Variations in Multiple Birth Rates and Impact on Perinatal Outcomes in Europe

Objective

Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level.

Methods

We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with random-effects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups.

Results

In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1–9.8) of preterm birth (<37 weeks GA), an almost 12-fold increased risk (pRR 11.7, 95% CI 11.0–12.4) of very preterm birth (<32 weeks GA). Pooled RR were 2.4 (95% Cl 1.5–3.6) for fetal mortality at or after 28 weeks GA and 7.0 (95% Cl 6.1–8.0) for neonatal mortality. PAR of neonatal death and very preterm birth were higher in countries with high MBR compared to low MBR (17.1% (95% CI 13.8–20.2) versus 9.8% (95% Cl 9.6–11.0) for neonatal death and 29.6% (96% CI 28.5–30.6) versus 17.5% (95% CI 15.7–18.3) for very preterm births, respectively).

Conclusions

Wide variations in MBR and their impact on population outcomes imply that efforts by countries to reduce MBR could improve perinatal outcomes, enabling better long-term child health.     

In Vitro Protein Synthesis by Plastids of Phaseolus vulgaris: IV. Amino Acid Incorporation by Etioplasts and Effect of Illumination of Leaves on Incorporation by Plastids 1

Protein synthesis in vitro by etioplasts and chloroplasts from Phaseolus vulgaris was examined to study the factors regulating the development of etioplasts into chloroplasts. The properties of incorporation of (14)C-leucine into protein by etioplasts from plants grown 6.5 days in darkness are similar to those of chloroplasts from plants of the same age that were illuminated for 12 hours. However, the rate of incorporation per plastid by chloroplasts is 4 times higher than the rate of amino acid incorporation by etioplasts. When 6-day-old plants are placed in light, this 4-fold increase occurs within 6 hours and is maintained up to 36 hours. The difference in rate of amino acid incorporation into protein between etioplasts and chloroplasts represents a real difference in the ability of etioplasts and chloroplasts to synthesize protein. A difference in pool size of leucine between etioplasts and chloroplasts does not account for the difference in amino acid incorporation between etioplasts and chloroplasts. Also the difference in photosynthetic capabilities of etioplasts and chloroplasts does not account for the difference in the ability to incorporate amino acid into protein. Furthermore, there are no factors in homogenates of etiolated leaves which inactivate amino acid incorporation into protein by chloroplasts. The difference in rates of amino acid incorporation between etioplasts and chloroplasts is correlated with the state of development of the plastids. The plastids have increased ability to incorporate amino acid into protein when the plastids are undergoing growth and differentiation.     

Evolution of the functional properties of pyruvate kinase isozymes: pyruvate kinase L fromRana pipiens

Summary The regulatory properties of type L pyruvate kinase fromRana pipiens are intermediate between those of the mammalian K and L isozymes. As with mammalian type L, the levels of the frog isozyme are affected by the animal's nutritional state. The mammalian and amphibian isozymes show similar sensitivities to fructose 1,6-bisphosphate activation and amino acid inhibition. By contrast, the frog L isozyme shares several properties of the K class: ie. irreversible inactivation by oxidized glutathione and lack of response to a cyclic AMP stimulated phosphorylation. Furthermore, as for some mammalian K isozymes, frog type L shows a high PEP affinity and a low cooperativity of PEP binding.Insofar as the properties of this present day enzyme reflect those of its counterpart in the amphibian ancestor of higher vertebrates, our results suggest that at its first expression, the type L resembled the type K. Many important regulatory properties of the L isozyme, especially the sensitivity to phosphorylation, were acquired more recently perhaps in association with an increased importance of constant blood glucose.Abbreviations DTT dithiothreitol - EDTA ethylenediamine tetraacetic acid - EGTA ethyleneglycol-bis(2-aminoethylether)-N,N-tetraacetic acid - FB fructose-1,6-bisphosphate - PEP phosphoenolpyruvate - PK pyruvate kinase     

Correlation between 5-aminolaevulinate accumulation and protochlorophyll photoconversion

A 1-min light pulse delivered to mustard seedlings (Sinapis alba L.) 60 h after sowing initiates the release of cotyledonary 5-aminolaevulinate (ALA) accumulation which continues for at least 2 h in the dark. Phytochrome (P _fr) increases the rate of ALA accumulation after a 24-h red light pretreatment but is not the trigger for this release. It is shown that the rate of ALA accumulation varies with the wave-length and fluence rate of the 1-min light pulse and can be predicted from the degree of protochlorophyll-(ide) photoconversion. There is a linear correlation between the rate of ALA accumulation and the degree of protochlorophyll(ide) (PChl)chlorophyll(ide) a (Chl a) photoconversion in etiolated seedlings. In seedlings pretreated with red light this correlation is non-linear and the rate increases more rapidly with increasing degrees of PChlChl a photoconversion. It is suggested that there may exist an interaction between P _fr and PChlChl a photoconversion in controlling ALA accumulation.Abbreviations ALA 5-aminolaevulinate - Chl chlorophyll(ide) - PChl protochlorophyll(ide) - cp cotyledon pair - LA laevulinate     

Mapping of a complex gene locus coding for part of the Saccharomyces cerevisiae fatty acid synthetase multienzyme complex

Summary Using two different experimental approaches—UV induced mitotic recombination and meiotic segregation—a fatty acid synthetase gene locus has been mapped on chromosome Fragment V of the Saccharomyces cerevisiae genetic map. This locus has been tentatively designated as fas1AB since it is a complex locus coding for at least two different fatty acid synthetase component enzymes, namely the -hydroxyacid dehydratase and the enoyl reductase. According to the meiotic segregation patterns obtained, fas1AB is 41.6 centimorgans from ura1 and 35.7 centimorgans from trp3. Furthermore, the same criteria of mitotic sectoring and meiotic segregation indicate that the second known fatty acid synthetase gene cluster in yeast is genetically unlinked to fas1AB or to any other of the known genetic loci on Fragment V.     

Die Feinstruktur der Kehlkopfmuskeln des Laubfrosches,Hyla arborea arborea (L.), im Vergleich zu einem Skelettmuskel

Zusammenfassung Um Hinweise auf die Funktion des Kehlkopfes bei der Rufabgabe zu bekommen, führten wir eine vergleichende elektronenmikroskopische Untersuchung an den vier Kehlkopfmuskeln rufaktiver Laubfrösche durch. Zum weiteren Vergleich studierten wir auch einen Extremitätenmuskel.Die Kehlkopfmuskeln sind untereinander gleich gebaut, unterscheiden sich aber in mehrfacher Hinsicht vom Extremitätenmuskel: Ihre Myofibrillen sind nur ein Drittel so dick. Die Kehlkopfmuskeln enthalten sehr viele, auffallend große und dichte Mitochondrien; das sarcoplasmatische Retikulum ist mächtig entwickelt. Sie enthalten außerdem sehr viel Fett, das stets mit den Mitochondrien assoziiert ist. In beiden Muskeltypen kommt Glykogen vor; seine Menge ist in den Kehlkopfmuskeln jedoch größer als im Extremitätenmuskel. Die Zahl der motorischen Endplatten ist in den Kehlkopfmuskeln 25 mal höher als im M. plantaris longus. Die Zahl der Triaden pro Sarcomer und ihre Anordnung ist bei den beiden Muskeltypen gleich.Die Kehlkopfmuskeln winterstarrer Hyla-Männchen unterscheiden sich in ihrem Feinbau und Fettgehalt nicht von den Muskeln rufaktiver Tiere.

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The fine structure of the laryngeal muscles of the tree frog, Hyla arborea arborea (L.), compared with that of a skeletal muscle

Summary In order to obtain information on the function of the larynx during vocalization, a comparative electron microscopic study was made of the four laryngeal muscles of male tree frogs druing their vocalizing phase. A skeletal muscle (m. plantaris longus) was examined for comparison.The fine structure of the laryngeal muscles is uniform, but differs from skeletal muscles in several respects: the diameter of the myofibrils of the laryngeal muscles is only 1/3 that of the skeletal muscle. They contain many strikingly large and dense mitochondria. There is a strongly developed sarcoplasmic reticulum. Laryngeal muscles contain large quantities of fat which is always associated with mitochondria. Laryngeal muscles contain more glycogen than skeletal muscle. The number of motor endplates in laryngeal muscles is 25 times larger than in m. plantaris longus. The number of triads per sarcomere and their location is the same in both types of muscle.The laryngeal muscles of hibernating and active tree frogs do not show any difference with respect to fine structure and amount of fat.

Mit Unterstützung durch die Deutsche Forschungsgemeinschaft.     

Vom Einfluß des Phytochroms auf die Xylemdifferenzierung im Hypokotyl des Senfkeimlings (Sinapis alba L.)

Zusammenfassung P₇₃₀, das aktive Phytochrom, bewirkt eine vermehrte Bildung von Gefäßen (Tracheen und Tracheiden) im Hypokotyl des Senfkeimlings. Das Differenzierungsmuster der Leitbündel und der Verlauf der Leitbahnen sind im belichteten und im etiolierten Keimling gleich. Es wird geschlossen, daß auch bezüglich der Ausbildung der Leitbahnen das P₇₃₀ lediglich im Rahmen einer sekundären Differenzierung als Auslöser wirkt. Die primäre Differenzierung (vgl. Wagner und Mohr, 1966 b) wird durch P₇₃₀ offenbar nicht beeinflußt.

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Phytochrome-mediated control of xylem differentiation in the hypocotyl of the mustard seedling (Sinapis alba L.)

Summary P₇₃₀, the active phytochrome, causes an increased formation of xylem elements (tracheids and vessel elements) in the hypocotyl of the mustard seedling (Figs. 3,4). On the other hand, the pattern of differentiation of the bundles and the course of the bundles within the hypocotyl (Figs. 1,2) are the same in etiolated as well as in illuminated seedlings.—It has been concluded that in connection with bundle differentiation P₇₃₀ acts only as a trigger at the level of secondary differentiation. The pattern of differentiation is laid down in the course of primary differentiation which apparently is not influenced by P₇₃₀. The same problem has been dealt with more in detail in a foregoing paper (Wagner and Mohr, 1966b).

     

Der Einfluss von Wirkstoffen,von Röntgen- und Elektronenstrahlen auf die Cambiumtätigkeit vonBeta vulgaris

Ohne ZusammenfassungMit 10 Textabbildungen.Dissertation der Naturwissenschaftlichen Fakultät der Universität Erlangen.Herrn Prof. Dr.J. Schwemmle, der die Anregung zu der vorliegenden Arbeit gab, danke ich für das Interesse und die Förderung, die er meiner Arbeit zuteil werden ließ. Mein Dank gilt ferner den Herren Dr.F. Wachsmann und Dr.Breuer, die mir bei der Bestrahlung der Objekte behilflich waren.     

Pseudobalanion planctonicum (Ciliophora, Prostomatida): ecological significance of an algivorous nanociliate in a deep meso-eutrophic lake

Pseudobalanion plancioracum was the most abundant ciliate speciesin the pelagic zone of Lake Constance, FRG, over a 3 year period.Annual averages accounted for 30, 35 and 43% of total ciliatenumbers in the uppermost 20 m of the water column in 1987, 1988and 1989 respectively. Highest cell numbers were observed inearly spring, simultaneously with the first phytoplankton maximum.The small ciliate (mean length 15 µm, mean cell volume1300 µm³) is a raptorial feeder and predominantly consumesphytoplankton. In laboratory cultures, P planctonicum grew wellon a diet of Rhodomonas sp. (Cryptophyceae). Maximum growthrates increased from 0.46 day^–1 at 5 5°C to 1.52 day^–1at 18.5° C, while temperatures above 21°C were lethal.Depending on food concentration, 0.2–4.4 Rhodomonas cellswere ingested per ciliate and hour.