Search

Objectives. We investigated the relationship between women's first-trimester working conditions and infant birthweight. Methods. Pregnant women (N=8266) participating in the Amsterdam Born Children and Their Development study completed a questionnaire gathering information on employment and working conditions. After exclusions, 7135 women remained in our analyses. Low birthweight and delivery of a small-for-gestational-age (SGA) infant were the main outcome measures. Results. After adjustment, a workweek of 32 hours or more (mean birthweight decrease of 43 g) and high job strain (mean birthweight decrease of 72 g) were significantly associated with birthweight. Only high job strain increased the risk of delivering an SGA infant (odds ratio [OR] = 1.5; 95% confidence interval [CI]=1.1, 2.2). After adjustment, the combination of high job strain and a long workweek resulted in the largest birthweight reduction (150 g) and the highest risk of delivering an SGA infant (OR=2.0; 95% CI=1.2, 3.2). Conclusions. High levels of job strain during early pregnancy are associated with reduced birthweight and an increased risk of delivering an SGA infant, particularly if mothers work 32 or more hours per week. (doi:10.2105/AJPH.2008.138412)

BACKGROUND: Maternal exposure to wood fuel smoke may lead to impaired fetal growth due to hypoxia and or oxidative stress from smoke constituents such as carbon monoxide and particulate matter. OBJECTIVES: We studied the risk of low birth weight (LBW) and reduced mean birth weight in relation to reported use of wood for cooking during the prenatal period, compared with natural gas (NG). METHODS: We studied a historical cohort of women who had a singleton live birth in the years 2000-2002, from a semirural area of Pakistan. Infant&apos;s birth weight was obtained from records, and prenatal records had data for maternal body mass index and parity. Cooking habits, daytime sleep habits, and type of fuel used during the pregnancies in 2000-2002 were ascertained by a survey done in 2004-2005. We performed multiple linear and logistic regression modeling using propensity scores to adjust for confounding variables. RESULTS: Unadjusted mean ([+ or -] SD) birth weight was 2.78 [+ or -] 0.45 kg in wood users, and 2.84 [+ or -] 0.43 kg (p < 0.06) in NG users. Infants born to wood users averaged 82 g lighter than infants born to NG users when weight was adjusted for confounders (p < 0.07). The rate of LBW (< 2,500 g) was 22.7% among wood users compared with 15.0% in NG users (p < 0.01), for an adjusted relative risk of 1.64 (95% confidence interval, 1.10-2.34). The population attributable risk for LBW explained by wood use was estimated to be 24%. CONCLUSION: Cooking with wood fuel during pregnancy, a potentially modifiable exposure, was associated with LBW and marginally lower mean birth weight compared with using NG. KEY WORDS: birth weight, cooking habits, historical cohort, natural gas, pregnancy, propensity scores. Environ Health Perspect 116:543-549 (2008). doi:10.1289/ehp.10782 available via http://dx.doi.org/ [Online 15 January 2008], Low birth weight (LBW) is associated with high mortality and morbidity in infants (Ismail et al. 2003; Khan et al. 2005; Moss et al. 2002; Tripathy et al. 2002). LBW [...]

BACKGROUND: The "developmental origins of adult disease" hypothesis was originally derived from evidence linking low birth weight to cardiovascular diseases including stroke. Subsequently, it has been expanded to include developmental exposures to environmental contaminants as risk factors for adult onset disease. OBJECTIVE: Our goal in this study was to test the hypothesis that developmental exposure to polychlorinated biphenyls (PCBs) alters stroke outcome in adults. METHODS: We exposed rats to the PCB mixture Aroclor 1254 (A1254) at 0.1 or 1 mg/kg/day in the maternal diet throughout gestation and lactation. Focal cerebral ischemia was induced at 6-8 weeks of age via middle cerebral artery occlusion, and infarct size was measured in the cerebral cortex and striatum at 22 hr of reperfusion. PCB congeners were quantified in brain tissue by gas chromatography with microelectron capture detection, and cortical and striatal expression of Bcl2 and Cyp2C11 were quantified by quantitative reverse transcriptase-polymerase chain reaction. RESULTS: Developmental exposure to A1254 significantly decreased striatal infarct in females and males at 0.1 and 1 mg/kg/day, respectively. Predominantly ortho-substituted PCB congeners were detected above background levels in brains of adult females and males exposed to A1254 at 1 but not 0.1 mg/kg/day. Effects of developmental A1254 exposure on Bcl2 and Cyp2C11 expression did not correlate with effects on infarct volume. CONCLUSION: Our data provide proof of principle that developmental exposures to environmental contaminants influence the response of the adult brain to ischemic injury and thus represent potentially important determinants of stroke susceptibility. KEY WORDS: Aroclor 1254, cerebral ischemia, developmental origins of adult disease, polychlorinated biphenyls, stroke. Environ Health Perspect 116:474-480 (2008). doi:10.1289/ehp.10828 available via http://dx.doi.org/ [Online 14 January 2008], Neonatal factors can cause latent functional changes that increase susceptibility to disease and/or dysfunction later in life. This hypothesis of the "developmental origins of adult disease" was originally derived from [...]

Epidemiological studies suggest that infants of low birth weight show poor neonatal growth and increased susceptibility to adult diseases such as diabetes and lung disease. Uncoupling protein 2 and 3 (UCP2 and UCP3) have been implicated in the development of such diseases; pigs provide an ideal model to examine the influence of birth weight due to the natural variance in piglet weight within a litter. This study examined whether birth weight influences the expression of UCP2 and UCP3 in adipose tissue, skeletal muscle, and lung. Piglets from 11 litters were ranked according to birth weight and three from each litter assigned to small (SFD), normal (NFD), or large for dates (LFD) groups. Blood samples and morphometric measurements were taken over the first 14 days of life, and tissue samples were taken on day 7 or 14. Plasma hormone and metabolite concentrations and the expression of UCP2 and UCP3 mRNA in adipose tissue, skeletal muscle, and lung were measured. UCP2 and UCP3 expression in adipose tissue was lower in the SFD compared with the LFD group on day 7. UCP3 expression in skeletal muscle was higher than that of adipose tissue. Lung UCP2 and skeletal muscle UCP3 mRNA expression were unaffected by size at birth. Regression analysis indicated that UCP3 expression was differentially associated with IGF-1, leptin, and insulin. In conclusion, low birth weight is associated with tissue-specific effects on UCP expression. It remains to be established whether these subsequently contribute to pathological conditions such as diabetes. mitochondria; postnatal growth; metabolism

Objective. To estimate the influence of low birth weight (LBW; [less than or equal to] 2500 g) on academic achievement in reading and mathematics in 12th grade in 2 socioeconomically and racially disparate, geographically defined communities. Methods. Representative samples of LBW and normal birth weight (NBW) children who were born in 1983-1985 and were from the inner city of Detroit and nearby middle class suburbs were assessed longitudinally. Woodcock-Johnson Psycho-Educational Battery-Revised standardized tests of reading and mathematics were used at ages 11 and 17 (n = 773). Multiple regression analysis applying generalized estimating equations was used to assess the independent effects of LBW on test scores. Results. Compared with NBW children, LBW children manifested deficits of 3 to 5 points in age-standardized tests of academic achievement at age 17 that had persisted with little change from age 11. LBW-related deficits were similar in urban and suburban communities and were independent of family factors. At age 17, LBW children were ~50% more likely than NBW children to score below the standardized population mean in both reading and mathematics. The LBW-related deficits in academic achievement in adolescence were largely accounted for by LBW-related deficits in general cognitive abilities, measured by IQ tests at age 6. Conclusions. Interventions to address the lingering effects of LBW on the acquisition of core academic skills during the school years should focus on preschool LBW children in both inner city and suburban communities. Pediatrics 2004;114:1035-1040; low birth weight, longitudinal study, academic achievement, urban and suburban communities, epidemiology., ABBREVIATIONS. LBW, low birth weight; VLBW, very low birth weight; NBW, normal birth weight; WJ-R, Woodcock-Johnson Psycho-Educational Battery-Revised; GEE, generalized estimating equation; SE, standard error. Research on the long-term cognitive [...]

Objective. Information on the mental health of very low birth weight (VLBW; Methods. We compared a cohort of 241 survivors among VLBW infants who were born between 1977 and 1979 (mean birth weight: 1180 g; mean gestational age at birth: 29.7 weeks), 116 of whom were men and 125 of whom were women, with 233 control subjects from the same population in Cleveland who had normal birth weights (108 men and 124 women). Young adult behavior was assessed at 20 years of age with the Achenbach Young Adult Self-Report and the Young Adult Behavior Checklist for parents. In addition, the young adults and parents completed the ADHD Rating Scale for Adults. Gender-specific outcomes were adjusted for sociodemographic status. Results. VLBW men reported having significantly fewer delinquent behaviors than normal birth weight (NBW) control subjects, but there were no differences on the Internalizing, Externalizing, or Total Problem Behavior scales. Parents of VLBW men reported significantly more thought problems for their sons than did parents of control subjects. VLBW women reported significantly more withdrawn behaviors and fewer delinquent behavior problems than control subjects. Their rates of internalizing behaviors (which includes anxious/depressed and withdrawn behaviors) above the borderline clinical cutoff were 30% versus 16% (odds ratio: 2.2; 95% confidence interval [CI]: 1.2-4.1). Parents of VLBW women reported significantly higher scores for their daughters on the anxious/depressed, withdrawn, and attention problem subscales compared with control parents. The odds ratios for parent-reported rates above the borderline-clinical cutoff among women for the anxious/depressed subscale was 4.4 (95% CI: 1.4-13.5), for thought problems was 3.7 (95% CI: 1.2-11.6), and for attention problems was 2.4 (95% CI: 1.0-5.5). There were no differences in the young adult self-report of attention-deficit/ hyperactivity disorder (ADHD). Parents of VLBW men reported higher mean scores on the attention subtype of ADHD but not higher rates of ADHD. Conclusion. The increase in psychopathology among VLBW survivors in young adulthood indicates a need for anticipatory guidance and early intervention that might help to prevent or ameliorate potential psychopathology. Pediatrics 2004;114:932-940; very low birth weight, psychopathology, behavior., ABBREVIATIONS. VLBW, very low birth weight; NBW, normal birth weight; YASR, Young Adult Self-Report; YABCL, Young Adult Behavior Checklist; CBCL, Child Behavior Checklist; ADHD, attention-deficit/hyperactivity disorder; DSM, Diagnostic and Statistical [...]

Objective. To compare the value of serial cranial ultrasound (US) with a single magnetic resonance imaging (MRI) before discharge in very low birth weight preterm infants to predict cerebral palsy (CP). Methods. Infants who weighed Results. The sensitivity and specificity of MRI for predicting CP were 71% and 91% at 20 month and 86% and 89% at 31 months, respectively. The sensitivity and specificity of US for predicting CP were 29% and 86% at 20 months and 43% and 82% at 31 months. Conclusions. As a predictor of outcome for CP, MRI at near-term in very low birth weight preterm neonates is superior to US. However, both US and MRI demonstrate high specificity. Pediatrics 2004;114:992-998; magnetic resonance imaging, ultrasound, preterm infant, brain injury, cerebral palsy., ABBREVIATIONS. VLBW, very low birth weight; CP, cerebral palsy; PVL, periventricular leukomalacia; US, ultrasound; MRI, magnetic resonance imaging; GA, gestational age; TR, repetition time; TE, echo time; NEX, number of [...]

Byline: C. Buhrer (1), I. Grimmer (1), B. Metze (1), M. Obladen (1) Keywords: Key words Newborn infants; Prematurity; CRIB score; Risk factors; Mortality; Impairment; Outcome Abstract: Objective: To assess the ability of the Clinical Risk Index for Babies (CRIB) to predict long-term neurodevelopmental impairment in very low birth weight (VLBW) infants.APDesign: Single-center cohort study.APSetting: Tertiary neonatal care hospital and follow-up clinic.APPatients: Four hundred fifty-five VLBW infants consecutively admitted from 1992 to 1997 inclusive.APMeasurements and results: Calculations of CRIB scores from birth weight, gestational age, the presence of congenital malformations, worst base excess, maximum and minimum appropriate fraction of inspired oxygen (FIO.sub.2) during the first 12 h of life was possible in 430 infants. Three hundred eighty-six infants survived until discharge (89 %) and 352 (91 %) were examined at 1 year corrected age using the Griffiths scales of mental development. Major neurodevelopmental impairment (general quotient < 2 standard deviations below average) was observed in 76 infants (22 %). CRIB scores and the individual CRIB components differed significantly between infants with and those without neurodevelopmental impairment. By logistic regression analysis, CRIB scores and minimum FIO.sub.2 were independent predictors of death, while CRIB and maximum FIO.sub.2 were independently associated with neurodevelopmental impairment. For combined poor outcome (death or impairment), CRIB, minimum and maximum FIO.sub.2 were independent predictors. In predicting major neurodevelopmental impairment, the area under the receiver operating characteristic curve for CRIB (0.703 +- 0.035) did not differ significantly from that of birth weight (0.697 +- 0.035) or any other CRIB component.APConclusion: While high CRIB scores are associated with major neurodevelopmental impairment, the CRIB score is of limited value for stratification in randomized trials or for adjustments in comparing performance between hospitals with neurodevelopmental impairment as the main outcome measure. Author Affiliation: (1) Department of Neonatology, Charite-Virchow Hospital, Humboldt University, D-13344 Berlin, Germany e-mail: christoph.buehrer@charite.de Tel.: + 49-30-45 06 64 13 Fax: + 49-30-45 06 69 22, DE Article note: Received: 19 September 1999/Final revision received: 19 July 1999/Accepted: 20 December 1999

In our recent study (Bell et al. 2007)we identified associations between air pollution and low birth weight in Connecticut and Massachusetts based on 358,504 births from 1999 to 2002. Salam [...]

The etiology of low birth weight (LBW; defined as weighing less than 2.5 kg at birth) is complex, with demographic, nutritional, reproductive, and socioeconomic factors each potentially playing a role. [...]

BACKGROUND. Very low birth weight survivors are at increased risk of developing emotional and behavioral problems and low social and academic competencies. Information on such problems in very low birth weight adolescents is still sparse. OBJECTIVES. Our purpose for this work was to study gender-specific emotional and behavioral problems and social and academic competencies in a cohort of very low birth weight adolescents in north Norway. METHODS. Families with very low birth weight adolescents aged 13 to 18 years, born between 1978 and 1989 (n = 162) were addressed by mail and asked to complete the Child Behavior Check List and the Youth Self-Report. Data were compared with 2 normative adolescent populations (Child Behavior Check List, n = 540; Youth Self-Report, n = 2522). Scores given by very low birth weight adolescents and their parents on identical items in Child Behavior Check List and Youth Self-Report (cross-informant syndrome constructs) were compared in pairs. To explore predictive effects, demographic and" early medical characteristics were entered into a hierarchical multiple regression analysis. RESULTS. There were 156 eligible families, and 99 (63.5%) responded. All completed the Child Behavior Check List, and 82 (52.6%) completed the Youth Self-Report. Very low birth weight boys reported less externalizing and internalizing behaviors and thought and attention problems and higher activity score, whereas very low birth weight girls reported less externalizing behavior and less social, thought, and attention problems and higher activity score compared with normative adolescents. Very low birth weight parents, however, reported more social and attention problems and less social and school competence in boys and more internalizing behavior and social and attention problems and less school competence in girls compared with normative parents. They scored high proportions of both genders within the borderline/clinical range on all of the scales, except for externalizing behavior and social problems in girls. Female very low birth weight adolescents, in contrast to males, reported more problems than parents when compared in pairs, and externalizing problems in particular were not recognized by parents. CONCLUSIONS From parents&apos; point of view, significant proportions of very low birth weight adolescents experience more emotional and behavioral problems and less competence than normative adolescents. In contrast, very low birth weight adolescents state less problems and similar or higher competence than normative adolescents. Very low birth weight adolescent girls report more emotional and behavioral problems compared with their parents than very low birth weight adolescent boys do. Externalizing problems in very low birth weight adolescent girls are often not recognized by parents. To better understand these seemingly paradoxical findings and to develop adequate intervention programs, there is a need for prospective longitudinal studies. KEY WORDS. very low birth weight, adolescent, behavioral problems, emotional problems, competence, gender-specific, Child Behavior Check List, Youth Self-Report., URL: www.pediatrics.org/cgi/doi/10.1542/peds.2005-3024 Lauritz Bredrup Dahl, PhD, Per Ivar Kaaresen, MD, Jorunn Tunby, MPH, Bjorn Helge Handegard, CSc, Siv Kvernmo, PhD, John A. Ronning, [...]