bluuebunny/crossref_metadata_2025 huggingface dataset:
Access to intensive neonatal care and neonatal survival in low birthweight infants: A population study in Norway
Authors: Forbes John F. , Larssen Karl‐Erik , Bakketeig Leiv S.
Published: April 2008

Summary. This study evaluates the impact of regional differences in access to intensive neonatal care on neonatal survival in geographically defined populations of 4 692 low birthweight births in Norway 1979–81. For infants weighing 1 250 to 2 499 g our results are consistent with the existence of a dose‐response association between neonatal survival and the level of immediate access to intensive neonatal care. Although not statistically significant, there was a clear gradient in the risk of mortality within 24 hours. A similar pattern of survival could not be consistently demonstrated for infants weighing less than 1 250 g.
Village health workers are able to teach mothers how to safely prepare sugar/salt solutions
Authors: Yach D. , Hoogendoorn L. , Schirnding Y.E.R. Von
Published: April 2008

Summary. In the predominantly rural Hewu district of Ciskei 54% of infant deaths are diarrhoea‐related. The aim of this study was to determine whether village health workers (VHWs) could teach mothers to safely prepare homemade sugar‐salt solutions (SSS). VHWs from 11 villages were selected for training while 11 randomly selected villages acted as controls. VHWs selected for training were taught to prepare SSSs and to teach mothers with children under 5 years about the use of such solutions. A card illustrating the main points was given to all mothers. Six weeks after training, randomly selected mothers in control villages (n=320) and experimental villages (n=327) were interviewed and asked to prepare SSS. Experimental and control villages had similar children's diarrhoeal disease rates (using a 2 week recall period). In experimental villages 81.5% of mothers compared to 29.7% in control villages had received SSS cards (i.e. been visited). Of recently occurring diarrhoeal‐episodes 76.6% were initially treated with a SSS (correct formula used in 81% of cases) in experimental villages compared to 50.5% (correct formula used in 48% of cases) in control villages (P<0.05 for SSS use). Greater use of enemas and home remedies occurred in control villages (P<0.05). Of solutions made in experimental villages 7% had sodium concentrations over 100 mmol/litre compared to 36% in control villages. Results show that VHWs can effectively train mothers to safely prepare SSS and the VHW program has been expanded to other areas.
The epidemiology and service implications of congenital and constitutional anomalies in ethnic minorities in the United Kingdom
Authors: Little Julian , Nicoll Angus
Published: April 2008

Summary. The literature on the incidence in the UK of congenital and constitutional anomalies in populations deriving from Africa, the Caribbean, the Far East, the Indian subcontinent and the Mediterranean is reviewed. These groups represent an increasing proportion of the whole child population. Comparison with the white population and between groups reveals that the burden of impairment varies with country of origin. Some of the reasons implicated include different gene frequencies and mating patterns, age/parity distribution and uptake of preventive services. Comparisons with prevalence at birth in the countries of origin are made where possible. In general, populations with high rates in their country of origin retain their high rates (e.g. central nervous system anomalies among births to parents deriving from the Indian subcontinent). There is a general lack of data on the prevalence of handicapping conditions such as cerebral palsy, as well as the associated health needs and service utilisation amongst ethnic minorities.
The California Child Health and Development Studies of the School of Public Health, University of California at Berkeley*
Authors: van den Berg BEA J. , Christianson ROBERTA E. , Oechsli FRANK W.
Published: April 2008

Summary

The Child Health and Development Studies are prospective longitudinal studies on medical and social aspects of pregnancies and on the health and development of children. Data have been assembled on about 20 000 pregnancies occurring in one hospital between 1959 and 1967, and on follow‐up of the children through adolescence. A currently ongoing project updates certain vital statistics of the entire study population. The data assembled in this longitudinal study supported a wide range of research projects, several of which proved to be important for the health of mothers and children. Notwithstanding, subsets of the assembled data, with potential value for public health, have not yet been explored. The data archive has been made accessible to the research community at large so that other significant research topics can be investigated. In the following article, brief descriptions are given of the history and design of the Child Health and Development Studies, of the contents of the data archive, and of the major areas of research that have been explored. Procedures to obtain access to the data and to the user's manual are explained, and a bibliography is included.
The study of risk habits in reproductive and perinatal epidemiologic research: the use of a donor inseminated population of women
Authors: van Noord‐Zaadstra B.M. , Karbaat J. , te Velde E.R. , Habbema J.D.F. , van der Maas P.J.
Published: April 2008

Summary. In this study we assess whether a population of donor inseminated women (ADI) provides an efficient alternative to an open population of women of reproductive age to study the effects of risk habits (cigarette smoking and alcohol consumption) on reproductive and perinatal health. An ADI population can be prospectively monitored before and after pregnancy; women enter the programme because of their husband's infertility. In the pilot clinic every couple asking for first insemination was requested to fill in a self‐administered questionnaire on risk habits and the use of medicine. Medical histories of both the man and woman were taken. In 1986 and 1987, 519 women entered the programme. The response rate was 95%. Distribution of the exposure variables of the women currently smoking (52%) and currently drinking (68%) compared well with a general population survey from the town of Rotterdam. With regard to their risk habits and reproductive health, the population of women married to totally infertile men seems representative of women of reproductive age from an open population.
Book review
Authors: KINLEN L.J.
Published: April 2008

International Incidence of Childhood Cancer. Editors: D.M Parkin, C.A. Stiller, G.J. Draper, C.A. Bieber, B. Terracini & J. L. Young. International Agency for Research on Cancer, Scientific Publication No. 87, Lyon, 1988, pp. 401, £30.
A hypothesis on the increasing rates of ectopic pregnancy
Authors: James William H.
Published: April 2008

Summary. Rates of ectopic pregnancy have been increasing in the developed world in recent decades. The cause of this increase is not established. There is evidence that women with ectopic pregnancies have low oestrogen levels and that tubal contractions are under oestrogenic control. Low diets and vigorous exercise both lower women's oestrogen levels. Over the last two decades, women have been increasingly engaged in physically demanding sport and in dieting. It is inferred here that there are increasing minorities of women with suboptimal hormone levels, and it is suggested that diminishing oestrogen levels (due to dieting and increasing participation in sport) have been responsible for the increasing rates of ectopic pregnancy.
(Mis)Understanding Cleveland: foundational issues and the sexual abuse of children
Authors: Kessel Ross
Published: April 2008

Summary. The Cleveland case led to the widespread condemnation of a new system for the diagnosis, initial treatment, and management of child sexual abuse. The Butler‐Sloss Report identifies what went wrong as resulting from poor organisational links among agencies and poor interpersonal skills among professionals. Without denying that these faults occurred, this paper claims that what happened in Cleveland did so primarily because those making policy ignored two foundational issues inherent in the problem of child abuse: the status of the child in society and hence the State's justification in intervening on her behalf, and the status of abuse and the abuser and the consequences of their medicalisation. Analysis of these foundational issues suggests what additional steps will need to be taken if we are to deal effectively with sexually abused children and their families.
Anaemia during pregnancy as a risk factor for infant iron deficiency: report from the Valencia Infant Anaemia Cohort (VIAC) study
Authors: Colomer Julia , Colomer Concepción , Gutierrez Dolores , Jubert Angeles , Nolasco Andres , Donat Joaquín , Fernandez‐Delgado Rafael , Donat Francisco , Alvarez‐Dardet Carlos
Published: April 2008

Summary. A prospective cohort study with a 1‐year follow‐up of 156 neonates was carried out specifically designed to test the hypothesis that there is a positive relationship between iron deficiency during pregnancy and the development of the same disease in newborn infants. Exposure was defined as being born of a mother with ferropenic anaemia at delivery, and cases as the infants who developed iron deficiency during their first year of life. A statistically significant positive association was detected with an odds ratio of 6.57 (95% confidence limits 1.81–25.97). A stratified analysis was also performed to control the effect of potential confounders such as socio‐economic variables, feeding practices and other factors linked with the iron status of infants. This second analytical procedure showed no alteration in the association detected in the simple analysis but that there was a statistically significant strong interaction between the quantity of cow's milk intake and the ferropenic status of the mother. These results show a relationship between iron deficiency of the mother at delivery and the development of iron deficiency in the infants. These new findings could be important in the development of new prevention programmes applied to pregnant women.
An epidemiological study of congenital anorectal malformations: 15 Danish birth cohorts followed for 7 years
Authors: Christensen Kaare , Madsen Carl M. , Hauge Mogens , Kock Kirsten
Published: April 2008

Summary. In the county of Fyn (about 500 000 inhabitants) which is a well defined and representative 10% sample of the total Danish population, 15 total birth cohorts were scrutinized for the occurrence of anorectal malformations (ARM). All the patients were followed until the age of 7 or death. In a total of 96 073 births, 29 cases were observed; one concordant monozygotic pair was counted as one case. The study showed the point prevalence at birth to be 3.0 per 10000; almost the same frequency has been found in Sweden whereas other figures from Europe and North America are lower. Children with ARM have in general a poor prognosis, largely due to the many associated anomalies. In this material, 11 of 12 isolated ARM cases survived until age 7, but five of these had significant handicaps. Out of 17 probands with associated anomalies, only seven survived until age 7, all of them having some handicap. This group of patients spent at least 15 times more days in hospital than an age‐matched group from the same region until age 7, and they underwent a considerable number of operations. The study showed an increased frequency of chromosome anomalies among children with ARM.
Methodological considerations in research on child sexual abuse
Authors: Plunkett Angela , Oates R. Kim
Published: April 2008

Summary. Child sexual abuse research presents practical, methodological and statistical challenges. This paper examines some recent literature about the incidence and effects of child sexual abuse. Researchers who use epidemiological studies to attempt to ascertain the prevalence of different forms of abuse should be aware of the different populations studied, different methodologies used, diverse definitions of sexual abuse and practical limitations on participants' memories. Common problems in retrospective and prospective studies into the effects of child sexual abuse include the use of atypical populations, inappropriate statistical analyses, the use of un validated psychometric instruments and limited sources of information on child functioning. Attention must also be paid to potentially confounding demographic and family variables. A thorough understanding of, and attention to, these problem areas in child sexual abuse research will give a clearer picture of the prevalance and effects of abuse, thus indicating the most appropriate forms of prevention and treatment.
The development of a model for predicting infants at high risk of sudden infant death syndrome in Tasmania
Authors: D'Espaignet EDOUARD T. , Dwyer Terence , Newman NEVILLE M. , Ponsonby ANNE‐LOUISE , Candy STEVEN G.
Published: April 2008

Summary. A statutory ‘Notification of Birth’ form, containing obstetric and perinatal information, has been routinely collected for Tasmanian deliveries since 1974. For the period 1980 to 1984, birth notification data was collected for over 99% of Tasmanian deliveries. This data was examined for the 130 cases of sudden infant death syndrome (SIDS) that occurred from 1980 to 1984 and for 610 controls. It was then used to construct an at‐birth scoring system to predict infants at higher risk of SIDS in the postneonatal period. A predictive model of the relative risk of SIDS was developed by fitting a binomial/logistic generalised linear model to the binary 1980–1984 case control data with birth variables used as predictors. The final predictive model contained five variables (maternal age, infant sex, birth weight, month of birth and feeding practice) and had a sensitivity of 62% and specificity of 73%. The model was then tested on independent birth cohorts from 1985 and 1986 and found to have a sensitivity of 47% and specificity of 77%. The risk of SIDS in the group of infants classified as high risk was 7.9 per 1000 live births and in the group at low risk it was 2.5 per 1000 live births. In addition, the model predicted 74% of neonatal deaths occurring during these 2 years. This compares well with other predictive models developed elsewhere, The predictive model will be used to identify infants at high risk for SIDS in a prospective cohort study.
Socio‐economic factors associated with preterm delivery in Greece: a population‐based study
Authors: Lekea‐Karanika Vasso , Tzoumaka‐Bakoula Chryssa , Matsaniotis N.S.
Published: April 2008

Summary. A total population sample of singleton births to mothers with certain last menstrual period dates was identified from the Greek National Perinatal Survey of April 1983. Two groups were considered (3116 primigravidae and 6524 multigravidae) with preterm rates of 5.9% and 8.4% respectively. Of all 17 factors considered, primigravidae showed unadjusted significant associations between preterm delivery and marital status, region of mother's residence, maternal occupation, maternal education and paternal education level. Multigravidae preterm deliveries were associated with marital status, mother's age at marriage, father's age at marriage, mother's age at delivery, mother's education, father's education and maternal smoking at the end of the pregnancy. Logistic regression was used to identify the socio‐economic and demographic characteristics independently associated with preterm delivery. For primigravidae, the only significant factors were maternal marital status and region of the country. For multigravidae, significant factors were maternal age at delivery, marital status and smoking habit at the end of pregnancy.
Perinatal factors influencing infant feeding practices at birth: the Bedouin Infant Feeding Study
Authors: Forman Michele R. , Berendes Heinz W. , Lewando‐Hundt Gillian , Sarov Batia , Naggan Lechaim
Published: April 2008

Summary. Bedouin Arab women delivering newborns at Soroka Medical Center, Israel, during 1 year were interviewed in hospital to determine the factors influencing infant feeding practices at birth. Eighty‐six per cent breastfed, 11% breast and bottlefed, and 3% bottlefed at birth. Based on a multiple logistic regression analysis, the factors that significantly reduced the odds ratio (OR) of exclusive breastfeeding vs. breast and bottle feeding or bottle feeding at birth include: delivering during the high birth season (OR = 0.49); maternal recall of feeling unwell during pregnancy (OR = 0.59); delivering a low birthweight newborn (OR = 0.10); a newborn diagnosed with major malformations (OR = 0.30) or with major illnesses (OR = 0.32); and delivering by Cae‐sarean section (OR = 0.09). In contrast, multiparae experienced an increased odds (OR = 1.67) of breastfeeding. Among primiparae, the factors that significantly reduced the odds of exclusive breastfeeding include: delivering during the high birth season (OR = 0.47); delivering a low birthweight newborn (OR = 0.12); and delivering by Caesarean section (OR = 0.18). Mothers of high‐risk neonates and those who deliver by Caesarean section need to be educated about the benefits of exclusive breastfeeding. Young primiparae are a challenge and require qualitative and quantitative research into the reasons precluding exclusive breastfeeding.
Antecedents of macrosomia
Authors: Brunskill Andrew J. , Rossing Mary Anne , Connell Frederick A. , Daling Janet
Published: April 2008

Summary. Antecedents of high birthweight (macrosomia) were studied using the state birth certificates of White singleton infants born in three large metropolitan counties of Washington State from 1984 to 1986. Cases consisted of 2082 live‐born macrosomic infants, defined by a birthweight of over 4.5 kg. A random sample of 4440 live births with birthweights of 2.5‐4.0kg was selected as a comparison group. Estimates for the independent risks associated with gestational and established diabetes, male sex, parity, duration of gestation, maternal smoking during pregnancy, maternal age, and median income of maternal residential area were obtained and combined in a single logistic model. Maternal smoking was associated with a decreased risk of macrosomia (OR 0.4, 95% CI 0.3‐0.5). Established diabetes (OR 6.4, 95% CI 2.7–15.4), gestational diabetes (OR 3.2, 95% CI 2.1–5.1) and male sex of the infant (OR 2.4, 95% CI 2.2‐2.7) were associated with an increased risk. Increasing parity was related to an increasing risk from para one (OR 1.4, 95% 1.2‐1.6) to para six and greater (OR 3.3, 95% CI 1.5–7.4). Increasing duration of gestation was associated with an increasing risk from 33–36 weeks (OR 0.8, 95% CI 0.5‐1.2) to 43–45 weeks (OR 3.3, 95% CI 2.5‐4.2). Maternal age, median income of maternal area of residence, and maternal marital status were not significantly associated with macrosomia.
Differences in early postnatal morbidity risk by pattern of fetal growth in Argentina
Authors: Caulfield Laura E. , Haas Jere D. , Belizán José M. , Rasmussen Kathleen M. , Edmonston Barry
Published: April 2008

Summary Information on a cohort of 5539 singleton births delivered at term in two hospitals in Rosario, Argentina, was used to examine differences in early postnatal morbidity between small for gestational age (SGA) infants classified by their ponderal index (PI). SGA infants with low PI (SGA‐LPI) were 4.35 (90% CI: 1.50, 12.61) times more likely to have asphyxia, 13.75 (2.48, 76.31) times more likely to have hypoglycae‐mia and 2.32 (1.03, 5.26) times more likely to have respiratory distress (RD) than SGA infants with adequate PI (SGA‐API). The increased risks of asphyxia and hypoglycaemia observed for SGA‐LPI infants diminished, but remained statistically significant after controlling for the infant's gender, birthweight, gestational age and hospital of birth. There was no difference in risk of hyperbilirubinaemia between SGA‐API and SGA‐LPI infants. With the exception of risk of hyperbilirubinaemia, SGA‐API infants carried the same risks of morbidity as non‐SGA infants. The results of the study show that SGA infants do not constitute a homogeneous group with respect to their prospects for early postnatal health and survival. Furthermore, the pattern of differences in morbidity risk between SGA‐API and SGA‐LPI infants observed in this study is consistent with the timing hypothesis for the aetiology of variation in PI among SGA infants.
Social differences in low birthweight and preterm deliveries in twins
Authors: Buekens P. , MacGillivray I. , Campbell D. , Dramaix M. , Darquennes H. , Derom R. , Thiery M.
Published: April 2008

Summary The relationship between low social class and low birth‐weight or preterm deliveries is well established in singletons but not in twins. We present a study using all twin deliveries registered in Belgium in 1983 and in Aberdeen between 1951 and 1983. No significant relationship was found between social class and low birthweight, very low birthweight or preterm deliveries in the Belgian sample. In Aberdeen, we found significantly higher rates of low birthweight twins in low social classes. This increase of low birthweight twins in low social classes occurred in Aberdeen during the period 1951–1968, but not in the more recent data.
The Pregnancy Risk Assessment Monitoring System: design, questionnaire, data collection and response rates
Authors: Adams Melissa M. , Shulman Holly B. , Bruce Carol , Hogue Carol , Brogan Donna
Published: April 2008

Summary The birth certificate, the primary tool for population‐based surveillance of the condition of infants at birth and maternal status during pregnancy, provides little data about maternal behaviour during pregnancy. To collect data on maternal behaviours that influence pregnancy outcome, we implemented the Pregnancy Risk Assessment Monitoring System in seven states. For this population‐based surveillance, new mothers were sampled from birth certificates 2 to 6 months after delivery and contacted by mail; follow‐up of nonrespondents was by telephone. Participants completed a 10‐page questionnaire. Stratification permitted over‐sampling of women with adverse pregnancy outcomes. Among 10563 women sampled during 1988 and 1989, stratum‐specific response rates ranged from 30% to 89%. In 11 of the 28 strata, response rates were greater than 70%. Response rates varied considerably between states. Rates were lower for Black mothers, mothers of low birthweight infants, unmarried mothers and mothers with less than 12 years of education. Active refusal to participate and undelivered mail occurred infrequently. Mail and telephone surveillance of new mothers can yield adequate response rates in selected population groups. Trials of alternative approaches to enhancing response among Black and disadvantaged mothers, such as additional mailings or post‐partum in‐hospital recruitment, are needed.
Sigtuna score versus Apgar score: simple and practical evaluation of the newborn
Authors: Aksit Sadik , Yaprak Isin , Bakiler Rahmi , Caglayan Suat , Ergin Sevin
Published: April 2008

Summary. In this prospective study, we investigated the relation between the Apgar and Sigtuna scores in 1605 newborns. In 169 of them, umbilical arterial blood specimens were analysed for blood gases. There were significant correlations between the Sigtuna and Apgar scores at 1, 5 and 10 minutes after birth (P< 0.001). Umbilical arterial blood pH (pHua) values were shown to be correlated with both the Sigtuna and Apgar scores. The Sigtuna score was similar to the Apgar score in respect of sensitivity, specificity, positive predictive value and negative predictive value in relation to pH level. We conclude that because of the simplicity of the Sigtuna score, it may be used in place of the Apgar score to establish a rapid diagnosis of asphyxia.
A trial of health education aimed to reduce cigarette smoking among pregnant women
Authors: Rush D. , Orme J. , King J. , Eiser J.R. , Butler N.R.
Published: April 2008

Summary. Three hundred and forty‐six women who reported smoking one or more cigarettes per day prior to the 20th week of gestation were recruited into a trial of health educational counselling to stop or reduce cigarette smoking. Counselling was begun at the first prenatal visit and then continued subsequently in the home. Among the 319 women included in analysis, at first follow‐up visit those who received counselling smoked 1.7 fewer cigarettes a day than control women (P<0.05) and 10.4% had stopped smoking, compared to 5.4% in the control group (NS). Similar but not significant differences were noted at the end of pregnancy. Study effects were limited to the 284 women smoking five or more cigarettes a day at booking. This report refers primarily to them. At first follow‐up visit the proportion of such women in the counselled group who ceased smoking (9.3%) was significantly greater than in the control group (2.6%; P < 0.05). The magnitude of this difference persisted through late pregnancy (11.8% vs. 4.3%; NS) and delivery (10.6% vs. 4.7%; NS). The differences between counselled women and controls in numbers of cigarettes reported smoked at first and last prenatal follow‐up visits (2.4 and 2.1) and at delivery (2.0) were all statistically significant. While there was no effect of counselling on either serum thiocyanate or end expiratory carbon monoxide, the counselled group gained slightly more weight than controls during the study (0.47 vs. 0.44 kg per week among controls; NS), and their infants had modestly higher birthweight (44 g; NS).
Infants with single umbilical artery studied in a national registry. 2: Survival and malformations in infants with single umbilical artery
Authors: Lilja Monica
Published: April 2008

Summary. Registry data on all infants born in Sweden between 1983 and 1986 are reviewed to describe perinatal mortality and malformation rate of infants with single umbilical artery (SUA). Since SUA is much more common in infants with chromosomal anomalies and in twins this analysis is confined to the 1694 singletons who were not recorded as having chromosomal anomalies. There was significantly increased risk of perinatal mortality among these infants largely due to an increased frequency of congenital malformations, low birthweight and preterm delivery. Nevertheless, at least 36% of the perinatal mortality occurred in the absence of malformations or low birthweight. We found the overall risk of severe malformation in SUA infants to be increased 4.3 times. Some malformations were especially common, such as anorectal atresia and oesophageal atresia.
Concordance of parental race/ethnicity in relation to the risk of sudden infant death syndrome (SIDS)
Authors: Li De‐Kun , Daling Janet R.
Published: April 2008

Summary. It has been reported that parental human leukocyte antigen (HLA) compatibility is associated with certain adverse reproductive outcomes such as multiple spontaneous fetal losses and malformations, particularly among women without a prior livebirth. In order to study the relation between parental HLA compatibility and the risk of SIDS, a population‐based case‐control study was conducted using 1982–1990 Washington State linked birth and death certificate data. Concordance of parental race/ethnicity combined with prior maternal fetal loss was used as surrogate measures of parental HLA compatibility. The relation was evaluated separately among infants with and without a prior live‐born sibling. Among first liveborn infants, those of racially discordant parents were at reduced risk of SIDS compared with those of racially concordant parents (relative risk [RR] = 0.57, 95% confidence interval = 0.34–0.96). Infants of white‐minority parents were all at lower risk of SIDS than infants of white‐white parents. Infants of racially concordant parents with two or more prior fetal losses were at increased risk of SIDS (RR = 2.44, 1.07–5.56), relative to infants of racially discordant parents. No such associations were observed among infants with prior live‐born siblings. In fact, in this latter population, infants of racially concordant parents tended to have a lower risk of SIDS than those of discordant parents. This study suggests that a portion of SIDS cases, particularly among first live‐born infants, may be due to parental HLA sharing. However, final determination of the existence of this relationship requires actual HLA typing of parents of both cases and controls.
Pre‐school children's absenteeism from Swedish municipal day‐care centres in 1977 and 1990: methodology and socio‐demographic factors
Authors: Rasmussen Finn , Bondestam Margareta
Published: April 2008

Summary. The absenteeism of Swedish pre‐school children from municipal day‐care centre departments (DCCDs) was studied for the years 1977 and 1990. The research questions were: (1) has absenteeism due to illness changed from 1977 to 1990? and (2) is absenteeism caused by illness which is influenced by socio‐demographic factors? Absenteeism was recorded during February, March and April for 92% of 0–6 year olds enrolled in 476 DCCDs in 1977, and for 88% of the children in 561 DCCDs in 1990. It was measured as the number of days the children were not in attendance due to any illness, divided by the total number of days they could have attended their DCCD. Absenteeism was higher in 1977 than in 1990 for all ages. In 1977 and 1990, among 0–1 year olds it was 20.5% and 14.3%, respectively. The proportion of 0–2 year olds who had been absent for 25% or more of possible days of attendance was 24.5% in 1977 and 14.0% in 1990. Children 0–2 years of age with self‐employed mothers were absent less from their DCCD than those whose mothers were manual workers or non‐manual employees. Among 0–2 year olds living in the largest cities, absenteeism was higher for those living in apartments compared with the children living in single‐family houses.
First report from the Plunket National Child Health Study: smoking during pregnancy in New Zealand
Authors: Alison Lilias H. , Counsell Anthea M. , Geddis David C. , Sanders Diane M.
Published: April 2008

Summary.The Plunket National Child Health Study is a 5‐year longitudinal study of a birth cohort of 4285 children born in New Zealand during 1990–1991. This paper describes the major lines of epidemiological research, the methods and study design, and reports on the demographic data of New Zealand children. During this first report from the Plunket Child Health Study, we examine on the smoking rates of New Zealand mothers during pregnancy. Overall 33% of mothers smoked during pregnancy. Particularly high rates were found amongst teenage mothers, Maori women, single women and women with lower educational levels. Over 60% of women in these categories smoked during pregnancy.
The Dutch famine birth cohort study: design, validation of exposure, and selected characteristics of subjects after 43 years follow‐up
Authors: Lumey L. H. , Ravelli A. C. J. , Wiessing L. G. , Koppe J. G. , Treffers P. E. , Stein Z. A.
Published: April 2008

Summary. A historical birth cohort study of 1116 women born between August 1 1944 and April 15 1946 in the Wilhelmina Gasthuis hospital in Amsterdam, the Netherlands, was set up to study the short‐ and long‐term effects of a limited period of extreme nutritional deprivation in the winter of 1944–1945 in the Western Netherlands. The degree of food deprivation is evidenced by a dramatic decline in third trimester pregnancy weight gain and infant birthweight. All women were traced and 84% (683/813) of survivors presently resident in the Netherlands agreed to be interviewed in their homes. There were no differences in characteristics at birth between interviewed and uninterviewed survivors. The women who were interviewed had 1299 offspring and were able to recall birthweight of all of them. Additional birthweight information from hospital and well‐baby clinic (WBC) records is available for about half of the offspring. Since the famine was imposed on the entire population of a well‐defined area, whose opportunities to obtain food elsewhere were severely restricted, and the women from this hospital cohort were predominantly lower middle class, the relationship between fetal nutrition and subsequent health outcomes in this cohort is not likely to be confounded by unmeasured attributes related to social class. In addition, selective losses to follow‐up could be excluded, which makes the Dutch famine birth cohort a valuable resource for future studies in perinatal epidemiology.
Trends in Down's syndrome prevalence in California, 1983–1988
Authors: Hahn Judith A. , Shaw Gary M.
Published: April 2008

Summary. Trends in the prevalence of Down's syndrome in livebirths were examined in California from 1983 to 1988, a time period when prenatal screening and subsequent termination of Down's syndrome pregnancies among women under 35 years of age was increasing. In the population‐based ascertainment areas of the California Birth Defects Monitoring Program (CBDMP), 1058 infants with Down's syndrome were identified, giving a crude prevalence of 1.03 (95% confidence interval [CI]: 0.97,1.09). The risk ratio for 1988 compared with 1983, after adjusting for maternal age and other confounders, was 0.98 (95% CI: 0.78,1.23), showing that there was no change in livebirth prevalence over this period. The data were also examined for mothers under 35 years of age to determine whether increasing use of prenatal screening leading to termination masked an increase in prevalence. A modest increase was seen.
Social differences in late fetal death and infant mortality in Sweden 1985–86
Authors: Haglund B. , Cnattingius S. , Nordström M.‐L.
Published: April 2008

Summary. Social differences in late fetal death and infant mortality were examined in a population‐based prospective study. All singletons born to Nordic citizens in Sweden 1985–86 were included, 185 156 births in all. The overall rates of late fetal death and infant mortality were 3.5 and 5.3 per 1000 respectively. Socio‐economic status of the household (SES) and mothers' education were used as social indicators. Logistic regression analyses showed significant odds ratios between 1.3 and 1.8 for late fetal death for blue‐collar workers and women with less than 12 years education. The analyses of neonatal mortality showed a U‐shaped relationship: both unskilled blue‐collar workers and high level white‐collar workers had significant odds ratios (OR) as compared with intermediate level white‐collar workers (OR=1.5). Similar results were obtained when using the mothers' education as indicator of social status: 9 years education or less or 15 years or more were associated with significant higher mortality rates than 12 years education (OR=1.6). An inverse relationship between social status and post‐neonatal mortality was seen in the crude analysis. Mothers' education revealed more social differences than SES (crude OR=2.0 and 1.5 respectively in the least privileged group). However, when adjusting for the effects of maternal age, parity and smoking, no significant odds ratios for the social variables were obtained.
Infant feeding and growth of Chinese infants: birth to 2 years
Authors: Leung Sophie , Davies D.P.
Published: April 2008

Summary. A cohort of 174 healthy full‐term Chinese infants was followed up regularly for 2 years for their weight, length, head circumference, triceps and subscapular skinfold thickness, and their feeding practice. The majority of babies (92% at 2 months) were bottle fed with full strength infant formula. The energy intake over the first year of life was comparable with that of healthy Caucasian infants. The mean protein intake during the weaning period exceeded fourfold that of the WHO recommendation. At 2 years, infants were ‐0.6 standard deviation score (SDS) lighter and ‐0.4 SDS shorter than the National Centre for Health Statistics (NCHS) reference.
The risk of diabetes in a subsequent pregnancy associated with prior history of gestational diabetes or macrosomic infant
Authors: McGuire Valerie , Rauh Mitchell J. , Mueller Beth A. , Hickock Durlin
Published: April 2008

Summary. Prior studies suggest that diagnosis of gestational diabetes is associated with increased risk for development of gestational diabetes in future pregnancies, and with subsequent onset of established diabetes. The magnitudes of these risks have not been measured. Using linked birth certificate data from Washington State it is possible to identify all women with two or more births occurring during 1984‐91. All women with gestational diabetes (n= 1375) or with established diabetes (n= 220), during their pregnancy for the second or greater birth were identified, and a control group consisting of women whose second or greater birth was not complicated by either condition was randomly selected (n = 6380). Data from the birth certificate, for the previous birth, were compared in order to estimate the risks of developing gestational or established diabetes in a subsequent pregnancy among women with prior gestational diabetes relative to women without gestational diabetes. The age‐adjusted risk of developing gestational diabetes in the pregnancy for the subsequent birth associated with prior gestational diabetes was 23.2 (95% (confidence interval) CI = 17.2–31.2); the risk of having developed established diabetes by the time of the subsequent birth was 55.5 (95% CI = 34.4–89.4). Women who had a macrosomic infant (> 4000 gm) in the prior birth were also at increased risk for developing gestational diabetes (odds ratio OR = 3.3, 95% CI = 2.9‐3.8) or established diabetes (OR = 5.8, 95% CI = 4.0–8.5). When data were restricted to patients with only one prior birth, to patients with early prenatal care, to delivery at facilities with long‐established protocols for diagnosing gestational diabetes, or to more recent years, the risk estimates remained similarly elevated. The 23‐fold increased risk of gestational diabetes associated with having gestational diabetes indicated on the birth certificate of a woman's previous baby, although not unexpected, is still remarkable and reinforces the importance of careful monitoring of women with this history. Although changes in how screening is conducted may account for some of the elevation in risk, our results stayed consistently elevated even when restrictions were made within the data to control for this. The fact that there was a 56‐fold increased risk of having developed established diabetes by the time of the subsequent birth on record, associated with prior gestational diabetes, and a 6‐fold increased risk associated with a macro‐somic infant, supports the idea that these may be early steps in the development of established diabetes, and identifies a group that may benefit from close monitoring and possible intervention.
Case ascertainment for state‐based birth defects registries: characteristics of unreported infants ascertained through birth certificates and their impact on registry statistics in New York State
Authors: Olsen Carolyn L. , Polan Adele K. , Cross Philip K.
Published: April 2008

Summary. .Cases in the New York State Congenital Malformations Registry are reported by hospitals and physicians. This study was undertaken to determine whether case finding should be expanded to include routine matching of Vital Records files to the registry in order to identify unreported children. Matching of children who were born in 1983‐86 and who had a congenital malformation noted on their birth certificate yielded 2837 children who were not in the registry. The hospital of record was asked to submit a registry report if the child's medical record contained a congenital malformation. Medical records for 1267 (45%) of these children indicated that the child was normal, with no mention of a malformation. Medical records could not be located for 137. Registry reports were submitted for 1433,67 of whom were subsequently found in the registry, leaving 1366 bona fide new cases. These new cases differ significantly from registry cases for a number of birth certificate variables and type of congenital malformation. The birth certificate cases were more likely than registry cases to have only one malformation and to have only a minor malformation. The 1366 new cases comprised 2.1 % of all registry cases for 1983‐86. Their addition increased the statewide prevalence of major malformations by 1.7% from 416.5 to 423.4 per 10000 livebirths. Except for anencephaly, the prevalence of specific malformations was not altered measurably by the addition of these cases. Lengthy and continuous follow‐up was required to obtain registry reports. The small number of cases found does not seem to justify the amount of resources that would be required to use birth certificates routinely to augment case finding in New York State.
Hospital admissions for lower respiratory tract illness before the age of two years in Western Australia
Authors: Read Anne W. , Gibbins John , Stanley Fiona J.
Published: April 2008

Summary. .In this study, hospital admissions for lower respiratory tract illness before two years of age have been documented for all children born in Western Australia in 1986. Admissions data were linked to birth and death records for individual children. Of the total cohort, 5% of non‐Abqriginal and 17% of Aboriginal children were hospitalised only once for lower respiratory tract illness; 1% of non‐Aboriginal and 11% of Aboriginal children had repeated admissions. Perinatal conditions comprised the greatest proportion of the admissions for non‐Aboriginal children, and pneumonia for Aboriginal children. Non‐Aboriginal children had decreasing admission rates from the neonatal period onwards, whereas those for Aboriginal children increased. For all children, those of low or high birthweight, male sex and those with young or unmarried mothers or residing in country regions were more likely to be admitted. This research has highlighted potential risk factors for serious respiratory illness in early childhood and has shown the feasibility of using linked data for the total population to formulate and test hypotheses relating to respiratory morbidity.
The likely increase in maternal mortality rates in the United Kingdom and in France until 2005
Authors: Salanave Benoit , Bouvier‐Colle Marie Hélène
Published: April 2008

Summary. In the UK, the decline in maternal mortality rates has stopped. In France, where they are higher than in most European countries, maternal mortality rates have been increasing since 1990. Based on the population projections published by Eurostat, maternal mortality predictions have been made for 1995, 2000, 2005 and 2010. A rise in the level of maternal mortality rates of more than 0.5 per 100000 livebirths is expected between now and 2005, in both countries. In the present context of near stability, this rise could be viewed as an important increase. Maternal mortality rises with maternal age and the proportion of births to women over thirty is growing and will continue to rise until 2000–2005. This structural and demographic evolution explains the expected rise of maternal mortality rates and shows how the change in the maternal age distribution of births will affect these rates.
CD30 on stimulated CD4+ T lymphocytes in newborns regarding atopic heredity
Authors: Stencel‐Gabriel Krystyna , Gabriel Iwona , Czuba Zbigniew , Mazur Bogdan , Paul Marek , Górski Paweł
Published: April 2008

CD30 was initially described as Ki‐1 Ag on Reed‐Sternberg cells of Hodgkin's lymphoma and its and CD30L+ expression on T cells in placenta were equally frequent in the atopic and non‐atopic women. In this article we present a study of CD30 mean fluorescence intensity (MFI) on CB T CD4+ cells. We tested the hypothesis that in newborns with atopy family history there is a changed CB T cells response after antigen stimulation comparing with those without atopy family history. The study population consisted of 31 newborn babies (29‐breastfed, two non‐breastfed) and their mothers. Eleven of them had positive and 20 had negative atopy family history. Performed tests included cord blood, which was a subject to flowcytometry analysis and was cultured for 24 h, cytokine production was measured (IFN‐ γ, IL‐4 and IL‐12). Secondly, we measured total maternal and cord blood IgE levels. We studied CD30 MFI as in our studies in larger group of newborns, CD30 expression on CD4+ T cells appeared to be very low. MFI of CD4+ CD30+ after PHA‐stimulation (213.55: range: 41.77–434.51) was significantly increased compared to MFI of CD4+ CD30+ before PHA‐stimulation (43.63: range 28.67–134.67)(p ≤ 0.001). Newborns with and without atopy family history were analyzed. We found no difference between MFI of CD4+ CD30+ on non‐stimulated T cells in non‐atopic (43.80: range 28.66–134.66) and atopic (43.30: range 29.12–80.92) (p > 0.05). After PHA stimulation MFI of CD4+ CD30+ in non‐atopic (273.05 (range: 42.9–434.51) was significantly increased compared with the atopic newborns to MFI of 87.1 (range: 41.78–241.42) (p = 0.00). We have not found any correlation between MFI of CD4+ CD30+ and total maternal and total CB IgE levels. The role of CD30 in immunological response needs further research studies.
Lack of evidence of endosymbiotic toxin‐producing bacteria in clinical Rhizopus isolates
Authors: Partida‐Martinez Laila P. , Bandemer Sabine , Rüchel Reinhard , Dannaoui Eric , Hertweck Christian
Published: April 2008

Infections by Rhizopus spp. account for about 90% of zygomycoses, many of which are lethal in immunocompromised patients. We recently noted that several strains of Rhizopus microsporus harbour rare bacterial endosymbionts (Burkholderia sp.) for the production of ‘mycotoxins’, which might play a role as virulence factors in human Rhizopus infections. In this study eight clinical Rhizopus spp. isolates have been investigated for the presence of toxin‐producing bacterial endosymbionts. By metabolomic data, PCR targeting bacterial 16S rDNA and microscopic investigations with fluorescence dyes we provide three lines of evidence showing that the fungal strains are not associated with endofungal bacteria. Consequently, toxin‐producing bacteria are not essential for Rhizopus infections and the development of zygomycoses in humans.
Equivalent and sufficient effects of leuprolide acetate and goserelin acetate to suppress serum testosterone levels in patients with prostate cancer
Authors: Fujii Yasuhisa , Yonese Junji , Kawakami Satoru , Yamamoto Shinya , Okubo Yuhei , Fukui Iwao
Published: April 2008

OBJECTIVE

To compare the effects of leuprolide acetate and goserelin acetate for suppressing serum testosterone levels in Japanese patients with prostate cancer, as several recent studies suggested that serum testosterone is not always suppressed below the upper limit of the castration range in patients using luteinizing hormone‐releasing hormone (LH‐RH) agonists, especially leuprolide acetate.

PATIENTS AND METHODS

In all, 232 patients with prostate cancer, whose serum testosterone levels were measured before and during treatment using a 1‐ or 3‐monthly formulation of leuprolide or goserelin, were enrolled in a retrospective study. The mean age of the patients was 69.8 years and the mean testosterone level before the LHRH treatment was 4.54 ng/mL. The patients had their testosterone levels assessed a mean (range) of 5.4 (1–35) times during the LHRH treatment. A castrate serum testosterone level was defined as ≤0.5 ng/mL.

RESULTS

The mean maximum testosterone level during 1‐monthly leuprolide (40 patients), 3‐monthly leuprolide (68), 1‐monthly goserelin (50), or 3‐monthly goserelin (74) treatment was 0.22, 0.20, 0.19 and 0.20 ng/mL, respectively (not significant). Four patients, including two treated with 1‐monthly leuprolide, one with 3‐monthly leuprolide and one with 3‐monthly goserelin, had serum testosterone above the castrate level, with a maximum of 0.5–0.65 ng/mL. Three of these patients had elevated testosterone only once or twice during the follow‐up, and the remaining patient had serum testosterone fluctuating at 0.4–0.6 ng/mL throughout the follow‐up.

CONCLUSIONS

One‐ and 3‐monthly formulations of leuprolide and goserelin have equivalent and sufficient effects to suppress serum testosterone levels in men with prostate cancer. There were testosterone levels just outside the castrate range in a few patients during treatment.