Determinants of intrauterine growth retardation: evidence against maternal depletion

This analysis examines the relationship between length of preceding birth interval and risk of intrauterine growth retardation using data on Swedish infants from the 1973 World Health Organization study of perinatal mortality. Results of a multivariate logit analysis demonstrate that the lower than average mean birth weight of infants born after short birth intervals cannot be completely attributed to their shorter mean gestation length. Infants born after birth intervals of 12 months or less are 30% more likely to be small for gestational age (SGA) than infants born 18-59 months after the previous birth, even when the effects of maternal age and parity are controlled. The results obtained here do not support maternal depletion as an explanation for the association between short birth intervals and elevated risk of SGA, since there is no evidence of an attenuation of the risk of SGA with increasing length of interval in the under 18 month birth interval range.     

Birth interval, mortality and growth of children in a rural area in Kenya

The impact of the length of birth intervals on mortality and growth of children from the perinatal period to 2 years in the Northern Division of Machakos District, Eastern Province, Kenya, were analyzed. There are 2 types of birth intervals: 1) the prospective birth interval--between the birth concerned (the 1st birth of the interval pair) and the subsequent birth; and 2) the retrospective birth interval--between the birth considered (the 2nd of the interval pair) and the preceeding birth. This study includes 3019 women who had at least 1 live birth between April, 1974 and April, 1981. They gave birth to 6778 children (including stillbirths). Births occurring in 1974 are excluded in the analysis because of considerable underregistration. 102 stillbirths and 213 deaths in the 1st 2 years are analyzed. They have been grouped into deaths during the perimatal period; the 1st year after the 1st week of life (infant period); and the 2nd year of life. The most convient method of analysis of the relation between retrospective birth interval and mortality is multivariate analysis, as the intermedicate biological and behavioral factors through which birth intervals can affect health are simultaneously influenced by other variables like maternal age and birth order; the log linear model is applied here. The probability of dying is the dependent variable. The impact of short prospective intervals are closely associated. Only infant and child deaths occurring after the conception of the next child are included. The size of cohorts in which these deaths occur can be calculated with a life table approach. The mortality probability between 5 and 12 months for children with short prospective intervals is .034. This is higher than the corresponding rate for all children in the area (P0.05). It is shown that children with short retrospective or prospective birth intervals do not run a greater risk of mortality or growth retardation than children with longer intervals, neither during the perinatal period nor during the 1st 2 years of life.     

Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study

ObjectiveTo study the impact of interpregnancy interval on maternal morbidity and mortality.DesignRetrospective cross sectional study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay.SettingLatin America and the Caribbean, 1985-97.Participants456 889 parous women delivering singleton infants.ResultsShort (<6 months) and long (>59 months) interpregnancy intervals were observed for 2.8% and 19.5% of women, respectively. After adjustment for major confounding factors, compared with those conceiving at 18 to 23 months after a previous birth, women with interpregnancy intervals of 5 months or less had higher risks for maternal death (odds ratio 2.54; 95% confidence interval 1.22 to 5.38), third trimester bleeding (1.73; 1.42 to 2.24), premature rupture of membranes (1.72; 1.53 to 1.93), puerperal endometritis (1.33; 1.22 to 1.45), and anaemia (1.30; 1.18 to 1.43). Compared with women with interpregnancy intervals of 18 to 23 months, women with interpregnancy intervals longer than 59 months had significantly increased risks of pre-eclampsia (1.83; 1.72 to 1.94) and eclampsia (1.80; 1.38 to 2.32).Conclusions Interpregnancy intervals less than 6 months and longer than 59 months are associated with an increased risk of adverse maternal outcomes.     

Catch-up growth in females born short for gestational age reduces the risk of giving birth to short-for-gestational-age infants

OBJECTIVES: The aim of the present study was to study the effect of catch-up growth on the offspring's length at birth among females born short for gestational age. METHODS: Data of 1,363 females born short for gestational age (<-2 standard deviation scores) were obtained from the Swedish Birth Register. The females were included in the register both as babies and mothers. The effect of catch-up growth on the offspring's birth length was studied. RESULTS: Short adult stature was associated with a threefold increase in the risk of giving birth to a short infant [OR 3.08 (CI 1.73-5.50)] and smoking increased the risk in a dose-dependent manner. Overweight was associated with a reduced risk [OR 0.46 (CI 0.22-0.96)] of giving birth to a short infant. CONCLUSION: Catch-up growth to normal adult stature among women born short for gestational age is associated with a reduced risk of giving birth to a short-for-gestational-age infant.     

Low Birth Weight,Small for Gestational Age and Preterm Births before and after the Economic Collapse in Iceland: A Population Based Cohort Study

Objective

Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.

Study design

The study population constituted all Icelandic women giving birth to live-born singletons from January 1^st 2006 to December 31^st 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD''s) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6^th 2008.

Results

Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6–9 months after the collapse.

Conclusion

The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.     

Month of birth predicted reproductive success and fitness in pre-modern Canadian women

Conditions experienced during early development affect human health and survival in adulthood, but whether such effects have consequences for fitness is not known. One surrogate for early conditions is month of birth, which is known to influence health and survival in many human populations. We show that in nineteenth century Canada, month of birth predicted a woman's fitness measured by the number of grandchildren produced, with the genetic contribution to the following generations by women born in different months differing by over seven grandchildren. This difference was mainly caused by differences in the reproductive rates of both mothers and their offspring, rather than differences in their survival. Women born in the best months of the year had longer reproductive lifespans, larger numbers of live births and raised more offspring to adulthood than those who were born in the worst months. Furthermore, the offspring of those women born in the best months also had greater reproductive rates, suggesting that month of birth also influenced a mother's ability to invest in her offspring. Our results suggest that early conditions may have important consequences for human lifetime reproductive performance within and between generations, and that timing of birth had large effects on fitness in this rural community.     

Reproductive parameters of wild female Rhinopithecus roxellana

On the basis on 6 years of observation, we estimated the reproductive parameters of a Golden snub-nosed monkey (Rhinopithecus roxellana) group in the Qinling Mountains, China. We observed 88 births in 47 females from 2001 to 2006. Two methods were used to calculate the birthrate. The first method is based on the number of births observed in a year, giving 0.49+/-0.07 (mean+/-SD), and the second method is based on the female-years of observation, giving 0.49+/-0.17 births per female per year in this troop. The mean interbirth interval is 21.88+/-6.01 months (mean+/-SD). The mortality of infant born between 2002 and 2005 was 22.4%. The interbirth intervals of females that had lost an infant before the age of 6 months were significantly shorter than that of females whose infants survived for more than 6 months. A female usually gives birth once every 2 years if the previous offspring survives to a weaning age of 5-6 months, or will give birth in the next year if the previous young dies before reaching an age of 6 months. Births were significantly concentrated during March to May of each year. The mean birth date was on April 14, median was April 12; and the standard deviation was 13.98 days. Birth peak occurs 6-7 months after mating peak. From observations on 15 individuals that gave birth for the first time, we concluded that the wild female Golden snub-nosed monkeys in Qinling Mountains start giving birth at an age of 5 or 6 years. We suggest that the seasonal reproductive pattern is an adaptive response to the availability of seasonal food. Our results are consistent with the hypothesis that these reproductive characteristics are a result of adaptation to the seasonality of mountain climate and food resources.     

Seasonal variations in male mice at the time of sexual maturation

The sexual maturation of male mice reared under constant laboratory conditions was studied in animals born in different months of the year. The body weights were significantly affected by the month of birth. Males born in March and May were heavier at 4 and 5 weeks of age than those born in autumn and winter. As indicated by the relative weights of accessory glands, males born in spring matured earlier compared with animals born in other months of the year. Variation in the relative testicular weights during maturation was not influenced by the month of birth. Female mice also showed a significant relationship between the month of birth and sexual maturation. Females born in March reached puberty, as measured by the age of vaginal opening and first oestrus, earlier than those born in other months of the year.     

Seasonal characteristics of and age at menarche

Data from approximately 600 U.S. women were analyzed for seasonality in menarche. Data were converted to the ratio of observed (O) to expected (E) cases, based on an equal distribution of events over the year, per considered time span of the year. The greatest O/E ratio in menarche (1.55) occurred during January, followed by August (1.43) and July (1.24). The lowest O/E ratio in menarche occurred in February and May (0.68). Seasonal patterns in menarche were detected for the separate cohorts of women born during the 1940s, 1950s, and 1960s, with a shift from a December-January peak in menarche for those born in the 1940s and 1950s to an August-September peak for those born in the 1960s. Girls who were younger (8-14 yrs) at menarche exhibited a seasonal difference in the peak number of menarches by about 6 months in comparison to the pattern for girls who were older (15-17 yrs). Girls who experienced menarche during August-October were statistically significantly younger (p less than 0.05) than those born during the other three seasons. Season of birth was not statistically significantly associated with season of menarche. Overall, no 12-month pattern was substantiated by cosinor analysis in the month of menarche. However, a 6-month rhythm was detected in menarche for women born between 1940 and 1960 (p = 0.004, A = 29% M, phi = January and July).     

Reduced final height and indications for insulin resistance in 20 year olds born small for gestational age: regional cohort study.

OBJECTIVE: To investigate whether the association between low birth weight and increased risk of developing impaired glucose tolerance, insulin resistance, hypertriglyceridaemia, and hypertension in middle age is apparent by the age of 20 in people born small for gestational age. DESIGN: Regional cohort study. SETTING: Maternity registry, Haguenau, France. SUBJECTS: 236 full term singleton babies born small for gestational age (birth weight or length, or both, below third centile) during 1971-8 and 281 with normal birth weight (between 25th and 75th centile). All subjects were contacted and evaluated at a mean (SD) age of 20.6 (2.1) years. MAIN OUTCOME MEASURES: Adult height; concentrations of glucose, insulin, and proinsulin during an oral glucose tolerance test; lipid and fibrinogen concentrations; and blood pressure. RESULTS: After sex and target height were adjusted for, subjects who had been born small for gestational age were significantly shorter at age 20 than those with a normal birth weight (men 4.5 cm shorter (95% confidence interval 6.0 to 3.0 cm); women 3.94 cm shorter (5.2 to 2.7 cm)). After sex and body mass index were adjusted for, mean plasma glucose concentration 30 minutes after a glucose load, fasting insulin concentration (in women), and insulin and proinsulin concentrations 30 and 120 minutes after a glucose load were significantly higher in subjects who had been born small for gestational age than in those with a normal birth weight. Mean lipid and fibrinogen concentrations and blood pressure were not different between the two groups. CONCLUSIONS: Intrauterine growth retardation has long term consequences such as reduced final height Raised insulin and proinsulin concentrations are present in young adults born small for gestational age and could be markers of early changes in insulin sensitivity.     

Seroprevalence of Cytomegalovirus,Epstein Barr Virus and Varicella Zoster Virus among Pregnant Women in Bradford: A Cohort Study

Objective

To estimate the seroprevalence of cytomegalovirus (CMV), Epstein Barr virus (EBV) and varicella zoster virus (VZV) among pregnant women in Bradford by ethnic group and country of birth.

Methods

A stratified random sample of 949 pregnant women enrolled in the Born in Bradford birth cohort was selected to ensure sufficient numbers of White UK born women, Asian UK born women and Asian women born in Asia. Serum samples taken at 24-28 weeks’ gestation were tested for CMV IgG, EBV IgG and VZV IgG. Each woman completed a questionnaire which included socio-demographic information.

Results

CMV seroprevalence was 49% among the White British women, 89% among South Asian UK born women and 98% among South Asian women born in South Asia. These differences remained after adjusting for socio-demographic factors. In contrast, VZV seroprevalence was 95% among women born in the UK but significantly lower at 90% among South Asian women born in Asia. EBV seroprevalence was 94% overall and did not vary by ethnic group/country of birth.

Conclusions

Although about half of White British women are at risk of primary CMV infection in pregnancy and the associated increased risk of congenital infection, most congenital CMV infections are likely to be in children born to South Asian women with non-primary infection during pregnancy. South Asian women born in South Asia are at risk of VZV infection during pregnancy which could produce congenital varicella syndrome or perinatal chickenpox. Differences in CMV and VZV seroprevalence by ethnic group and country of birth must be taken into account when universal immunisation against these viruses is contemplated.     

Reexamination of interpregnancy intervals and subsequent birth outcomes: Evidence from U.S. linked birth/infant death records

Abstract

This study examines the net effects of the interpregnancy interval (time period from one birth to the next pregnancy) on the risks of preterm birth, intrauterine growth retardation, and infant mortality, for blacks and whites separately, using data from 1991 U.S. Linked Birth‐Infant Death files. Results show that short (less than 7 months) and long (61+ months) intervals between pregnancies raise the risk of preterm birth and intrauterine growth retardation for both race groups, though the increase in risk is generally less than 30 per cent. Short intervals also raise (slightly) the risk of infant mortality after controlling for birthweight and gestational age.     

Associations between Childbirth,Hospitalization and Disability Pension: A Cohort Study of Female Twins

Background

As the literature on long-term effects of childbirth on risk of morbidity or permanent work incapacity (DP) is limited, we aimed to study associations of childbirth with hospitalization and DP, adjusting for familial factors.

Methods

This cohort study included female twins, i.e. women with twin sister, born 1959–1990 in Sweden (n = 5 118). At least one in the twin pair had their first childbirth 1994–2009. Women were followed regarding all-cause and cause-specific (mental or musculoskeletal diagnoses) DP during year 2–5 after first delivery or equivalent. Associations between childbirth, hospitalization and DP were calculated as hazard ratios (HR) with 95% confidence intervals (CI).

Results

Women who did not give birth had markedly higher number of DP days/year compared to those giving birth. Hospitalization after first childbirth was associated with a higher HR of DP. Those hospitalized at least once after their first childbirth had a three-fold DP risk (HR: 3.2; 95% CI 1.1–9.6), DP due to mental diagnoses (HR: 3.2; 1.2–8.8), and of DP due to musculoskeletal diagnoses (HR: 6.1; 1.6–22.9). Lower HRs in the discordant twin pair analyses indicated that familial factors may influence the studied associations.

Conclusions

Women who did not give birth had a much higher risk for DP than those who did. Among those who gave birth, the risk for DP was markedly higher among those with a previous hospitalization, and especially in women with repeated hospitalizations. The results indicate a health selection into giving birth as well as the importance of morbidity for DP.     

The effect of divorce on infant mortality in a remote area of Bangladesh

The process of divorce is usually lengthy and hazardous, and can start quarrels that can lead to the abuse of women and their children. This study examines the effects of divorce on neonatal and postneonatal mortality of babies born before and after divorce in Teknaf, a remote area of Bangladesh. The longitudinal demographic surveillance system (DSS) followed 1,762 Muslim marriages in 1982-83 for 5 years to record divorce, deaths of spouse, emigration and births. It recorded 2,696 live births during the follow-up period, and their survival status during infancy. Logistic regression models were used to estimate the effect of divorce on neonatal and postneonatal mortality, controlling for maternal age at birth, parity, sex of the child and household economic status. The odds of neonatal and postneonatal deaths among babies born after divorce or less than 12 months before mothers were divorced were more than double the odds of those born to mothers of intact marriages. The odds of postneonatal deaths were two times higher among babies born more than 12 months before divorce happens than their peers. The high mortality of infants born before and after mothers were divorced may reflect how abusive marriage and divorce increase the vulnerability of women and children in rural Bangladesh. Divorce and abuse of women are difficult and intractable social and health problems that must be addressed.     

Effects of maternal birth season on birth seasonality in the Canadian population during the seventeenth and eighteenth centuries

Birth records of the French-Canadian population for the period 1621-1765 were analyzed retrospectively to examine the effect of maternal birth season on the seasonal distribution of births. Preliminary examination indicated that there was a bimodal pattern in birth seasonality: a major peak in early spring, a trough in early summer, a minor peak in autumn, and a trough around December. Because this seasonality was strongly biased at the level of the first birth by the month of marriage, which was concentrated in November, the seasonality of nonfirst births (n = 32,926) was examined in relation to the four seasons of maternal birth. Mothers born in May-July showed a flatter monthly distribution of nonfirst births at a maternal age of 28 years or more. Analysis of marriage-first birth intervals indicated that mothers who married in August-October showed a lower percentage of immediate conception (intervals of 8-10 months), whereas those mothers born in May-July had a higher percentage of immediate conception. This difference in birth seasonality shown by mothers born in May-July is similar to results from early twentieth-century Japan. Some seasonal infertility factors could have affected the embryos at the earliest stage of pregnancy, modifying a part of the seasonal variation in birth rate.     

Birth seasonality and interbirth interval of captive Rhinopithecus bieti

This study, which is based on 10 years of birth records, shows that black-and-white snub-nosed monkeys (Rhinopithecus bieti) in captivity display marked birth seasonality. The birth season starts in December and ends in June, with a peak from March to May, and a median birth date of April 10. More male infants than female ones are born in captivity. More males were born at the Kunming Institute of Zoology (KIZ) than at the Kunming Zoo (KZ). Of 17 interbirth intervals (IBIs), 29% were from females that had lost an infant at <1 year of age or experienced stillbirth, and 71% were from females whose infant survived more than 1 year. The mean IBI for the former group (428+/-SD 87 days) was significantly shorter than that for the latter group (706+/-71 days), in agreement with reports of other Colobine species. Infant mortality was lower in captivity than in the field, which may reflect the relatively stable food availability and climate in captivity compared to the harsh conditions in the wild.     

Reference values for height, weight and body mass index of German born Turkish children

Turkish children and adolescents born in Northern Europe grow different from native Northern European children, but reference values for height, weight and BMI for these children do not exist. With this study, we intend to provide growth standards for German born Turkish children. Data were obtained from 797 Turkish children and adolescents born in Germany age 0-25.8 years (males), respectively 0-18.3 years (females). We generated synthetic reference values for height, weight, and BMI. The results show that Turkish children and adolescents are heavier after the age of 6 years, and that they remain short after puberty. Eighteen year old Turkish men, and 15-year-old Turkish women are shorter (males 175.2 cm vs. 180.4 cm, p < 0.05; females 159.3 cm vs. 165.0 cm, p < 0.05), and heavier than Germans. Six out of 53 young Turkish men and 9 out of 100 young Turkish women were obese. Twelve out of 53 young Turkish men (23%) and 18 out of 100 young Turkish women (18%) have fallen below the 3rd centile for height. It can be concluded that growth of Turkish children and adolescents born in Germany significantly differs from native children. Reference LMS values for body height, weight and BMI of German born Turkish boys and girls are presented.     

Effect of long term androgen removal on androgen-induced proliferation of seminal vesicle cells in adult mice

Male mice were castrated on day 60 after birth; daily injections of testosterone propionate (TP, 4 micrograms/g b.wt) were started 1.2 or 6 months after the castration. The incorporation of 5-[125I]iodo-2'-deoxyuridine [( 125I]IdUrd) into the whole seminal vesicles was determined on various days after starting the TP injections as an index for proliferation. Although the peak of [125I]IdUrd uptake was observed 3 days after starting the TP injections in both short (1-2 months) and long (6 months) term castrated mice, the peak was significantly lower and the period of proliferation was longer in the long term group than in the short term group; the weights of seminal vesicles before TP injections were 6 and 10 mg in the long and short term groups, respectively. Although TP injections induced the proliferation of only epithelial cells in the short term group, the same treatment induced the proliferation of both epithelial and fibromuscular cells in the long term group. The deficient responsiveness to androgen of the seminal vesicle cells found in the long term castrated mice was completely recovered by TP pretreatment for 2 weeks. The present findings suggest that so-called imprinted cells in the mouse seminal vesicle induced by neonatal and prepubertal testicular androgens are very slowly lost at least in part by androgen removal for long periods such as more than 6 months in adult mice and that the loss is at least in part due to the death of fibromuscular cells, which is recovered rather quickly by androgen pretreatment.     

Birth order and health status in a British national sample.

Researchers analyzed data from the National Child Development Study--a cohort of every child born in England, Scotland, and Wales during the 1st week of March 1953 with follow up studies in 1965, 1969, 1973, and 1980-1981 to examine the relationship between health status and birth order and whether children with low birth orders were less likely to experience illness than those with older siblings. 1st born children tended to have received the needed number of immunizations, but children of higher birth order did not tend to have received them. Further they were more likely to have attended infant welfare and toddler clinics for health care than children of higher birth order. The only childhood contagious disease which demonstrated a social class effect was pertussis. It tended to afflict children from nonmanual homes regardless of birth order. Absences from school lasting between 1 week-1 month of 1st born children were less frequent than for other children. The leading reasons for 1st, 3rd, and later born 11 year old children who experienced such long absences included infectious diseases; bronchitis; ear, nose, and throat complaints; pneumonia; tonsillitis, or viral influenza. After age 15, 1st and 2nd born children were less likely to be absent and, if absent, they tended to only miss 1 week of school. Significantly more 3rd and 4th born children were absent from school for 1 week-3 months. 1st and 2nd born children from more affluent families tended to have early childhood asthma. In conclusion, the health experiences of the later birth orders were different than those of the 1st born. This did not mean, however, that later birth order children were in poorer health than 1st born children.     

Cervical cancer screening in Middle Eastern and Asian migrants to Australia: A record linkage study

Background. Australia's organized cervical screening program recommends two-yearly screening for women aged 18–69 years and reminder letters are sent at 27 months. Cervical screening registers hold comprehensive information on screening, but not country of birth. A linkage study was performed in order to assess cervical screening behavior in migrants. Methods. To assess screening participation, we linked year 2000 records for 12,541 Middle Eastern/Asian-born women 20–54 years of age, and an age and area matched random sample of 12,143 Australian-born women in the New South Wales (NSW) Midwives Data Collection (MDC), which records country of birth, to screening register records. Screening behavior after 2000 was assessed in women without a recorded prior cervical abnormality. Results. The odds ratios for being screened at least once within a 3 year period, with reference to Australian-born women and adjusted for age, parity, socioeconomic status and smoking, were 0.88 (95% CI: 0.81–0.97) and 0.74 (95% CI: 0.70–0.79) in women born in the Middle East and Asia, respectively. Screening increased with increasing socioeconomic status (SES), absence of smoking and greater parity in Australian-born women but little, if at all, in migrant women. In a sensitivity analysis in which hospital admitted patients were the source of population samples, some patterns were sufficiently different to suggest that selection for illness can affect the strength and direction of associations in linked data. Conclusion. Migrant women from Asian and Middle-eastern countries are less likely than Australian-born women to participate in cervical screening at the recommended interval. Their likelihood of screening is also less related to socioeconomic status, smoking and parity than that in Australian-born women.