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Wu Y, Zeng F, Li J, Jiang Y, Zhao S, Knibbs LD, Zhang X, Wang Y, Zhang Q, Wang Q, Hu Q, Guo X, Chen Y, Cao G, Wang J, Yang X, Wang X, Liu T, Zhang B. Sex-specific relationships between prenatal exposure to metal mixtures and birth weight in a Chinese birth cohort. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115158. [PMID: 37348214 DOI: 10.1016/j.ecoenv.2023.115158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/14/2023] [Accepted: 06/17/2023] [Indexed: 06/24/2023]
Abstract
Birth weight is an indicator linking intrauterine environmental exposures to later-life diseases, and intrauterine metal exposure may affect birth weight in a sex-specific manner. We investigated sex-specific associations between prenatal exposure to metal mixtures and birth weight in a Chinese birth cohort. The birth weight of 1296 boys and 1098 girls were recorded, and 10 metals in maternal urine samples collected during pregnancy were measured using inductively coupled plasma mass spectrometry. Bayesian Kernel Machine Regression was used to estimate the association of individual metals or metal mixtures and birth weight for gestational age (BW for GA). The model showed a sex-specific relationship between prenatal exposure to metal mixtures and BW for GA with a significant negative association in girls and a non-significant positive association in boys. Cadmium (Cd) and nickel (Ni) were positively and negatively associated with BW for GA in girls, respectively. Moreover, increasing thallium (Tl) concentration lowered the positive association between Cd and BW for GA and enhanced the negative association between Ni and BW for GA in girls. When exposure to other metals increased, the positive association with Cd diminished, whereas the negative association with Ni or Tl increased. Our findings provide evidence supporting the complex effects of intrauterine exposure to metal mixtures on the birth weight of girls and further highlight the sex heterogeneity in fetal development influenced by intrauterine environmental factors.
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Affiliation(s)
- Ying Wu
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fulin Zeng
- Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinhui Li
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Yukang Jiang
- School of Mathematics, Sun Yat-sen University, Guangzhou, Guangdong, China; Southern China Center for Statistical Science, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China; Chinese University of Hong Kong (CUHK) Shenzhen Research Institute, Shenzhen, Guangdong, China
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Xiaojun Zhang
- Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Yiding Wang
- Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Qianqian Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qiansheng Hu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaobo Guo
- School of Mathematics, Sun Yat-sen University, Guangzhou, Guangdong, China; Southern China Center for Statistical Science, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yumeng Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Ganxiang Cao
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Jing Wang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Xingfen Yang
- Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Xueqin Wang
- Department of Statistics and Finance/International Institute of Finance, School of Management, University of Science and Technology of China, Hefei, Anhui, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou, Guangdong, China.
| | - Bo Zhang
- Guangdong-Hongkong-Macao Joint Laboratory for Contaminants Exposure and Health, School of Public Health, Food Safety and Health Research Center, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China.
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Joglekar R, Cauley M, Lipsich T, Corcoran DL, Patisaul HB, Levin ED, Meyer JN, McCarthy MM, Murphy SK. Developmental nicotine exposure and masculinization of the rat preoptic area. Neurotoxicology 2022; 89:41-54. [PMID: 35026373 PMCID: PMC8917982 DOI: 10.1016/j.neuro.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022]
Abstract
Nicotine is a neuroteratogenic component of tobacco smoke, e-cigarettes, and other products and can exert sex-specific effects in the developing brain, likely mediated through sex hormones. Estradiol modulates expression of nicotinic acetylcholine receptors in rats, and plays critical roles in neurodevelopmental processes, including sexual differentiation of the brain. Here, we examined the effects of developmental nicotine exposure on the sexual differentiation of the preoptic area (POA), a brain region that normally displays robust structural sexual dimorphisms and controls adult mating behavior in rodents. Using a rat model of gestational exposure, developing pups were exposed to nicotine (2 mg/kg/day) via maternal osmotic minipump (subcutaneously, sc) throughout the critical window for brain sexual differentiation. At postnatal day (PND) 4, a subset of offspring was analyzed for epigenetic effects in the POA. At PND40, all offspring were gonadectomized, implanted with a testosterone-releasing capsule (sc), and assessed for male sexual behavior at PND60. Following sexual behavior assessment, the area of the sexually dimorphic nucleus of the POA (SDN-POA) was measured using immunofluorescent staining techniques. In adults, normal sex differences in male sexual behavior and in the SDN-POA area were eliminated in nicotine-treated animals. Using novel analytical approaches to evaluate overall masculinization of the adult POA, we identified significant masculinization of the nicotine-treated female POA. In neonates (PND4), nicotine exposure induced trending alterations in methylation-dependent masculinizing gene expression and DNA methylation levels at sexually-dimorphic differentially methylated regions, suggesting that developmental nicotine exposure is capable of triggering masculinization of the rat POA via epigenetic mechanisms.
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Affiliation(s)
- Rashmi Joglekar
- Duke University Nicholas School of the Environment, Durham, NC 27708 USA
| | - Marty Cauley
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Durham, NC 27708 USA
| | - Taylor Lipsich
- Duke University Medical Center, Department of Obstetrics & Gynecology, Durham, NC 27708 USA
| | - David L. Corcoran
- Duke Center for Genomic and Computational Biology, Durham, NC 27708 USA
| | - Heather B. Patisaul
- North Carolina State University, Department of Biological Sciences, Raleigh, NC 27695 USA
| | - Edward D. Levin
- Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Durham, NC 27708 USA
| | - Joel N. Meyer
- Duke University Nicholas School of the Environment, Durham, NC 27708 USA
| | - Margaret M. McCarthy
- University of Maryland School of Medicine, Department of Pharmacology, Baltimore, MD 21201 USA
| | - Susan K. Murphy
- Duke University Medical Center, Department of Obstetrics & Gynecology, Durham, NC 27708 USA
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Joglekar R, Grenier C, Hoyo C, Hoffman K, Murphy SK. Maternal tobacco smoke exposure is associated with increased DNA methylation at human metastable epialleles in infant cord blood. ENVIRONMENTAL EPIGENETICS 2022; 8:dvac005. [PMID: 35355955 PMCID: PMC8962709 DOI: 10.1093/eep/dvac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Metastable epialleles (MEs) are genomic regions that are stochastically methylated prior to germ layer specification and exhibit high interindividual but low intra-individual variability across tissues. ME methylation is vulnerable to environmental stressors, including diet. Tobacco smoke (TS) exposure during pregnancy is associated with adverse impacts on fetal health and maternal micronutrient levels as well as altered methylation. Our objective was to determine if maternal smoke exposure impacts methylation at MEs. Consistent with prior studies, we observed reductions in one-carbon pathway micronutrients with gestational TS exposure, including maternal folate (P = 0.02) and vitamins B6 (P = 0.05) and B12 (P = 0.007). We examined putative MEs BOLA3, PAX8, and ZFYVE28 in cord blood specimens from 85 Newborn Epigenetics STudy participants. Gestational TS exposure was associated with elevated DNA methylation at PAX8 (+5.22% average methylation; 95% CI: 0.33% to 10.10%; P = 0.037). In human conceptal kidney tissues, higher PAX8 transcription was associated with lower methylation (R s = 0.55; P = 0.07), suggesting that the methylation levels established at MEs, and their environmentally induced perturbation, may have meaningful, tissue-specific functional consequences. This may be particularly important because PAX8 is implicated in several cancers, including pediatric kidney cancer. Our data are the first to indicate vulnerability of human ME methylation establishment to TS exposure, with a general trend of increasing levels of methylation at these loci. Further investigation is needed to determine how TS exposure-mediated changes in DNA methylation at MEs, and consequent expression levels, might affect smoking-related disease risk.
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Affiliation(s)
- Rashmi Joglekar
- Integrated Toxicology and Environmental Health Program, Nicholas School of the Environment, Duke University, PO Box 90328, Durham, NC 27708, USA
- Department of Obstetrics and Gynecology, Division of Reproductive Sciences, Duke University Medical Center, 70 W Main Street, Suite 510, Durham, NC 27701, USA
| | - Carole Grenier
- Department of Obstetrics and Gynecology, Division of Reproductive Sciences, Duke University Medical Center, 70 W Main Street, Suite 510, Durham, NC 27701, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Epidemiology and Environmental Epigenomics Lab, North Carolina State University, 850 Main Campus Drive, Suite 1104, Raleigh, NC 27606, USA
| | - Kate Hoffman
- Division of Environmental Sciences and Policy, Nicholas School of the Environment, Duke University, Grainger Hall, 9 Circuit Drive, Durham, NC 27708, USA
| | - Susan K Murphy
- Integrated Toxicology and Environmental Health Program, Nicholas School of the Environment, Duke University, PO Box 90328, Durham, NC 27708, USA
- Department of Obstetrics and Gynecology, Division of Reproductive Sciences, Duke University Medical Center, 70 W Main Street, Suite 510, Durham, NC 27701, USA
- Division of Environmental Sciences and Policy, Nicholas School of the Environment, Duke University, Grainger Hall, 9 Circuit Drive, Durham, NC 27708, USA
- Department of Pathology, Duke University Medical Center, DUMC 3712, Durham, NC 27710, USA
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Voerman E, Jaddoe VWV, Shokry E, Ruijter GJG, Felix JF, Koletzko B, Gaillard R. Associations of maternal and infant metabolite profiles with foetal growth and the odds of adverse birth outcomes. Pediatr Obes 2022; 17:e12844. [PMID: 34384140 PMCID: PMC9285592 DOI: 10.1111/ijpo.12844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/18/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adaptations in maternal and foetal metabolic pathways may predispose to altered foetal growth and adverse birth outcomes. OBJECTIVE To assess the associations of maternal early-pregnancy metabolite profiles and infant metabolite profiles at birth with foetal growth from first trimester onwards and the odds of adverse birth outcomes. METHODS In a prospective population-based cohort among 976 Dutch pregnant women and their children, serum concentrations of amino acids, non-esterified fatty acids (NEFA), phospholipids (PL) and carnitines in maternal early-pregnancy blood and in cord blood were obtained by liquid-chromatography tandem mass spectrometry. Information on foetal growth was available from first trimester onwards. RESULTS After false discovery rate correction for multiple testing, higher infant total and individual NEFA concentrations were associated with a lower weight, length, and head circumference at birth. Higher infant total and individual acyl-lysophosphatidylcholine (lyso.PC.a) and alkyl-lysophosphatidylcholine concentrations were associated with higher weight and head circumference (lyso.PC.a only) at birth, higher odds of LGA and lower odds of SGA. Few individual maternal metabolites were associated with foetal growth measures in third trimester and at birth, but not with the odds of adverse birth outcomes. CONCLUSIONS Our results suggest that infant metabolite profiles, particularly total and individual lyso.PC.a and NEFA concentrations, were strongly related to growth measures at birth and the odds of adverse birth outcomes. Few individual maternal early-pregnancy metabolites, but not total metabolite concentrations, are associated with foetal growth measures in third trimester and at birth.
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Affiliation(s)
- Ellis Voerman
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Engy Shokry
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's HospitalLMU ‐ Ludwig‐Maximilians Universität MünchenMunichGermany
| | - George J. G. Ruijter
- Department of Clinical Genetics, Center for Lysosomal and Metabolic Disease, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Janine F. Felix
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's HospitalLMU ‐ Ludwig‐Maximilians Universität MünchenMunichGermany
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
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Peacock JL, Lo J, Rees JR, Sauzet O. Minimal clinically important difference in means in vulnerable populations: challenges and solutions. BMJ Open 2021; 11:e052338. [PMID: 34753761 PMCID: PMC8578978 DOI: 10.1136/bmjopen-2021-052338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION AND MOTIVATION Many health studies measure a continuous outcome and compare means between groups. Since means for biological data are often difficult to interpret clinically, it is common to dichotomise using a cut-point and present the 'percentage abnormal' alongside or in place of means. Examples include birthweight where 'abnormal' is defined as <2500 g (low birthweight), systolic blood pressure with abnormal defined as >140 mm Hg (high blood pressure) and lung function with varying definitions of the 'limit of normal'. In vulnerable populations with low means, for example, birthweight in a population of preterm babies, a given difference in means between two groups will represent a larger difference in the percentage with low birthweight than in a general population of babies where most will be full term. Thus, in general, the difference in percentage of patients with abnormal values for a given difference in means varies according to the reference population's mean value. This phenomenon leads to challenges in interpreting differences in means in vulnerable populations and in defining an outcome-specific minimal clinically important difference (MCID) in means since the proportion abnormal, which is useful in interpreting means, is not constant-it varies with the population mean. This has relevance for study power calculations and data analyses in vulnerable populations where a small observed difference in means may be difficult to interpret clinically and may be disregarded, even if associated with a relatively large difference in percentage abnormal which is clinically relevant. METHODS To address these issues, we suggest both difference in means and difference in percentage (proportion) abnormal are considered when choosing the MCID, and that both means and percentages abnormal are reported when analysing the data. CONCLUSIONS We describe a distributional approach to analyse proportions classified as abnormal that avoids the usual loss of precision and power associated with dichotomisation.
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Affiliation(s)
- Janet L Peacock
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Jessica Lo
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Judith R Rees
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Odile Sauzet
- Epidemiology and International Public Health, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
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Wang J, Gao W, Tang ML, Liu C. Estimating treatment effects in the presence of unobserved confounders. COMMUN STAT-SIMUL C 2021. [DOI: 10.1080/03610918.2021.1966465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jun Wang
- School of Mathematics and Statistics, Yunnan University, Kunming, China
| | - Wei Gao
- School of Mathematics and Statistics, Northeast Normal University, Changchun, China
| | - Man-lai Tang
- School of Mathematics and Statistics, Hang Seng Management College Hong Kong, Hong Kong, Hong Kong
| | - Changbiao Liu
- School of Mathematics and Statistics, Inner Mongolia Normal University, Huhehaote, China
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7
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Social Determinants of Cigarette Smoking among American Women during Pregnancy. WOMEN 2021. [DOI: 10.3390/women1030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Educational attainment is among the most substantial protective factors against cigarette smoking, including during pregnancy. Although Minorities’ Diminished Returns (MDRs) of educational attainment, defined as weaker protective effect of education for racial and ethnic minority groups compared to Non-Hispanic Whites, has been demonstrated in previous studies; such MDRs are not tested for cigarette smoking during pregnancy. To better understand the relevance of MDRs to tobacco use during pregnancy, this study had three aims: firstly, to investigate the association between educational attainment and cigarette smoking in pregnant women; secondly, to compare racial and ethnic groups for the association between educational attainment and cigarette smoking; and thirdly, to explore the mediating effect of poverty status on such MDRs, among American adults during pregnancy. This cross-sectional study explored a nationally representative sample of pregnant American women (n = 338), which was taken from the Population Assessment of Tobacco and Health (PATH; 2013). Current smoking was the outcome. Educational attainment was the independent variable. Region and age were the covariates. Poverty status was the mediator. Race and ethnicity were the effect modifiers. Overall, a higher level of educational attainment (OR = 0.54, p < 0.05) was associated with lower odds of current smoking among pregnant women. Race (OR = 2.04, p < 0.05) and ethnicity (OR = 2.12, p < 0.05) both showed significant interactions with educational attainment on smoking, suggesting that the protective effect of educational attainment against smoking during pregnancy is smaller for Blacks and Hispanics than Non-Hispanic Whites. Poverty status fully mediated the above interactions. In the United States, highly educated pregnant Black and Hispanic women remain at higher risk of smoking cigarettes, possibly because they are more likely to live in poverty, compared to their White counterparts. The results suggest the role that labor market discrimination has in explaining lower returns of educational attainment in terms of less cigarette smoking by racial and ethnic minority pregnant women.
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Heng S, O'Meara WP, Simmons RA, Small DS. Relationship between changing malaria burden and low birth weight in sub-Saharan Africa: A difference-in-differences study via a pair-of-pairs approach. eLife 2021; 10:e65133. [PMID: 34259625 PMCID: PMC8279759 DOI: 10.7554/elife.65133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background According to the World Health Organization (WHO), in 2018, an estimated 228 million malaria cases occurred worldwide with most cases occurring in sub-Saharan Africa. Scale-up of vector control tools coupled with increased access to diagnosis and effective treatment has resulted in a large decline in malaria prevalence in some areas, but other areas have seen little change. Although interventional studies demonstrate that preventing malaria during pregnancy can reduce the rate of low birth weight (i.e. child's birth weight <2500 g), it remains unknown whether natural changes in parasite transmission and malaria burden can improve birth outcomes. Methods We conducted an observational study of the effect of changing malaria burden on low birth weight using data from 18,112 births in 19 countries in sub-Saharan African countries during the years 2000-2015. Specifically, we conducted a difference-in-differences study via a pair-of-pairs matching approach using the fact that some sub-Saharan areas experienced sharp drops in malaria prevalence and some experienced little change. Results A malaria prevalence decline from a high rate (Plasmodium falciparum parasite rate in children aged 2-up-to-10 (i.e. PfPR2-10) > 0.4) to a low rate (PfPR2-10 < 0.2) is estimated to reduce the rate of low birth weight by 1.48 percentage points (95% confidence interval: 3.70 percentage points reduction, 0.74 percentage points increase), which is a 17% reduction in the low birth weight rate compared to the average (8.6%) in our study population with observed birth weight records (1.48/8.6 ≈ 17%). When focusing on first pregnancies, a decline in malaria prevalence from high to low is estimated to have a greater impact on the low birth weight rate than for all births: 3.73 percentage points (95% confidence interval: 9.11 percentage points reduction, 1.64 percentage points increase). Conclusions Although the confidence intervals cannot rule out the possibility of no effect at the 95% confidence level, the concurrence between our primary analysis, secondary analyses, and sensitivity analyses, and the magnitude of the effect size, contribute to the weight of the evidence suggesting that declining malaria burden can potentially substantially reduce the low birth weight rate at the community level in sub-Saharan Africa, particularly among firstborns. The novel statistical methodology developed in this article-a pair-of-pairs approach to a difference-in-differences study-could be useful for many settings in which different units are observed at different times. Funding Ryan A. Simmons is supported by National Center for Advancing Translational Sciences (UL1TR002553). The funder had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
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Affiliation(s)
- Siyu Heng
- Graduate Group in Applied Mathematics and Computational Science, School of Arts and Sciences, University of PennsylvaniaPhiladelphiaUnited States
- Department of Statistics, The Wharton School, University of PennsylvaniaPhiladelphiaUnited States
| | - Wendy P O'Meara
- Global Health Institute, School of Medicine, Duke UniversityDurhamUnited States
| | - Ryan A Simmons
- Global Health Institute, School of Medicine, Duke UniversityDurhamUnited States
- Department of Biostatistics and Bioinformatics, School of Medicine, Duke UniversityDurhamUnited States
| | - Dylan S Small
- Department of Statistics, The Wharton School, University of PennsylvaniaPhiladelphiaUnited States
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9
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Reynolds CME, Egan B, Daly N, McKeating A, Sheehan SR, Turner MJ. The interaction between maternal smoking, illicit drug use and alcohol consumption associated with neonatal outcomes. J Public Health (Oxf) 2020; 42:277-284. [PMID: 30753536 DOI: 10.1093/pubmed/fdz010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The adverse effects of smoking on neonatal outcomes, such as small-for-gestational-age (SGA), has been extensively studied however, the consequences of smoking combined with alcohol and/or drug use is less clear. METHODS This retrospective observational study analyzed clinical and sociodemographic details of 40156 women who delivered a singleton baby between the years 2011 and 2015. RESULTS Compared with women who had never smoked, smokers who did not engage in alcohol or drug use had an odds ratio (OR) of delivering a baby who was SGA of 3.2 (95% CI: 3.1-3.5). Smokers who used illicit drugs in isolation or in combination with alcohol during pregnancy had higher ORs for SGA (1.4, 95% CI: 1.1-1.7, P = 0.006 and 1.8, 95% CI: 1.2-2.7, P = 0.007) compared to women who smoked but did not engage in alcohol or drug use in pregnancy. These women also delivered babies with lower mean birthweights (125 g, P < 0.001 and 181.4 g, P = 0.003) and head circumferences (0.4 cm, P < 0.001 and 0.3 cm, P = 0.048). Women who smoked and used alcohol, but not illicit drugs were not associated adverse outcomes above that of smoking in isolation. CONCLUSION Illicit drug use combined with maternal smoking during pregnancy increases the risk of adverse neonatal outcomes above that of smoking in isolation.
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Affiliation(s)
- Ciara M E Reynolds
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland.,UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland
| | - Brendan Egan
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.,The School of Health and Human Performance, Dublin City University, Ireland
| | - Niamh Daly
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
| | - Aoife McKeating
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
| | - Sharon R Sheehan
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
| | - Michael J Turner
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
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Rhee J, Fabian MP, Ettinger de Cuba S, Coleman S, Sandel M, Lane KJ, Yitshak Sade M, Hart JE, Schwartz J, Kloog I, Laden F, Levy JI, Zanobetti A. Effects of Maternal Homelessness, Supplemental Nutrition Programs, and Prenatal PM 2.5 on Birthweight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4154. [PMID: 31661898 PMCID: PMC6862522 DOI: 10.3390/ijerph16214154] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/15/2019] [Accepted: 10/23/2019] [Indexed: 01/15/2023]
Abstract
Few studies examined the impact of maternal socioeconomic status and of its combined effects with environmental exposures on birthweight. Our goal was to examine the impact of maternal homelessness (mothers ever homeless or who lived in shelters during pregnancy) and participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) during pregnancy in conjunction with air pollution exposure on birthweight in the Boston-based Children's HealthWatch cohort from 2007 through 2015 (n = 3366). Birthweight was obtained from electronic health records. Information on maternal homelessness and WIC participation during pregnancy were provided via a questionnaire. Prenatal fine particulate matter (PM2.5) exposures, estimated at the subject's residential address, were calculated for each trimester. We fit linear regression models adjusting for maternal and child characteristics, seasonality, and block-group-level median household income and examined the interactions between PM2.5 and each covariate. Prenatal maternal homelessness was associated with reduced birthweight (-55.7 g, 95% CI: -97.8 g, -13.7 g), while participating in WIC was marginally associated with increased birthweight (36.1 g, 95% CI: -7.3 g, 79.4 g). Only average PM2.5 during the second trimester was marginally associated with reduced birthweight (-8.5 g, 95% CI: -19.3, 2.3) for a 1 µg/m3 increase in PM2.5. The association of PM2.5 during the second trimester with reduced birthweight was stronger among non-Hispanic Black mothers and trended toward significance among immigrants and single mothers. Our study emphasizes the independent and synergistic effects of social and environmental stressors on birthweight, particularly the potentially protective effect of participating in WIC for vulnerable populations.
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Affiliation(s)
- Jongeun Rhee
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - M Patricia Fabian
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA.
| | | | - Sharon Coleman
- Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, MA 02118, USA.
| | - Megan Sandel
- Department of Pediatrics, School of Medicine, Boston University, Boston, MA 02118, USA.
- Department of Pediatrics, Boston Medical Center, Boston, MA 02118, USA.
| | - Kevin James Lane
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA.
| | - Maayan Yitshak Sade
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - Jaime E Hart
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Joel Schwartz
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - Francine Laden
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - Jonathan I Levy
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA.
| | - Antonella Zanobetti
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
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11
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Furse S, Snowden SG, Olga L, Prentice P, Ong KK, Hughes IA, Acerini CL, Dunger DB, Koulman A. Evidence from 3-month-old infants shows that a combination of postnatal feeding and exposures in utero shape lipid metabolism. Sci Rep 2019; 9:14321. [PMID: 31586083 PMCID: PMC6778076 DOI: 10.1038/s41598-019-50693-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/17/2019] [Indexed: 12/13/2022] Open
Abstract
We tested the hypothesis that both postnatal feeding and conditions in utero affect lipid metabolism in infants. Infants who experienced restrictive growth conditions in utero and others exposed to maternal hyperglycaemia were compared to a control group with respect to feeding mode. Dried blood spots were collected from a pilot subset of infant participants of the Cambridge Baby Growth Study at 3mo. Groups: (a) a normal gestation (control, n = 40), (b) small for gestational age (SGA, n = 34) and (c) whose mothers developed hyperglycaemia (n = 59). These groups were further stratified by feeding mode; breastfed, formula-fed or received a mixed intake. Their phospholipid, glyceride and sterol fractions were profiled using direct infusion mass spectrometry. Statistical tests were used to identify molecular species that indicated differences in lipid metabolism. The abundance of several phospholipids identified by multivariate analysis, PC(34:1), PC(34:2) and PC-O(34:1), was 30-100% higher across all experimental groups. SM(39:1) was around half as abundant in in utero groups among breastfed infants only. The evidence from this pilot study shows that phospholipid metabolism is modulated by both conditions in utero and postnatal feeding in a cohort of 133 Caucasian infants, three months post partum.
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Affiliation(s)
- Samuel Furse
- Core Metabolomics and Lipidomics Laboratory, Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Level 4 Pathology, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Stuart G Snowden
- Core Metabolomics and Lipidomics Laboratory, Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Level 4 Pathology, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Laurentya Olga
- Department of Paediatrics, University of Cambridge, Box 116, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Philippa Prentice
- Department of Paediatrics, University of Cambridge, Box 116, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Ken K Ong
- Department of Paediatrics, University of Cambridge, Box 116, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Ieuan A Hughes
- Department of Paediatrics, University of Cambridge, Box 116, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Box 116, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - David B Dunger
- Department of Paediatrics, University of Cambridge, Box 116, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Albert Koulman
- Core Metabolomics and Lipidomics Laboratory, Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Level 4 Pathology, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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12
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Magnus MC, Henderson J, Tilling K, Howe LD, Fraser A. Independent and combined associations of maternal and own smoking with adult lung function and COPD. Int J Epidemiol 2019; 47:1855-1864. [PMID: 30339246 PMCID: PMC6280943 DOI: 10.1093/ije/dyy221] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 02/07/2023] Open
Abstract
Background Limited evidence suggests that exposure to maternal smoking in utero or early life might be associated with chronic obstructive pulmonary disease (COPD), but whether this is independent of later own smoking remains unclear. Our objective was to examine the independent and combined association of maternal and own smoking with adult lung function and COPD. Methods We used UK Biobank to examine associations of maternal smoking around delivery, and pack-years of own smoking, with lung function (n = 502 626) and hospitalization/death from COPD (n = 433 863). We calculated the additive interaction between maternal and own smoking on the outcomes of interest, and estimated the association with maternal smoking within categories of own smoking. Results There was no strong evidence that maternal smoking influenced adult lung health among never smokers. Exposure to both maternal and own smoking was associated with lower Forced expiratory volume (FEV1)/ forced vital capacity (FVC) and greater risk of hospitalization/death from COPD than expected from their independent associations. For FEV1/FVC, the mean difference according to maternal smoking was –0.02 (–0.06, 0.02), –0.01 (–0.05, 0.03), –0.11 (–0.16, –0.05) and –0.11 (–0.19, –0.04) among women who smoked ≤10, 11–20, 21–30 and >30 pack-years, respectively. The association between maternal smoking and COPD also varied by pack-years of own smoking, with a hazard ratio of 2.25 (1.30, 3.89) for ≤10 years, 1.23 (0.80, 1.89) for 11–20 years, 1.30 (0.85, 2.01) for 21–30 years and 1.14 (0.91, 1.43) for >30 years. Conclusions Our findings indicate an excess reduction in FEV1/FVC and risk of COPD due to maternal smoking that is heterogeneous across levels of own smoking.
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Affiliation(s)
- Maria C Magnus
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Department of Population Health Sciences, Bristol Medical School, Bristol, UK.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - John Henderson
- Department of Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Department of Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Department of Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Department of Population Health Sciences, Bristol Medical School, Bristol, UK.,NIHR Bristol Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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13
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Pemathilaka RL, Caplin JD, Aykar SS, Montazami R, Hashemi NN. Placenta-on-a-Chip: In Vitro Study of Caffeine Transport across Placental Barrier Using Liquid Chromatography Mass Spectrometry. GLOBAL CHALLENGES (HOBOKEN, NJ) 2019; 3:1800112. [PMID: 31565368 PMCID: PMC6436596 DOI: 10.1002/gch2.201800112] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/22/2019] [Indexed: 05/18/2023]
Abstract
Due to the particular structure and functionality of the placenta, most current human placenta drug testing methods are limited to animal models, conventional cell testing, and cohort/controlled testing. Previous studies have produced inconsistent results due to physiological differences between humans and animals and limited availability of human and/or animal models for controlled testing. To overcome these challenges, a placenta-on-a-chip system is developed for studying the exchange of substances to and from the placenta. Caffeine transport across the placental barrier is studied because caffeine is a xenobiotic widely consumed on a daily basis. Since a fetus does not carry the enzymes that inactivate caffeine, when it crosses a placental barrier, high caffeine intake may harm the fetus, so it is important to quantify the rate of caffeine transport across the placenta. In this study, a caffeine concentration of 0.25 mg mL-1 is introduced into the maternal channel, and the resulting changes are observed over a span of 7.5 h. A steady caffeine concentration of 0.1513 mg mL-1 is reached on the maternal side after 6.5 h, and a 0.0033 mg mL-1 concentration on the fetal side is achieved after 5 h.
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Affiliation(s)
| | - Jeremy D. Caplin
- Department of Mechanical EngineeringIowa State UniversityAmesIA50011USA
- Petit Institute for Bioengineering and BioscienceGeorgia Institute of TechnologyAtlantaGA30332USA
| | - Saurabh S. Aykar
- Department of Mechanical EngineeringIowa State UniversityAmesIA50011USA
| | - Reza Montazami
- Department of Mechanical EngineeringIowa State UniversityAmesIA50011USA
| | - Nicole N. Hashemi
- Department of Mechanical EngineeringIowa State UniversityAmesIA50011USA
- Department of Biomedical SciencesIowa State UniversityAmesIA50011USA
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14
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Guo L, Li S, Lu R, Yin L, Gorson-Deruel A, King L. The research topic landscape in the literature of social class and inequality. PLoS One 2018; 13:e0199510. [PMID: 29965983 PMCID: PMC6028105 DOI: 10.1371/journal.pone.0199510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 06/09/2018] [Indexed: 11/19/2022] Open
Abstract
The literature of social class and inequality is not only diverse and rich in sight, but also complex and fragmented in structure. This article seeks to map the topic landscape of the field and identify salient development trajectories over time. We apply the Latent Dirichlet Allocation topic modeling technique to extract 25 distinct topics from 14,038 SSCI articles published between 1956 to 2017. We classified three topics as "hot", eight as "stable" and 14 as "cold", based on each topic's idiosyncratic temporal trajectory. We also listed the three most cited references and the three most popular journal outlets per topic. Our research suggests that future effort may be devoted to Topics "urban inequalities, corporate social responsibility and public policy in connected capitalism", "education and social inequality", "community health intervention and social inequality in multicultural contexts" and "income inequality, labor market reform and industrial relations".
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Affiliation(s)
- Liang Guo
- Institute of Computational Social Science, Shandong University, Weihai, China
| | - Shikun Li
- Institute of Computational Social Science, Shandong University, Weihai, China
| | - Ruodan Lu
- Engineering Department, Cambridge University, Cambridge, United Kingdom
| | - Lei Yin
- Institut Supérieur de Management et Communication, Paris, France
| | | | - Lawrence King
- Department of Economics, University of Massachusetts, Amherst, MA, United States
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15
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Abstract
The development of liaison psychiatry services over the last 20 years is briefly reviewed--sophisticated liaison services have been confined to teaching hospitals. Limited manpower and other resources have prevented the development of liaison services in most district general hospitals; further developments are unlikely unless these deficiencies are corrected and psychiatrists take a more active role in developing links with physicians and surgeons. The time is right for such development as physicians are keen to extend our understanding of psychological and social factors in causing non-organic disorders, reduce unnecessary investigations and provide more comprehensive care. Increased collaboration between physicians and psychiatrists will provide a better service for many patients and this should be extended to all district general hospitals.
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Affiliation(s)
- F Creed
- University Department of Psychiatry, Manchester Royal Infirmary
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16
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Mamluk L, Edwards HB, Savović J, Leach V, Jones T, Moore THM, Ijaz S, Lewis SJ, Donovan JL, Lawlor D, Smith GD, Fraser A, Zuccolo L. Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently 'safe' levels of alcohol during pregnancy? A systematic review and meta-analyses. BMJ Open 2017; 7:e015410. [PMID: 28775124 PMCID: PMC5642770 DOI: 10.1136/bmjopen-2016-015410] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine the effects of low-to-moderate levels of maternal alcohol consumption in pregnancy on pregnancy and longer-term offspring outcomes. SEARCH STRATEGY Medline, Embase, Web of Science and Psychinfo from inception to 11 July 2016. SELECTION CRITERIA Prospective observational studies, negative control and quasiexperimental studies of pregnant women estimating effects of light drinking in pregnancy (≤32 g/week) versus abstaining. Pregnancy outcomes such as birth weight and features of fetal alcohol syndrome were examined. DATA COLLECTION AND ANALYSIS One reviewer extracted data and another checked extracted data. Random effects meta-analyses were performed where applicable, and a narrative summary of findings was carried out otherwise. MAIN RESULTS 24 cohort and two quasiexperimental studies were included. With the exception of birth size and gestational age, there was insufficient data to meta-analyse or make robust conclusions. Odds of small for gestational age (SGA) and preterm birth were higher for babies whose mothers consumed up to 32 g/week versus none, but estimates for preterm birth were also compatible with no association: summary OR 1.08, 95% CI (1.02 to 1.14), I2 0%, (seven studies, all estimates were adjusted) OR 1.10, 95% CI (0.95 to 1.28), I2 60%, (nine studies, includes one unadjusted estimates), respectively. The earliest time points of exposure were used in the analysis. CONCLUSION Evidence of the effects of drinking ≤32 g/week in pregnancy is sparse. As there was some evidence that even light prenatal alcohol consumption is associated with being SGA and preterm delivery, guidance could advise abstention as a precautionary principle but should explain the paucity of evidence.
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Affiliation(s)
- Loubaba Mamluk
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Hannah B Edwards
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Jelena Savović
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Verity Leach
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Timothy Jones
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Theresa H M Moore
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Sharea Ijaz
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Sarah J Lewis
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Debbie Lawlor
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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17
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Dede H, Takmaz O, Ozbasli E, Dede S, Gungor M. Higher Level of Oxidative Stress Markers in Small for Gestational Age Newborns Delivered by Cesarean Section at Term. Fetal Pediatr Pathol 2017; 36:232-239. [PMID: 28368675 DOI: 10.1080/15513815.2017.1303860] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The aim of our study was to determine lipid peroxidation products and antioxidant enzyme activity in umbilical cord blood of small for gestational age (SGA) neonates. MATERIALS AND METHODS Umbilical cord arterial blood samples were collected from 21-term singleton SGA newborn infants and 21 age- and sex-matched appropriate for gestational age (AGA) term neonates prospectively born by elective cesarean section for determination of malondialdehyde (MDA) as a marker of lipid peroxidation and superoxide dismutase (SOD) for antioxidant activity. RESULTS MDA levels were increased (5.20 vs. 3.52 nmol/mL; p < 0.001), while levels of SOD (6.24 vs. 8.99 U/mL; p < 0.01) were decreased in SGA neonates when compared with AGA newborn infants. CONCLUSIONS Elevated MDA levels and decreased SOD activity in umbilical cord blood may show the possibility of insufficient protective mechanisms against increased oxidative stress in SGA neonates born by cesarean section.
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Affiliation(s)
- Hulya Dede
- a Department of Obstetrics and Gynecology , Acibadem University Maslak Hospital , Istanbul , Turkey
| | - Ozguc Takmaz
- a Department of Obstetrics and Gynecology , Acibadem University Maslak Hospital , Istanbul , Turkey
| | - Esra Ozbasli
- a Department of Obstetrics and Gynecology , Acibadem University Maslak Hospital , Istanbul , Turkey
| | - Suat Dede
- a Department of Obstetrics and Gynecology , Acibadem University Maslak Hospital , Istanbul , Turkey
| | - Mete Gungor
- a Department of Obstetrics and Gynecology , Acibadem University Maslak Hospital , Istanbul , Turkey
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18
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Miller TL, Jacobson DL, Somarriba G, Neri D, Kurtz-Vraney J, Graham P, Gillman MW, Landy DC, Siminski S, Butler L, Rich KC, Hendricks K, Ludwig DA. A multicenter study of diet quality on birth weight and gestational age in infants of HIV-infected women. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27863014 DOI: 10.1111/mcn.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/21/2016] [Accepted: 08/12/2016] [Indexed: 11/30/2022]
Abstract
We determined factors associated with diet quality and assessed the relationship between diet quality, birth weight, and gestational age in a prospective national multicenter cohort study. We evaluated diet quality with the Healthy Eating Index (HEI, scale 0-100) in the third trimester of pregnancy with three 24-hr multiple-pass dietary recalls in 266 HIV+ women enrolled in the Pediatric HIV/AIDS Cohort Study. Covariates included demographics, food security, pre-pregnancy body mass index, HIV disease severity, substance use, and antiretroviral exposures. A two-stage multivariate process using classification and regression trees (CART) followed by multiple regression described HEI tendencies, controlled possible confounding effects, and examined the association of HEI with birth weight and gestational age. To assess the stability of the CART solution, both the HEI 2005 and 2010 were evaluated. The mean HEI scores were 56.1 and 47.5 for the 2005 and 2010 HEI, respectively. The first-stage CART analysis examined the relationship between HEI and covariates. Non-US born versus US-born mothers had higher HEI scores (15-point difference, R2 = 0.28). There was a secondary partition due to alcohol/cigarette/illicit drug usage (3.5-point difference, R2 = 0.03) among US-born women. For the second-stage CART adjusted multiple regression, birth weight z-score was positively related to HEI 2005 and 2010 (partial r's > 0.13, P's ≤ 0.0398), but not gestational age (r = 0.00). We conclude that diet quality among HIV+ women is associated with higher birth weight. Despite the influence of a large cultural effect and poor prenatal behaviors, interventions to improve diet in HIV+ women may help to increase birth weight.
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Affiliation(s)
- Tracie L Miller
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Denise L Jacobson
- Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Gabriel Somarriba
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Daniela Neri
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Joy Kurtz-Vraney
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Patricia Graham
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Matthew W Gillman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - David C Landy
- Department of Orthopedic Surgery, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Suzanne Siminski
- Amherst Office, Frontier Science Technology Research Foundation INC, New York, USA
| | - Laurie Butler
- Amherst Office, Frontier Science Technology Research Foundation INC, New York, USA
| | - Kenneth C Rich
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kristy Hendricks
- Department of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire, USA
| | - David A Ludwig
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
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19
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Witt WP, Mandell KC, Wisk LE, Cheng ER, Chatterjee D, Wakeel F, Park H, Zarak D. Infant birthweight in the US: the role of preconception stressful life events and substance use. Arch Womens Ment Health 2016; 19:529-42. [PMID: 26767530 PMCID: PMC5570463 DOI: 10.1007/s00737-015-0595-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/07/2015] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. Data were from the Early Childhood Longitudinal Study-Birth Cohort (n = 9,350). Data were collected in 2001. Exposure to PSLEs was defined by indications of death of a parent, spouse, or previous live born child; divorce or marital separation; or fertility problems prior to conception. Survey data determined alcohol and tobacco usage during the 3 months prior to and in the final 3 months of pregnancy. We used staged multivariable logistic regression to estimate the effects of women's substance use and PSLEs on the risk of having a very low (<1,500 g, VLBW) or low (1,500-2,499 g, LBW) birthweight infant, adjusting for confounders. Women who experienced any PSLE were more likely to give birth to VLBW infants (adjusted odds ratio [AOR] = 1.35; 95 % confidence interval [CI] = 1.10-1.66) than women who did not experience any PSLE. Compared to women who never smoked, women who smoked prior to conception (AOR = 1.31; 95 % CI = 1.04-1.66) or during their last trimester (AOR = 1.98; 95 % CI = 1.56-2.52) were more likely to give birth to LBW infants. PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby. Interventions to improve birth outcomes may need to address women's health and health behaviors in the preconception period.
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Affiliation(s)
- Whitney P Witt
- Center for Maternal and Child Health Research, Truven Health Analytics, Inc, 4819 Emperor Boulevard, Suite 125, Durham, NC, 27703, USA.
| | | | - Lauren E Wisk
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA
| | - Erika R Cheng
- Department of Pediatrics, Section of Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Debanjana Chatterjee
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, MN, USA
| | - Fathima Wakeel
- Ferris State University's College of Health Professions, Big Rapids, MI, USA
| | - Hyojun Park
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Dakota Zarak
- Department of Psychology, University of Wisconsin, Madison, WI, USA
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20
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Phung H, Bauman A, Nguyen TV, Young L, Tran M, Hillman K. Risk factors for low birth weight in a socio-economically disadvantaged population: parity, marital status, ethnicity and cigarette smoking. Eur J Epidemiol 2016; 18:235-43. [PMID: 12800948 DOI: 10.1023/a:1023384213536] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Low birth weight (LBW) is a public health problem, because it is associated with increased risk of morbidity and mortality. The principal aim of this study was to assess risk factors for LBW in a large multi-ethnic and socio-economically disadvantaged population. Data from 3242 mothers, who attended the Well Baby Clinic (Southwestern Sydney, Australia) for the first time, were analysed in relation to their demographic characteristics and socio-economic indices. The overall birthweight was 3377 +/- 577 g (mean +/- SD). In multiple linear regression analysis, smoking during pregnancy, marital status, parity, and country of birth were independently associated with birth weight. According to this analysis, lower birth weight was associated with mothers who had smoked during pregnancy (by 215.2 +/- 18.6 g), who were single (46.9 +/- 21 g), and of Asian background (108.5 +/- 38.2 g). However, higher parity was associated with significantly higher birth weight. The presence of each factor was coded as 1 and the absence, 0. A 'risk score' was then derived by summing up the individual scores. When birth weight was classified as 'low birth weight' (defined as those with birth weight being less than 2500 g) or normal birth weight, the overall prevalence of LBW was 1.9%. Each unit increase in the risk score was associated with a 1.9-fold (95% confidence interval: 1.5-2.6) increase in the risk of LBW. These data suggest that apart from marital status, ethnicity and parity, maternal smoking is the single most important preventable risk factors for LBW.
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Affiliation(s)
- H Phung
- The Simpson Centre For Health Services Research, Liverpool Hospital, South Western Sydney Area Health Services, Faculty of Medicine University of New South Wales, Australia.
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21
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Wang LY, Wang N, Le F, Li L, Lou HY, Liu XZ, Zheng YM, Qian YQ, Chen YL, Jiang XH, Huang HF, Jin F. Superovulation Induced Changes of Lipid Metabolism in Ovaries and Embryos and Its Probable Mechanism. PLoS One 2015; 10:e0132638. [PMID: 26167919 PMCID: PMC4500408 DOI: 10.1371/journal.pone.0132638] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/16/2015] [Indexed: 12/14/2022] Open
Abstract
This research was intended to investigate the fetal origins of changed birth weight of the offspring born through assisted reproductive technology (ART). The association between hormone and lipid metabolism or body weight has been generally accepted, and as the basic and specific treatment in ART procedure, gonadotropin stimulation might have potential effects on intrauterine lipid metabolism. In our studies, the mice were superovulated with two doses of gonadotropin. The cholesterol metabolism in ovaries and the triglyceride metabolism in embryos were analyzed. The results showed gonadotropin probably accelerated luteinization and induced a longer time follicle development and ovulation, which resulted in histological and morphological alteration of ovary, and increased the cholesterol content and the expressions of steroidogenesis-related genes. In embryos, gonadotropin increased lipid accumulation and decreased fatty acid synthesis in a dose-dependent manner. Moreover, the changes of fatty acid composition were also shown in superovulation groups. Our studies firstly provided the evidence that the superovulation might affect the maternal and fetal lipid metabolism. These variations of lipid metabolism in our results may be associated with birth weight of ART infants.
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Affiliation(s)
- Li-Ya Wang
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
| | - Ning Wang
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
| | - Fang Le
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
| | - Lei Li
- Department of Gynecologic Oncology, Henan Cancer Hospital, Zhengzhou, 450003, China
| | - Hang-Ying Lou
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
| | - Xiao-Zhen Liu
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
| | - Ying-Ming Zheng
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
| | - Ye-Qing Qian
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
| | - Yun-Long Chen
- College of Life Science, Zhejiang University, Hangzhou, 310058, China
| | - Xin-Hang Jiang
- College of Life Science, Zhejiang University, Hangzhou, 310058, China
| | - He-Feng Huang
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, 910 Hengshan Road, Shanghai, 200030, China
| | - Fan Jin
- Centre of Reproductive Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Key Laboratory of Reproductive Genetics (Zhejiang), Ministry of Health, Hangzhou, 310006, China
- * E-mail:
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Bussières EL, Tarabulsy GM, Pearson J, Tessier R, Forest JC, Giguère Y. Maternal prenatal stress and infant birth weight and gestational age: A meta-analysis of prospective studies. DEVELOPMENTAL REVIEW 2015. [DOI: 10.1016/j.dr.2015.04.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bech BH, Frydenberg M, Henriksen TB, Obel C, Olsen J. Coffee Consumption During Pregnancy and Birth Weight: Does Smoking Modify the Association? JOURNAL OF CAFFEINE RESEARCH 2015. [DOI: 10.1089/jcr.2015.0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Bodil Hammer Bech
- Section for Epidemiology, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Morten Frydenberg
- Section for Biostatistics, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | | | - Carsten Obel
- Section for General Practice/Family Medicine, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Jørn Olsen
- Section for Epidemiology, Department of Public Health, University of Aarhus, Aarhus, Denmark
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Maternal caffeine consumption and small for gestational age births: results from a population-based case-control study. Matern Child Health J 2015; 18:1540-51. [PMID: 24288144 DOI: 10.1007/s10995-013-1397-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Caffeine is consumed in various forms during pregnancy, has increased half-life during pregnancy and crosses the placental barrier. Small for gestational age (SGA) is an important perinatal outcome and has been associated with long term complications. We examined the association between maternal caffeine intake and SGA using National Birth Defects Prevention Study data. Non-malformed live born infants with an estimated date of delivery from 1997-2007 (n = 7,943) were included in this analysis. Maternal caffeine exposure was examined as total caffeine intake and individual caffeinated beverage type (coffee, tea, and soda); sex-, race/ethnic-, and parity-specific growth curves were constructed to estimate SGA births. Crude and adjusted odds ratios (aORs) and 95% confidence intervals were estimated using unconditional logistic regression. Interaction with caffeine exposures was assessed for maternal smoking, vasoconstrictor medication use, and folic acid. Six hundred forty-eight infants (8.2%) were found to be SGA in this analysis. Increasing aORs were observed for increasing intakes of total caffeine and for each caffeinated beverage with aORs (adjusting for maternal education, high blood pressure, and smoking) ranging from 1.3 to 2.1 for the highest intake categories (300+ mg/day total caffeine and 3+ servings/day for each beverage type). Little indication of additive interaction by maternal smoking, vasoconstrictor medication use, or folic acid intake was observed. We observed an increase in SGA births for mothers with higher caffeine intake, particularly for those consuming 300+ mg of caffeine per day. Increased aORs were also observed for tea intake but were more attenuated for coffee and soda intake.
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Cosson E, Bihan H, Reach G, Vittaz L, Carbillon L, Valensi P. Psychosocial deprivation in women with gestational diabetes mellitus is associated with poor fetomaternal prognoses: an observational study. BMJ Open 2015; 5:e007120. [PMID: 25748416 PMCID: PMC4360844 DOI: 10.1136/bmjopen-2014-007120] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To evaluate the prognoses associated with psychosocial deprivation in women with gestational diabetes mellitus (GDM). DESIGN Observational study considering the 1498 multiethnic women with GDM who gave birth between January 2009 and February 2012. SETTING Four largest maternity units in the northeastern suburban area of Paris. PARTICIPANTS The 994 women who completed the Evaluation of Precarity and Inequalities in Health Examination Centers (EPICES) questionnaire. MAIN OUTCOME MEASURE Main complications of GDM (large infant for gestational age (LGA), shoulder dystocia, caesarean section, pre-eclampsia). RESULTS Psychosocial deprivation (EPICES score ≥30.17) affected 577 women (56%) and was positively associated with overweight/obesity, parity and non-European origin, and negatively associated with family history of diabetes, fruit and vegetable consumption and working status. The psychosocially deprived women were diagnosed with GDM earlier, received insulin treatment during pregnancy more often and were more likely to have LGA infants (15.1% vs 10.6%, OR=1.5 (95% CI 1.02 to 2.2), p<0.05) and shoulder dystocia (3.1% vs 1.2%, OR=2.7 (0.97 to 7.2), p<0.05). In addition to psychosocial deprivation, LGA was associated with greater parity, obesity, history of GDM, ethnicity, excessive gestational weight gain and insulin therapy. A multivariate analysis using these covariates revealed that the EPICES score was independently associated with LGA infants (per 10 units, OR=1.12 (1.03 to 1.20), p<0.01). CONCLUSIONS In our area, psychosocial deprivation is common in women with GDM and is associated with earlier GDM diagnoses and greater insulin treatment, an increased likelihood of shoulder dystocia and, independently of obesity, gestational weight gain and other confounders with LGA infants.
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Affiliation(s)
- Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Hélène Bihan
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
- Department of Diabetology, Metabolic Diseases, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, Bobigny, France
| | - Gérard Reach
- Department of Diabetology, Metabolic Diseases, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, Bobigny, France
| | - Laurence Vittaz
- Department of Endocrinology-Diabetology, Ballanger Hospital, Aulnay-Sous-Bois, France
| | - Lionel Carbillon
- Department of Obstetrics and Gynecology, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Paul Valensi
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
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Kolsuz LD, Topcuoglu S, Gursoy T, Karatekin G, Ovali HF. Amplitude-integrated electroencephalographic activity and middle cerebral artery Doppler flow measurements in preterm small for gestational age infants. J Child Neurol 2015; 30:412-6. [PMID: 25296921 DOI: 10.1177/0883073814549996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/07/2014] [Indexed: 11/16/2022]
Abstract
Amplitude-integrated encephalography (EEG) is frequently used in neonatal intensive care units to monitor brain functions. Its bedside application and easy interpretation are the most important features. Brain development of small for gestational age infants can be affected by intrauterine chronic hypoxia. The current study aimed to evaluate cerebral functions of small for gestational age infants by means of amplitude-integrated EEG. Thirty- to 34-week-old 22 small for gestational age and 27 appropriate for gestational age preterm infants were included in the study. The mode of delivery, gender, birth weight, and Apgar scores of the patients were recorded. Following middle cerebral artery mean velocity measurement with cranial Doppler at the 24th hour of birth, an amplitude-integrated EEG recording was performed on all infants, for a period of 4 to 24 hours. Small for gestational age infants had significantly higher middle cerebral artery mean velocity than appropriate for gestational age infants (21.09 ± 4.25 vs 17.8 ± 4.07; P = .029). The amplitude-integrated EEG recordings showed lower "lower border of quiet sleep" and total Burdjalov score in small for gestational age infants when compared with appropriate for gestational age infants (2.5 [1-3.25] µV vs 3 [2.75-4] µV; P = .04, 8 [6-10], 9 [9-11]; P = .04, respectively). Increased middle cerebral artery blood flow observed in small for gestational age infants might be a marker of chronic intrauterine hypoxia to which these infants were exposed. These infants demonstrated a more immature pattern of amplitude-integrated EEG.
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Affiliation(s)
- Leyla Daban Kolsuz
- Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Sevilay Topcuoglu
- Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Tugba Gursoy
- Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Güner Karatekin
- Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - H Fahri Ovali
- Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
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Podvornik N, Globevnik Velikonja V, Praper P. Depression and Anxiety in Women During Pregnancy in Slovenia. Zdr Varst 2014; 54:45-50. [PMID: 27646621 PMCID: PMC4820148 DOI: 10.1515/sjph-2015-0006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 11/17/2014] [Indexed: 01/15/2023] Open
Abstract
Objective The aim of the study was to evaluate the prevalence of elevated depression and anxiety among pregnant women and to examine its correlation with medical complications and socio-demographic characteristics. Methods The study is based on a cross-sectional design of a sample of 348 women in three trimesters of pregnancy who received routine obstetrical care at the University Medical Centre Ljubljana, Department of Obstetrics and Gynaecology. The responding women filled out a questionnaire on socio-demographic variables, the Centre for Epidemiologic Studies Depression Scale CES-D and the State Trait Anxiety Inventory STAI. Results 21.7% of pregnant women were identified as suffering from elevated depression symptomatology, 15.7% reported high state anxiety and 12.5% had high trait anxiety. No significant differences in depression and anxiety across pregnancy trimesters were found. The women who have suffered from health complications during previous pregnancies showed higher state anxiety; those experiencing complications during their current pregnancy reported more intense symptoms of depression and of state and trait anxiety than women free of complications. Less educated, lower income and mothers of many children in the third pregnancy trimester reported more intensive symptoms of depression and trait anxiety. Conclusions Elevated depression and anxiety are frequent among pregnant women. The results draw attention to the need for early detection and treatment of depression and anxiety during pregnancy.
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Affiliation(s)
- Nuša Podvornik
- University of Ljubljana, Faculty of Arts, Department of Psychology, Aškerčeva 2, 1000 Ljubljana, Slovenia
| | - Vislava Globevnik Velikonja
- University Medical Centre Ljubljana, Clinic of Gynaecology and Obstetrics, Zaloška 7, 1000 Ljubljana, Slovenia
| | - Peter Praper
- University of Ljubljana, Faculty of Arts, Department of Psychology, Aškerčeva 2, 1000 Ljubljana, Slovenia
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Lopez WD, Seng JS. Posttraumatic stress disorder, smoking, and cortisol in a community sample of pregnant women. Addict Behav 2014; 39:1408-13. [PMID: 24926909 DOI: 10.1016/j.addbeh.2014.04.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 04/21/2014] [Accepted: 04/30/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The prevalence of posttraumatic stress disorder (PTSD) in the United States is higher among pregnant women than women generally. PTSD is related to adverse birth outcomes via physiological and behavioral alterations, such as smoking. METHODS We utilize salivary cortisol measures to examine how traumatic stress, smoking and the hypothalamic-pituitary-adrenal axis interact. Pregnant women (n=395) gave cortisol specimens as part of a cohort study of PTSD and pregnancy at three health systems in the Midwestern United States. Women were divided into three groups: nonsmokers, quitters (who stopped smoking during pregnancy), and pregnancy smokers. Mean cortisol values at three points, sociodemographics, trauma history, and PTSD were compared across groups. We assessed the association of smoking group and PTSD with late afternoon cortisol levels. RESULTS Smokers, quitters, and nonsmokers differed on demographic risk factors and PTSD symptom load. Late afternoon and bedtime cortisol measures were significantly positively correlated with smoking in pregnancy, with smokers with PTSD presenting the highest cortisol levels. Regression analysis showed that smoking in pregnancy was associated with higher late afternoon cortisol in an additive manner with PTSD symptoms. CONCLUSIONS Smoking appears to have a different relationship with cortisol level for those with and without PTSD. This is the first study to show additive effects of smoking and PTSD on cortisol levels in pregnant women. Since high cortisol, smoking, and PTSD have been shown to adversely affect perinatal outcomes, and since those continuing to smoke in pregnancy had the highest PTSD symptom load, PTSD-specific smoking cessation programs in maternity settings are warranted.
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Chen LW, Wu Y, Neelakantan N, Chong MFF, Pan A, van Dam RM. Maternal caffeine intake during pregnancy is associated with risk of low birth weight: a systematic review and dose-response meta-analysis. BMC Med 2014; 12:174. [PMID: 25238871 PMCID: PMC4198801 DOI: 10.1186/s12916-014-0174-6] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/05/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Considerable controversy exists regarding the relation between maternal caffeine intake during pregnancy and risk of low birth weight (birth weight <2,500 g). We aim to assess this association using a systematic review and dose-response meta-analysis of prospective studies. METHODS Potential articles were identified by searching MEDLINE and SCOPUS databases through 17 July 2013. Two authors independently extracted information on study design, participant characteristics and estimates of associations. Random-effects models were used to derive the summary relative risks (RRs) and corresponding 95% confidence intervals (CIs). Dose-response relationships were assessed using generalized least-squares trend estimation. RESULTS In our meta-analysis, we included 13 prospective studies: 9 with low birth weight as a binary outcome variable (90,747 participants and 6,303 cases) and 6 with birth weight as a continuous outcome variable (10,015 participants; 2 studies reported both types of outcomes). Compared with the reference category with no or very low caffeine intake, the RR (95% CI) of low birth weight was 1.13 (1.06 to 1.21; I 2 0.0%) for low intake (50 to 149 mg/day), 1.38 (1.18 to 1.62; I 2 31.9%) for moderate intake (150 to 349 mg/day), and 1.60 (1.24 to 2.08; I 2 65.8%) for high intake (≥350 mg/day). In the dose-response analysis, each 100-mg/day increment in maternal caffeine intake (around one cup of coffee) was associated with 13% (RR 1.13, 1.06 to 1.21) higher risk of low birth weight. The association persisted in strata defined according to various study characteristics. Moderate (-33 g, 95% CI -63 to -4; I 2 0.3%) and high (-69 g, 95% CI -102 to -35; I 2 0.0%) caffeine intakes were also associated with a significantly lower birth weight as compared with the reference category. CONCLUSIONS Higher maternal caffeine intake during pregnancy was associated with a higher risk of delivering low birth weight infants. These findings support recommendations to restrict caffeine intake during pregnancy to low levels.
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Affiliation(s)
- Ling-Wei Chen
- />Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, Block MD3, 117597 Singapore, Singapore
| | - Yi Wu
- />Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, Block MD3, 117597 Singapore, Singapore
| | - Nithya Neelakantan
- />Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, Block MD3, 117597 Singapore, Singapore
| | - Mary Foong-Fong Chong
- />Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- />Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore
| | - An Pan
- />Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, Block MD3, 117597 Singapore, Singapore
- />Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Rob M van Dam
- />Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 16 Medical Drive, Block MD3, 117597 Singapore, Singapore
- />Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- />Department of Nutrition, Harvard School of Public Health, Boston, MA USA
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McPherson KC, Beggs AD, Sultan AH, Thakar R. Can the risk of obstetric anal sphincter injuries (OASIs) be predicted using a risk-scoring system? BMC Res Notes 2014; 7:471. [PMID: 25056485 PMCID: PMC4119183 DOI: 10.1186/1756-0500-7-471] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 07/21/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Perineal trauma involving the anal sphincter is an important complication of vaginal delivery. Prediction of anal sphincter injuries may improve the prevention of anal sphincter injuries. Our aim was to construct a risk scoring model to assist in both prediction and prevention of Obstetric Anal Sphincter Injuries (OASIs). We carried out an analysis of factors involved with OASIs, and tested the constructed model on new patient data. METHODS Data on all vaginal deliveries over a 5 year period (2004-2008) was obtained from the electronic maternity record system of one institution in the UK. All risk factors were analysed using logistic regression analysis. Odds ratios for independent variables were then used to construct a risk scoring algorithm. This algorithm was then tested on subsequent vaginal deliveries from the same institution to predict the incidence of OASIs. RESULTS Data on 16,920 births were analysed. OASIs occurred in 616 (3.6%) of all vaginal deliveries between 2004 and 2008. Significant (p < 0.05) variables that increased the risk of OASIs on multivariate analysis were: African-Caribbean descent, water immersion in labour, water birth, ventouse delivery, forceps delivery. The following variables remained independently significant in decreasing the risk of OASIs: South Asian descent, vaginal multiparity, current smoker, home delivery. The subsequent odds ratios were then used to construct a risk-scoring algorithm that was tested on a separate cohort of patients, showing a sensitivity of 52.7% and specificity of 71.1%. CONCLUSIONS We have confirmed known risk factors previously associated with OASIs, namely parity, birth weight and use of instrumentation during delivery. We have also identified several previously unknown factors, namely smoking status, ethnicity and water immersion. This paper identifies a risk scoring system that fulfils the criteria of a reasonable predictor of the risk of OASIs. This supersedes current practice where no screening is implemented other than examination at the time of delivery by a single examiner. Further prospective studies are required to assess the clinical impact of this scoring system on the identification and prevention of third degree tears.
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Affiliation(s)
| | | | - Abdul H Sultan
- Department of Obstetrics & Gynaecology, Croydon University Hospital, 530 London Road, Croydon, CR7 7YE London, UK.
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Graignic-Philippe R, Dayan J, Chokron S, Jacquet AY, Tordjman S. Effects of prenatal stress on fetal and child development: A critical literature review. Neurosci Biobehav Rev 2014; 43:137-62. [DOI: 10.1016/j.neubiorev.2014.03.022] [Citation(s) in RCA: 179] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 02/19/2014] [Accepted: 03/31/2014] [Indexed: 12/13/2022]
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Educated mothers, healthy infants. The impact of a school reform on the birth weight of Norwegian infants 1967–2005. Soc Sci Med 2014; 105:84-92. [DOI: 10.1016/j.socscimed.2014.01.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 01/07/2014] [Accepted: 01/11/2014] [Indexed: 11/23/2022]
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Wennergren G, Ekerljung L, Alm B, Bjerg A, Lötvall J, Lundbäck B. Alarmingly high prevalence of smoking and symptoms of bronchitis in young women in Sweden: a population-based questionnaire study. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2014; 22:214-20. [PMID: 23660690 PMCID: PMC6442788 DOI: 10.4104/pcrj.2013.00043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: After 10 years of a decrease in smoking among young people in Sweden, we now have indications of increased smoking. Aims: To provide up-to-date information on the prevalence of smoking and smoke-associated respiratory symptoms in young adults in Sweden, with a special focus on possible gender differences. Methods: In the West Sweden Asthma Study, a detailed postal questionnaire focusing on asthma, respiratory symptoms, and possible risk factors was mailed to 30,000 randomly selected subjects aged 16–75 years. The analyses are based on responses from 2,702 subjects aged 16–25 years. Results: More young women than men were smokers (23.5% vs. 15.9%; p<0.001). Women started smoking earlier and smoked more. Symptoms such as longstanding cough, sputum production, and wheeze were significantly more common in smokers. In the multiple logistic regression analysis, smoking significantly increased the risk of recurrent wheeze (odds ratio (OR) 2.0 (95% CI 1.4 to 3.0)) and sputum production, (OR 2.4 (95% CI 1.9 to 3.1)). Conclusions: The alarmingly high prevalence of smoking among young women was parallel to a similarly high prevalence of bronchitis symptoms. This is worrisome, both in itself and because maternal smoking is a risk factor for illness in the child. Adverse respiratory effects of smoking occur within only a few years of smoking initiation.
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Affiliation(s)
- Göran Wennergren
- Krefting Research Centre, Department of Medicine, University of Gothenburg, Gothenburg, Sweden.
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Pfinder M. Anthropometric and health-related behavioral factors in the explanation of social inequalities in low birth weight in children with prenatal alcohol exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:849-65. [PMID: 24406666 PMCID: PMC3924478 DOI: 10.3390/ijerph110100849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 12/18/2013] [Accepted: 12/25/2013] [Indexed: 12/01/2022]
Abstract
There is evidence for social inequalities in the health status of children with prenatal alcohol exposure (PAE). This study aimed to describe social inequalities in low birth weight (LBW) in children/adolescents with PAE and to examine the contribution of anthropometric and health-related behavioral factors to the explanation of social inequalities. A total of 2,159 participants with parental self-reported moderate to regular PAE (enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents) were examined. At similar levels of PAE, the risk of LBW was significantly increased in subjects with a low socioeconomic status (SES) (adjusted odds ratio (OR) 2.78, 95% confidence interval (CI) 1.59, 4.86) and middle SES (adjusted OR 2.04, 95% CI 1.28, 3.24). Maternal height, maternal body mass index (BMI) and smoking during pregnancy mediated the association. The mediating effect of maternal height was 12.5% to 33.7%. Maternal BMI explained 7.9% of the socioeconomic difference in LBW between the high and low SES groups in children with PAE. The mediating effect of smoking during pregnancy was 17.3% to 31.5%. Maternal height, maternal BMI and smoking during pregnancy together explained 24.4% to 60.1% of the socioeconomic differences in LBW in children with PAE. A large proportion of the socioeconomic differences in LBW in children with PAE can be attributed to anthropometric and health-related behavioral factors.
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Affiliation(s)
- Manuela Pfinder
- Bielefeld Graduate School in History and Sociology, Faculty of Sociology, University of Bielefeld, P.O. Box 10-01-31, Bielefeld 33501, Germany.
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Almeida J, Mulready-Ward C, Bettegowda VR, Ahluwalia IB. Racial/Ethnic and nativity differences in birth outcomes among mothers in New York City: the role of social ties and social support. Matern Child Health J 2014; 18:90-100. [PMID: 23435918 PMCID: PMC10999902 DOI: 10.1007/s10995-013-1238-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Immigrants have lower rates of low birth weight (LBW) and to some extent preterm birth (PTB), than their US-born counterparts. This pattern has been termed the 'immigrant health paradox'. Social ties and support are one proposed explanation for this phenomenon. We examined the contribution of social ties and social support to LBW and PTB by race/ethnicity and nativity among women in New York City (NYC). The NYC Pregnancy Risk Assessment Monitoring System survey (2004-2007) data, linked with the selected items from birth certificates, were used to examine LBW and PTB by race/ethnicity and nativity status and the role of social ties and social support to adverse birth outcomes using bivariate and multivariable analyses. SUDAAN software was used to adjust for complex survey design and sampling weights. US- and foreign-born Blacks had significantly increased odds of PTB [adjusted odds ratio (AOR) = 2.43, 95 % CI 1.56, 3.77 and AOR = 2.6, 95 % CI 1.66, 4.24, respectively] compared to US-born Whites. Odds of PTB among foreign-born Other Latinas, Island-born Puerto Ricans' and foreign-born Asians' were not significantly different from US-born Whites, while odds of PTB for foreign-born Whites were significantly lower (AOR = 0.47, 95 % CI 0.26, 0.84). US and foreign-born Blacks' odds of LBW were 2.5 fold that of US-born Whites. Fewer social ties were associated with 32-39 % lower odds of PTB. Lower social support was associated with decreased odds of LBW (AOR 0.69, 95 % CI 0.50, 0.96). We found stronger evidence of the immigrant health paradox across racial/ethnic groups for PTB than for LBW. Results also point to the importance of accurately assessing social ties and social support during pregnancy and to considering the potential downside of social ties.
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Affiliation(s)
| | - Candace Mulready-Ward
- NYC Department of Health and Mental Hygiene, Bureau of Maternal, Infant and Reproductive Health, New York, NY, USA
| | - Vani R Bettegowda
- Perinatal Data Center, March of Dimes Foundation, White Plains, NY, USA
| | - Indu B Ahluwalia
- Pregnancy Risk Assessment Monitoring System, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Poon AK, Yeung E, Boghossian N, Albert PS, Zhang C. Maternal Dietary Patterns during Third Trimester in Association with Birthweight Characteristics and Early Infant Growth. SCIENTIFICA 2013; 2013:786409. [PMID: 24490111 PMCID: PMC3893866 DOI: 10.1155/2013/786409] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 12/15/2013] [Indexed: 05/30/2023]
Abstract
Our analysis examined the impact of maternal dietary patterns and lifestyle factors on markers of fetal growth, specifically birthweight and size for gestational age (small- (SGA) or large-for-gestational age (LGA)). The Infant Feeding Practices Study II, a prospective cohort study, surveyed pregnant women during their 3rd trimester, of which a subgroup (n = 893) completed a food frequency questionnaire. Maternal dietary patterns were evaluated by diet scores (Alternative Healthy Eating Index for Pregnancy and alternate Mediterranean diet) and by carbohydrate quality (glycemic index and glycemic load). Poisson regression with robust standard errors was used to examine the relative risk of SGA and separately LGA, with dietary patterns and other lifestyle factors. Linear regression was used to determine the association of birthweight and early infant growth with better dietary patterns. Relative risk of SGA and LGA was not associated with dietary patterns. Birthweight and infant growth were not associated with maternal diet. Smoking, however, increased the risk of delivering an SGA infant (RR = 2.92, 95% CI: 1.58-5.39), while higher prepregnancy BMI increased the risk of delivering an LGA infant (RR = 1.06, 95% CI: 1.03-1.09). Future studies are needed to evaluate whether deficiencies in more specific maternal dietary nutrients play a role in fetal growth.
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Affiliation(s)
- Anna K. Poon
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Boulevard, 7B03, Bethesda, MD 20892, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Baltimore, MD 21205, USA
| | - Edwina Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Boulevard, 7B03, Bethesda, MD 20892, USA
| | - Nansi Boghossian
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Boulevard, 7B03, Bethesda, MD 20892, USA
| | - Paul S. Albert
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Boulevard, 7B03, Bethesda, MD 20892, USA
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Boulevard, 7B03, Bethesda, MD 20892, USA
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Islam M, Rahman S, Kamruzzaman, Islam M, Samad A. Effect of maternal status and breastfeeding practices on infant nutritional status - a cross sectional study in the south-west region of Bangladesh. Pan Afr Med J 2013; 16:139. [PMID: 24847401 PMCID: PMC4024436 DOI: 10.11604/pamj.2013.16.139.2755] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 12/03/2013] [Indexed: 11/23/2022] Open
Abstract
Introduction The aim of this study was to address the current scenario of LBW and infant nutritional and to analyze the effect of maternal status and pattern of their breast feeding practices on perinatal and postnatal infant development. Methods Cross-sectional study design with structured questionnaires was used among 510 mother-infant pair to collect data. Maternal anthropometric, socio-economic and demographic characteristics and breast feeding practice were used as independent variable and birth weight and infant growth status as dependent variable. Descriptive and crosstab analysis were used to analyze the effect. Results The study revealed that about 29.4% infants were born with low birth weight (LBW). Mother with no education and from low income family were more likely (OR: 3.484, 95%CI: 1.993-6.089 and OR: 2.078, 95% CI: 1.274-3.387) to have LBW infant compared with mother with higher education and from higher income family. Similarly, lower maternal height, weight and MUAC (< 150 cm, <50 kg and < 22 cm respectively) were shown to have more risk of having LBW compared with higher height, weight and MUAC (RR: 1.628, 2.375 and 2.115; 95%CI: 1.250- 2.120, 1.844- 3.059, 1.623- 2.757). The prevalence of exclusive breastfeeding was found among 45% mother. Postnatal growth and development of infant was not found significantly different (P > 0.05) among those who breast feed exclusively and non-exclusively. Conclusion The study confirms that lower level of maternal education; family income and anthropometric measurement significantly increase the risk of LBW. The prevalence of exclusive breastfeeding practice was not found satisfactory.
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Affiliation(s)
- Mohidul Islam
- Dept of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
| | - Shahinur Rahman
- Dept of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
| | - Kamruzzaman
- Dept of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
| | - Mominul Islam
- Dept of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
| | - Abdus Samad
- Dept of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
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Weber D, Stuetz W, Bernhard W, Franz A, Raith M, Grune T, Breusing N. Oxidative stress markers and micronutrients in maternal and cord blood in relation to neonatal outcome. Eur J Clin Nutr 2013; 68:215-22. [PMID: 24327121 DOI: 10.1038/ejcn.2013.263] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 10/21/2013] [Accepted: 10/22/2013] [Indexed: 01/26/2023]
Abstract
BACKGROUND/OBJECTIVES Oxidative stress and micronutrient deficiencies have been related to lower birth weight (BW), small for gestational age (SGA) offspring and preterm delivery. SUBJECTS/METHODS The relation between neonatal outcome (BW, head circumference, SGA, preterm delivery) with markers of oxidative stress and micronutrients in maternal and cord blood was to be examined. Oxidative stress markers (protein carbonyls (PrCarb), 3-nitrotyrosine (3NT), malondialdehyde (MDA)), total protein concentration and lipid-soluble micronutrients (carotenoids, retinol, tocopherols) were measured in 200 newborns (11% preterms, 13% SGA) and 151 mothers. Associations between target parameters in cord plasma and maternal serum with BW, head circumference and risk of being SGA or preterm were explored. RESULTS Maternal protein concentration, PrCarb, MDA and all lipid-soluble micronutrients were significantly higher compared with newborns, except for 3NT, which was significantly elevated in newborns. Newborn parameters correlated positively with those of mothers. Preterms had lower proteins and retinol but higher PrCarb than terms. Maternal PrCarb and retinol were inversely associated with BW and head circumference. Mothers with PrCarb, MDA and retinol in the highest quintile had a 3.3-fold (0.9; 12.1), 2.1-fold (0.7; 6.4) and 3.3-fold (1.2; 9.4) risk, respectively, for delivering an SGA newborn, whereas the lowest quintile of retinol in cord blood was associated with an increased risk for preterm delivery. CONCLUSIONS Oxidative stress (elevated PrCarb) was associated with lower BW/head circumference and SGA. Inadequate hemodilution may explain the inverse relation of maternal retinol with BW and head circumference, and the association between highest maternal retinol and risk for SGA.
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Affiliation(s)
- D Weber
- Department of Nutritional Toxicology, Institute of Nutrition, Friedrich-Schiller-University of Jena, Jena, Germany
| | - W Stuetz
- Department of Nutritional Toxicology, Institute of Nutrition, Friedrich-Schiller-University of Jena, Jena, Germany
| | - W Bernhard
- Department of Neonatology, Faculty of Medicine, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany
| | - A Franz
- Department of Neonatology, Faculty of Medicine, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany
| | - M Raith
- Department of Neonatology, Faculty of Medicine, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany
| | - T Grune
- Department of Nutritional Toxicology, Institute of Nutrition, Friedrich-Schiller-University of Jena, Jena, Germany
| | - N Breusing
- Department of Applied Nutritional Science/Dietetics, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Doamekpor LA, Amutah NN, Ramos LJ. Fathers matter: the role of paternal age in infant mortality. Am J Mens Health 2013; 8:175-82. [PMID: 24262789 DOI: 10.1177/1557988313511492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Infant mortality is the most widely used indicator of a nation's health status and is associated with a plethora of maternal and socioeconomic factors. Although the association between young and old maternal age and the risk of infant mortality is well established, the link between paternal age and birth outcomes has received far less attention. This study seeks to examine the added impact of paternal age on infant mortality, above and beyond that of maternal age among married couples. Using the 2002 linked birth and infant death data set (N = 63,754), hazard odds ratios for the association between combined adolescent and adult maternal and paternal age and the risk of infant mortality were estimated. Maternal demographic characteristics, such as education and race/ethnicity were controlled. The findings indicate that, independent of maternal education and race/ethnicity, adolescent father adds additional risk, above and beyond that of maternal age, only when the mother is older (21-45 years; hazard ratio = 2.7). This study highlights that for married couples, adolescent fathers add to the risk of infant mortality when the mothers are older, providing insight into the role of paternal age in infant mortality. Implications for additional research are discussed.
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Tayie FA, Powell C. Sex differences in the association between prenatal smoking and decreased birthweight, and intensive health care of the neonate. Behav Med 2013; 38:138-42. [PMID: 23121211 DOI: 10.1080/08964289.2012.703977] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Gender-specific associations between prenatal smoking and birthweight, and neonate intensive health care were studied. Cross-sectional data from 11,583 newborns in the continuous National Health and Nutrition Examination Survey (NHANES) 2003-2008 early childhood data sets were used. Change in infant birthweight and likelihood of receiving neonatal intensive care by prenatal smoking exposure were assessed. Multivariable regression models were used to assess the influence of prenatal smoking on birthweight and likelihood of receiving intensive neonatal health care. Compared with infants from nonsmoking mothers, prenatal smoking associated with significant decrease in infant birthweight, -203.0 g ± 32.5, P < 0.001. The change in birthweight differed between infant boys, -220.2 g ± 44.5, and girls, -184.1 g ± 38.8. Newborns exposed to prenatal smoking were more likely to have low birthweight, odds ratio 1.46, P < 0.03, and to receive neonatal intensive health care, odds ratio 1.20; P < 0.04. It is imperative that prenatal counseling emphasizes prenatal maternal smoking.
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Affiliation(s)
- Francis A Tayie
- Human Environmental Studies Dept., Central Michigan University, Mt. Pleasant, MI 48859, USA.
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43
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Junger M, Japel C, Coté S, Xu Q, Boivin M, Tremblay RE. Smoking and medication during pregnancy predict repeated unintentional injuries in early childhood but not single unintentional injuries. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2013; 14:13-24. [PMID: 23212766 PMCID: PMC3546297 DOI: 10.1007/s11121-012-0304-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study investigates prospectively the development of single and repeated unintentional injuries from birth to 42 months in a random population sample of new-born children in Quebec (Canada) (N = 1,770). The outcome measures are single unintentional injuries (SUI) and repeated unintentional injuries (RUI). Results showed that the risk factors for SUI differed from the risk factors for RUI. SUI was predicted by mother's antisocial behavior during high school (OR = 1.72) and mother's age at first birth (OR = 1.82) with children from older mothers at higher likelihood of SUI. Also, boys (OR = 1.36) and hyperactive children (OR = 1.06) were at increased risk of SUI. RUI was predicted by maternal smoking during pregnancy (OR = 1.68), medication on prescription (OR = 1.53) and medication without prescription (OR = 1.54). Boys (OR = 2.01), children with a difficult temperament (OR = 1.13) and those with single mothers had higher rates of RUI (OR = 2.05). Maternal perception of impact (OR = 1.15) and maternal feelings of self-efficacy (OR = 0.87; marginally significant) were also associated with RUI. These results show that maternal and child risk factors identified during pregnancy and just after birth can predict SUI as well as RUI in early childhood. However, the only common risk factor for SUI and RUI is the child's sex, with boys being at higher risk than girls. Implications of these findings and suggestions for prevention are discussed.
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Affiliation(s)
- Marianne Junger
- Institute for Innovation and Governance Studies, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
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Maternal severe stressful life events and risk of neural tube defects among rural Chinese. ACTA ACUST UNITED AC 2013; 97:109-14. [DOI: 10.1002/bdra.23108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 11/21/2012] [Accepted: 11/27/2012] [Indexed: 11/07/2022]
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45
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van Baal CGM, Boomsma DI. Etiology of individual differences in birth weight of twins as a function of maternal smoking during pregnancy. ACTA ACUST UNITED AC 2012. [DOI: 10.1375/twin.1.3.123] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBirth weight is in large extent influenced by gestational age. In addition genetic and environmental factors determine intrauterine growth and birth weight. The contributions of these factors may be influenced by maternal smoking during pregnancy. We examined birth weight and maternal smoking in a sample of 2930 twin pairs from the Netherlands Twin Register using structural equation modelling. Gestational age accounted for 27–44% of the variance in birth weight. A lower variability of birth weight and a lower association of birth weight with gestational age was found in twins whose mothers smoked during pregnancy. The variance not associated with gestational age was independent of maternal smoking during pregnancy. A systematic smaller part of the variability in birth weight was associated with variability in gestational age in second born twins compared to first born twins. The heritability of interindividual differences in birth weight was modest (10% for twins with non-smoking mothers and 11% for twins with smoking mothers). Common environmental influences other than gestational age accounted for a slightly larger part of the variance not associated with gestational age (17–20%).
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Foltran F, Gregori D, Franchin L, Verduci E, Giovannini M. Effect of alcohol consumption in prenatal life, childhood, and adolescence on child development. Nutr Rev 2012; 69:642-59. [PMID: 22029831 DOI: 10.1111/j.1753-4887.2011.00417.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The effects of alcohol consumption in adults are well described in the literature, while knowledge about the effects of alcohol consumption in children is more limited and less systematic. The present review shows how alcohol consumption may negatively influence the neurobiological and neurobehavioral development of humans. Three different periods of life have been considered: the prenatal term, childhood, and adolescence. For each period, evidence of the short-term and long-term effects of alcohol consumption, including neurodevelopmental effects and associations with subsequent alcohol abuse or dependence, is presented.
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Affiliation(s)
- Francesca Foltran
- Laboratories of Epidemiological Methods and Biostatistics, Department of Environmental Medicine and Public Health, University of Padova, Padova, Italy
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Thiengo DL, Pereira PK, Santos JFDC, Cavalcanti MT, Lovisi GM. Depressão durante a gestação e os desfechos na saúde do recém-nascido: coorte de mães atendidas em unidade básica de saúde. JORNAL BRASILEIRO DE PSIQUIATRIA 2012. [DOI: 10.1590/s0047-20852012000400004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Descrever a associação entre depressão durante a gestação e os efeitos no recém-nascido (baixo peso ao nascer e prematuridade). MÉTODOS: Foi realizado um estudo de coorte, com 100 gestantes atendidas entre março e setembro de 2011 em uma unidade de atenção básica de saúde de Nova Iguaçu. As gestantes responderam sobre características sociodemográficas, condições médicas/obstétricas, eventos estressantes e apoio social. A depressão foi avaliada por meio do Composite International Diagnostic Interview (CIDI). Após o período do pós-parto, as mães responderam às questões sobre baixo peso e prematuridade ao nascer. RESULTADOS: A prevalência da depressão na gravidez foi de 18% (IC95%: 12,2-23,8). Fatores associados com desfecho neonatal foram depressão gestacional (OR: 6,60 IC: 1,51-28,91) e uso de álcool (OR: 8,75 IC: 1,10-69,71). CONCLUSÃO: As implicações do presente estudo para a prática enfatizam a necessidade de triagem para depressão durante a gestação.
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Chen MJ, Grobman WA, Gollan JK, Borders AEB. The use of psychosocial stress scales in preterm birth research. Am J Obstet Gynecol 2011; 205:402-34. [PMID: 21816383 PMCID: PMC3205306 DOI: 10.1016/j.ajog.2011.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 04/13/2011] [Accepted: 05/01/2011] [Indexed: 10/18/2022]
Abstract
Psychosocial stress has been identified as a potential risk factor for preterm birth. However, an association has not been found consistently, and a consensus on the extent to which stress and preterm birth are linked is still lacking. A literature search was performed with a combination of keywords and MeSH terms to detect studies of psychosocial stress and preterm birth. Studies were included in the review if psychosocial stress was measured with a standardized, validated instrument and if the outcomes included either preterm birth or low birthweight. Within the 138 studies that met inclusion criteria, 85 different instruments were used. Measures that had been designed specifically for pregnancy were used infrequently, although scales were sometimes modified for the pregnant population. The many different measures that have been used may be a factor that accounts for the inconsistent associations that have been observed.
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Affiliation(s)
- Melissa J Chen
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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49
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Lopez WD, Konrath SH, Seng JS. Abuse-related post-traumatic stress, coping, and tobacco use in pregnancy. J Obstet Gynecol Neonatal Nurs 2011; 40:422-31. [PMID: 21645115 PMCID: PMC3140595 DOI: 10.1111/j.1552-6909.2011.01261.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine the relationship between trauma history, posttraumatic stress disorder (PTSD), coping, and smoking in a diverse sample of pregnant women, some of whom are active smokers. DESIGN Secondary analysis from a prospective study on PTSD and pregnancy outcomes. SETTING Maternity clinics at three health systems in the midwestern United States. PARTICIPANTS Women age 18 or older (1,547) interviewed at gestational age fewer than 28 weeks. METHODS Participants were classified at nonsmokers, quitters (stopped smoking during pregnancy), and pregnancy smokers. Demographic, trauma, and pregnancy factors, substance use, and use of tobacco to cope were compared across groups. Logistic regression assessed the influence of these factors on being a smoker versus a nonsmoker and a quitter versus a pregnancy smoker. RESULTS Smokers differed from nonsmokers on all demographic risk factors (being African American, being pregnant as a teen, having lower income and less education, and living in high-crime areas), had higher rates of current and lifetime PTSD, and were more likely to report abuse as their worst trauma. Pregnancy smokers had lower levels of education, were more likely to classify their worst trauma as "extremely troubling," and were more likely to exhibit PTSD hyperarousal symptoms. In regression models, smoking "to cope with emotions and problems" doubled the odds of continuing to smoke while pregnant even after accounting for several relevant risk factors. CONCLUSION Smoking behavior in pregnancy may be influenced by the need to cope with abuse-related PTSD symptoms. Clinicians should consider using trauma-informed interventions when working with tobacco-using pregnant women.
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Affiliation(s)
- William D Lopez
- Research Center for Group Dynamics, Institute for Social Research, University of Michigan, 6134, 426 Thomson Street, Ann Arbor, MI 48106, USA.
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50
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Burgette LF, Reiter JP. Modeling adverse birth outcomes via confirmatory factor quantile regression. Biometrics 2011; 68:92-100. [PMID: 21689080 DOI: 10.1111/j.1541-0420.2011.01639.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We describe a Bayesian quantile regression model that uses a confirmatory factor structure for part of the design matrix. This model is appropriate when the covariates are indicators of scientifically determined latent factors, and it is these latent factors that analysts seek to include as predictors in the quantile regression. We apply the model to a study of birth weights in which the effects of latent variables representing psychosocial health and actual tobacco usage on the lower quantiles of the response distribution are of interest. The models can be fit using an R package called factorQR.
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Affiliation(s)
- Lane F Burgette
- Department of Statistical Science, Duke University, Durham, North Carolina 27708, USA.
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