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At least 19 recordsLinked to original sources
PubMed1992

Reinterpreting the effects of maternal smoking on infant birthweight and perinatal mortality: a multivariate approach to birthweight standardization.

Infants of women who smoke during pregnancy have lower birthweights and have been observed to have higher rates of perinatal mortality than infants of non-smokers. It is not clear whether this increased risk of mortality is due to an excess of small births among smokers or to an independent effect of smoking. Although infants of smokers have overall higher mortality rates than non-smokers, low birthweight (< 2500 g) infants of smokers have lower mortality rates than low birthweight infants of non-smokers. However, comparison of birthweight-specific mortality between two groups is problematic when there are differences in the birthweight distributions. Methods that have been developed to standardize for these differences by comparing mortality rates relative to their own mean do not allow for simultaneous control of confounding variables. Using data from over 13,000 births of women who participated in a prepaid health care plan we present a method to standardize for birthweight while adjusting for variables that may confound the relationship between maternal smoking and perinatal mortality. After controlling for race, maternal age, education, parity, and number of cigarettes smoked, we found that 85% of the increased mortality due to smoking was attributable to an excess of small births in the birthweight distribution of offspring of smoking mothers, while 15% was due to higher birthweight-specific mortality at almost all standardized birthweights. Contrary to previous reports, we found that low birthweight infants of smoking mothers are at higher risk of perinatal mortality if a population-specific standard for birthweight is used.

Birth Weight↗
PubMed1985

High maternal serum alpha-fetoprotein and low birthweight. A study concerning possible correlation between maternal weight, smoking, and serum alpha-fetoprotein and subsequent birthweight and gestational age.

Maternal serum alpha-fetoprotein (AFP) levels between 15 and 19 weeks gestation were studied in relation to birthweight, gestational age, maternal weight, and daily cigarette consumption in 1739 pregnancies. All infants were born after the 28th week of gestation and all were without neural tube defects. Gestational age was estimated by early measurement of the fetal biparietal diameter. High maternal serum AFP, low maternal weight, and the number of cigarettes smoked per day were found to correlate with low birthweight, but not with gestational age. By testing the influence of the individual parameters on the subsequent birthweight, no significant correlation was found between the AFP levels and birthweight. Low birthweight was mainly a result of cigarette smoking and low maternal weight. Screening for AFP in the second trimester, therefore, seems to be of no value in predicting low birthweight when maternal weight is taken into consideration.

Adult↗
PubMed1992

The contrasting effects of parental birthweight and gestational age on the birthweight of offspring.

Investigations on intergenerational effects on birthweight have been carried out using the data of the 1958 British National Birthday Trust Fund cohort and its follow-up to 23 years, the National Child Development Study (NCDS-4), which included information on all births to cohort members by that age. This report is directed particularly at ascertaining the independent effect of parental gestational age on babies' birthweight. The two main findings are a direct association between parental and offspring birthweight (significant for both mothers and fathers after allowing for confounding factors), but an inverse association with parental gestational age (significant only for the mothers). It is postulated that at least part of this effect is mediated through the association between maternal fetal growth rate and their babies' birthweight; the faster the rate the shorter the gestational age for a given birthweight. It was not possible to ascertain what part genetic factors played in this relationship. Larger and more informative intergenerational studies are needed to further knowledge on this question.

Adult↗
PubMed1977

Influence of folic acid on birthweight and growth of the erythroblastotic infant. I. Birthweight.

The birthweights of 100 infants with erythroblastosis were carefully matched as to sex, gestational age, and parity with the birthweights of 200 control infants born during the same period. At all gestational ages the average birthweight of the affected infants was below that of the controls, the average reduction being 227 g. The more severely affected infants tended to be at a lower centile for birthweight than were the mildly affected ones. The relationships between maternal serum folate, cord blood serum folate, and centile for birthweight among affected infants were also studied. There was a strong correlation between low maternal serum folate and the incidence of small-for-dates babies among the affected infants. There was also a strong correlation between maternal and cord blood serum folate values. There was a lack of correlation between maternal serum folate and cord blood haemoglobin. It is concluded that infants with erythroblastosis are lighter than controls and that the reason for this may be a shortage of folic acid available for fetal growth.

Birth Weight↗
PubMed1989

Delivery of the low birthweight and the very low birthweight breech: cesarean section or vaginal delivery?

We studied neonatal survival rates, APGAR scores, and length of hospital stay in 199 singleton breeches weighing 1000-2500 grams at birth. We found that in the birthweight range of 1000-1750 grams, breeches who were delivered by cesarean section had a significantly higher survival rate (74%) than those who were delivered vaginally (36%, p less than 0.01), however, in the birthweight range of 1751-2500 grams, there was no significant difference in the survival rates between breeches delivered abdominally and those delivered vaginally. The 1-minute and the 5-minute APGAR scores and the length of the hospital stay were not significantly different between the abdominal and the vaginal delivery groups in either birthweight range. The data indicate that the very low birthweight breech (less than or equal to 1750 grams) may benefit from a prophylactic cesarean section.

Apgar Score↗
PubMed1991

Development and validation of a simple device to estimate birthweight and screen for low birthweight in developing countries.

Low birthweight (less than 2500 g) is the major factor associated with the death of infants within the first 4 weeks of life. The mean birthweight of newborn babies of a certain geographic area reflects the quality of maternal and child health care service as well as the degree of socioeconomic development of that particular region. Hence, birthweight is being used increasingly as an indicator for health and socioeconomic planning. However, in a developing country such as Thailand, two-fifths of the babies are delivered at home and are not weighed because scales are not available. To solve this problem in rural areas, a circular nomographic chart was developed with which the birthweight can be computed from a newborn baby's chest and mid-arm circumferences. Preliminary trials comparing these charts with standard baby scales showed a high degree of accuracy with sufficient sensitivity and specificity.

Arm↗
PubMedDate not supplied

Very low birthweight and normal birthweight infants. A comparison of continuing morbidity.

One hundred and forty-eight (95.5%) of 155 consecutive two-year survivors of 227 very low birthweight (VLBW, less than 1501 g) infants and 50 (83.3%) of 60 infants of normal birthweight who were selected at random, all of whom were born at the Royal Women's Hospital, Melbourne from October 1980 to March 1982, were seen at the age of two years. Social, psychological and health data were compared between the groups. The mean Bayley Mental Developmental Index scores of VLBW children were significantly lower; the prevalence of major handicaps and poor growth (height and weight below the 10th percentile), and the number of hospital readmissions, wheezing episodes, major and minor congenital anomalies and postnatally-acquired malformations (for example, abnormally shaped skull) were significantly greater in VLBW children. There was a trend for a greater number of episodes of otitis media, lower respiratory tract infections and surgical procedures per child in VLBW children. Extremely low birthweight children (birthweight less than 1000 g) contributed significantly to this morbidity. Parents of VLBW children perceived significantly more problems with infant vomiting and behavioural disturbances at two years of age. The children of mothers of limited education, or immigrant status and non-fee paying or lower socioeconomic families had lower mean Bayley Mental Developmental Index scores but similar handicap rates and health status in both weight cohorts.

Child Behavior↗
PubMed1992

Normal birthweight at Port Moresby General Hospital: a retrospective survey of normal term births to determine birthweight distribution.

A retrospective survey was carried out of term babies born to Papua New Guinean parents at the Port Moresby General Hospital. Only babies of known gestational age from uncomplicated pregnancies who were delivered after 37 and before 42 completed weeks were included in the study. The purpose of the study was to determine the birthweight distribution at term of uncomplicated pregnancies for Papua New Guineans at the Port Moresby General Hospital. The sources of the data were the patients' case records and the labour ward register. The Epi Info V5 (CDC and WHO) statistical software package was used for the analysis. 404 subjects were studied; 116 of these were nulliparae before the index delivery. For the whole study population some of the findings were as follows: mean birthweight 3251g, standard deviation 403.5, mode 3100g, median 3250g, 10th percentile 2713g, 90th percentile 3750g. Birthweight at 41-42 weeks was significantly greater than at 37-38 completed weeks. The height and parity of the mother and sex of the baby also had significant effects on birthweight but the latest birth interval had no significant influence. Babies of highland mothers were significantly heavier than babies of Papuan mothers.

Age Factors↗
PubMed1991

Differential birthweights and the clinical relevance of birthweight standards in a multiethnic society.

Using a computer-stored database, birthweights and related variables over 25,000 infants born in Amsterdam (The Netherlands) were analysed retrospectively. Only after allowing for maternal height, did the difference between mean birthweights of Dutch and Asian infants disappear, whereas Negroid and Mediterranean infants continued to show respectively lower and higher means than the others. These results confirm that the birthweight standards presently used are inappropriate for detection of deviant weight in non-Dutch groups.

Birth Weight↗
PubMed1986

Neonatal mortality risk in relation to gestational age and birthweight. Results of a national survey of preterm and very-low-birthweight infants in the Netherlands.

In a cohort of 1338 very preterm and/or very-low-birthweight infants, representing 94% of all infants born alive after less than 32 weeks' gestation or weighing less than 1500 g in the Netherlands in 1983, the neonatal mortality rate was 233 per 1000. In these infants, the best obstetric estimate of gestational age was a better predictor of neonatal mortality than birthweight. In such pregnancies, careful obstetric assessment of gestational age seems to be a more accurate basis for clinical decisions and management than the expected birthweight.

Birth Weight↗
PubMed1989

International Collaborative Effort (ICE) on birthweight; plurality; and perinatal and infant mortality. II: Comparisons between birthweight distributions of births in member countries from 1970 to 1984.

Member states of the International and Collaborative Effort (ICE) are the United States of America, England and Wales, Denmark, Bavaria and North Rhine-Westphalia of the Federal Republic of Germany, Israel, Japan, Norway, Scotland and Sweden. The group has collected, analysed and compared distributions of birthweight for member countries, where available from 1970 onwards, for singleton and all livebirths, stillbirths, early and late neonatal and postneonatal deaths. The present paper is an account of the differences in birthweight distributions, and trends over time seen between and within countries, for livebirths and stillbirths. The major findings are the relative robustness over time of the parameters which characterize the distribution of birthweight within countries, and the marked and consistent differences between these distributions in different countries.

Birth Weight↗
PubMed1992

The association of maternal low birthweight and infant low birthweight in a racially mixed population.

The association between maternal low birthweight (LBW) and infant low birthweight has been explored in previous studies in mainly middle and upper income, Caucasian populations. This study investigated whether the association found in these populations is true in a racially mixed, low socio-economic group. A case-control methodology was used and estimates of association were derived by means of logistic regression analyses. Data were gathered for 167 LBW infant-mother dyads and 338 adequate weight infant-mother controls matched on race and parity. The odds of a LBW infant having a LBW mother were 80% more likely than for adequate weight infants (OR = 1.80, 95% CI 1.14-2.84). This association was stronger for Hispanic women and their infants than for Black or non-Hispanic White women and their infants. Women who were both preterm and LBW had the higher estimate of risk for infant LBW than women who were LBW due to intrauterine growth retardation (IUGR). As found in previous research, the estimate of association between maternal LBW and infant LBW was greater for those infants who were LBW due to IUGR than those who were LBW due to being premature. The question of whether maternal LBW is also associated with increased risk of neonatal mortality and morbidity is as yet left unanswered.

Adolescent↗
PubMedDate not supplied

Anxiety and depression in mothers of low birthweight and very low birthweight infants: birth through 5 months.

The purpose of this study was to compare two common psychologic stress responses, anxiety and depression, in 27 mothers of very low birthweight (VLBW; less than or equal to 1500 grams) preterm infants and 35 mothers of low birthweight (LBW; 1501-2500 grams) preterm infants from the time of the infant's birth until the infants reached 5 months adjusted gestational age. There were significant differences in the patterns of anxiety and depression experienced by mothers of LBW and VLBW infants over time. Mothers of VLBW infants had higher anxiety and depression until 2 months adjusted gestational age while mothers of LBW infants had higher anxiety and depression at 3 and 4 months. Nursing interventions designed to decrease stress during the first postpartal week and to counsel mothers about patterns of anxiety and depression they may experience over time may be useful.

Adult↗
PubMed1990

Tolerance of fat emulsions in very low birthweight neonates: effect of birthweight on plasma lipid concentrations.

Plasma concentrations of various lipid fractions (total lipids, free glycerol, true triglycerides, free fatty acids, and cholesterol) were studied in 20 normally grown neonates ranging in birthweight from 820 to 1500 gm and in gestational age from 28 to 34 weeks. They were subdivided into three weight categories: 750 to 999, 1000 to 1249, and 1250 to 1500 gm. A lipid emulsion was infused at a constant rate over 24 hours, beginning with an hourly infusion rate of 0.04 gm/kg and increasing each day by 0.04 gm/kg up to a maximum of 0.16 gm/kg. Neonates who weighed less than 1000 gm had higher mean plasma concentrations of total lipids and free glycerol at hourly infusion rates of 0.08 and 0.16 and of triglycerides and free fatty acids at hourly infusion rate of 0.16 gm/kg than their heavier peers. These data suggest that extreme caution be used when administering parenteral fat emulsions to neonates who weigh less than 1000 gm and that we need to monitor plasma closely for signs of hyperlipemia.

Birth Weight↗
PubMed1989

Predictors of low birthweight delivery: a study of factors influencing birthweights.

The average birth weight among the 292 infants was 3,028 (+/- 349 g). The incidence of LWB was 8.9 per cent, being predominantly SGA. There were no significant statistical differences of socioeconomic, obstetric and anthropometric variables between the mothers of the LBW and non LBW groups. Maternal height and mid arm circumference seem to be a promising predictors of LBW delivery. The decision of the cut-off points of these variables depends on the objective and the available resources. These variables should be field-tested in a wider scale before being advocated for use as predictors of LBW delivery.

Adult↗