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Aim This paper examines the incidence and possible prenatal and postnatal risk factors for the emergence of the sudden infant death syndrome (SIDS) in the Bjelovar-Bilogora County in Croatia.

Cardiovascular risk factors, such as abdominal obesity and obesity in general, are very prevalent among patients with bipolar disorder (BD). Although long-term use of psychotropic medications is an important determinant of these risk factors, other evidence suggests that early development may interact with the mood disorder diathesis to exponentially increase the risk of obesity. The goal of our study was to test whether season of birth is associated with adult body mass index (BMI) and abdominal obesity in individuals with bipolar disorder. We compared season of birth effects on BMI in 375 adult patients with bipolar disorder and 196 adult patients with unipolar major depression. We found a significant season of birth effect on BMI in patients with bipolar disorder, but not unipolar. In patients with bipolar disorder, season of birth was also associated with waist circumference, with a stronger effect in males. Season of birth affects adult BMI and waist circumference in patients with bipolar disorder, but not in patients with unipolar depression. Our results suggest that early environmental factors, yet to be identified, interact with specific neurobiological features of bipolar disorder to determine stable traits and disease risk factors in adult life.

The most prevalent musculoskeletal disorder of childhood with unclear aetiology is growing pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GP pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3–7 years. Among them, ten pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. A total of 78 children presenting GPs met Peterson’s criteria. Genu valgum severity was a significant factor for GP manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33 cm) and birth length or weight (smaller than 50 cm and 3000 g, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive of the disorder. Our data are potentially supportive for the “bone strength” theory and for the contribution of anatomical disturbances in GP appearance.

Objetivo: El análisis del pH de sangre arterial de cordón umbilical sigue siendo un criterio objetivo usado para determinar el estado metabólico del recién nacido tras el parto, y por tanto del bienestar fetal. El objetivo de este estudio fue identificar los factores perinatales asociados con los valores de sangre arterial de cordón umbilical. Material y métodos: Se realizó un estudio descriptivo y analítico entre Enero de 2010 y Enero de 2013 en un hospital de tercer nivel en el sur de España, con mujeres atendidas por parto. Los criterios de inclusión fueron: embarazo sin complicaciones y parto vaginal único, a término, con presentación cefálica. Las variables independientes con gran significación tras un análisis univariante fueron: edad, paridad, edad gestacional, analgesia epidural, plan de parto, episiotomía, duración de la primera fase del parto, y uso de oxitocina. Como variable dependiente se consideró: los valores de pH de sangre arterial de cordón umbilical (< = 7.24; > 7.24). El número total de mujeres fue de 165. El análisis estadístico se realizó mediante regresión logística múltiple. Resultados: La analgesia epidural y la edad gestacional mayor o igual a 41 semanas influyeron negativamente en el pH de cordón umbilical neonatal, mientras que haber presentado un plan de parto tuvo una influencia protectora. Conclusiones: Los hallazgos de este estudio proporcionan a los profesionales más evidencias sobre los elementos que pueden influenciar en el bienestar neonatal, con el fin de actuar en consecuencia, anticipándose a las situaciones de riesgo y aplicando una atención más eficaz. Objective: Perinatal asphyxia is the mayor cause of neonatal morbidity and mortality. The analysis of umbilical arterial cord blood pH remains an objective criterion used to determine the metabolic state of the newborn after birth, and therefore of fetal wellbeing. The aim was to identify the perinatal factors associated with umbilical arterial cord blood pH values. Materials and methods: A descriptive and analytical study was conducted between January 2010 and January 2013 at a tertiary hospital in the Southern Spain. The inclusion criteria were: Uncomplicated pregnancy and vaginal single delivery at term with vertex presentation. Independent variables with greater significance after the univariate analysis were: Age, parity, gestational age, epidural analgesia, birth plan, and episiotomy, duration of first labor stage and oxytocin use. It was considered as a dependent variable the umbilical arterial blood pH values (< = 7.24; > 7.24). The total number of women was 165. Statistical analysis was performed using logistic regression. Results: Epidural analgesia and gestational age more than or equal to 41 weeks have negatively influence the neonatal umbilical cord pH, while having presented a birth plan could have a protective influence. Conclusions: findings of this study provide to the professionals more evidence on the elements that may influence neonatal wellbeing, in order to act accordingly, anticipating risk situations and applying more effective care.

Fundamento. La etiología de la obesidad infantil es compleja y se encuentra implicada la interacción de factores genéticos y ambientales. Las complicaciones obstétricas se han asociado al desarrollo de trastornos mentales y médicos, incluida la obesidad. El objetivo de esta investigación es estudiar la asociación entre las complicaciones durante el embarazo y el parto y el desarrollo de obesidad infantil. Participantes y método. Se presentan los datos de un estudio de casos y controles compuesto por 60 madres de niños con obesidad comparado con 92 madres de niños controles con normopeso y con edades comprendidas entre los 8 y 12 años. Se realizó una entrevista clínica a las madres y se estudiaron las complicaciones obstétricas mediante la Escala Lewis-Murray. Resultados. Se observó una mayor frecuencia de complicaciones durante el parto en el grupo de madres de niños con obesidad. La complicación obstétrica más frecuente fue la cesárea de emergencia, mostrando diferencias significativas con el grupo control sano. La edad de la madre en el parto menor de 30 años y el nivel socioeconómico bajo fueron las variables que mostraron una mayor relación con la obesidad actual de los niños. Conclusiones. Las complicaciones obstétricas parecen estar relacionadas con el desarrollo posterior de obesidad infantil. Es necesario continuar estudiando el periodo perinatal como factor relevante, de cara a desarrollar e implementar programas de prevención e intervención temprana. Background. The aetiology of childhood obesity is complex. It involves the interaction of genetic and environmental factors. Obstetric complications have been associated with the development of mental disorder and other medical conditions. The aim of this research is to study the association between perinatal complications and childhood obesity. Methods. We present data from a case-control study composed of 60 mothers of obese children and 92 mothers of healthy control children between 8-12 years. We interviewed the mothers and we studied obstetric complications with the Lewis -Murray Scale. We compared the two groups with chi- square analysis and odds ratios. Results. We found a higher prevalence of obstetric complications in delivery in the group with obesity. The most frequent obstetric complication was emergency caesarean; a significant difference was shown with the control group (p < 0.05). Conclusion. Obstetric complications are related to the development of childhood obesity. It is important to study the perinatal period as a relevant factor, in order to develop and implement prevention programs.

Background: In utero and early-life exposures are suspected to modulate the risk of prostate cancer. This study examines the influence of certain perinatal and childhood-related factors on prostate cancer risk overall and by Gleason score at biopsy. Methods: MCC-Spain is a multicase-control study where 1088 histologically-confirmed incident prostate cancer cases (aged 42-85 years) and 1345 population-based controls (aged 38-85 years), frequency matched by age and province of recruitment, were recruited in 7 Spanish provinces. Self-reported perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with prostate cancer risk, globally and according to Gleason score at biopsy, was evaluated using logistic and multinomial regression mixed models, adjusting for age, family history of prostate cancer, educational level and body mass index one year before the interview, and including the province as a random effect term. Results: Most perinatal factors were not related to prostate cancer risk, with the exception of middle-high socioeconomic level at birth (OR for high grade tumors = 1.36; 95%CI = 1.09-1.68). Regarding puberty, risk rose by 6% for each year of delayed onset (OR = 1.06; 95%CI = 1.01-1.10; p trend = 0.016), with a clear excess of risk in men who reached puberty after age 15 (OR: 1.35; 95%CI = 1.08-1.68). A borderline significant positive association with prepubertal height was also observed (p trend = 0.094). Conclusion: Some exposures experienced in utero and during adolescence, when the prostate is still maturing, might be relevant for prostate cancer risk in adulthood. (C) 2016 Elsevier Ltd. All rights reserved.

BACKGROUND: Accumulated exposure to hormones and growth factors during early life may influence the future risk of breast cancer (BC). This study examines the influence of childhood-related, socio-demographic and anthropometric variables on BC risk, overall and by specific pathologic subtypes. METHODS: This is a case-control study where 1539 histologically-confirmed BC cases (23-85 years) and 1621 population controls, frequency matched by age, were recruited in 10 Spanish provinces. Perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with BC risk, globally and according to menopausal status and pathologic subtypes, was evaluated using logistic and multinomial regression models, adjusting for tumor specific risk factors. RESULTS: Birth characteristics were not related with BC risk. However, women with high socioeconomic level at birth presented a decreased BC risk (OR=0.45; 95% CI=0.29-0.70), while those whose mothers were aged over 39 years at their birth showed an almost significant excess risk of hormone receptor positive tumors (HR+) (OR=1.35; 95% CI=0.99-1.84). Women who were taller than their girl mates before puberty showed increased postmenopausal BC risk (OR=1.26; 95% CI=1.03-1.54) and increased HR+ BC risk (OR=1.26; 95% CI=1.04-1.52). Regarding prepubertal weight, while those women who were thinner than average showed higher postmenopausal BC risk (OR=1.46; 95% CI=1.20-1.78), associated with HR+ tumors (OR=1.34; 95% CI=1.12-1.61) and with triple negative tumors (OR=1.56; 95% CI=1.03-2.35), those who were heavier than average presented lower premenopausal BC risk (OR=0.64; 95% CI=0.46-0.90) and lower risk of epidermal growth factor receptor positive tumors (OR=0.61; 95% CI=0.40-0.93). CONCLUSION: These data reflect the importance of hormones and growth factors in the early stages of life, when the mammary gland is in development and therefore more vulnerable to proliferative stimuli. The authors acknowledge funds provided by the Spanish Ministry of Economy and Competitiveness (Carlos III Institute of Health; PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI14/01219 and Rio Hortega CM13/00232), the Catalan Government 2009SGR1489 & 2014SGR756-F, and, by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT-2006-036224-HIWATE, and by the Spanish Association Against Cancer (AECC) Scientific Foundation.

There is some evidence that perinatal factors, specifically birth weight (BW), may be related to the onset of prostate cancer (PRCA). This case–control study, nested within the Malmö Diet and Cancer Cohort Study, used archived birth record data from 308 incident PRCA cases diagnosed between 1991 and 2005, and 637 age-matched controls among 4781 men born (1923–1945) in Malmö and Lund, Sweden. We applied conditional logistic regression to examine the birth size–PRCA association, including tumour subtypes, adjusting for perinatal and adult factors. Compared with controls, cases had a non-significantly higher mean BW and were more likely to have high (>4000 g) BW (21% v. 18%), but did not differ in other birth size measures, nor in mean adult body mass index . We observed a non-linear association between BW and PRCA risk. Compared with BWs between 3000 and 3500 g (reference), the fully adjusted odds ratios (OR, 95% CI) were 0.55 (0.33–0.91) for 4000 g. Among men with aggressive tumours, the reduction in risk for those with BWs

Using the Swedish Medical Birth Registry (MBR), obstetrical and demographic information was retrieved for 250 children with autism or Asperger syndrome who were born in Malmoe, Sweden, and enrolled at the local Child and Youth Habilitation Center. The reference group consisted of all children born in Malmoe during 1980—2005. Obstetric sub-optimality (prematurity, low Apgar scores, growth restriction, or macrosomia) was positively associated with autism but not with Asperger syndrome. Maternal birth outside the Nordic countries was positively associated with autism (adjusted OR: 2.2; 95%CI: 1.6—3.1) and negatively associated with Asperger syndrome (OR: 0.6; 95%CI: 0.3—0.97). The highest risk estimate for autism was found among children to women who were born in sub-Saharan Africa (OR: 7.3), or in East Asia (OR: 3.4).

The studies of perinatal factors long-term effects on obesity development are summarized in this article. Maternal body mass and nutrition role during pregnancy was demonstrated in Dutch hunger studies and several works in vivo. The association between birth weight, obesity, and abdominal fat distribution in future life were demonstrated several times. Breast feeding duration and risk of obesity have inverse association, but excessive breast feeding also can increase obesity risk. Early accelerated weight gain and further risk of obesity are also associated. Based on the effect of nitrition in preterm newborns study and several works in vivo it is hypothesized that increased food consumption during infancy can program elevated leptin concentrations for fat mass ratio durng future life. Further investigations in this area can lead to breakthrough in solving the problem of obesity and overweight prophylaxis.

The present study was conducted to learn whether the perinatal and environmental factors could influence the total and antigen-specific IgE levels in umbilical cord blood. Retrospective data were obtained from 173 mother-infant pairs. Total and specific (for children's food, wheat/grass and house dust mite-HDM) cord blood IgE levels were determined using the immunoassay test. The total cord blood IgE was between 0.0-23.08 IU/ml (mean 0.55 ± 2.07 IU/ml; median 0.16 IU/ml). Total IgE levels were significantly higher in boys compared with girls (OR = 2.2; P = 0.007), and in newborns with complicated pregnancy (OR = 2.7; P = 0.003). A greater number of siblings correlated with increases in the total cord blood IgE (P < 0.02). We detected specific IgE in 34 newborns (40 positive tests). A long-standing contact with a cat during pregnancy decreased the specific IgE level for wheat/grass (OR = 3.2; P < 0.07) and for children's food (OR = 5.0; P < 0.04), and the contact with a dog decreased the specific-IgE for wheat/grass (OR = 0.3; P < 0.05). Exposure to tobacco smoke correlated with the positive specific IgE toward house dust mite (OR = 4.7; P = 0.005).

In this population-based Norwegian cohort study (2.1 million children), the impact of birth and parental characteristics on the risk of neuroblastoma (178 cases) was evaluated. In children below the age of 18 months, there was an increased neuroblastoma risk among those with congenital malformations and suggestion of increased risk when the mother had pre-eclampsia.

Congenital hypothyroidism is a more common pediatric endocrine disorder and also most common preventable cause of mental retardation. Early diagnosis by measuring Thyroid hormones thyroxine (T4), Thyroid Stimulating Hormone (TSH) levels and prompt treatment is crucial in improving intellectual outcome and for growth of the baby. There are several perinatal factors which influence cord blood TSH, T4 values which has to be considered while int erpreting the results. Umbilical cord blood samples were collected for assessment of TSH and T4 in 100 newborns. The influence of birth weight and gestational age on T4 & TSH levels was assessed. On comparing mean TSH and T4 levels among preterm and term i nfants, it was found that there was statistically significant difference in the mean TSH levels between term and preterm infants. Difference in mean T4 levels among low birth weight and normal birth weight infants was statistically significant. To conclude Birth weight & gestational age have influence on Cord blood TSH and T4 levels and a caution in their interpretation should be considered.

Uvod: Od brojnih perinatalnih čimbenika relevantnih za procjenu stanja djeteta po rođenju, izdvojeni su gestacijska dob, vrijednosti Apgar-skora u 1. minuti i u 5. minuti te pH arterijske krvi po rođenju kao mogući pokazatelji prognoze kvalitete života ispitivane djece kasnije. Materijali i metode: U istraživanje je uključeno 81 dijete koje je bilo liječeno na Odjelu intenzivnog liječenja KBC Rijeka, Klinike za pedijatriju, u razdoblju od kolovoza 2013. do kolovoza 2014. Prvi dio istraživanja je retrospektivna studija u kojem su podatci o djeci vađeni iz povijesti bolesti ,dok je drugi dio istraživanja prospektivna studija gdje se prikupljanje podataka vršilo putem Pedijatrijskog upitnika o kvaliteti života (PedsQL) – dojenačka skala kojeg su roditelji ili skrbnici ispunjavali. U obradi podataka korišteni su Kolmogorov-Smirnov test, neparametrijski Wilcoxon Matched Pairs test, neparametrijski Mann-Whitney test, parametrijski T-test, Pearsonov te Spearmanov koeficijent korelacije. Rezultati: Istraživanjem je dokazano da postoji statistiĉki znaĉajna razlika u prosječnim vrijednostima Apgar-skora u 1.minuti mjereno prema gestacijskoj dobi odnosno da lošije vrijednosti Apgar-skora imaju djeca rođena s ≤ 37 tjedana gestacije. Analizom upitnika o kvaliteti života dobili smo podatke da djeca imaju najvećih poteškoća sa kognitivnim funkcioniranjem te emocionalnim funkcioniranjem. Nadalje, nema dokazane statistiĉki značajne razlike između kvalitete života u djece rođene u ranoj gestacijskoj dobi ili sa lošijim vrijednostima Apgar-skora u 5. minuti. Rasprava: Istraživanje je provedeno na djeci do 12 mjeseci života i putem roditeljskog izvješća ĉime im se pokušala utvrditi kvaliteta ţivota u kasnijoj životnoj dobi. Rezultati našeg ispitivanja podudaraju se sa onima iz literature. Zaključak: Potrebna su daljnja i opsežnija istraživanja povezanosti razliĉitih perinatalnih ĉimbenika sa kvalitetom života kasnije u djece. Introduction: Some of many perinatal factors relevant to the assessment of a child at birth were selected for this research: gestational age, Apgar score in 1st minute and in 5th minute and the pH of arterial blood. These factors were selected as possible predictors of prognosis quality of life of children. Materials and Methods: The study includes 81 children who were treated at the Department of Intensive Care Rijeka, Department of Pediatrics in the period from August 2013 to August 2014. The first part of the study is a retrospective study in which the extraction of data was from history of illness and the second part is a prospective study where data were collected through the Pediatric quality of Life Questionnaire (PedsQL) - infant scale. In the processing of data used tests are Kolmogorov-Smirnov test, non-parametric Wilcoxon Matched Pairs test, nonparametric Mann-Whitney test, parametric t-test, Pearson and Spearman correlation coefficient. Results: The study has demonstrated a statistically significant difference in the average values of Apgar-score in 1st minute, measured according to gestational age. Lower Apgar-score have children born with ≤ 37 weeks of gestation. In the analysis of questionnaire about the quality of life we have received information that children have the greatest difficulty with emotional functioning. Furthermore, there is no proven statistically significant difference between the quality of life in children born in the early gestational age or with lower Apgar-score in the 5th minute. Discussion: The study was conducted on children under 12 months of age and by parental reports, in which they tried to determine the quality of life in later age. Our data coincide with those in the literature. Conclusion: There is a great need to continue and to deepen research to find the link between different perinatal factors and the quality of life.

Lapsuusiän astman ja allergisten sairauksien esiintyvyys on noussut useissa länsi- maissa 1900-luvun puolivälin jälkeen. Esiintyvyys nousee yhä joissakin maissa, vaikka toisissa maissa nousu näyttäisi pysähtyneen tai jopa laskeneen. Varhaislapsuuden ja jopa sikiöaikaisten ympäristötekijöiden arvellaan olevan yhteydessä astman ja allergisten sairauksien syntyyn. Erityisesti muuttuneella mikrobialtistuksella ja suoliston mikrobistolla on mahdollisesti keskeinen vaikutus immunipuolustuksen kehittymiseen ja kypsymiseen. Siten niillä tekijöillä, joilla on vaikutusta mikrobialtistukseen ja suoliston mikrobistoon, kuten synnytystavalla ja antibioottien käytöllä, saattaa olla merkitystä astman ja allergisten sairauksien kehittymisessä. Perinataalitekijöiden ja lapsen antibioottien käytön yhteyttä astman syntyyn on selvitetty useissa tutkimuksissa, kun taas eri ympäristötekijöiden yhteyttä lehmänmaitoallergian syntyyn on tutkittu vain vähän. Tämän tutkimuksen tavoitteena oli selvittää äidin taustatekijöiden, perinataalitekijöiden ja antibioottien käytön yhteyttä lapsen riskiin sairastua lehmänmaitoallergiaan ja astmaan. Näitä yhteyksiä selvitettiin rekisteritietoihin pohjautuvassa upotetussa tapaus-verrokki asetelmassa. Tutkittavat oli poimittu kaikista Suomessa 1.1.1996–30.4.2004 syntyneistä lapsista. Näistä lapsista kaikki ne, joille oli myön- netty erityisäidinmaidonkorvikkeiden tai lääkkeiden erityiskorvausoikeus lehmänmaitoallergian tai astman johdosta vuoden 2005 loppuun mennessä ja jotka olivat ostaneet erityisäidinmaidonkorvikkeita tai astmalääkkeitä diagnoosin (erityiskorvausoikeuden) jälkeen määriteltiin tapauksiksi. Jokaiselle tapaukselle poi- mittiin sukupuolen, syntymäajan ja syntymäsairaanhoitopiirin mukaan kaltaistettu verrokki. Tutkimukseen otettiin lopulta mukaan 16237 maitoallergian ja 20272 astman tapaus-verrokkiparia. Erityiskorvausoikeus- ja lääkeostotiedot saatiin Kansaneläkelaitoksen lääketiedostoista ja tiedot äidin taustatekijöistä ja perinataalitekijöistä saatiin Terveyden ja hyvinvoinnin laitoksen ylläpitämästä Syntyneiden lasten rekisteristä. Tilastolliset analyysit toteutettiin käyttäen ehdollista logistista regressiota. Analyysit tehtiin erikseen alle 3-vuotiaina ja 3-vuotiaana tai sitä vanhempana diagnoosin saaneilla lapsilla, sillä astma-diagnoosi on haastellinen pienillä lapsilla. Siten tämän työn päätuloksiksi voidaan katsoa tulokset maitoallergian ja astmadiagnoosin 3-vuotiaana tai sitä vanhempana saaneiden osalta. Äidin aikaisempien synnytysten määrä oli käänteisessä yhteydessä sekä lehmänmaitoallergian (OR 0.71, 95% CI 0.59–0.86, 5 tai useampi synnytys vs. ei aikaisempia synnytyksiä) että 3-vuotiaana tai sitä vanhempana diagnosoidun astman (OR 0.36, 95% CI 0.27–0.49, 5 tai useampi synnytys vs. ei aikaisempia synnytyksiä) riskiin. Lisäksi, äidin ikä ja sosioekonominen asema synnytyksen hetkellä sekä lapsen syntymäpaino ja syntyminen keisarinleikkauksella olivat suorassa yhteydessä lehmänmaitoallergian riskiin. Äidin tupakointi raskauden aikana ja monisikiöraskaus olivat yhteydessä vähentyneeseen lehmänmaitoallergian riskiin. Lyhyt raskauden kesto oli yhteydessä suurentuneeseen 3-vuotiaana tai sitä vanhempana diagnosoidun astman riskiin. Äidin raskaudenaikainen antibioottien käyttö oli yhteydessä lapsen suurentuneeseen lehmänmaitomaitoallergian (OR 1.21, 95% CI 1.14–1.28) ja 3-vuotiaana tai sitä vanhempana diagnosoidun astman (OR 1.14, 95% CI 1.04–1.24) riskiin, kun oli huomioitu useita äidin taustatekijöitä, perinataalitekijöitä ja lapsen oma antibioottien käyttö. Lapsen oma antibioottien käyttö varhaislapsuudessa oli yhteydessä suurentuneeseen lehmänmaitoallergian (OR 1.71, 95% CI 1.59–1.84) ja 3-vuotiaana tai sitä vanhempana diagnosoidun astman (OR 1.55, 95% CI 1.44–1.67) riskiin. Sekä äidin että lapsen antibioottien käyttö oli yhteydessä suurentuneeseen lehmänmaitoallergian ja 3-vuotiaana tai sitä vanhempana diagnosoidun astman riskiin. Lisäksi, vaikka useat äidin taustatekijät ja perinataalitekijät olivat yhteydessä lapsen riskiin sairastua joko lehmänmaitoallergiaan tai astmaan, vain äidin aikaisempien synnytysten lukumäärä oli käänteisessä yhteydessä sekä lehmänmaitoallergian että 3-vuotiaana tai sitä vanhempana diagnosoidun astman riskiin. Antibioottien käyttöön ja astmariskiin liittyvät havainnot ovat samansuuntaisia kuin mitä on aikaisemmin havaittu muissa vastaavissa, isoissa rekisteritietoihin perustuvissa tutkimuksissa, kun taas lehmänmaitoallergiaan liittyvät havainnot tulee vahvistaa lisätutkimuksin. Lisäksi, tässä tutkimuksessa havaittujen yhteyksien taustalla olevista biologisista mekanismeistä tarvitaan lisää tutkimuksia. Tämän tutkimuksen tulokset tukevat käsitystä siitä, että sikiöaikaisilla ja varhaislapsuuden mikrobialtistukseen yhteydessä olevillä ympäristötekijöillä on mahdollisesti vaikutusta lehmänmaitoallergian ja astman kehittymiseen lapsuusiässä, vaikka sairauksien riskitekijät näyttävät osittain eroavan. The prevalence of asthma and allergic diseases in childhood has increased in several industrialized countries since the second half of the twentieth century. In some countries, the prevalence is still rising, although in others it seems to have plateaued or even decreased. It has been suggested that environmental factors operating prenatally and in early life affect the development of asthma and allergic diseases. Particularly changes in microbial exposure are proposed to play an important role in the development and maturation of the immune system. Thus, the factors that affect microbial exposure, such as mode of delivery and the use of antibiotics, may influence the development of asthma and allergic diseases. Several studies have explored the associations between perinatal factors and children's use of antibiotics and the risk of asthma, with inconsistent findings, while less is known about environmental risk factors for cow’s milk allergy. The aim of the present study was to assess whether maternal background factors, perinatal factors and the use of antibiotics are associated with the development of cow’s milk allergy and asthma in childhood. These associations were addressed in a register-based case-control study nested in a cohort of all Finnish children born between 1 January 1996 and 30 April 2004. Among these children, all those who were diagnosed with cow’s milk allergy (i.e. received a special reimbursement for the cost of special infant formula) or asthma (i.e. received a special reimbursement for the cost of antiasthmatic drugs) by the end of year 2005 and purchased, respectively, special infant formulas or antiasthmatic drugs after diagnosis were identified as cases. For each case, one sex-, birth date- and birth hospital district-matched control child was selected. Altogether, 16,237 cow’s milk allergy case-control pairs and 20,272 asthma case-control pairs were included in the study. Information on received special reimbursements, drug purchases, maternal background and perinatal factors were obtained from, respectively, the Special Reimbursement Register of the Social Insurance Institution, the Drug Prescription Register of the Social Insurance Institution and the Finnish Medical Birth Register of the National Institute for Health and Welfare. Statistical analysis was conducted using conditional logistic regression separately for children diagnosed with asthma before the age of three years and at the age of three years or later, as the asthma diagnosis in young children is challenging. Thus, the results related to cow’s milk allergy and asthma diagnosed at the age of three years or later are considered as the main results of the present study. The number of maternal previous deliveries was inversely associated with the risk of both cow’s milk allergy (OR 0.71, 95% CI 0.59–0.86 for five or more deliveries vs. no previous deliveries) and asthma diagnosed at the age of three years or later (OR 0.36, 95% CI 0.27–0.49 for five or more deliveries vs. no previous deliveries). In addition, maternal age at delivery, socioeconomic status, child’s birth weight and delivery by caesarean section were directly associated with the risk of cow’s milk allergy. Maternal smoking during pregnancy and multiple pregnancy were associated with a decreased risk of cow’s milk allergy. Further, maternal asthma and a short gestational age were associated with an increased risk of asthma diagnosed at the age of three years or later. Maternal use of antibiotics during pregnancy was associated with an increased risk of cow’s milk allergy (OR 1.21, 95% CI 1.14–1.28) and asthma diagnosed at the age of three years or later (OR 1.14, 95% CI 1.04–1.24) in the offspring after considering several maternal sociodemographic background and perinatal factors and the child’s use of antibiotics. Maternal use of cephalosporins during pregnancy was associated with the risk of both cow’s milk allergy and asthma diagnosed at the age of three years or later. In addition, maternal use of macrolides and penicillins with extended spectrum were associated with the risk of cow’s milk allergy. The children’s own use of antibiotics during early childhood was associated with an increased risk of cow’s milk allergy (OR 1.71, 95% CI 1.59–1.84) and asthma diagnosed at the age of three years or later (OR 1.55, 95% CI 1.44–1.67). All common specific antibiotics used during early childhood were associated with the risk of both cow’s milk allergy and asthma diagnosed at the age of three years or later, except phenoxymethylpenicillin, which was not associated with the risk of asthma. In summary, the present study found that the use of antibiotics by the mother and the child were associated with an increased risk of both cow’s milk allergy and asthma diagnosed at the age of three years or later in childhood. Further, although several maternal sociodemographic background and perinatal factors were found to be associated with either the risk of cow’s milk allergy or asthma in childhood, only a high number of maternal previous deliveries were associated with a decreased risk of both cow’s milk allergy and asthma diagnosed at the age of three years or later. The antibiotics and asthma findings are in line with results from similar large, register-based studies, but the cow’s milk allergy findings will have to be confirmed in future studies. In addition, biological mechanisms underpinning the associations observed in the present study need to be explored further. The results of the present study provide further evidence that environmental factors affecting microbial exposure during the prenatal period and in early child- hood may play a role in the development of cow’s milk allergy and asthma in childhood, although some maternal-related and perinatal risk factors seem to be different for these two diseases.

Introduction. The association of prenatal growth with nutritional status, metabolic syndrome (MS), and insulin resistance (IR) was studied in school-age children.Methods. A retrospective cohort study was designed linking present data of children with perinatal records. 3325 subjects were enrolled. Anthropometry, blood pressure (BP), and pubertal status were assessed. Blood lipids, glucose, and insulin were measured. Linear associations were assessed using the Cochran-Armitage test. Odds ratios and nonlinear associations were computed.Results. 3290 children (52% females, mean age of 11.4 ± 1 years) were analyzed. Prevalence of obesity, stunting, MS, and IR was 16.0%, 3.6%, 7.3%, and 25.5%, respectively. The strongest positive association was between birth weight (BW) and obesity (OR 2.97 (95% CI 2.01–4.40) at BW ≥ 4,000 g compared to BW 2,500–2,999). The strongest inverse association was between birth length (BL) and stunting (OR 8.70 (95% CI 3.66–20.67) at BL < 48 cm compared to BL 52-53 cm). A U-shaped association between BL and BP ≥ 90th percentile was observed. Significant ORs were also found for MS and IR. Adjustments for present fat mass increased or maintained the most prenatal growth influences.Conclusions. Prenatal growth influences MS, IR, and nutritional status. Prenatal growth was more important than present body composition in determining these outcomes.

We used the Swedish Family-Cancer Database to analyse the effects of birth order and family size on the risk of common cancers among offspring born over the period 1958–96. Some 1.38 million offspring up to age 55 years with 50.6 million person-years were included. Poisson regression analysis included age at diagnosis, birth cohort, socio-economic status and region of residence as other explanatory variables. The only significant associations were an increasing risk for breast cancer by birth order and a decreasing risk for melanoma by birth order and, particularly, by family size. When details of the women's own reproductive history were included in analysis, birth orders 5–17 showed a relative risk of 1.41. The effects on breast cancer may be mediated through increasing birth weight by birth order. For melanoma, socio-economic factors may be involved, such as limited affordability of sun tourism in large families. Testis cancer showed no significant effect and prostate cancer was excluded from analysis because of the small number of cases. © 2001 Cancer Research Campaign http://www.bjcancer.com

The objective of the study is to determine perinatal and postnatal factors that may affect the occurrence of small cerebellar hemorrhage (CBH) and to evaluate the effect of small CBH on neurodevelopmental outcome in very preterm infants. This prospective study in an unselected cohort of very preterm infants was approved by the medical ethics committee, and informed parental consent was obtained. Presence of small CBH (

Background: The aim of the present study was to determine the effect of various perinatal factors on cord blood TSH among newborns in Isfahan, Iran. Materials and Methods: This was a descriptive-analytic cross sectional study which performed in Isfahan Iran. During a period of four months, since February to May 2012 a total number of 440 newborns delivered in Alzahra and Shahid beheshti hospitals were enrolled in the study. For all newborns one mL blood sample from umbilical vein was obtained by one of the project investigators and sent to laboratory for further examinations. Cord blood TSH and birth body weight (BBW), gestational age, history of gestational diabetes mellitus (GDM), apgar at one minute, apgar at five minute, newborn gender and the mother′s age were documented. Differences considered statistically significant if P < 0.01. Results: 440 newborns enrolled in the study, 221 (50.2%) were male and 219 (49.8%) were female. Among study parameters, method of delivery had statistically significant relation with cord blood TSH (P < 0.001), and other factors such as BBW, gestational age, GDM, apgar at one minute, apgar at five minute, newborn gender and the mother′s age didn′t have statistically significant relationship with cord TSH level. Conclusion: In conclusion we deduce that the only factor that can affect cord blood TSH was method of delivery. Infant with vaginal delivery has higher TSH level in cord blood. Other factors that were evaluated in this study didn′t have any statistically significant relationship.

Objective: The aim of this study was to examine paternal age in relation to risk of autism spectrum disorders (ASDs) in a setting other than the industrialized west. Design: A case-control study of Aruban-born children (1990-2003). Cases (N = 95) were identified at the Child and Adolescent Psychiatry Clinic, the only such clinic in Aruba; gender and age matched controls (N = 347) were gathered from public health records. Parental age was defined categorically (≤29, 30-39, 40-49, ≥50y). The analysis was made, using conditional logistic regression. Results: Advanced paternal age was associated with increased risk of ASDs in offspring. In comparison to the youngest paternal age group (≤29y), risk of autism increased 2.18 times for children born from fathers in their thirties, 2.71 times for fathers in their forties, and 3.22 thereafter. Conclusion: This study, part of the first epidemiologic study of autism in the Caribbean, contributes additional evidence, from a distinctive sociocultural setting, of the risk of ASD associated with increased paternal age. © 2012 van Balkom et al.

Cilj rada. Procijeniti povezanost perinatalnih čimbenika i razvojnog poremećaja kuka u novorođenčadi i dojenčadi u našoj sredini. Metode. Istraživanje je provedeno na skupini od 140 rodilja i djece s ultrazvučno dijagnosticiranim razvojnim poremećajem kuka te 420 rodilja i djece u koje je isključen poremećaj, kao kontrolne skupine. Ultrazvučni pregledi vršeni su linearnom sondom od 6,2 MHz, a rezultati prikazani ultrazvučnom klasifikacijom kuka i opisom nalaza po Grafu. Analizirani su: životna dob i paritet rodilja, komplikacije u trudnoći, za vrijeme i nakon poroda, način poroda, gestacijska dob, spol novorođenčeta, porodna težina, porodna duljina, ponderalni indeks, Apgar indeks i neonatalne komplikacije. U statističkoj analizi korišteni su ANOVA, 2 test i Studentov t-test. Rezultati. Od ukupno 2511 novorođenčadi u 140 (6,9%) dijagnosticiran je razvojni poremećaj kuka, značajno veće učestalosti u ženskoga spola (72,9%), stava zatkom (10,7%), carskog reza (25,7%), starije životne dobi i višeg pariteta rodilja, novorođenčadi porodne težine >4000 g i ponderalnog indeksa >2,85 te na oba kuka (49,3%). Zaključak. Istraživanje je ukazalo na veću učestalost ove deformacije u ženskog spola, stava zatkom, velike porodne težine i ponderalnog indeksa novorođenčadi, što povezujemo s mehaničkim i hormonalnim čimbenicima rizika., Objective. The aim of this study was to evaluate the relationship of perinatal factors and developmental displacement of the hip in our setting. Methods. The study inculuded 140 mothers and children with developmental displacement of the hip and 420 mothers and healthy children, as a control group. Ultrasound was applied with a 6.2 MHz linear scanner and results were classified according to Graf. The following factors were analyzed: age and maternal parity, complications in pregnancy, during and after delivery, fetal posture, type of delivery, gestational age, newborn sex, birth weight, birth length, ponderal index, Apgar score and neonatal complications. ANOVA, Chi-square and Student t-test were used for statistical analysis. Results. From a total 2511 newborns, 140 (6.9%) children were diagnosed with developmental displacement of the hip, which incidence where significantly higher in females (72.9%), in breech presentation (10.7%), cesarean section (25.7 %), higher maternal age and parity, birth weight >4000 g, ponderal index >2.85 and bilateral (49.3%) cases. Conclusion. Female sex, breech presentation, high birthweight and ponderal index were confirmed as risk factors for developmental displacement of the hip, which connects to intrauterine mechanical and hormonal risk factors.

Objetivo: Evaluar el impacto de los factores maternos y perinatales: peso previo al embarazo, presencia de hipertensión, diabetes y tabaquismo, peso al nacer y tiempo de lactancia con el desarrollo de sobrepeso y obesidad en los niños de 5 a 10 años en una población bogotana. Materiales y métodos: se realizó un diseño de casos y controles no pareado, incluyendo 528 niños con sus respectivas madres con una relación 1:2, en quienes se identificaron los descritos, y también factores postnatales relevantes: dieta, ejercicio y tiempo de pantalla. Se analizó con un modelo de regresión logística binomial la importancia de cada uno para la patología Resultados:Se encontró una mayor prevalencia de casos en los estratos 1 y 2 comparados con los demás estratos (p= 0,034). También se encontraron diferencias en la prevalencia de sobrepeso y obesidad en las madres de los casos (27%; p =0,01), mayor ingesta calórica en el grupo de los controles (42,9% vs 30,9%; p= 0,04). En el modelo de regresión logística se encontró que los factores que en conjunto mostraron significancia estadística fueron, un peso al nacer mayor de 2500 gr OR 2,31(IC 95%:1,13-4,78 p=0,021), un IMC materno antes de la gestación > de 25 OR 3,42(IC 95%:1,42-8,29 p=0,06), peso al año mayor de 7,5 kg OR 2,77 (IC 95%:1,11-2,78 p=0,028) y una ingesta calórica entre 600 a 1900 calorías/día OR 1.58 (IC 95%:1,06-2,35 p=0,02).Conclusiones: son factores de riesgo para el desarrollo de la obesidad infantil, la progresión hacia un percentil superior en peso, antes el embarazo, nacimiento y primer año de vida. Objective: Evaluate the impact of maternal and perinatal factors: pre-pregnancy weight, presence of hypertension, diabetes and smoking, birth weight and breastfeeding time and development of overweight and obesity in children aged 5 to 10 years in a population Bogotá. Materials and methods: We conducted a case-control design unpaired, including 528 children with their mothers with a ratio 1:2, who were identified as described, and relevant postnatal factors: diet, exercise and screen time. Was analyzed with a binomial logistic regression model the importance of each to the pathology Results: We found a higher prevalence of cases in strata 1 and 2 compared with the other strata (p = 0.034). There were also differences in the prevalence of overweight and obesity in mothers of cases (27%, P = 0.01), increased caloric intake in the control group (42.9% vs. 30.9%, p = 0.04). n the logistic regression model found that the factors that showed statistical significance were a birth weight greater than 2500 g OR 2.31 (95% :1,13-4, 78 p = 0.021), pre-pregnancy BMI> 25 OR 3.42 (95% :1,42-8: 29 p = 0.06), weight7.5 kg at first year OR 2.77 (CI 95%: 1 ,11-2, 78 p = 0.028) and caloric intake from 600 to 1900 calories / day OR 1.58 (95%:1,06-2: 35 p = 0.02). Conclusions: risk factors for development of childhood obesity were, the progression to a higher percentile in weight before pregnancy, birth and first year of life.

Objective To determine the perinatal risk factors of long-term neurologic impairment for preterm infants. Methods A case-control study was conducted with 60 neurologically impaired and 60 healthy children, all born prematurely. Results There was no relation between neurologic impairment and maternal pregnancy complications or prenatal steroid administration, bacteriologic content of cervical smear, fetal presentation, fetal heart rate, or mode of delivery. Cerebral palsy was associated with early neurologic signs, perinatal asphyxia, neonatal septicemia, abnormal brain ultrasound findings, prolonged interval between rupture of membranes and delivery, and multiple placental lesions. Children with minimal cerebral dysfunction were more frequently first born. Multiple placental lesions, neonatal septicemia, abnormal brain ultrasound findings, and perinatal asphyxia were independently correlated with long-term neurologic impairment. Conclusion Perinatal infection, perinatal asphyxia, and abnormal brain ultrasound findings seem to be risk factors for cerebral palsy whereas primigravidity seems to be correlated with minimal cerebral dysfunction.

The association between early life factors and body mass index (BMI) in adulthood has been demonstrated in developed countries. The aim of the present study was to assess the influence of early life factors (birth weight, gestational age, maternal smoking, and social class) on BMI in young adulthood with adjustment for adult socioeconomic position. A cohort study was carried out in 1978/79 with 6827 mother-child pairs from Ribeirão Preto city, located in the most developed economic area of the country. Biological, economic and social variables and newborn anthropometric measurements were obtained shortly after delivery. In 1996, 1189 males from this cohort, 34.3% of the original male population, were submitted to anthropometric measurements and were asked about their current schooling on the occasion of army recruitment. A multiple linear regression model was applied to determine variables associated with BMI. Mean BMI was 22.7 (95%CI = 22.5-23.0). After adjustment, BMI was 1.22 kg/m(2) higher among infants born with high birth weight (or = 4000 g), 1.21 kg/m(2) higher among individuals of low social class at birth and 0.69 kg/m(2) higher among individuals whose mothers smoked during pregnancy (P0.05). The association between social class at birth and BMI remained statistically significant (P0.05) even after adjustment for adult schooling. These findings suggest that early life social influences on BMI were more important and were not reversed by late socioeconomic position. Therefore, prevention of overweight and obesity should focus not only on changes in adult life styles but also on factors such as high birth weight.