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Objectives Evidence of the association between food environment and birth outcomes is limited. This study aimed to examine the association between individual-level food access measures and birth outcomes. Methods All birth certificates (N = 15,786) from January 1, 2008 to December 31, 2009 in eight counties in South Carolina were included. Access to food was evaluated by the distance to the nearest food store and the number of each type of store within a 1-mile (1.6-km) radius from the women's homes. Birth outcomes included birth weight, low birth weight, gestational age, and preterm birth (PTB). Results A further distance to the nearest convenience store was associated with higher birth weight and gestational age. Birth weight in areas with two or more convenience stores within a 1-mile (1.6-km) buffer was less [two stores: [beta] = -46.2, 95 % confidence interval (CI) -76.5, -15.9; three or more stores: [beta] = -48.6, 95 % CI -78.8, -18.5], and gestational age was shorter in areas with one or two convenience stores (one store: [beta] = -0.11, 95 % CI -0.21, -0.00; two or more stores: [beta] = -0.13, 95 % CI -0.25, 0.00) than in areas without convenience stores in the neighborhood. Having three or more convenience stores in the neighborhood was associated with increased risk of PTB compared with no convenience stores. Accessibility and availability of supermarkets and grocery stores were not associated with any birth outcomes. Conclusions for Practice This analysis suggests that access to unhealthy foods is associated with adverse birth outcomes. Future investigations with more comprehensive measures of food environment are warranted., Author(s): Xiaoguang Ma[sup.1] [sup.2] [sup.3] , Jihong Liu[sup.4] , James W. Hardin[sup.4] , Guang Zhao[sup.4] , Angela D. Liese[sup.3] [sup.4] Author Affiliations: (1) Department of Nutrition and Food Hygiene, School [...]

Children born at term with low birth weight (LBW) are regarded growth restricted and are at particular risk of adverse health outcomes requiring a high degree of parental participation in the day-to-day care. This study examined whether their increased risk of special health care needs compared to other children may influence mothers' opportunities for participation in the labor market at different times after delivery. Data from 32,938 participants in the population-based Norwegian Mother and Child Cohort Study with singleton children born at term in 2004-2006 were linked to national registers in order to investigate the mothers' employment status when their children were 1-3 years in 2007 and 4-6 years in 2010. Children weighing less than two standard deviations below the gender-specific mean were defined as LBW children. Although not significantly different from mothers of children in the normal weight range, mothers of LBW children had the overall highest level of non-employment when the children were 1-3 years. At child age 4-6 years on the other hand, LBW was associated with an increased risk of non-employment (RR 1.39: 95% CI 1.11-1.75) also after adjustment for factors associated with employment in general. In accordance with employment trends in the general population, our findings show that while mothers of normal birth weight children re-enter the labor market as their children grow older, mothers of LBW children born at term participate to a lesser extent in paid employment and remain at levels similar to those of mothers with younger children. Keywords Birth weight * Child care * Employment * Special health care needs * Work participation, Introduction Improved neonatal care has contributed to increased survival among preterm and low birth weight (LBW) infants [1, 2]. However, the risk for chronic conditions requiring a high degree of [...]

This study evaluated the effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program selected by the West Virginia--Right From The Start Project for state-wide dissemination. A process evaluation documented the fidelity of SCRIPT delivery by Designated Care Coordinators (DCC), licensed nurses and social workers who provide home-based case management to Medicaid-eligible clients in all 55 counties. We implemented a quasi-experimental, non-randomized, matched Comparison (C) Group design. The SCRIPT Experimental E Group (N = 259) were all clients in 2009-2010 that wanted to quit, provided a screening carbon monoxide (CO), and received a SCRIPT home visit. The (C) Group was derived from all clients in 2006-2007 who had the same CO assessments as E Group clients and reported receiving cessation counseling. We stratified the baseline CO of E Group clients into 10 strata, and randomly selected the same number of (C) Group clients (N = 259) from each matched strata to evaluate the effectiveness of the SCRIPT Program. There were no significant baseline differences in the E and (C) Group. A Process Evaluation documented a significant increase in the fidelity of DCC delivery of SCRIPT Program procedures: from 63 % in 2006 to 74 % in 2010. Significant increases were documented in the E Group cessation rate (+9.3 %) and significant reduction rate (+4.5 %), a [greater than or equal to] 50 % reduction from a baseline CO. Perinatal health case management staff can deliver the SCRIPT Program, and Medicaid-supported clients can change smoking behavior, even very late in pregnancy. When multiple biases were analyzed, we concluded the SCRIPT Dissemination Project was the most plausible reason for the significant changes in behavior. Keywords Smoking * Pregnancy * Cessation * Tobacco * Evaluation, Introduction Since Simpson documented a dose-response relationship between smoking and low birth-weight (LBW) in 1957 [1], numerous epidemiologic studies have established multiple, causal effects between smoking and adverse infant and [...]

Background Preterm very-low-birth-weight (PT-VLBW) infants are at risk of an elevated systolic blood pressure (SBP) in infancy and adulthood; however, the pathogenesis remains unclear. Altered renal development or function may be associated with increased SBP, but their contribution in PTVLBW is unknown. Methods We determined renal function and its relationship to SBP in three groups of PT-VLBW at 1, 2, and 3 years of age, using serum cystatin-C to calculate the estimated glomerular filtration rate (eGFR). Results Cystatin-C levels decreased from 0.84 ± 0.2 (SD) within the 1-year group to 0.70 ± 0.1 mg/l (± SD; P Conclusions Preterm very-low-birth-weight infants demonstrate increasing renal function with advancing age. An elevated SBP and eGFR at 1 year suggests dysfunctional renal autoregulation and hyperfiltration, which may alter subsequent renal function and contribute to the lower eGFR seen at 3 years in infants with the lowest birth weight and gestational age. Keywords Glomerular filtration rate * Cystatin-C * Renal development * Developmental programming * Developmental plasticity, Introduction Barker and colleagues pioneered the concept that environmental factors, particularly abnormal fetal nutrition, program the risk of cardiovascular disease, hypertension (HTN), type 2 diabetes, obesity, and chronic kidney disease [...]

Maternal perturbations or sub-optimal conditions during development are now recognized as contributing to the onset of many diseases manifesting in adulthood. This 'developmental programming' of disease has been explored using animal models allowing insights into the potential mechanisms involved. Impaired renal development, resulting in a low nephron number, has been identified as a common outcome that is likely to contribute to the development of hypertension in the offspring as adults. Changes in other organs and systems, including the heart and the hypothalamic-pituitary-adrenal axis, have also been found. Evidence has recently emerged suggesting that epigenetic changes may occur as a result of developmental programming and result in permanent changes in the expression patterns of particular genes. Such epigenetic modifications may be responsible not only for an increased susceptibility to disease for an individual, but indirectly for the establishment of a disease state in a subsequent generation. Further research in this field, particularly examination as to whether epigenetic changes to genes affecting kidney development do occur, are essential to understanding the underlying mechanisms of developmental programming of disease. Keywords Kidney* Glucocorticoids* Prenatal programming * Epigenetic modification, Introduction Hypertension is a major risk factor for the development of cardiovascular disease (CVD) and a common complication of other metabolic disorders, such as obesity and type-2 diabetes. These chronic [...]

Low birth weight (LBW) is associated with type 2 diabetes and depression, which may be related to prenatal stress and insulin resistance as a result of chronic hypothalamic-pituitary-adrenal (HPA) axis hyperactivity. We examined whether treatment with a selective serotonin reuptake inhibitor [escitalopram (ESC)] could downregulate HPA axis activity and restore insulin sensitivity in LBW rats. After 4-5 wk of treatment, ESC-exposed LBW (SSRI-LBW) and saline-treated control and LBW rats (Cx and LBW) underwent an oral glucose tolerance test or a hyperinsulinemic euglycemic clamp to assess whole body insulin sensitivity. Hepatic phosphoenolpyruvate carboxykinase (PEPCK) mRNA expression and red skeletal muscle PKB Ser[sup.473] phosphorylation were used to assess tissue-specific insulin sensitivity, mRNA expression of the hypothalamic mineralocorticoid receptor was five-fold upregulated in LBW (P < 0.05 vs. Cx), accompanied by increased corticosterone release during restraint stress and total 24-h urinary excretion (P < 0.05 vs. Cx), whole body insulin resistance (P < 0.001 vs. Cx), and impaired insulin suppression of hepatic PEPCK mRNA expression (P < 0.05 vs. Cx). Additionally, there was a tendency for reduced red muscle PKB Ser[sup.473] phosphorylation. The ESC treatment normalized corticosterone secretion (P < 0.05 vs. LBW), whole body insulin sensitivity (P < 0.01) as well as postprandial suppression of hepatic mRNA PEPCK expression (P < 0.05), and red muscle PKB Ser[sup.473] phosphorylation (P < 0.01 vs. LBW). We conclude that these data suggest that the insulin resistance and chronic HPA axis hyperactivity in LBW rats can be reversed by treatment with an ESC, which downregulates HPA axis activity, lowers glucocorticoid exposure, and restores insulin sensitivity in LBW rats. selective serotonin reuptake inhibitors doi:10.1152/ajpendo.00606.2009.

Low birth weight is associated with an increased risk of hypertension and renal dysfunction at adulthood. Such an association has been shown to involve a reduction of nephron endowment and to be enhanced by accelerated postnatal growth in humans. However, while low-birth-weight infants often undergo catch-up growth, little is known about the long-term vascular and renal effects of accelerated postnatal growth. We surimposed early postnatal overfeeding (OF; reduction of litter size during the suckling period) to appropriate-birth-weight (NBW+OF) and intrauterine growth restriction (IUGR; IUGR+OF) pups, obtained after a maternal gestational low-protein diet. Blood pressure (systolic blood pressure; SBP) and renal function (glomerular filtration rate; GFR) were measured in young and aging offspring. Glomerulosclerosis and nephron number were determined in aging offspring (22 too). Nephron number was reduced in both IUGR and IUGR+OF male offspring (by 24 and 26%). GFR was reduced by 40% in 12-too-old IUGR+OF male offspring, and both NBW+OF and IUGR+OF aging male offspring had sustained hypertension (+25 mmHg) and glomernlosclerosis, while SBP and renal function were unaffected in IUGR aging offspring. Female offspring were unaffected. In conclusion, in this experimental model, early postnatal OF in the neonatal period has major long-lasting effects. Such effects are gender dependent. Reduced nephron number alone, associated with IUGR, may not be sufficient to induce long-lasting physiological alterations, and early postnatal OF acts as a 'second hit.' Early postnatal OF is a suitable model with which to study the long-term effects of postnatal growth in the pathogenesis of vascular disorders and renal disease. nephrogenesis; nephron number; catch-up growth; hypertension; glomernlosclerosis; developmental origins of adult diseases; low birth weight doi:10.1152/ajprenal.90704.2008.

Epidemiological studies demonstrated a relationship between low birth weight mainly caused by intrauterine growth restriction (IUGR) and adult metabolic disorders. The concept of metabolic programming centers on the idea that nutritional and hormonal status during the key period of development determines the long-term control of energy balance by programming future feeding behavior and energy expenditure. The present study examined the consequence of early or late 'catch-up growth' after IUGR on feeding behavior and metabolic cues of male offspring of rat dams exposed to protein restriction during gestation and/or lactation. Our results suggest that early catch-up growth may be favorable for fasting metabolic parameters at weaning, as no differences were observed on plasma leptin, triglyceride, glucose, and insulin levels compared with controls. In contrast, if pups remained malnourished until weaning, low insulin concentration was detected and was accompanied by hyperphagia associated with a large increase in hypothalamic NPY and AgRP mRNA expression. At adult age, on a regular chow diet, only the meal structure was modified by fetal programming. The two IUGR groups demonstrated a reduced meal duration that enhanced the speed of food ingestion and consequently increased the rest period associated to the satiety state without changes in the hypothalamic expression of appetite neuropeptides. Our findings demonstrate that in IUGR, regardless of postnatal growth magnitude, metabolic programming occurred in utero and was responsible for both feeding behavior alteration and postprandial higher insulin level in adults. Additionally, catch-up growth immediately after early malnutrition could be a key point for the programming of postprandial hyperleptinemia. perinatal nutrition; appetite neuropeptides; hypothalamus; feeding behavior

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 [...]

Tests on young adults with very low birth weight were performed to determine the association between small size at birth and impaired glucose regulation later in life. Young adults with a very low birth weight were found to have higher indexes of insulin resistance and glucose intolerance and higher blood pressure than those born at term.

This research note combines two national Taiwanese data sets to investigate the relationships among low birth weight (LBW) babies, their parents' educational levels, and their future academic outcomes. We find that LBW is negatively correlated with the probability of such children attending college at age 18; however, when both parents are college or high school graduates, such negative effects may be partially offset. We also show that discrimination against daughters occurs, but only for daughters who were LBW babies. Moreover, high parental education can buffer the LBW shock only among moderately LBW children (as compared with very LBW children) and full-term LBW children (as compared with preterm LBW children).

Forty-one children aged 10.5 [+ or -] 0.2 years (range, 8.0-15.0 yr), born with low birth weight of 1,218.2 [+ or -] 36.6 g (range, 765-1,580 g) were selected from hospital archives on the basis of whether they had received neonatal diuretic treatment or as healthy matched controls. The children were tested for salt appetite and sweet preference, including rating of preferred concentration of salt in tomato soup (and sugar in tea), ratings of oral spray (NaCl and sucrose solutions), intake of salt or sweet snack items, and a food-seasoning, liking, and dietary questionnaire. Results showed that sodium appetite was not related to neonatal diuretic treatment, birth weight, or gestational age. However, there was a robust inverse correlation (r = -0.445, P < 0.005) between reported dietary sodium intake and the neonatal lowest serum sodium level (NLS) recorded for each child as an index of sodium loss. The relationship of NLS and dietary sodium intake was found in both boys and girls and in both Arab and Jewish children, despite marked ethnic differences in dietary sources of sodium. Hence, low NLS predicts increased intake of dietary sodium in low birth weight children some 8-15 yr later. Taken together with other recent evidence, it is now clear that perinatal sodium loss, from a variety of causes, is a consistent and significant contributor to long-term sodium intake. dietary sodium; humans; hyponatremia; neonates; perinatal programming; sodium appetite