bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Birth Weight Standards Based on Healthy Populations Improve the Identification of Small-for-Gestational-Age Newborns at Risk of Adverse Neonatal Outcomes?
Authors: Ferdynus Cyril , Quantin Catherine , Abrahamowicz Michal , Platt Robert , Burguet Antoine , Sagot Paul , Binquet Christine , Gouyon Jean-Bernard 
Published: January 2009

OBJECTIVES. To develop neonatal growth standards based on (1) the entire population of live births and (2) a healthy subpopulation and compare them in identifying infants as small for gestational age and at risk of adverse neonatal outcomes.PATIENTS AND METHODS. We included all births, between 28 and 41 weeks of gestation, reported in Burgundy (France) from 2000 to 2006. Fetal deaths, multiple births, and chromosomal aberrations were excluded. We first estimated separate birth weight distributions at each week of gestation for (1) all neonates and (2) only infants born from women without maternal diseases. Small for gestational age was defined as a birth weight below the 10th percentile of the corresponding standard. We assessed the associations of small for gestational age on the basis of the alternative definitions, with mortality and major neonatal outcomes.RESULTS. We included 127 584 live births. For term newborns, small for gestational age was significantly associated with an increased risk of death with both standards. In contrast, for preterm newborns (32–36 weeks), small for gestational age was not significantly associated with mortality and morbidity. Very preterm infants (28–31 weeks) identified as small for gestational age according to the healthy-population standard were at higher risk of chronic lung disease and intraventricular hemorrhage. When using the entire-population standard, small for gestational age was associated with chronic lung disease but not intraventricular hemorrhage. The area under the receiver operating characteristic for predicting an intraventricular hemorrhage was significantly greater for small for gestational age defined with the healthy-population standard compared with small for gestational age classified with the entire-population standard.CONCLUSIONS. Neonatal growth standards based on healthy populations could improve the identification of very preterm neonates as small for gestational age and at risk of intraventricular hemorrhage.
Hallucinations and Other Psychotic Symptoms Associated With the Use of Attention-Deficit/Hyperactivity Disorder Drugs in Children
Authors: Mosholder Andrew D. , Gelperin Kate , Hammad Tarek A. , Phelan Kathleen , Johann-Liang Rosemary 
Published: January 2009

OBJECTIVES. To gain a better understanding of the capacity of psychostimulant medications to induce adverse psychiatric reactions and determine the frequency of such reactions, we analyzed postmarketing surveillance data and clinical trial data for drugs, either approved or under development, for the treatment of attention-deficit/hyperactivity disorder.
METHODS. The US Food and Drug Administration requested manufacturers of drugs approved for attention-deficit/hyperactivity disorder or with active clinical development programs for that indication to search their electronic clinical trial databases for cases of psychosis or mania using prespecified search terms. The manufacturers supplied descriptions of clinical trials, numbers of patients exposed to study drug, and duration of exposure to permit calculations of incidence rates. Independently, cases of psychosis or mania in children and adults for drugs used to treat attention-deficit/hyperactivity disorder from the Food and Drug Administration Adverse Event Reporting System safety database were analyzed. Manufacturers were asked to conduct similar analyses of their postmarketing surveillance databases.
RESULTS. We analyzed data from 49 randomized, controlled clinical trials in the pediatric development programs for these products. A total of 11 psychosis/mania adverse events occurred during 743 person-years of double-blind treatment with these drugs, and no comparable adverse events occurred in a total of 420 person-years of placebo exposure in the same trials. The rate per 100 person-years in the pooled active drug group was 1.48. The analysis of spontaneous postmarketing reports yielded &gt;800 reports of adverse events related to psychosis or mania. In ∼90% of the cases, there was no reported history of a similar psychiatric condition. Hallucinations involving visual and/or tactile sensations of insects, snakes, or worms were common in cases in children.
CONCLUSIONS. Patients and physicians should be aware that psychosis or mania arising during drug treatment of attention-deficit/hyperactivity disorder may represent adverse drug reactions.
Cord Blood Leptin and Adiponectin as Predictors of Adiposity in Children at 3 Years of Age: A Prospective Cohort Study
Authors: Mantzoros Christos S. , Rifas-Shiman Sheryl L. , Williams Catherine J. , Fargnoli Jessica L. , Kelesidis Theodoros , Gillman Matthew W. 
Published: January 2009

OBJECTIVES. Leptin and adiponectin are adipocyte-secreted hormones that regulate energy homeostasis and metabolism. Because their roles in the neonatal period and in early childhood are poorly understood, we aimed in this prospective cohort study to determine the extent to which umbilical cord blood leptin and adiponectin concentrations predict measures of adiposity and growth at 3 years of age.
PATIENTS AND METHODS. We studied 588 children participating in the prospective prebirth cohort study Project Viva. We examined associations of cord blood leptin and adiponectin levels with weight changes during the first 6 months of life, 3-year circulating leptin and adiponectin concentrations, and the following adiposity-related outcomes at 3 years of age: BMI z score, height-for-age z score, and sums of triceps and subscapular skinfold thicknesses to represent overall adiposity, as well as subscapular/triceps skinfold ratio to represent central adiposity.
RESULTS. Cord blood leptin and adiponectin were each directly associated with the duration of gestation and birth weight for gestational age z scores. Cord blood leptin levels were negatively associated with change in weight-for-length, weight-for-age, and length-for-age z scores between birth and 6 months of age. Similarly, cord blood adiponectin was negatively associated with change in weight-for-length and weight-for-age z scores. After adjusting for several maternal and child factors related to obesity, each 10 ng/mL increment of cord blood leptin was associated with a reduction in BMI z score and higher leptin levels at 3 years but not with skinfold thicknesses. Each 10 μg/mL increment of cord blood adiponectin was positively associated with a higher subscapular skinfold thickness/triceps skinfold thickness ratio at 3 years.
CONCLUSIONS. Lower cord blood leptin levels are associated with smaller size at birth but more pronounced weight gain in the first 6 months of life and higher BMI at 3 years of age. Cord blood adiponectin levels are also directly associated with birth weight for gestational age, inversely associated with weight gain in the first 6 months of life, and predict an increase in central adiposity at age 3 years.
Prenatal Alcohol Exposure and Language Delay in 2-Year-Old Children: The Importance of Dose and Timing on Risk
Authors: O'Leary Colleen , Zubrick Stephen R. , Taylor Catherine L. , Dixon Glenys , Bower Carol 
Published: January 2009

OBJECTIVE. The aim of this study was to investigate the association of dose and timing of prenatal alcohol exposure with early language acquisition.METHODS. We examined language delay in a randomly selected, population-based sample of Western Australian children born in 1995–1996 whose mothers had agreed to participate in a longitudinal study on health-related behaviors and who had completed the 2-year questionnaire (N = 1739). Information on alcohol consumption was collected at 3 months after birth for four periods; the three months pre-pregnancy and for each trimester separately. Prenatal alcohol exposure was grouped into none, low, moderate-heavy and binge (&gt;5) based on the total quantity consumed per week, quantity consumed per occasion, and frequency of consumption. The communication scale from the Ages & Stages Questionnaire was used to evaluate language delay. Logistic regression analysis was used to generate odds ratios and 95% confidence intervals, adjusted for confounding factors.RESULTS. There was no association between low levels of alcohol consumption and language delay at any time period, although there was a nonsignificant 30% increase in risk when moderate-to-heavy levels of alcohol were consumed in the third trimester. Children exposed to a binge pattern of maternal alcohol consumption in the second trimester had nonsignificant, three-fold increased odds of language delay, with a similar estimate following third trimester alcohol exposure after controlling for covariates.CONCLUSIONS. This study did not detect an association between low levels of prenatal alcohol exposure and language delay when compared with women who abstained from alcohol during pregnancy. A nonsignificant threefold increase in the likelihood of language delay was seen in children whose mothers binged during late pregnancy. However, the small numbers of women with a binge-drinking pattern in late pregnancy limited the power of this study; studies analyzing larger numbers of children exposed to binge drinking in late pregnancy are needed.
Parenting Behavior Is Associated With the Early Neurobehavioral Development of Very Preterm Children
Authors: Treyvaud Karli , Anderson Vicki A. , Howard Kelly , Bear Merilyn , Hunt Rod W. , Doyle Lex W. , Inder Terrie E. , Woodward Lianne , Anderson Peter J. 
Published: January 2009

OBJECTIVE. There is an increasing focus on social and environmental factors that promote and support the early development of highly vulnerable children such as those born very preterm. The aim of this study was to assess the relationship between parenting behavior, parent-child synchrony, and neurobehavioral development in very preterm children at 24 months of age.METHODS. Participants were 152 very preterm children (&lt;30 weeks’ gestation or &lt;1250 g birth weight) and their parents/guardians. At 2 years’ corrected age, parents/guardians and children completed a semistructured parent-child interaction task assessing dyad synchrony and parenting behavior (positive affect, negative affect, sensitivity, facilitation, and intrusiveness). Cognitive and motor development was assessed by using the Bayley Scales of Infant Development II, and the Infant Toddler Social and Emotional Assessment was used to assess socioemotional development (social-emotional competence and internalizing and externalizing behavior).RESULTS. After controlling for social risk, most parenting domains were associated with cognitive development, with parent-child synchrony emerging as the most predictive. Greater parent-child synchrony was also associated with greater social-emotional competence, as was parenting that was positive, warm, and sensitive. Parents who displayed higher levels of negative affect were more likely to rate their children as withdrawn, anxious, and inhibited, but, unexpectedly, higher negative affect was also associated with more optimal psychomotor development. Parenting was not associated with externalizing behaviors at this age.CONCLUSIONS. Specific parenting behaviors, particularly parent-child synchrony, were associated with neurobehavioral development. These findings have implications for the development of targeted parent-based interventions to promote positive outcomes across different developmental domains during the first 2 years of life for very preterm children.
Economic Evaluation of Tandem Mass Spectrometry Newborn Screening in Australia
Authors: Norman Richard , Haas Marion , Chaplin Meredyth , Joy Pamela , Wilcken Bridget 
Published: January 2009

OBJECTIVE. The goal was to investigate the cost-effectiveness of tandem mass spectrometry screening for the detection of inborn metabolic errors in an Australian setting.
METHODS. Cost-effectiveness analysis from the health service perspective was undertaken on the basis of registry data for affected individuals. The intervention group was contrasted with both a contemporaneous group in nonscreening states and a historical cohort. The registry covers all individuals identified in Australia between 1994 and 2002. Main outcome measures were the total net cost of screening, the cost of treatment, life-years saved, and deaths averted.
RESULTS. The total net cost of testing was estimated to be A$218 000 per 100 000 infants. Medical costs incurred by the intervention group exceeded those for the control group by A$131 000 per 100 000 infants. The number of life-years saved per 100 000 infants screened was 32.378 life-years per 100 000 infants through an expected mortality rate reduction of 0.738 deaths per 100 000 infants. The cost per death averted was estimated to be A$472 913 and the cost per life-year saved was estimated to be A$10 779, which compare favorably with existing cost-effectiveness standards. This conclusion is particularly robust because conservative assumptions were made throughout, because of data limitations. Sensitivity analyses suggested that this result was relatively robust to adjustment of model parameters.
CONCLUSIONS. Tandem mass spectrometry screening for conditions caused by rare errors of metabolism is likely to be a cost-effective intervention in Australia.
Impact of the 2004–2005 Influenza Vaccine Shortage on Pediatric Practice: A National Survey
Authors: McQuillan Lon , Daley Matthew F. , Stokley Shannon , Crane Lori A. , Beaty Brenda L. , Barrow Jennifer , Babbel Christine , Dickinson L. Miriam , Kempe Allison 
Published: January 2009

BACKGROUND. A severe influenza vaccine shortage occurred during the 2004–2005 influenza season because of the loss of all vaccine made by Chiron (Emeryville, CA) for US distribution.OBJECTIVES. The objectives of this study were to assess among pediatricians nationally: (1) influenza vaccine-delivery strategies; (2) reported vaccine shortages and factors associated with experiencing shortages; and (3) the impact of shortages on vaccine redistribution, patient referral, and clinical practice, including patient prioritization.METHODS. A survey was administered in March 2005 through June 2005 to 427 pediatricians who participated in a national network representative of the American Academy of Pediatrics membership.RESULTS. Our response rate was 82%. Thirty-nine percent of the pediatricians had a computerized method for identifying patients at high risk needing vaccination. Ninety-four percent and 79% reported giving high-priority to children ≥24 months old with high-risk conditions and children 6 to 23 months old, respectively, whereas 41% gave high-priority to household contacts and caregivers of children &lt;6 months old. Forty-three percent reported experiencing shortages of vaccine for patients at high risk, whereas only 14% ordered Chiron vaccine. In multivariate analyses, ordering vaccine from Chiron and ordering Aventis Pasteur (Lyon, France) vaccine solely from a vaccine distributor were associated with experiencing a shortage. Forty-eight percent of respondents obtained additional vaccine from another source, most frequently the public health sector, whereas 37% reported selling or giving away vaccine. In addition, 47% referred patients at high risk elsewhere for vaccination, primarily to public health clinics. Forty-nine percent reported having unused vaccine remaining at the end of the season.CONCLUSIONS. Although few pediatricians ordered Chiron vaccine, substantial influenza vaccine shortages were reported, highlighting the tenuousness of injectable influenza vaccine supplies for children. The extensive redistribution of vaccine suggests that cooperative efforts between the private and public sectors were widespread. Efforts to vaccinate patients at high risk during shortages would be aided by better systems to identify and recall these patients.
Clinical Inactivity Among Pediatricians: Prevalence and Perspectives
Authors: Freed Gary L. , Dunham Kelly M. , Switalski Kara E. 
Published: January 2009

INTRODUCTION. During their careers, physicians may have periods of clinical inactivity for a variety of reasons. Concerns have been raised about the impact of clinical inactivity on the growing physician workforce shortage. It is unknown how these periods of clinical inactivity impact physician competence and patient safety. With this study we sought to determine the rates of clinical inactivity, the duration of periods of inactivity, professional activities during those periods, and the perspective of pediatricians regarding future requirements of competency for return to clinical practice.
PATIENTS AND METHODS. A random sample of 6757 American Board of Pediatrics diplomates aged ≤65 years received a structured questionnaire by mail. The survey explored the prevalence of and reasons for clinical inactivity and perspectives on the return to clinical practice. Clinical inactivity was defined as a period of absence of ≥12 months from any direct or consultative clinical care.
RESULTS. The response rate was 74%. Of respondents, 88% (n = 4176) were currently engaged in pediatric clinical care. Twelve percent (n = 554) indicated that they had experienced a period of clinical inactivity lasting ≥12 months. Women were more likely than men (16% vs 7%) to have had periods of clinical inactivity. Controlling for gender, generalists were no more likely than subspecialists to report a past period of clinical inactivity. More than one third of the respondents (n = 1672 [36%]) agreed that pediatricians who return from clinical inactivity after &gt;1 year should undergo a competency evaluation.
CONCLUSIONS. Almost 1 in 8 pediatricians has suspended clinical care for ≥1 year, and a similar proportion of respondents were inactive at the time of our survey. Currently, all of these physicians may maintain both their licensure and board certification during these periods. The impact of clinical inactivity on patient care and patient safety is unknown.
Genetic Contribution to Patent Ductus Arteriosus in the Premature Newborn
Authors: Bhandari Vineet , Zhou Gongfu , Bizzarro Matthew J. , Buhimschi Catalin , Hussain Naveed , Gruen Jeffrey R. , Zhang Heping 
Published: January 2009

BACKGROUND. The most common congenital heart disease in the newborn population, patent ductus arteriosus, accounts for significant morbidity in preterm newborns. In addition to prematurity and environmental factors, we hypothesized that genetic factors play a significant role in this condition.
OBJECTIVE. The objective of this study was to quantify the contribution of genetic factors to the variance in liability for patent ductus arteriosus in premature newborns.
PATIENTS AND METHODS. A retrospective study (1991–2006) from 2 centers was performed by using zygosity data from premature twins born at ≤36 weeks' gestational age and surviving beyond 36 weeks' postmenstrual age. Patent ductus arteriosus was diagnosed by echocardiography at each center. Mixed-effects logistic regression was used to assess the effect of specific covariates. Latent variable probit modeling was then performed to estimate the heritability of patent ductus arteriosus, and mixed-effects probit modeling was used to quantify the genetic component.
RESULTS. We obtained data from 333 dizygotic twin pairs and 99 monozygotic twin pairs from 2 centers (Yale University and University of Connecticut). Data on chorioamnionitis, antenatal steroids, gestational age, body weight, gender, respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, oxygen supplementation, and bronchopulmonary dysplasia were comparable between monozygotic and dizygotic twins. We found that gestational age, respiratory distress syndrome, and institution were significant covariates for patent ductus arteriosus. After controlling for specific covariates, genetic factors or the shared environment accounted for 76.1% of the variance in liability for patent ductus arteriosus.
CONCLUSIONS. Preterm patent ductus arteriosus is highly familial (contributed to by genetic and environmental factors), with the effect being mainly environmental, after controlling for known confounders.
Effect of Cell Phone Distraction on Pediatric Pedestrian Injury Risk
Authors: Stavrinos Despina , Byington Katherine W. , Schwebel David C. 
Published: January 2009

OBJECTIVE. Early adolescents are using cell phones with increasing frequency. Cell phones are known to distract motor vehicle drivers to the point that their safety is jeopardized, but it is unclear if cell phones might also distract child pedestrians. This study was designed to examine the influence of talking on a cell phone for pediatric pedestrian injury risk.
PARTICIPANTS AND METHODS. Seventy-seven children aged 10 to 11 years old completed simulated road crossings in an immersive, interactive virtual pedestrian environment. In a within-subjects design, children crossed the virtual street 6 times while undistracted and 6 times while distracted by a cell phone conversation with an unfamiliar research assistant. Participants also completed several other experimental tasks hypothesized to predict the impact of distraction while crossing the street and talking on a cell phone.
RESULTS. Children's pedestrian safety was compromised when distracted by a cell phone conversation. While distracted, children were less attentive to traffic; left less safe time between their crossing and the next arriving vehicle; experienced more collisions and close calls with oncoming traffic; and waited longer before beginning to cross the street. Analyses testing experience using a cell phone and experience as a pedestrian yielded few significant results, suggesting that distraction on the cell phone might affect children's pedestrian safety no matter what their experience level. There was some indication that younger children and children who are less attentive and more oppositional may be slightly more susceptible to distraction while talking on the cell phone than older, more attentive, and less oppositional children.
CONCLUSION. Our results suggest that cell phones distract preadolescent children while crossing streets.