Birth Weight Odds Ratio Research Articles

Risk factors of strabismus in children in madagascar

Background: The aims of this study was to determine risk factor of strabismus in malagasy children.
 Methods: It was a case-control study doing at Hospital University Joseph Ravoahangy Andrianavalona from 1st June to November 2023. Children who had strabismus were the case. The control were children who didn’t have strabismus and came to the hospital for vision anomaly and had a similar demography specificity like case. The number of controls was twice the number of cases. All children with organic ophthalmic pathologies were excluded. The data was processed by Epi.info 7.0 software. We used Odds Ratio (OR) test to find association between strabismus and risk factor. Confidence interval (CI) was fixed at 95%. Association was significant for a value of p<0,05.
 Results: 
 Fourty one cases was found for 88 controls. A significant association was found for strabismus and low birth weight OR: 3,69CI[1.68-8.10]p<0,00 ; prematurity OR :2,57IC[1,15-5,73]p<0,01 ; neonatal asphyxia OR : 3,28 IC[1,35-7,97]p<0,00 ; febrile convulsion OR :3,08IC[1,42-6,68]p<0,00 ; and neonatal septicemia OR : 9,90IC[4,20-23,34]p<0,00.
 Conclusion: Strabismus was associated in children with neonatal pathology. A systematic vision field is necessary for patient with risk factor.

The Prevalence of Nonsyndromic Oral Clefts in Twins Compared to Singletons: The Association With Birth Weight.

To examine the prevalence of nonsyndromic oral clefts in twins compared to singletons in the United States and to evaluate the association between birth weight and nonsyndromic oral clefts. A large population-based cross-sectional study was performed using the data from the US National Center for Health Statistics database in 2017. Our sample consisted of 128 310 twins and 3 723 273 singletons. The variables collected were sociodemographic variables, environmental predictors, and clinical measures. Descriptive analysis, bivariate, and multivariate logistic regression were performed. The main outcome variable in our study is nonsyndromic oral clefts. The prevalence of nonsyndromic oral clefts was 5.22 per 10 000 in twins and 5.12 per 10 000 in singletons. Results show no significant risk of nonsyndromic oral clefts in twins compared to singletons (P = .92). There was a significant relationship between birth weight and infant diagnosed with nonsyndromic oral clefts (P = .01). Unadjusted odds ratio for birth weight was 2.52 (95% CI: 2.25-2.82). Adjusted odds for potential confounders such as mother's age, race, mother's education, gender of the infant, APGAR 5-minute score, gestational age, prenatal smoking, number of prenatal care visits, and mother's body mass index were resulted in similar but with a slightly lower odds of 2.11 (95% CI: 1.78-2.50). Compared to singletons, twins did not have higher risk of nonsyndromic oral clefts. Infants with low birth weight were more prone to have nonsyndromic oral clefts.

Smoking and Smoking Cessation in the Risk for Fetal Growth Restriction and Low Birth Weight and Additive Effect of Maternal Obesity.

Many studies have shown that neonates of smoking mothers have a lower birth weight, but several issues remain poorly studied, e.g., the effects of giving up smoking or the combined effects of smoking and maternal obesity. Therefore, we evaluated a prospective cohort of 912 mothers in a single pregnancy, recruited in Poland, in 2015−2016. In the cohort, we recorded 72 (7.9%) newborns with birth weight <10th percentile, 21 (2.3%) fetal growth restriction (FGR) cases, and 60 (6.6%) low birth weight (LBW, <2500 g) newborns. In the cohort, 168 (18.4%) women smoked before pregnancy; the mean number of cigarettes/day was 10.8 (1–30), and the mean number of years of cigarette smoking was 8.5 (1–25). Among smokers, 57 (6.3%) women smoked in the first trimester. Adjusted odds ratio (AOR) of newborn outcomes (with 95% confidence intervals, CI) was calculated in multi-dimensional logistic regressions. Compared to participants who had never smoked, smoking before pregnancy was associated with a higher odds ratio of birth weight <10th percentile (AOR = 1.93, CI: 1.08–3.44, p = 0.027), but the result for LBW (AOR = 2.76, CI: 1.05–7.26, p = 0.039) and FGR (AOR = 1.13, CI: 0.38–3.36, p = 0.822) had the wider confidence interval or was insignificant. Effects of smoking cessation before pregnancy were statistically insignificant for the studied outcomes. Smoking in the first trimester was associated with a higher risk of birth weight <10th percentile (AOR = 4.68, CI: 2.28–9.62, p < 0.001), LBW (AOR = 6.42, CI: 1.84–22.36, p = 0.004), and FGR (AOR = 3.60, CI: 0.96–13.49, p = 0.057). Smoking cessation in the second/third trimester was associated with a higher odds ratio of birth weight <10th percentile (AOR = 4.54, CI: 1.58–13.02, p = 0.005), FGR (AOR = 3.36, CI: 0.6–18.74, p = 0.167), and LBW (AOR = 2.14, CI: 0.62–7.36), p = 0.229), to a similar degree to smoking in the first trimester. The odds ratios were higher in the subgroup of pre-pregnancy body mass index ≥25 kg/m2 for the risk of birth weight <10th percentile (AOR = 6.39, CI: 2.01–20.34, p = 0.002) and FGR (AOR = 6.25, CI: 0.86–45.59, p = 0.071). The length of cigarette smoking time was also the risk factor for studied outcomes. Conclusions: Smoking in the first trimester increased the studied risks, and the coexistence of excessive maternal weight increased the effects. Smoking cessation during the second/third trimester did not have a protective effect.

Trajectories of maternal leisure-time physical activity and sedentary behavior during adolescence to young adulthood and offspring birthweight

PurposeThe objectives of the study were to determine the extent to which trajectories of maternal preconception leisure-time physical activity (LTPA) and leisure-time sedentary behavior (LTSB) during adolescence and young adulthood are associated with offspring birth weight (BW) and to test if these associations differ by offspring sex or maternal pre-pregnancy overweight–obese status. MethodsParticipants with one or more birth (n = 1408) were identified from the National Longitudinal Study of Adolescent to Adult Health. Group-based trajectory modeling was used to characterize trajectories of LTPA (frequency/week) and LTSB (hours/week) which were measured, on average, over 7 years between age 15 and 22 years. Weighted regression and Wald tests were used to estimate and test mean differences and odds ratios for BW, small for gestational age, and large for gestational age (LGA). ResultsThree trajectories were identified for LTPA and five for LTSB. Associations differed by offspring sex for continuous BW and LGA (interaction P = .10 and .008, respectively). Among female offspring, participants with high followed by decreasing LTPA delivered offspring with 90 g greater BW (95% confidence interval [CI]: −4 to 184) and 72% greater risk of LGA (95% CI: 0.94–3.14), compared with participants with low LTPA. Among male offspring, LTPA patterns were not associated with BW. A pattern of high then decreasing LTPA among normal weight, but not overweight–obese women, was associated with 2.03 times greater risk of LGA (95% CI: 1.06–3.88). LTSB trajectories were not associated with BW. ConclusionsAssociations of preconception trajectories of LTPA with offspring BW may differ by offspring sex and maternal pre-pregnancy overweight–obese status.

Intrapartum fever, epidural analgesia and histologic chorioamnionitis.

Our objective was to determine whether epidural analgesia and histologic chorioamnionitis were independent predictors of intrapartum fever. This secondary analysis, retrospective cohort study included term parturients with placental examination during 2005. Logistic regression used fever (⩾38 °C) as the dependent variable. Significance was defined as P⩽0.05. There were 488 (76%) of 641 term parturients with placental examination and epidural. Independent predictors of intrapartum fever were epidural odds ratio (OR)=3.4, confidence interval (CI): 1.70, 6.81, histologic chorioamnionitis OR=3.18, 95% CI: 2.04, 4.95, birthweight OR=2.07, 95%CI: 1.38, 3.12, vaginal exams OR=1.15, 95% CI:1.06, 1.24, duration ruptured membranes OR=1.03, 95% CI: 1.01,1.05, parity⩾1 OR=0.44: 0.29, 0.66 and thick meconium OR=0.35: 95%CI: 0.24, 0.85. Epidural analgesia and histologic chorioamnionitis were independent predictors of intrapartum fever. Modification of labor management may reduce the incidence of intrapartum fever.

ABSTRACT 470

Background and aims: RDS is one of the most common cause of admitting in the NICUs. although we know some risk factors associated with this lung disease, but we emphasize them through descriptive analytic study. Aims: to determine the association between the mode of delivery, gestational age, sex and Birth weight with respiratory distress syndrome in neonates admitted in NICU. Methods: this study was performed on all neonates admitted in NICU during 2009 through november 2013.each neonates with final diagnosis of RDS was selected and its information was documented. Data was analysed using Logestic regression test(spss16). Results: from 847 neonate admitted in NICU during this periode, 34/1% were RDS.Mean of gestational age, APGAR(min 5th) and birth weight were 32/87 week,8/88 and 2033/34gr. 71/84% deivered by c/s and 58/4% were male. association between these three variable with RDS were significant(pvalue<./001) odds ratio of birth weight up to 2500, 1500–2500 and lower than 1500 with RDS was 1, 4.119 and 4.6 respectively. Conclusions: these findings are importatnt to obestetricians in the critical decision regarding the timing and mode of delivery and to Nurses who consult and refer women in pregnancy period and may face neonates with respiratory problems.

Newborn infant characteristics and risk of future rheumatoid arthritis: a twin-control study

Low birth weight has been proposed as a risk factor for rheumatoid arthritis (RA). The twin-control study design provides an opportunity to investigate the significance of potential prenatal determinants for adult morbidity by accounting for maternal characteristics and early environmental and genetic factors. We investigated the association between birth weight and RA in a sample of 42 twin pairs discordant for rheumatoid arthritis in which valid information on birth weight, birth length, and order was available from midwife records. Difference plot and conditional logistic regression were used to investigate the relationship between RA and birth weight or birth order adjusting for birth length and sex. The intra-pairwise birth weight differences, i.e., RA twin minus co-twin, ranged from -750 to 1,100 g, mean 78 g (95 % CI -13 to 70), 146 g (95 % CI (-36 to 329) in monozygotic, 32 g (95 % CI -90 to 154) in dizygotic, same sex and 69 g (95 % CI -122 to 260) in dizygotic, opposite sex twin pairs. The odds ratio for birth weight as risk factor for RA was 1.00 (95 % CI 0.997-1.003) when adjusting for birth length, birth order, and sex, irrespective of ACPA status. The odds ratio for developing RA as first born twin was 2.33 (95 % CI 0.97-5.60) when adjusting for birth length, birth weight, and sex, irrespective of ACPA status. In this twin-control study, birth weight was not associated with the development of RA in adult life. Being born first may predispose to RA.

AB0078 Birth weight is not an independent risk factor for the development of rheumatoid arthritis in adulthood.

BackgroundCircumstances in early life, including low birth weight, have been proposed as risk factors for development of rheumatoid arthritis (RA) in adulthood. The twin-control study design provides an opportunity to...

Short- and Long-Term Outcomes at 2, 5 and 8 Years Old for Neonates at Borderline Viability—An 11-Year Experience

Neurodevelopmental outcome of borderline viability neonates have lagged behind improvement in survival figures. Accurate figures based on local outcome allow us to better counsel parents and to prognosticate with greater accuracy on both short- and longterm outcomes. A retrospective cohort study of 101 consecutively born neonates, born from 21 to 26 weeks gestation over an 11-year period from 1 January 1994 to 31 December 2005 was conducted. Long-term outcomes were assessed at 2, 5 and 8 years of age in terms of mental developmental index (MDI) or intelligence quotient (IQ) scores, hearing and visual impairments, handicaps and impairments, school placement and interventions required. Survival rates were 20.0%, 60.9%, 70.4% and 73.2% for neonates born at 21 to 23, 24, 25 and 26 weeks gestation respectively. Factors that predicted increased mortality included higher alveolar-arterial oxygen difference (AaDO2) with odds ratio (OR) 1.005 and lower birth weight OR 0.993. Rates of severe retinopathy of prematurity (ROP) (stage 3 or worse) were 100%, 57.1%, 42.1% and 26.7% for 21 to 23, 24, 25 and 26 weeks gestation respectively. Rates of bronchopulmonary dysplasia (BPD) were 100.0%, 57.1%, 63.2% and 60.0% respectively. Rates of severe intraventricular haemorrhage (IVH) were 0%, 7.1%, 5.3% and 10.0% respectively. Moderate to severe disability rates at 2 years old were 100%, 44.4%, 33.3% and 30.4% respectively. At 5 years old, moderate to severe disability rates were 16.7%, 22.2% and 14.3% respectively for those born at 24, 25 and 26 weeks gestation. Interpretation at 8 years was limited by small numbers. Our results indicated that local figures for mortality and morbidity remained high at the limits of viability, although they were comparable to outcomes for large scale studies in advanced countries.

The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes.

OBJECTIVETo determine associations of gestational diabetes mellitus (GDM) and obesity with adverse pregnancy outcomes in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study.RESEARCH DESIGN AND METHODSParticipants underwent a 75-g oral glucose tolerance test (OGTT) between 24 and 32 weeks. GDM was diagnosed post hoc using International Association of Diabetes and Pregnancy Study Groups criteria. Neonatal anthropometrics and cord serum C-peptide were measured. Adverse pregnancy outcomes included birth weight, newborn percent body fat, and cord C-peptide >90th percentiles, primary cesarean delivery, preeclampsia, and shoulder dystocia/birth injury. BMI was determined at the OGTT. Multiple logistic regression was used to examine associations of GDM and obesity with outcomes.RESULTSMean maternal BMI was 27.7, 13.7% were obese (BMI ≥33.0 kg/m2), and GDM was diagnosed in 16.1%. Relative to non-GDM and nonobese women, odds ratio for birth weight >90th percentile for GDM alone was 2.19 (1.93–2.47), for obesity alone 1.73 (1.50–2.00), and for both GDM and obesity 3.62 (3.04–4.32). Results for primary cesarean delivery and preeclampsia and for cord C-peptide and newborn percent body fat >90th percentiles were similar. Odds for birth weight >90th percentile were progressively greater with both higher OGTT glucose and higher maternal BMI. There was a 339-g difference in birth weight for babies of obese GDM women, compared with babies of normal/underweight women (64.2% of all women) with normal glucose based on a composite OGTT measure of fasting plasma glucose and 1- and 2-h plasma glucose values (61.8% of all women).CONCLUSIONSBoth maternal GDM and obesity are independently associated with adverse pregnancy outcomes. Their combination has a greater impact than either one alone.

Categorisation of continuous exposure variables revisited. A response to the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study.

BackgroundAlthough the general statistical advice is to keep continuous exposure variables as continuous in statistical analyses, categorisation is still a common approach in medical research. In a recent paper from the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study, categorisation of body mass index (BMI) was used when analysing the effect of BMI on adverse pregnancy outcomes. The lowest category, labelled "underweight", was used as the reference category.MethodsThe present paper gives a summary of reasons for categorisation and methodological drawbacks of this approach. We also discuss the choice of reference category and alternative analyses. We exemplify our arguments by a reanalysis of results from the HAPO paper.ResultsCategorisation of continuous exposure data results in loss of power and other methodological challenges. An unfortunate choice of reference category can give additional lack of precision and obscure the interpretation of risk estimates. A highlighted odds ratio (OR) in the HAPO study is the OR for birth weight >90th percentile for women in the highest compared to the lowest BMI category ("obese class III" versus "underweight"). This estimate was OR = 4.55 and OR = 3.52, with two different multiple logistic regression models. When using the "normal weight" category as the reference, our corresponding estimates were OR = 2.03 and OR = 1.62, respectively. Moreover, our choice of reference category also gave narrower confidence intervals.SummaryDue to several methodological drawbacks, categorisation should be avoided. Modern statistical analyses should be used to analyse continuous exposure data, and to explore non-linear relations. If continuous data are categorised, special attention must be given to the choice of reference category.

Pregnancy outcome after cervical cone excision: a case‐control study

To investigate the effect of cervical laser conisation (CLC) or loop electrosurgical excision procedure (LEEP) on the outcome of subsequent pregnancies. Methods. Multi-centre, retrospective, case-control study, which included a cohort of 742 women, who, after treatment with LEEP or CLC, gave birth or suffered second trimester miscarriage. Control women (n=742) were extracted from the respective hospital birth registries and matched by age and parity. Outcome measures were perinatal mortality, length of gestation, birth weight and preterm premature rupture of membranes (pPROM). There was no significant difference in perinatal mortality among women treated with LCL or LEEP compared to controls, 6/742 versus 2/742: odds ratio (OR)=3.1 (95% CI: 0.6-15.2). Excluding second trimester miscarriages, ORs for giving birth before week 37, 32 and 28 after conisation compared to the controls were 3.4 (95% CI: 2.3-5.1), 4.6 (95% CI: 1.7-12.5), and 12.4 (95% CI: 1.6-96.1), respectively, after adjusting for smoking habits during pregnancy, marital status and educational level. Adjusted ORs of birth weight <2,500, <1,500 and <1,000 g after conisation compared to controls were 3.9 (95% CI: 2.4-6.3), 4.4 (95% CI: 1.5-13.6), and 10.4 (95% CI: 1.3-82.2), respectively. The adjusted OR for pPROM was 10.5 (95% CI: 3.7-29.5). Treatment by CLC and LEEP increases the risk of preterm delivery, low birth weight and pPROM in subsequent pregnancies.

Relationships between perinatal and maternal characteristics and hepatoblastoma: a report from the UKCCS

Within the context of a national population-based case-control study – the United Kingdom Childhood Cancer Study (UKCCS) – we aimed to explore relationships between perinatal and maternal factors and childhood hepatic tumours, for participants with data available from medical records. 26/28 children with hepatic tumours (22/24 hepatoblastomas, 4/4 hepatocellular carcinomas (HCC)) and 4753 age- and sex-matched controls were included. Polyhydramnios was associated with 0.9% of control pregnancies and 13.6% of case pregnancies (Odds Ratio (OR) = 28.64, 95% Confidence Interval (CI) = 6.94–118.21, P < 0.0001); eclampsia or severe pre-eclampsia complicated the pregnancies of 16.7% of mothers whose children developed hepatoblastoma compared with 0.5% of control pregnancies (OR = 52.50, 95% CI = 10.75–257.05, P < 0.0001). Three children with hepatoblastoma weighed <1500 g at birth, two of whom weighed <1000 g (OR for birthweight <1500 g = 69.00, 95% CI = 11.98–397.17, P < 0.0001). Of children with hepatoblastoma, 50% (11/22) had records of congenital anomalies, as did two of their mothers. Three mothers of children with hepatoblastoma had diagnoses of cancer – two of papillary carcinoma of the thyroid and one of acute lymphoblastic leukaemia (ALL). Paediatricians and others should be alert to the possibility of familial or genetic syndromes in children with hepatoblastomas. Potential links between maternal pre-eclampsia, low birthweight and subsequent malignancy merit further investigation. Hepatoblastoma is an extremely rare childhood tumour, but understanding the mechanism(s) underlying severe pre-eclampsia and eclampsia may also shed light on factors that contribute to the development of hepatoblastoma.

Neonatal outcome in a Danish national cohort of 8602 children born after in vitro fertilization or intracytoplasmic sperm injection: the role of twin pregnancy.

In Denmark, 4% of all infants are born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and 40% of these children are twins. We investigated neonatal outcome in a complete Danish IVF/ICSI birth cohort including 8602 infants born between 1995 and 2000: 3438 twins (40%) and 5164 singletons (60%). Births conceived after IVF or ICSI were identified by record linkage with the Danish IVF Registry and the National Medical Birth Registry. Data on neonatal outcome were collected from the National Patient Registry. IVF/ICSI twins had a 10-fold increased age- and parity-adjusted risk of delivery before 37 completed weeks [odds ratio (OR) 9.9, 95% confidence interval (95% CI) 8.7-11.3] and a 7.4-fold increased risk of delivery before 32 completed weeks (OR 7.4, 95% CI 5.6-9.8) compared with singletons. Correspondingly, ORs of birthweight <2500 g and birthweight <1500 g in twins were 11.8 (95% CI 10.3-13.6) and 5.4 (95% CI 4.1-7.0), respectively. The stillbirth rate was doubled in twins (13.1/1000) compared with singletons (6.6/1000) (p = 0.002). The risk of cesarean section and of admittance to a neonatal intensive care unit (NICU) was 4.6- and 1.8-fold higher in IVF/ICSI twins than in singletons. The rate of major malformations was 40.4/1000 in twins and 36.8/1000 in singletons (p = 0.4), whereas the total malformation rate (major + minor) was higher in twins (73.7/1000) than in singletons (55.0/1000) (p = 0.001). After exclusion of patent ductus arteriosus (PDA), which is strongly associated with preterm birth, no significant differences in any malformation rates were observed between twins and singletons. Apart from the frequency of ICSI children with hypospadias, which reached a significance level of p = 0.05, malformation rates in ICSI children were similar to those in IVF children. This study indicates that neonatal outcome in IVF/ICSI twins is considerably poorer than in singletons. Thus, the impact is to draw the attention of clinicians to the benefit of elective single embryo transfer (eSET).

Neonatal outcome in a Danish national cohort of 8602 children born after in vitro fertilization or intracytoplasmic sperm injection: the role of twin pregnancy

Background. In Denmark, 4% of all infants are born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and 40% of these children are twins. Methods. We investigated neonatal outcome in a complete Danish IVF/ICSI birth cohort including 8602 infants born between 1995 and 2000: 3438 twins (40%) and 5164 singletons (60%). Births conceived after IVF or ICSI were identified by record linkage with the Danish IVF Registry and the National Medical Birth Registry. Data on neonatal outcome were collected from the National Patient Registry. Results. IVF/ICSI twins had a 10-fold increased age- and parity-adjusted risk of delivery before 37 completed weeks [odds ratio (OR) 9.9, 95% confidence interval (95% CI) 8.7–11.3] and a 7.4-fold increased risk of delivery before 32 completed weeks (OR 7.4, 95% CI 5.6–9.8) compared with singletons. Correspondingly, ORs of birthweight <2500 g and birthweight <1500 g in twins were 11.8 (95% CI 10.3–13.6) and 5.4 (95% CI 4.1–7.0), respectively. The stillbirth rate was doubled in twins (13.1/1000) compared with singletons (6.6/1000) (p = 0.002). The risk of cesarean section and of admittance to a neonatal intensive care unit (NICU) was 4.6- and 1.8-fold higher in IVF/ICSI twins than in singletons. The rate of major malformations was 40.4/1000 in twins and 36.8/1000 in singletons (p = 0.4), whereas the total malformation rate (major + minor) was higher in twins (73.7/1000) than in singletons (55.0/1000) (p = 0.001). After exclusion of patent ductus arteriosus (PDA), which is strongly associated with preterm birth, no significant differences in any malformation rates were observed between twins and singletons. Apart from the frequency of ICSI children with hypospadias, which reached a significance level of p = 0.05, malformation rates in ICSI children were similar to those in IVF children. Conclusions. This study indicates that neonatal outcome in IVF/ICSI twins is considerably poorer than in singletons. Thus, the impact is to draw the attention of clinicians to the benefit of elective single embryo transfer (eSET).

Risk factors for neonatal mortality: Harare Central Hospital Neonatal Unit

To assess risk factors for neonatal mortality in a tertiary level neonatal unit. Case control analysis of routine neonatal data for 1998. Harare Central Hospital Neonatal Unit. All neonates delivered at Harare Maternity Hospital and admitted to the neonatal unit for care between January and December 1998. Neonatal mortality in hospital. A total of 5,305 neonatal admissions were studied of which 19.3% died in hospital. The median age at death was two days (Q1 = 1, Q3 = 3) and the median age at hospital discharge was 3 days (Q1 = 1, Q3 = 6). Risk factors for mortality were un-booked mother odds ratio (OR) 2.36 (95% CI = 1.98 to 2.81), breech delivery OR: 1.76 (95% CI = 1.39 to 2.22), low birth weight OR: 4.67 (95% CI = 3.92 to 5.57), prematurity OR: 2.36 (95% CI = 2.09 to 2.66), congenital malformations OR: 2.80 (95% CI = 1.72 to 4.53) and birth asphyxia OR: 1.79 (95% CI = 1.51-2.12). Being admitted for respiratory distress was associated with better survival OR: 0.22 (95% CI = 0.17 to 0.28). Having a Caesarian section was also protective OR: 0.60 (95% CI = 0.47 to 0.76). Mother's age, parity, time of delivery and sex were not significantly associated with mortality odds ratios (95% CI) of 1.07 (0.86 to 1.34), 0.94 (0.78 to 1.13), 1.10 (0.93 to 1.30) and 0.89 (0.78 to 1.03) respectively. On regression analysis birth weight greater than 2,500 g, being un booked and breech delivery were predictive of mortality with OR (95% CI) of 0.99 (0.99 to 0.99), 1.31 (1.12 to 1.61) and 1.15 (1.04 to 1.28) respectively. Low birth weight is the highest risk factor for mortality in this tertiary level hospital. Strategies targeted at low birth weight infants such as antenatal corticosteroid use, improved intrapartum care, appropriate antibiotic use, improved efficiency and access to neonatal intensive care will have the most impact on neonatal mortality.

Prospective study of risk factors for early and persistent wheezing in childhood

The object of this study was to determine the relative importance of low birth weight, preterm birth, low maternal age, household size, exposure to maternal smoking, personal smoking at 16 yrs of age, early termination of breastfeeding and socioeconomic status in the aetiology of wheezing illness in the first 5 yrs of life, and on the persistence of this illness at 16 yrs of age. In 15,712 children born in Britain during one week of April 1970, the occurrence of wheezing by 5 yrs of age, and of wheezing in the past year at 16 yrs of age within this group were analysed in multivariate logistic regression against each potential risk factor. The independent determinants of wheezing by 5 yrs of age were male sex, maternal smoking during pregnancy (odds ratio (OR) for 15+ cigarettes.day-1 = 1.39; 95% confidence interval (95% CI) 1.22-1.58) and low birthweight (OR for birthweight < 2.5 kg = 1.26; 95% Cl 1.07-1.50). Of children who had wheezed by 5 yrs of age, 15% reported wheezing in the past 12 months at 16 yrs of age. The persistence of symptoms at 16 yrs of age was independently related to low maternal age (OR for 20 vs 40 yrs of age = 1.96; 95% CI 1.08-3.45) and to high social status (OR for most vs least advantaged = 1.95; 95% CI 1.13-3.38). We conclude that low birth weight and maternal smoking in pregnancy are independent risk factors for early childhood wheezing, but in 85% of children with early wheezing it resolves by 16 yrs of age.(ABSTRACT TRUNCATED AT 250 WORDS)