources covers the first days and weeks. Here, the first data concerning the initial eleven weeks of human life are presented.

Age Factors↗
PubMed2005

Intraventricular haemorrhage in very-low-birthweight preterm infants: association with low prothrombin activity at birth.

AIM: To determine the occurrence of intraventricular haemorrhage (IVH) and its association with coagulation factors at birth in preterm neonates born before 30 wk gestation. METHODS: 38 neonates (median gestational age 27 wk, range 24-29 wk; median birthweight (BW) 933 g, range 515-1760 g) admitted to the neonatal intensive care unit were studied. Blood samples for coagulation factors were taken within 2 h after birth. The first cranial ultrasonographic examination was performed within the first 3 d. The occurrence of IVH was tested statistically by the Mann-Whitney U-test for association with the activity of coagulation factors and clinical variables. RESULTS: Thirteen IVHs occurred within the first 3 d of life. IVH was associated with BW <1000 g (p=0.012), low mean blood pressure within the first 2 d (p=0.026), gestational age <27 wk (p=0.054), low Apgar scores (<7) at 1 min (p=0.078) and intrauterine growth restriction (p=0.072). At birth (samples drawn with a median of first 36 min of life), infants with subsequent IVH had statistically significantly lower prothrombin (factor II) activity (p=0.024) than infants without IVH. CONCLUSION: The measured low prothrombin may have been affected by a prior bleeding event. Nevertheless, preterm infants with low prothrombin activity may be susceptible to IVH, or to the progression of it, if left undiagnosed.

Cerebral Hemorrhage↗
PubMed1988

Effect of creep partitions on teat-seeking behavior of newborn piglets.

In the first of two studies on teat-seeking behavior of newborn pigs, latencies from birth to first mammary contact (LMC) and to first suckle (LS) were recorded by live observation (n = 66). LMC accounted for 66% of LS and variances were similar between these two measures, suggesting that LMC is a good predictor of time to first suckle. In a second experiment, 32 litters of pigs were farrowed in crates equipped with either solid, vertically slatted, horizontally slatted or diamond mesh creep partitions. Piglet behavior following parturition was recorded via time-lapse videotape. LMC was determined for each piglet and movements were plotted for four focal pigs/litter. Partition type did not affect LMC (mean = 34 min). LMC was significantly affected by number of littermates present during teat-seeking (P less than .001), birth order (P less than .001) and frequency of position changes by the sow (r = .26, P less than .01). Neither sex nor birth weight affected LMC on a within-litter basis, but across litters smaller pigs had greater contact latencies (r = -.38, P less than .001). Partition type did not affect distance traveled or time spent in contact with the sow, in contact with the creep partitions,, free standing or the total of these. LMC was positively correlated (P less than .05) with contact time with the sow (r = .34) and time behind the sow's back (r = .38) and negatively correlated with time spent free standing (r = -.35, P less than .05) and in contact with the sow's rear legs (r = -.29; P less than .10).

Animals↗
PubMed1997

Influence of respiratory distress syndrome on body composition after preterm birth.

AIM: To observe changes in body composition during the first week after birth, in preterm neonates with and without respiratory distress syndrome (RDS), so as to be able to provide optimal fluid and energy intake. METHODS: Twenty four babies with RDS and 19 healthy preterm babies, with gestational ages ranging from 26-36 weeks, were studied daily for the first week after birth. Total body water (TBW) was measured using bioelectrical impedance analysis. The babies were weighed daily and a record made of fluid and energy intake. Body solids were calculated as the difference between body weight and TBW. RESULTS: There was a highly significant reduction in body weight by the end of the week, with the RDS babies losing more than the healthy babies (RDS 7.6%; non-RDS 3.7%). There was no significant difference in the amount of TBW at birth in the babies with and without RDS (RDS 85.1%; non-RDS 85.5%) and both groups lost the same amount of body water (RDS 10.9%; non-RDS 9.9%) by the end of the first week. The amount of total body water lost was unrelated to the volume of fluid administered. There was a loss of body solids during the first day in the RDS group, but, overall, there was a highly significant increase in both groups between birth and day 7, which was greater in the healthy babies (RDS 13.0%; non-RDS 42.7%). CONCLUSIONS: Loss of body water after birth occurs to the same extent in healthy preterm neonates and in babies with RDS and is unrelated to the volume of fluid administered. Given adequate nutritional support, an increase in body solids can accompany early postnatal weight loss and begins almost immediately after birth, in both healthy preterm babies and babies with RDS.

Analysis of Variance↗
PubMed1997

Longitudinal study of plasma cortisol and 17-hydroxyprogesterone in very-low-birth-weight infants during the first 16 weeks of life.

There are few published data on plasma cortisol and 17-hydroxyprogesterone (17-OHP) in very-low-birth-weight (VLBW) infants beyond the 1st week of life. We therefore measured plasma cortisol and 17-OHP longitudinally in 26 infants (median birth weight 930 g, median gestational age 28 weeks) from 1 to 16 postnatal weeks to document normative values. We also examined the effect of clinical state on plasma cortisol and 17-OHP levels. Median plasma cortisol decreased with postnatal age from 1 to 8 weeks (110 vs. 60 nmol/l; p = 0.0007) and with postconceptional age from 25 to 36 weeks (104 vs. 47 nmol/l; p = 0.002). Median plasma 17-OHP decreased with postnatal age from 1 to 16 weeks (17.0 vs. 7.1 nmol/l; p < 0.0005) and also with postconceptional age from 25 to 42 weeks (21.1 vs. 7.1 nmol/l; p < 0.0005). Plasma cortisol was not influenced by the clinical state. Median plasma 17-OHP was significantly higher for 'unwell' versus 'well' infants at 5-8 weeks postnatal age (23.0 vs. 12.5 nmol/l; p = 0.012) but not at other postnatal age intervals. These data provide information on adrenocortical function in VLBW infants during the first 4 months of life.

17-alpha-Hydroxyprogesterone↗
PubMed2006

Management of hypotension and low systemic blood flow in the very low birth weight neonate during the first postnatal week.

Systemic hypotension during the first postnatal week is associated with increased mortality and morbidity in the very low birth weight (VLBW) neonate. Hypotension is generally defined as blood pressure below the fifth percentile of the gestational- and postnatal-age dependent blood pressure norms. Recent studies indicate that in most VLBW neonates, cerebral blood flow autoregulation is indeed lost when blood pressure reaches the fifth percentile. Treatment of the circulatory compromise should address the primary pathogenic factor(s) of the condition (hypovolemia, myocardial compromise, failure of vasoregulation or a combination of factors). Recent findings also suggest that vasopressor resistance can be treated with a brief course of low-dose hydrocortisone. However, due to the short- and potential long-term side effects of early hydrocortisone treatment, its use should be restricted to neonates with vasopressor-resistant hypotension. Finally, concomitant administration of hydrocortisone with indomethacin should be avoided due to the increased incidence of gastrointestinal perforations.

Adrenergic beta-Agonists↗
PubMed1994

[Development and differentiation of macrophages and their related cells].

In murine, macrophages and their related cells are classified into monocyte-derived macrophages, resident macrophages, Ly-1(CD5)-positive macrophages, and dendritic cells. Monocyte-derived macrophages are terminal cells of the mononuclear phagocyte system, differentiate from monocytes which develop via promonocytes from monoblasts in bone marrow, and possess no proliferative capacity under a normal steady state. Monocytic cells first develop in hepatic hematopoiesis in ontogeny and are produced in bone marrow after birth. Monocytes first appear in peripheral blood in the late stage of ontogeny and are constantly produced in the bone marrow throughout adult life. Resident macrophages have a proliferative potential, can be sustained by self-renewal, and are suggested to be derived from colony forming unit-granulocyte/macrophages (CFU-GM) or earlier precursor cells, bypassing the stage of promonocytes and monocytes. In ontogeny, the resident macrophages differentiate from primitive/fetal macrophages which develop in blood islands of the yolk sac. The primitive/fetal macrophages precede the development of monocytic cell series, are distributed into embryonic tissues after the combination of the vitelline vessels to the fetal cardiovascular system, and are circulating in peripheral blood in the early stage of ontogeny. Ly-1-positive macrophages are a minor population residing in the peritoneal cavity, develop in the milky spots, and are suggested to be derived from precursor cells common to those of Ly-1 B cells. Dendritic cells are classified into two major groups; B cell-associated dendritic cells (follicular dendritic cells) and T cell-associated dendritic cells (Langerhans cells, interdigitating cells, veiled cells).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1998

First-trimester growth and the risk of low birth weight.

BACKGROUND: Previous studies have demonstrated a correlation between first-trimester size and birth weight. It is not known, however, whether low birth weight is related to first-trimester growth. We sought to determine whether the risk of low birth weight and birth weight that was low for gestational age is related to the size of the embryo or the fetus in the first trimester. METHODS: From a data base of ultrasound records of more than 30,000 pregnancies, we identified women who had no important medical problems, a normal menstrual history, and a first-trimester ultrasound scan in which the crown-rump length of the embryo or fetus had been measured. We examined the relation between the outcome of 4229 pregnancies and the difference between the measured and the expected crown-rump length in the first trimester, expressed as equivalent days of growth. RESULTS: A first-trimester crown-rump length that was two to six days smaller than expected was associated with an increased risk (as compared with a normal or slightly larger than expected crown-rump length) of a birth weight below 2500 g (relative risk, 1.8; 95 percent confidence interval, 1.3 to 2.4), a birth weight below 2500 g at term (relative risk, 2.3; 95 percent confidence interval, 1.4 to 3.8), a birth weight below the fifth percentile for gestational age (relative risk, 3.0; 95 percent confidence interval, 2.0 to 4.4), and delivery between 24 and 32 weeks of gestation (relative risk, 2.1; 95 percent confidence interval, 1.1 to 4.0), but not with delivery between 33 and 36 weeks (relative risk, 1.0; 95 percent confidence interval, 0.7 to 1.5). CONCLUSIONS: Suboptimal first-trimester growth may be associated with low birth weight, low birth-weight percentile, and premature delivery.

Birth Weight↗
PubMed1993

Maternal age at first childbirth and risk of low birth weight and preterm delivery in Washington State.

OBJECTIVE: To study the consequences of delayed first childbearing in a large, population-based US sample, with separate analysis of women aged 40 years or more and adjustment for socioeconomic factors, smoking, medical and reproductive conditions, and route of delivery. DESIGN AND SETTING: Retrospective survey of Washington State birth certificates from 1984 through 1988. SUBJECTS: First liveborn singleton infants of women aged at least 20 years. Of eligible white infants, all those born to women aged 35 to 39 years (n = 4019) and 40 years or more (n = 410) and a maternal age-stratified random sample of white infants of younger women were studied. All eligible black infants were studied. OUTCOME MEASURES: Low (< 2500 g) and very low (< 1500 g) birth weight and preterm delivery (< 37 weeks of gestation). RESULTS: Adjusted odds ratios for delivering a low-birth-weight white infant increased progressively with each 5-year maternal age group, reaching 2.3 (95% confidence interval, 1.6 to 3.4) for women aged 40 years or more compared with those aged 20 to 24 years. The maternal age effects for very low birth weight and preterm delivery were similar; for each, the odds ratio was 1.8 for the oldest group. No significant maternal age effect was found among births of black infants, but only 127 births to women aged 35 years or more were studied. CONCLUSION: Increasing maternal age at first childbirth is an independent risk factor for low birth weight and preterm delivery of white infants in the United States.

Adult↗