Decreased Infant Birth Weight Research Articles

In vitro screening of understudied PFAS with a focus on lipid metabolism disruption

Per- and polyfluoroalkyl substances (PFAS) are man-made chemicals used in many industrial applications. Exposure to PFAS is associated with several health risks, including a decrease in infant birth weight, hepatoxicity, disruption of lipid metabolism, and decreased immune response. We used the in vitro cell models to screen six less studied PFAS [perfluorooctane sulfonamide (PFOSA), perfluoropentanoic acid (PFPeA), perfluoropropionic acid (PFPrA), 6:2 fluorotelomer alcohol (6:2 FTOH), 6:2 fluorotelomer sulfonic acid (6:2 FTSA), and 8:2 fluorotelomer sulfonic acid (8:2 FTSA)] for their capacity to activate nuclear receptors and to cause differential expression of genes involved in lipid metabolism. Cytotoxicity assays were run in parallel to exclude that observed differential gene expression was due to cytotoxicity. Based on the cytotoxicity assays and gene expression studies, PFOSA was shown to be more potent than other tested PFAS. PFOSA decreased the gene expression of crucial genes involved in bile acid synthesis and detoxification, cholesterol synthesis, bile acid and cholesterol transport, and lipid metabolism regulation. Except for 6:2 FTOH and 8:2 FTSA, all tested PFAS downregulated PPARA gene expression. The reporter gene assay also showed that 8:2 FTSA transactivated the farnesoid X receptor (FXR). Based on this study, PFOSA, 6:2 FTSA, and 8:2 FTSA were prioritized for further studies to confirm and understand their possible effects on hepatic lipid metabolism.

Tweedie Regression Analysis of Determinants of Birth Weight in Navrongo

Abstract The study modelled and investigated the determinants of infant birth weight by considering maternal and infant factors as predictors. Monthly data spanning for a period of 37 months were obtained from the Navrongo Health Research Centre of the Navrongo Municipality of the Upper East region of Ghana. In modelling the birth weight of infants, the Tweedie regression model and its counterparts of exponential families (Gaussian, Gamma and inverse Gaussian) of distribution were developed. The performances of these models were evaluated using the Akaike Information Criterion. Based on the Akaike Information Criterion, the Tweedie regression model showed superiority in modelling the determinants of infant birth weight as compared to the other counterparts of the exponential families of distributions. The parameter estimates of the Tweedie regression model found child’s gender and maternal factors (religion, marital status and educational level) to contribute substantially to the birth weight of infants. Also, the study recommends that except for the status of antenatal care, emphasis must be placed on determining the reasons for the decrease in infant birth weight as a result of the maternal factors; parity, delivery type and the age of the mother.

Effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia: Institution based prospective cohort study.

Intestinal parasitosis is a common disease that causes misery and disability in poor populations. The number of individuals affected is staggering. From two billion peoples who harbor parasites worldwide, 300 million suffer severe morbidity and more than 25% of pregnant women are infected with hookworm, which causes intestinal bleeding and blood loss, and has been most commonly associated with anemia. Intestinal parasite infection during pregnancy has been associated with iron deficiency, maternal anemia, and impaired nutritional status, as well as decreased infant birth weight. This study aimed to assess the effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care in Debre Markos Referral Hospital from December 2017 to February 2019. A prospective cohort study design was conducted among 94 intestinal parasite-infected pregnant women as an exposed group and 187 pregnant women free from intestinal parasite were used as a control group. The effect of intestinal parasites on hematological profiles of pregnant women was assessed at Debre Markos Referral Hospital antenatal care ward. Socio-demographic data and nutrition status were assessed by using structured questionnaires and mid-upper arm circumference (MUAC), respectively. Two ml of venous blood and 2 gm of stool samples were collected to analyze the hematological profiles and detect intestinal parasites, respectively. Wet mount and formol-ether concentration (FEC) techniques were used to detect intestinal parasites. Hematological profile was analyzed using Mind ray BC-3000 plus instrument. Data were double entered into EpiData version 3.1 software and exported to SPSS version 24 software for analysis. Results were presented using tables and graphs. Associations of hemoglobin levels with intestinal parasitic infections were determined using binary logistic regression models. P≤0.05 was considered statistically significant. The mean hematological profile difference between parasite-infected and parasite-free pregnant women was computed using independent t-test. In the present study, the predominant parasites identified were Entamoeba histolytica, hookworm, Giardia lamblia, Schistosoma mansoni, and Ascaris lumbricoides. About 8.2% of intestinal parasite-infected pregnant women had mild anemia while 4% had moderate anemia. Only 1.2% of intestinal parasite-free pregnant women developed moderate anemia. The mean HGB, HCT, MCV, MCH, and MCHC values of intestinal parasite-infected pregnant women were 12.8g/dl, 38.2%, 94.7fl, 33.1pg and 34.7g/dl, respectively. But the mean HGB, HCT, MCV, MCH and MCHC values of pregnant women who were free from intestinal parasites were 14.4 g/dl, 39.8%, 94.9fl, 33.9pg and 35.5g/dl, respectively. Anemia was strongly associated with hookworm (AOR = 21.29, 95%CI: 8.28-54.75, P<0.001), S.mansoni (AOR = 63.73, 95% CI: 19.15-212, P<0.001) and A.lumbricoide (AOR = 14.12, 95% CI 3.28-60.65, P<0.001). Intestinal parasitic infection in pregnant women caused adverse impact on hematological profiles and was an independent predictor of anemia. Intestinal parasitic infection significantly decreased pregnant the level of HGB, HCT, MCV, MCH, and MCHC values. To minimize maternal anemia deworming could be good before pregnancy.

Is Previous Periacetabular Osteotomy Associated with Pregnancy, Delivery, and Peripartum Complications?

Surgical candidates for periacetabular osteotomy are commonly women of reproductive age with symptomatic acetabular dysplasia. However, little is known about how this surgical intervention contributes to the decision to become pregnant, obstetrical counseling regarding delivery, mode of delivery, or pregnancy-related complications. (1) Does a history of periacetabular osteotomy affect a patient's decision to become pregnant or does it affect obstetrical counseling regarding the safety of pregnancy and childbirth? (2) Is history of periacetabular osteotomy associated with in an increased risk of undergoing cesarean section compared with the national average? (3) Is a history of periacetabular osteotomy associated with increased complications, decreased infant birth weight, preterm delivery? In conjunction with obstetrician colleagues, we created a survey to investigate patient attitudes toward pregnancy, mode of delivery, pregnancy-related complications, and obstetrical counseling among female patients who previously underwent periacetabular osteotomy. A retrospective cohort of reproductive-age women who underwent periacetabular osteotomy between 2008 and 2015 completed a mailed survey or telephone interview. All 96 patients who were contacted were asked if the history of periacetabular osteotomy affected their decision to become pregnant. Our cohort included 31 patients who had undergone periacetabular osteotomy and had a subsequent pregnancy and delivery with a total of 38 pregnancies resulting in 41 births. A binomial test was used to determine if the rates of cesarean section, low birth weight, or preterm delivery were different from the documented US national average as published by the National Vital Statistics Report and CDC. One patient of 31 felt her periacetabular osteotomy negatively affected the appearance of her child; this surgical history affected 6.5% of patients (2 of 31) positively. Fifty-five percent (17 of 31) patients reported that their obstetrician expressed concern that their history of periacetabular osteotomy could affect their ability to carry to term or deliver vaginally. With a history of periacetabular osteotomy, 53% of deliveries (20 of 38) underwent cesarean section. This is higher than the national average of 32% (odds ratio 0.424 [95% confidence interval 0.214 to 0.837]; p = 0.006). Only one patient with a periacetabular osteotomy suffered a pregnancy-related complication. In singleton pregnancy after periacetabular osteotomy the preterm delivery rate was 14% (5 of 35) and the percentage of low-birth-weight infants was 2.9% (1 of 35). These percentages are not different from US data published by the National Vital Statistics Report, which reports an 8% preterm delivery rate (OR 0.523 [95% CI 0.154 to 1.772]; p = 0.1723) and 6.4% low birth weight (OR 2.34 [95% CI 0.607 to 9.025]; p = 0.3878) in singleton pregnancies. In this small survey study, we found no differences in terms of complications, preterm delivery or low birth weight infants between patients who had a history of periacetabular osteotomy and normative national data regarding complications of pregnancy and delivery. However, we did note that patients with a history of periacetabular osteotomy were more likely to deliver future children by cesarean section, which could be attributable to obstetrician preference as most obstetricians in another small survey study have expressed concern about patients with a history of periacetabular osteotomy. Future studies should aim to increase the knowledge of the association of periacetabular osteotomy and delivery method, specifically with transition to cesarean for failure to progress during labor. Future consideration of using the Academic Network of Conservational Hip Outcomes Research repository to develop National Surgical Quality Improvement Program data may help to elucidate this relationship more clearly and help guide appropriate indications for scheduled cesarean sections in the setting of prior pelvic osteotomy. Level IV, therapeutic study.

Relationships Between Infant Birth Weight and Maternal Mastication Ability, Caloric Intake and Prepregnancy Body Mass Index of Women with Posterior Tooth Loss

Objective: To analyze the relationships between infant birth weight and maternal mastication ability, caloric intake, and body mass index (BMI) of women with posterior tooth loss. Material and Methods: A cross-sectional study was conducted in 52 females aged 20–35 years who gave birth recently and had one or more unreplaced missing posterior teeth. The number and locations of the missing teeth were grouped on the basis of the Eichner Index. Prepregnancy BMI, caloric intake, and subjective mastication ability were recorded. Results: A significant difference was observed in the mean infant birth weights between the subjects with good and poor mastication in Eichner A2 (p<0.001), B1 (p=0.039), and B2 groups (p=0.039), that mean infant birth weight was lower in the group of women with poor mastication. The Pearson correlation test revealed a significant relationship between maternal caloric intake and infant birth weight (p<0.001). Mean infant birth weights differed between BMI categories, i.e., underweight, normal and overweight women subjects (2.59 ± 0.18 Kg, 2.99 ± 0.15 Kg, 3.58 ± 0.30 Kg) (p<0.001). The Kruskal-Wallis test revealed significant differences between the prepregnancy BMIs of pregnant women with posterior tooth loss and infant birth weights (p<0.001). Conclusion: We found that decreased subjective mastication ability in pregnant women who lost posterior teeth was associated with decreased infant birth weight, whereas higher mean caloric intake and higher prepregnancy BMI in pregnant mothers who lost posterior teeth were associated with increased infant birth weight.

The A581G Mutation in the Gene Encoding Plasmodium falciparum Dihydropteroate Synthetase Reduces the Effectiveness of Sulfadoxine-Pyrimethamine Preventive Therapy in Malawian Pregnant Women.

The A581 G: mutation in the gene encoding Plasmodium falciparum dihydropteroate synthase (dhps), in combination with the quintuple mutant involving mutations in both dhps and the gene encoding dihydrofolate reductase (dhfr), the so-called sextuple mutant, has been associated with increased placental inflammation and decreased infant birth weight among women receiving intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) during pregnancy. Between 2009 and 2011, delivering women without human immunodeficiency virus infection were enrolled in an observational study of IPTp-SP effectiveness in Malawi. Parasites were detected by polymerase chain reaction (PCR); positive samples were sequenced to genotype the dhfr and dhps loci. The presence of K540 E: in dhps was used as a marker for the quintuple mutant. Samples from 1809 women were analyzed by PCR; 220 (12%) were positive for P. falciparum. A total of 202 specimens were genotyped at codon 581 of dhps; 17 (8.4%) harbored the sextuple mutant. The sextuple mutant was associated with higher risks of patent infection in peripheral blood (adjusted prevalence ratio [aPR], 2.76; 95% confidence interval [CI], 1.82-4.18) and placental blood (aPR 3.28; 95% CI, 1.88-5.78) and higher parasite densities. Recent SP use was not associated with increased parasite densities or placental pathology overall and among women with parasites carrying dhps A581 G: . IPTp-SP failed to inhibit parasite growth but did not exacerbate pathology among women infected with sextuple-mutant parasites. New interventions to prevent malaria during pregnancy are needed urgently.

Prenatal exposure to organochlorine pesticides and infant birth weight in China

In utero exposure to organochlorine pesticides (OCPs) is thought to be potentially harmful to fetal development. We aimed to investigate the associations of maternal and cord serum OCPs levels with infant birth weight in China. In this study, we measured serum levels of 18 OCPs in 81 mother–infant pairs, including DDT, hexachlorocyclohexanes (BHC), hexachlorobenzene (HCB), heptachlors, chlordanes, endosulfan-I, and mirex using a high-resolution-gas-chromatography with high-resolution-mass-spectrometry method. We found that p,p′-DDE and β-BHC had the highest detection rate in both maternal and cord blood serum (97.2% and 96.7%, respectively), followed by HCB (93.0%, 51.7%), p,p′-DDT (88.7%, 36.7%), and p,p′-DDD (83.1%, 60.0%). Among all OCPs, the concentration of p,p′-DDE was the highest (mothers geometric mean (GM): 203.54ngg−1, newborns GM: 116.14ngg−1), followed by HCB (70.62ngg−1, 65.16ngg−1), and β-BHC (67.67ngg−1, 33.39ngg−1). Multiple linear regression analyses showed that each 1ngg−1 increment of cord serum p,p′-DDE, total DDT, and β-BHC was associated with a 0.10g, 0.10g, and 0.92g decrease in infant birth weight, respectively, and as the cord serum concentrations of p,p′-DDT, p,p′-DDD, HCB and mirex increased, the infant birth weight was also decreased, although the associations were not statistically significant due to the relatively small sample size. These results suggest that p,p′-DDE, β-BHC, and HCB were the predominant OCPs in the serum of Chinese pregnant women and cord blood of their newborns. Prenatal exposure to DDT, β-BHC, HCB, and mirex were associated with a decrease in birth weight, but these results need validation in larger sample-sized studies.

The impact of smoking in the home on the health outcomes of non-smoker occupants in the UK

Smoking in the home remains a key source of exposure to secondhand smoke for non-smokers, particularly since the UK public smoking ban in 2007. A systematic literature review was conducted to identify all UK evidence on the impact of secondhand smoke exposure in the home on health and behavioural outcomes in non-smoker occupants. MEDLINE, EMBASE and the Cochrane Library were searched to identify all relevant UK empirical studies from 2000 to June 2011. A qualitative overview of the evidence is presented. Exposure to secondhand smoke in UK homes was found to be associated with serious negative health effects in non-smokers, including significantly increased risk of meningococcal carriage (p < 0.001) and disease (p = 0.05) in children and adolescents, cognitive impairment (p < 0.001) in adults, a higher rate of medically attended accidents in children with smoking mothers (p < 0.01), and for non-smoking women, a significant decrease in infant birth weight (p = 0.007). Living in a smoking household significantly increased the risk of future regular smoking in children (p < 0.001). In conclusion, this systematic review has identified strong evidence of an association between secondhand smoke exposure in the home and several serious health conditions. This finding highlights the importance of educating current smokers on the consequences of non-smoker exposure to smoking in the home.

Sex Differences in the Association between Prenatal Smoking and Decreased Birthweight, and Intensive Health Care of the Neonate

Gender-specific associations between prenatal smoking and birthweight, and neonate intensive health care were studied. Cross-sectional data from 11,583 newborns in the continuous National Health and Nutrition Examination Survey (NHANES) 2003–2008 early childhood data sets were used. Change in infant birthweight and likelihood of receiving neonatal intensive care by prenatal smoking exposure were assessed. Multivariable regression models were used to assess the influence of prenatal smoking on birthweight and likelihood of receiving intensive neonatal health care. Compared with infants from nonsmoking mothers, prenatal smoking associated with significant decrease in infant birthweight, −203.0 g ± 32.5, P < 0.001. The change in birthweight differed between infant boys, −220.2 g ± 44.5, and girls, −184.1 g ± 38.8. Newborns exposed to prenatal smoking were more likely to have low birthweight, odds ratio 1.46, P < 0.03, and to receive neonatal intensive health care, odds ratio 1.20; P < 0.04. It is imperative that prenatal counseling emphasizes prenatal maternal smoking.

Followup in Southern California: Decreased Birth Weight following Prenatal Wildfire Smoke Exposure

Vol. 120, No. 9 News | Science SelectionsOpen AccessFollowup in Southern California: Decreased Birth Weight following Prenatal Wildfire Smoke Exposureis accompanied byBirth Weight following Pregnancy during the 2003 Southern California Wildfires Rebecca Kessler Rebecca Kessler Search for more papers by this author Published:1 September 2012https://doi.org/10.1289/ehp.120-a362bCited by:1AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit In fall 2003 wildfires blazed in Southern California, sending pollutant-laden smoke directly into the heavily populated Los Angeles and Orange counties. A new study of birth records from the area shows a decreased average birth weight among infants carried in utero during the wildfires [EHP 120(9):1340–1345; Holstius et al.].Chronic maternal exposure to ambient particulate matter (PM) and indoor biomass smoke during pregnancy has been linked to decreased infant birth weight, although similar effects attributable to wildfire smoke have been little studied. In this study, researchers analyzed 886,034 birth records of babies delivered between 2001 and 2005 in the South Coast Air Basin, an area that overlaps the wildfire-affected regions. They compared the average birth weight of infants carried in utero during the wildfires with that of infants who were either born before or conceived after the wildfires. They also compared birth weights of infants exposed during the first, second, and third trimesters of pregnancy.After adjusting for infant sex, gestational age at birth, and other factors known to influence birth weight, the researchers found that exposed infants weighed an average of 6.1 g (0.2 oz) less at birth than unexposed infants. Infants exposed during the second trimester showed the largest average reduction, at 9.7 g. Infants exposed during the third trimester showed an average reduction of 7.0 g, and those exposed during the first trimester showed an average reduction of 3.3 g (the latter was not statistically significant). The trends were corroborated by a sensitivity analysis that compared pregnant mothers according to whether the air-pollution monitor nearest their residence recorded high or low PM levels during the wildfires.Smoke from wildfires burning across Southern California, 27 October 2003AP Photo/Kevork DjansezianThe small reductions in birth weight attributed to the wildfires are unlikely to have serious health effects in any given individual. However, wildfires are predicted to increase in frequency and severity as climate change progresses, and the researchers note that the proportion of low-birth-weight babies—those weighing less than 2,500 g (5.5 lb) at birth—could rise as a result. This could have important populationwide repercussions because these babies are at increased risk for a variety of poor health outcomes.PM and carbon monoxide are among pollutants released by wildfires that could plausibly contribute to the birth-weight decrease. However, the researchers note that other pathways are possible and worthy of investigation, among them the increased stress that living through a wildfire may place on pregnant women.FiguresReferencesRelatedDetailsCited by Marko T, Suarez M, Todorova E, Mark C and Julie P (2020) A Scoping Review of Nurses' Contributions to Health-Related, Wildfire Research, Annual Review of Nursing Research, 10.1891/0739-6686.38.73, 38:1, (73-96), Online publication date: 23-Dec-2019. Related articlesBirth Weight following Pregnancy during the 2003 Southern California Wildfires29 May 2012Environmental Health Perspectives Vol. 120, No. 9 September 2012Metrics About Article Metrics Publication History Originally published31 August 2012Published in print1 September 2012 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.

Lack of evidence for prescription of antepartum bed rest.

Antepartum bed-rest treatment is based on assumptions that it is both effective and safe for mother and fetus. However, research indicates, that bed-rest treatment is ineffective for preventing preterm birth and fetal growth restriction, and for increasing gestational age at birth and infant birthweight. Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems. Studies conducted by aerospace scientists who have used bed rest as a model for the study of weightlessness in space using nonpregnant individuals report similar results. Antepartum bed-rest treatment should be discontinued until evidence of effectiveness is found.

Association of maternal serum concentrations of 2,2', 4,4'5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE) levels with birth weight, gestational age and preterm births in Inuit and European populations

BackgroundEpidemiological studies on the association between maternal exposure to persistent organic pollutants (POPs) and fetal growth alteration report inconsistent findings which weights in favor of additional studies.MethodsBlood samples were collected from interviewed pregnant women in Greenland (572), Kharkiv (611) and Warsaw (258) and were analyzed for CB-153 and p,p'-DDE by gas chromatography-mass spectrometry. Data on birth weight, gestational age and preterm birth were obtained for 1322 singleton live births. We examined the association between natural log-transformed serum POPs concentration and birth weight and gestational age using multiple linear regression and the association with prematurity using logistic regression controlling for potential confounding factors.ResultsThe median serum concentrations of CB-153 and p,p'-DDE were for Inuit mothers 105.6 and 298.9, for Kharkiv mothers 27.0 and 645.4 and for Warsaw mothers 10.7 and 365.2 ng/g lipids, respectively. Increase in CB-153 concentration by one unit on the log scale in Inuit mothers serum was associated with significant decrease in infant birth weight of -59 g and gestational age by -0.2 week. Decreases observed in the cohorts in Kharkiv (-10 g and -0.1 week) and in Warsaw (-49 g and -0.2 week) were not statistically significant. Increase in p,p'-DDE concentration by one unit on the log scale was associated with a statistically significant decrease in infant birth weight of -39.4 g and -104.3 g and shortening of gestational age of -0.2 week and -0.6 week in the Inuit and Warsaw cohorts, respectively. In the Kharkiv cohort decrease in birth weight (-30.5 g) was not significant, however a shortening of gestational age of -0.2 week per increase in p,p'-DDE concentration by one unit on the log scale was of the borderline significance. There was no significant association between CB-153 and p,p'-DDE concentrations and risk of preterm birth however, in all cohorts the odds ratio was above 1.ConclusionsIn utero exposure to POPs may reduce birth weight and gestational age of newborns however, new insights as to why results vary across studies were not apparent.

The effects of feeding rats diets deficient in folic acid and related methyl donors on the blood pressure and glucose tolerance of the offspring

In humans poor maternal folate status is associated with a decrease in infant birth weight. As low birth weight increases the risk of cardiovascular and metabolic disease in adults, an inadequate supply of folic acid in the mother's diet may increase the susceptibility of the offspring to disease. We have fed laboratory rats diets deficient in folic acid and the related methyl donors methionine and choline to examine the effects on growth, blood pressure and insulin action in the offspring. Poor folate status transiently increased fetal growth but did not produce a long-term change in body weight. There were, however, small changes in the hearts of the female offspring. When folate deficiency was combined with low intakes of methionine and choline, the kidneys of the male offspring were proportionately smaller, probably because of the limited availability of methionine. There was no effect on the blood pressure of either the male or female offspring. The pancreatic insulin content of fetuses from animals fed the folate-deficient diets were higher than those of the controls. Following an oral glucose challenge, there was a weak trend for glucose-stimulated insulin release to be increased in the offspring of dams fed the folate-deficient diet. The changes in insulin concentrations were, however, much smaller than the corresponding changes observed in the offspring of animals fed protein-deficient diets. These results suggest that folate deficiency during gestation causes modest changes to the insulin axis of the fetus.

A prospective study of the effects of female and male marijuana use on in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT) outcomes

This study was undertaken to examine whether marijuana use affects in vitro fertilization and gamete intrafallopian transfer (IVF/GIFT). Prospective study of 221 IVF/GIFT couples. Amount of lifetime heavy marijuana use adversely affected IVF/GIFT. Women smoking more than 90 times in their lifetime had 27% fewer oocytes retrieved (P = .03) and 1 fewer embryo transferred (P < .05). Women smoking marijuana more than 10 times in their lifetime had infants 17% (P = .01) smaller at birth. If men smoked marijuana 11 to 90 times in their lifetime, there was a 15% decrease in infant birth weight (P = .03); if this increased to more than 90 times, there was a 23% decrease (P = .01). Timing also played a role. Women smoking marijuana 1 year before IVF/GIFT had 25% fewer oocytes retrieved (P = .03), whereas couples had 28% (P = .04) fewer oocytes fertilized. Women and men who smoked in the past 15 years, had 12% (P = .04) and 16% (P = .03) smaller infants, respectively. Both timing and amount of marijuana use negatively affected IVF/GIFT.

Characteristics and risk factors for adverse birth outcomes in pregnant black adolescents

Objectives To describe maternal characteristics and birth outcomes in a group of pregnant minority adolescents and to characterize the impact of maternal age (<15 years versus 15-17 years) on birth outcomes. Study design A 10-year retrospective chart review was conducted in 1120 pregnant black adolescents (≤17 years of age) who had received prenatal care at an inner-city maternity clinic in Baltimore, Md. Results Pregnant black adolescents had a higher incidence of low birth weight infants, preterm delivery, and fetal death compared with normative data from the United States. Younger adolescents were more likely to have inadequate utilization of prenatal care ( P<.01). Older adolescents had a higher incidence of gonorrhea infections ( P = .046), greater rates of self-reported substance abuse ( P = .063), and a higher history of cigarette smoking ( P<.01). Low prepregnancy body mass index (BMI), inadequate weight gain, and poor prenatal care utilization were strong independent predictors of preterm birth ( P<.05). Low prepregnancy BMI, inadequate weight gain, female infant, and self-reported cigarette smoking history were significantly associated with decreased infant birth weight ( P<.05). Conclusions Pregnant black adolescents had increased risks of adverse pregnancy outcomes. This population should be studied further to develop age-appropriate and population-specific interventions to improve birth outcomes.

Severity of nausea and vomiting during pregnancy: what does it predict?

Relationships between the severity of nausea and vomiting during pregnancy and selected demographic (employment status, parity, age, smoking) and pregnancy outcome (birthweight, gender) variables are described. Women who volunteered for a community-based clinical trial were eligible for inclusion in this study. On three occasions, 12 hours apart, during early pregnancy using a continuous measure of nausea, vomiting, and retching, women assessed the amount, duration, and severity of symptoms as they occurred. After the birth of their infants, they provided information about the duration of nausea, vomiting, and retching as well pregnancy outcome information by responding to a mailed questionnaire. Multivariate methods were used to analyze data. More severe vomiting in early pregnancy was likely to continue for a longer period of time and was related to decreased infant birthweight. Gestational age, parity status, and severity of vomiting were predictors of infant birthweight and together explained 22 percent of the variance in birthweight. A significant relationship between fetal gender and severity of nausea and vomiting was not found. It may be possible to identify women at risk for third trimester vomiting and to provide appropriate nutritional support and counseling so that their risk of having a low-birthweight infant is reduced. A larger sample would be required to assess the relationship between fetal gender and severity of nausea, vomiting, and retching.

Alcohol consumption during pregnancy and infant birth weight.

Heavy maternal alcohol consumption during pregnancy has been consistently linked to decreased infant birth weight but the effects of low and moderate levels of drinking on infant birth weight remain unclear. This study addresses the relationship of low to moderate alcohol consumption and birth weight in a nationally representative cohort sample (National Longitudinal Survey of Youth, n = 4409 births). Statistical methods that account for the complex sample design were used in the analysis. Multiple linear regression and logistic regression were used to adjust the relationship between drinking and birth weight for relevant covariates. Results of this study revealed a nonstatistically significant trend in the direction of greater numbers of low-birth-weight babies born to mothers who drank more frequently during pregnancy. A significant interaction between drinking and smoking was found in which the negative effects on birth weight of smoking were less for those women who drank more heavily (P = 0.046).

The association between prenatal stress and infant birth weight and gestational age at birth: A prospective investigation

The aim was to test a model of the influence of maternal prenatal psychosocial stress on birth outcomes after controlling for biomedical risk. In a prospective study a sociodemographically homogeneous sample of 90 women was assessed during the third trimester with standard, reliable questionnaires that measured episodic and chronic stress, strain (response to stress), and pregnancy-related anxiety. Birth outcomes included infant birth weight, gestational age at birth, and intrapartum complications. Parity and biomedical (antepartum) risk was also coded. Bivariate and multivariate analyses were performed after controlling for the effects of biomedical risk factors. Independent of biomedical risk, each unit increase of prenatal life event stress (from a possible sample range of 14.7 units) was associated with a 55.03 gm decrease in infant birth weight and with a significant increase in the likelihood of low birth weight (odds ratio 1.32), and each unit increase of prenatal pregnancy anxiety (from a possible sample range of 5 units) was associated with a 3-day decrease in gestational age at birth. Independent of biomedical risk, maternal prenatal stress factors are significantly associated with infant birth weight and with gestational age at birth.

Maternal growth during pregnancy and decreased infant birth weight

We used stature and measurement of knee height to measure continued maternal growth during adolescent pregnancy in a sample of young gravidas (primigravidas and multiparas) and mature pregnant control subjects. Growth during pregnancy has been masked by a tendency of all gravidas to shrink while pregnant (approximately 0.5 cm over 6 mo of observation). Consequently, growth of many adolescent gravidas has not been clinically apparent. There was no effect on maternal growth during a first pregnancy in adolescence but this may be a result of the relatively good prepregnant nutrition status of the young gravidas in developed countries. Maternal growth during pregnancy, however, is associated with significantly decreased (-282 g, p less than 0.05) birth weight for infants when maternal growth continues during a subsequent adolescent pregnancy. This observation is consistent with the hypothesized competition between the metabolic demands of the growing adolescent mother and the nutrient needs of her developing fetus.

The relationship between cadmium zinc and birth weight in pregnant women who smoke

It is universally accepted that smoking during pregnancy results in decreased infant birth weight. However, the mechanism for decreased birth weight is not completely understood. This study tested the hypothesis that the cadmium/zinc interaction in the maternal-fetal-placental unit of the mother who smokes could be related to birth weight. Thiocyanate was used as the index of smoking status and atomic absorption spectroscopy was used to determine trace elements. Results show that cord vein red blood cell zinc and maternal whole blood cadmium levels are significant predictors of infant birth weight when variance that is due to clinical factors and thiocyanate is controlled with stepwise multiple regression techniques (n = 202). Bivariate correlation techniques showed that the factors affecting birth weight were different in the smoking and nonsmoking groups. For example, in nonsmokers (n = 125), the cord vein red blood cell zinc level was positively related to birth weight. In smokers (n = 77), maternal whole blood cadmium, placental cadmium, and placental zinc levels were negatively related to birth weight; the ratio of placental zinc to placental cadmium and the cord vein red blood cell zinc level were positively related to birth weight. The results suggest that increased maternal cadmium and decreased cord vein red blood cell zinc levels in infants of smokers may be significant clinically since increased maternal whole blood cadmium and decreased cord vein red blood cell zinc levels are both significantly related to decreased birth weight.