Low Birth Weight Factors Research Articles

Cardiac Development in Zebrafish and Human Embryonic Stem Cells Is Inhibited by Exposure to Tobacco Cigarettes and E-Cigarettes

BackgroundMaternal smoking is a risk factor for low birth weight and other adverse developmental outcomes.ObjectiveWe sought to determine the impact of standard tobacco cigarettes and e-cigarettes on heart development in vitro and in vivo.MethodsZebrafish (Danio rerio) were used to assess developmental effects in vivo and cardiac differentiation of human embryonic stem cells (hESCs) was used as a model for in vitro cardiac development.ResultsIn zebrafish, exposure to both types of cigarettes results in broad, dose-dependent developmental defects coupled with severe heart malformation, pericardial edema and reduced heart function. Tobacco cigarettes are more toxic than e-cigarettes at comparable nicotine concentrations. During cardiac differentiation of hESCs, tobacco smoke exposure results in a delayed transition through mesoderm. Both types of cigarettes decrease expression of cardiac transcription factors in cardiac progenitor cells, suggesting a persistent delay in differentiation. In definitive human cardiomyocytes, both e-cigarette- and tobacco cigarette-treated samples showed reduced expression of sarcomeric genes such as MLC2v and MYL6. Furthermore, tobacco cigarette-treated samples had delayed onset of beating and showed low levels and aberrant localization of N-cadherin, reduced myofilament content with significantly reduced sarcomere length, and increased expression of the immature cardiac marker smooth muscle alpha-actin.ConclusionThese data indicate a negative effect of both tobacco cigarettes and e-cigarettes on heart development in vitro and in vivo. Tobacco cigarettes are more toxic than E-cigarettes and exhibit a broader spectrum of cardiac developmental defects.

Impacto materno y neonatal del embarazo en la adolescencia

Objetivos: Determinar la asociación entre el embarazo en la adolescencia y sus repercusiones adversas en la madre y su recién nacido. Diseño: Estudio de cohorte no concurrente. Institución: Hospital Regional de Huacho, Perú. Pacientes: Gestantes de 10 a 19 años. Intervenciones: El grupo de adolescentes estuvo conformado por 313 gestantes de 10 a 19 años y el de no adolescentes por 944 gestantes de 20 a 34 años. Los datos fueron obtenidos del Sistema Informático Perinatal (SIP) del Hospital, del primer semestre de 2005. El riesgo fue estimado mediante el cálculo del riesgo relativo (RR) con un intervalo de confianza al 95% y el chi cuadrado (α=0,05), mediante SPSS 15.0 para Windows, y Microsoft Office Excel 2007. Principales medidas de resultados: Complicaciones maternas y neonatales. Resultados: Las adolescentes tuvieron una edad media de 17,5±1,5 años y las demás gestantes, 25,5±4 años. La mayoría de las gestantes fue conviviente (65,5% y 67,1%, respectivamente) y con estudios secundarios concluidos (82,4% y 70,7%, respectivamente). Las patologías del embarazo más frecuentes fueron la infección del tracto urinario (p=0,443; RR=1,07[0,90-1,27]) y la anemia (p=0,281; RR=0,89[0,72-1,10]. Las entidades neonatales más frecuentes fueron el peso bajo al nacer (p=0,011; RR=1,85 [1,15-2,98]) y el puntaje Ápgar bajo al primer minuto (p=0,009; RR=1,81 [1,16- 2,83]). Conclusiones: El embarazo en la adolescencia en la cohorte estudiada fue un factor de riesgo para el peso bajo al nacer, puntaje Ápgar bajo al primer minuto, prematuridad, síndrome aspirativo y resultado perinatal adverso. No se encontró asociación con entidades patológicas obstétricas.

Can Prevention of Low Birth Weight in Newborn may be Associated with Primordial Prevention of Cardiovascular Diseases and Type 2 Diabetes in Adult Life?

Poor nutrition during pregnancy may be a risk factor for low birth weight and for irreversible health issues including obesity, type 2 diabetes, hypertension and hypercholesterolemia in adult life. Low birth weight has also been related to greater mortality from coronary artery disease(CAD) and type 2 diabetes in adult life. One earlier study from Northern Europe proposed that poor social conditions in childhood may be risk factor for obesity, diabetes and cardiovascular diseases (CVDs) in later life. It is possible that multiple confounders related to energy and micronutrient deficiencies may be interacting in the process of adaptations in critical time periods, during fetal, postnatal and child development. A review of literature on the effects on birth size and length of babies and of multiple micronutrient supplementation during pregnancy in low-income countries indicates that incidence of low birth weight may be decreased by supplementation of about 15 micronutrients. This finding poses the possibility that for prevention of low birth weight, maternal micronutrient supplementation (15-20 nutrients) may be an important strategy. It is proposed that this strategy may lead the prevention of CVDs and type 2 diabetes in adult life. Cohort studies and long term follow up population based trials are needed to confirm this hypothesis.

Risk factors of low birth weight and effect of them on growth pattern of children up to sixth months of life: A cross-sectional study.

Introduction:Children are more risk-prone group of the population and low birth weight (LBW) is the leadingcause of newborns’ mortality and morbidity. LBW is defined as child's birth weight lower than 2500 g. Many maternal and fetal factors are determined as risk factors of LBW. This study tries to detect related factors to LBW and effect of them on children's growth pattern up to sixth month of life in Health centers of Urmia city, Iran.Materials and Methods:A cross-sectional study was carried out in Urmia city using registered data from mothers’ documents. All related data such age and weight of infants, mothers’ age, gestational age (GA) at the time of delivery, time gap between two pregnancies, past history of abortion, prenatal care history, systemic and underlying diseases, hemoglobin of mothers during pregnancy, and pattern of infant's growth up to sixth month of age were registered in a questionnaire. All registered data were transferred to SPSS 15 software and analyzed.Results:Mean ± SD of birth weight was 3071 ± 625.66 g. There was a significant relationship between birth weight and mother's age (P < 0.001) and weight (P < 0.001). Children of mothers younger than 18 years had much birth weights. There was a significant relationship between birth weight and GA during delivery (P < 0.001). Children of preterm labor had lower birth weights. In twins, LBW was more prevalent (P < 0.001).Conclusion:Our results show that LBW is related to multiple causes and that most of them are preventable with educational programs and also strict and regular prenatal care. Decreasing incidence of LBW children can be achieved by cooperation between different parts of health and clinical systems.

Sociodemographic and Obstetrical Factors Associated with Low Birth Weight: Community Based Retrospective Study in an Urban Slum of Western India

Aim: This study aimed to find out association between low birth weight and sociodemographic factors, obstetrical factors and ante natal care. The study also helped to recognize whether the known risk factors of low birth weight still exists or their relation is modified in current era in urban slum area of Surat city in Western India. Methods: This study is a part of large scale survey conducted to assess reproductive and child health services in Surat city in Western India. In this large scale study, out of 1004 community based ‘Maternal and Child Day Care Centre’, 30 centre were selected by using cluster sampling design. In the selected areas a household survey was conducted to assess maternal and child healthcare status. Birth weight less than 2500gm was considered as low birth weight and association of study variables with low birth weight was find out using Chi-square and Odds Ratio. Results: Among the 322 mothers interviewed, 51.6% were of 20-24 years of age; 97.2% were having antenatal registration; 35.7% had high risk pregnancy; 9.6% were working; 23.3% had birth interval ≤2 years. Low birth weight rate was 20.5%. High risk pregnancy, preterm birth and birth interval ≤2 years shows statistically significant (p

Contextual risk factors for low birth weight: a multilevel analysis.

BackgroundLow birth weight (LBW) remains to be a leading cause of neonatal death and a major contributor to infant and under-five mortality. Its prevalence has not declined in the last decade in sub-Saharan Africa (SSA) and Asia. Some individual level factors have been identified as risk factors for LBW but knowledge is limited on contextual risk factors for LBW especially in SSA.MethodsContextual risk factors for LBW in Ghana were identified by performing multivariable multilevel logistic regression analysis of 6,900 mothers dwelling in 412 communities that participated in the 2003 and 2008 Demographic and Health Surveys in Ghana.ResultsContextual-level factors were significantly associated with LBW: Being a rural dweller increased the likelihood of having a LBW infant by 43% (OR 1.43; 95% CI 1.01–2.01; P-value <0.05) while living in poverty-concentrated communities increased the risk of having a LBW infant twofold (OR 2.16; 95% CI 1.29–3.61; P-value <0.01). In neighbourhoods with a high coverage of safe water supply the odds of having a LBW infant reduced by 28% (OR 0.74; 95% CI 0.57–0.96; P-value <0.05).ConclusionThis study showed contextual risk factors to have independent effects on the prevalence of LBW infants. Being a rural dweller, living in a community with a high concentration of poverty and a low coverage of safe water supply were found to increase the prevalence of LBW infants. Implementing appropriate community-based intervention programmes will likely reduce the occurrence of LBW infants.

PO-0901 Neonatal Outcomes Of Adolescent Pregnancies In A Secondary Level Maternity Hospital In Romania

<h3>Background and aims</h3> Pregnant adolescents have high rates of poor birth outcomes, but the causes are unclear. There is a very marked association between young age of mothers and low birth weight and preterm delivery and some of the apparent effect of young maternal age on birth weight may be because the birth is likely to be the mother’s first, and first births have a higher incidence of prematurity. The aim of present study was to investigate neonatal outcomes of teenage pregnancies controlling for parity, gestational age and perinatal interventions. <h3>Methods</h3> A retrospective study comparing singleton deliveries classified into three teenage groups:12–15, 15–17, 18–19, and a comparison group of 24–29 years was performed in a secondary level Maternity Hospital in Mures County, Romania. For the adult group, 736 charts of mothers between the age of 24 and 29 delivering singleton babies were selected. <h3>Results</h3> The study population consisted of 1 131 women, 75 12–15 years old, 163 16–17 years old, 157 18–19 years old, and 736 24–29 years old. A significant linear association was found between maternal age and preterm birth, low birth weight, and neonatal birth related trauma. Length of hospitalisation, as a marker of the healthcare costs involved in the care of these high risk cases, was significant associated with maternal age after controlling for perinatal interventions. <h3>Conclusions</h3> Teenage pregnancy is a risk factor for low birth weight, preterm delivery, neonatal birth related trauma and high healthcare costs.

Prevalence &amp; Consequences of Anaemia in Pregnancy

Introduction: This study is planned with aim to identify prevalence of anaemia in specified population in south India and to know various adverse consequences of anaemia in mother and child. Methods: This is a prospective observational study done in pregnant women indicates anaemia in pregnancy is a risk factor for low birth weight(LBW), preterm delivery, poor APGAR score and possibly early neonatal death. Results: After comparison with non anaemic and anaemic group we fond that there is 2.5 to 3.5 times increase in LBW, preterm delivery and early neonatal death in anaemic group. WHO criteria is used for classification of anaemia and we found 60% of our study population are anaemic. Conclusion: This study conform the recommendations of various previous studies that anaemia is strongly associated with LBW, preterm delivery and early neonatal death.

The first 1000 days of life: prenatal and postnatal risk factors for morbidity and growth in a birth cohort in southern India

ObjectiveTo estimate the burden and assess prenatal and postnatal determinants of illnesses experienced by children residing in a semiurban slum, during the first 1000 days of life.DesignCommunity-based birth cohortSettingSouthern IndiaParticipantsFour...

Birth weight and factors associated with the prenatal period: a cross-sectional study in a maternity hospital of reference

This study examined factors related to birth weight in a maternity hospital in the city of Rio de Janeiro. It is a descriptive, sectional study conducted in the Herculano Pinheiro Maternity Hospital (HMHP) in Rio de Janeiro between December 2008 and February 2009, with postpartum mothers between 20 and 34 years of age. The chi-square test, the Student's t test and the logistical regression model were applied. 14.6% of the infants had low birth weight (less than 2500 g). There was a negative correlation between birth weight and smoking habits of the mother. The pre-pregnancy weight, maternal pre-pregnancy body mass index and number of pre-natal visit variables were positively associated with birth weight. Multiple regression analysis indicated maternal age as being a risk factor for low birth weight. The conclusion reached is that the marital status situation, where this was perceived as an important variable, as well as the number of prenatal visits, which in group analysis showed no statistical significance, deserve further investigation together with other studies.

Quantifying low birth weight, preterm birth and small-for-gestational-age effects of malaria in pregnancy: a population cohort study.

BackgroundThe association between malaria during pregnancy and low birth weight (LBW) is well described. This manuscript aims to quantify the relative contribution of malaria to small-for-gestational-age (SGA) infants and preterm birth (PTB) in pregnancies accurately dated by ultrasound on the Thai-Myanmar border at the Shoklo Malaria Research Unit.Methods and FindingsFrom 2001 to 2010 in a population cohort of prospectively followed pregnancies, we analyzed all singleton newborns who were live born, normal, weighed in the first hour of life and with a gestational age (GA) between 28+0 and 41+6 weeks. Fractional polynomial regression was used to determine the mean birthweight and standard deviation as functions of GA. Risk differences and factors of LBW and SGA were studied across the range of GA for malaria and non-malaria pregnancies. From 10,264 newborns records, population centiles were created.Women were screened for malaria by microscopy a median of 22 [range 1–38] times and it was detected and treated in 12.6% (1,292) of pregnancies. Malaria was associated with LBW, PTB, and SGA compared to those without malaria. Nearly two-thirds of PTB were classified as LBW (68% (539/789)), most of which 83% (447/539) were not SGA. After GA 39 weeks, 5% (298/5,966) of non-LBW births were identified as SGA. Low body mass index, primigravida, hypertension, smoking and female sex of the newborn were also significantly and independently associated with LBW and SGA consistent with previous publications.ConclusionsTreated malaria in pregnancy was associated with an increased risk for LBW, PTB, and SGA, of which the latter are most important for infant survival. Using LBW as an endpoint without adjusting for GA incorrectly estimated the effects of malaria in pregnancy. Ultrasound should be used for dating pregnancies and birth weights should be expressed as a function (or adjusted for GA) of GA in future malaria in pregnancy studies.

Low Birth Weight &amp; Associated Factors Among Newborns in Gondar Town, North West Ethiopia: Institutional Based CrossSectional Study

BACKGOUND: Reducing infant mortality is a global priority which is particularly relevant in developing countries including Ethiopia. One of the key strategies to reduce infant mortality rate and improving child health is improving birth weight; however, low birth weight is significantly higher in Ethiopia. The main aim of this study was to determine prevalence and identify associated factors of low birth weight among newborns in Gondar town, North West Ethiopia. METHODS: An institution based cross-sectional study was employed. Systematic sampling was used to select 540 study participants. A pre tested and structured questionnaire was used to collect data. The data was entered, cleaned and edited using EPI INFO version 2002 and exported to SPSS version 16.0 software packages for analysis. Both bivariate and multiple logistic regression were fitted and odds ratio and 95% CI were computed to identify associated factors and determine the strength of association. A p-value of <0.05 was considered as statistical significant. RESULT: The response rate was 100%.The mean gestational age of the newborns was 39.49±1.53 weeks. The mean age of the respondents was 25.8±5.5 years. The overall prevalence of low birth weight was 17.4%. The covariates pregnancy-induced hypertension (AOR 9.2(95%CI 3.36, 25.3)), malaria attack during pregnancy (AOR 4.9(95%CI 1.95, 12.3)), female sex newborn (AOR 2.1, (95%CI 1.18, 3.76)) and gestational age less than 37 weeks (AOR 18, 95%CI 5.8, 31.2)) were found to be significantly associated with birth weight of new born. CONCLUSION: There was a high prevalence of low birth weight in the study area. Effective treatment and preventive of malaria and pregnancy induced hypertension; prevention of preterm birth could reduce low birth weight. © 2014 iGlobal Research and Publishing Foundation. All rights reserved.

Is Air Pollution a Risk Factor for Low Birth Weight in Ulaanbaatar, Mongolia?

Ulaanbaatar (Mongolia) is one of the most air polluted capital cities in the world, with ambient sulfide dioxide (SO2) and particulate matter PM10 and PM2.5 levels > 23 times World Health Organ- ization (WHO) standards in winter. Several studies have examined the effects of air pollution on pregnancy, providing that exposure to ambient air pollutants is associated with poor birth out- come, such as low birth weight. Our study goal was to study the associations between air pollution exposures during pregnancy and low birth weight among all full-term births (gestational age 37 - 42 weeks) for a 6-year period (January 2008 through December 31, 2013) in Ulaanbaatar, Mongo- lia. In the study we recruited 160,676 singletons. We used a logistic regression adjusting for gesta- tional age, parental education level, parity and infant age. The adjusted relative risk of low birth weight was 1.06 (95% CI = 1.01 - 1.12) for each inter-quartile increase in NO2 concentrations. The risk of low birth weight was increased to 1.04 (95% CI = 0.93 - 1.15) for CO, 1.02 (95% CI 0.97 - 1.05) for SO2 and 1.03 (95% CI 1.01 - 1.08) for PM10. Each inter-quartile increase of NO2 concentra- tion during the first trimester reduced 10.74 gm of birth weight. SO2, CO and PM10 also decreased birth weight 7.62, 7.49, and 8.72 gm, respectively. Each inter-quartile increase of pollutants de- creases baby weight up to 11 grams.

Maternal periodontal disease as a significant risk factor for low birth weight in pregnant women attending a secondary care hospital in South India: a case-control study.

Periodontal disease (PD) is a common infection in the community; however, its relationship with low birth weight (LBW) has not been well-established. The aim was to determine the association between maternal PD and LBW. A case-control (1:1) study. The study population comprised of women who delivered at the hospital during the study period (September 2011 to February 2012).Women between 18 and 35 years of age, who delivered singleton, live infants during study period with at least 18 teeth were enrolled. Those with pregnancy induced hypertension, gestational diabetes, blood-borne viral infections, periodontal treatment within the past 6 months and valvular heart disease were excluded. Control population was parity matched to the cases. Chi-square test, t-test and univariant and multivariant logistic regression were used to analyze various study findings, and level of significance was set at 5% (P<0.05). PD was independently associated with LBW (odds ratio: 4.94, 95% confidence interval: 1.03-23.65, P=0.045). Additionally, conventional risk factors such as maternal height (P=0.029), secondary schooling (<8 years of schooling) (P=0.001), socio-economic status (P=0.046), type of family (joint) (P=0.008), number of ante-natal visits (P=0.028) and gestational age at birth (<37 weeks) (P=0.045) showed significant association with LBW. There seems to be an association between PD and LBW independent of conventional risk factors. Women who had PD were 5 times more likely to deliver LBW infants.

Periodontal disease as a potential risk factor for low birth weight and reduced maternal haemomglobin levels.

To investigate the association between maternal periodontal disease and its effect on haemoglobin levels and low birth weight infants. This observational study included 770 mothers. Data regarding the periodontal status, pregnancy outcome variables, haemoglobin levels (Hb%) and other factors that may contribute to adverse pregnancy outcomes were collected. The data were analysed using the chi-square test and univariate logistic regression analysis. Factors such as literacy (P = 0.002), adverse oral habits (P < 0.001), dental health negligence (P < 0.001), obstetric history (P = 0.001) and Hb% (P < 0.001) showed a significant association with periodontal disease. The study showed only seven mothers had not received antenatal care (ANC), which reflected the awareness of ANC during pregnancy. The reduced haemoglobin levels had an association with the severity of periodontal disease. The univariate logistic regression analysis indicated that mothers with a probing pocket depth (PPD) > 6 mm (OR = 2.21, 95% CI [1.07-4.55], P = 0.032) had a higher risk of giving birth to low birth weight infants. Periodontitis significantly influenced low birth weight. The increase in the severity of periodontal disease was associated with an increased rate of pre-term infants. The severity of periodontitis influenced the maternal haemoglobin levels, i.e. more severe peridontitis was associated with lower haemoglobin levels. Severe anaemia and periodontal infection may have an adverse effect on pregnancy and fetal development.

Prevalence and Factors Associated with Low Birth Weight in Axum and Laelay Maichew Districts, North Ethiopia: A Comparative Cross Sectional Study

Background: Weight at birth is a good indicator of the newborn’s chances for survival, growth, long-term health and psychosocial development. Low birth weight babies are significantly at risk of death, contributing to the high perinatal morbidity and mortality in Ethiopia. Therefore, the aimed of this study is to assess the prevalence and associated factors of Low Birth Weight in Axum and Laelay Maichew districts, Tigray, north Ethiopia. Method: An institution based comparative cross-sectional study using consecutive sampling technique was used to select a sample of 520 live birth neonates from both urban and rural districts. Data was collected from mothers’ using a structured interview questionnaire. The data were entered in to Epi-Info and analyzed on SPSS. Means and standard deviations of birth weight were calculated using the t-test. The chi-square (X2) test was computed to compare proportions of low birth weight with 95% Confidence Interval. Binary and multivariable logistic regression was used to identify the risk factors. Result: The prevalence of low birth weight was 9.9% and 6.3% in Axum and Laelay Maichew districts, respectively. In Axum district (Urban): low birth weight was associated with inadequate ANC service utilization [AOR=0.29, 95% CI:(0.12, 0.73)] and unwanted pregnancy [AOR=4.04, 95% CI:(1.17, 13.90)]. Sex of the neonate [AOR=6.08, 95% CI:(1.60, 23.07)] and pregnancy type [AOR=7.34, 95% CI:(2.050, 26.292)] were also significantly associated with low birth weight in Laelay Maichew district (rural). Conclusion and Recommendation: The prevalence of low birth weight was 9.9% and 6.3% in Axum and Laelay Maichew districts, respectively. The burden of low birth weight deliveries in these areas are associated with inadequate ANC service utilization, unwanted pregnancy and female sex of the neonate which deserve goal oriented prenatal care and choice based family planning service provision by the respective health facilities.

Parental Smoking During Pregnancy and Its Association with Low Birth Weight, Small for Gestational Age, and Preterm Birth Offspring: A Birth Cohort Study

Intrauterine exposure to tobacco smoke has been discerned as an important risk factor for low birth weight (LBW), small for gestational age (SGA), and preterm birth infants. In this cohort study, we investigated the association of the amount of parental smoking during the different pregnancy stages with birth weight and the incidence of preterm delivery. Our study population was acquired from the Taiwan Birth Cohort Study. Between June 2005 and July 2006, 21,248 postpartum women were interviewed 6 months after their deliveries by a structured questionnaire. The parents were divided into four groups according to the amount of smoking during preconception, the first trimester, and the second and third trimesters. The relationships of parental smoking with gestational age and birth weight during the different pregnancy stages were assessed using multivariate linear regression. Multiple logistic regression analyses were performed to estimate the odds ratios and 95% confidence intervals of preterm delivery, LBW, and SGA infants during the different parental smoking status and the different pregnancy stages. After adjusting for the physical and socioeconomic status of the parents and for paternal smoking during the same period, we found that maternal smoking decreased birth weight. Compared with the nonsmoking groups, all the maternal smoking groups had higher incidences of LBW, SGA, and preterm birth infants, especially when the mothers smoked >20 cigarettes/day. The association of paternal smoking with LBW, SGA, and preterm birth infants was insignificant. Maternal smoking is responsible for increased incidences of LBW and preterm delivery of babies, and therefore, smoking cessation/reduction should be advised to pregnant women to reduce morbidities in their neonates. Further studies are needed to clarify the correlation of fetal health with passive smoking, including exposure to environmental tobacco smoke and to other smokers in the family.

Prevalence and risk factors for low birth weight in Ardabil, Iran.

Introduction Low birth weight (LBW) is the most common cause of neonatal death in developing countries. The objective of our study was to determine the prevalence and risk factors associated with low birth weight in Ardabil, Iranfrom 2010 to 2011.Methods In a case–control study all live newborns were weighted without clothing using a standard calibrated scale. Gestational age was calculated using either the first day of the last normal menstrual period or estimated by obstetric sonography. 358 neonates with birth weight of less than 2500 g were considered as case and 705 normal weight neonates as control groups. Data were collected through a self-designed questionnaire from review of prenatal and hospital delivery records. Kruskal –wallis, chi-square, and logistic regression were applied to analyze data using SPSS version 16.Results Incidence of LBW was 6.3% and among these, 84.2% were preterm and 15.8% had intrauterine growth retardation. Hypertension (OR:8.64, CI: 2.63-28.31), multiple pregnancy (OR: 7.62, CI:3.09-13.32), leakage (OR:4.46, CI: 2.11-9.42), Oligohydramnios(OR:4.28, CI:1.90-9.76),history of preterm birth (OR:2.84, CI: 1.20-6.71), bleeding or spotting during pregnancy (OR:2.36,CI:1.41-3.95) were determined as important risk factors for preterm LBW. Risk of low birth weight in term infants increased by multiple pregnancy (OR:3.77, CI: 1.41-10.0), bleeding and spotting(OR:2.23, CI:1.22- 4.07),and urinary tract infection in weeks 26-30 of pregnancy (OR:2.42, CI :1.11-5.26).Conclusion Delivering quality health care for all pregnant women and early diagnosis and control of hypertension, urinary tract infection, and bleeding or spotting and leakage during pregnancy may significantly reduce the rate of low birth weight and improve public health in this area.

How Do Abused Drugs Affect Fetus, Newborn?

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessHow Do Abused Drugs Affect Fetus, Newborn?Aaron LevinAaron LevinSearch for more papers by this authorPublished Online:19 Apr 2013https://doi.org/10.1176/appi.pn.2013.4a10AbstractWhen it comes to the effects of prenatal exposure on the fetus, drugs of abuse pose various types of risk to the baby.Several commonly abused drugs, both legal and illegal, can have serious effects on a fetus, two pediatricians cautioned their colleagues in the March Pediatrics.“Alcohol can have pretty profound teratogenic, neurobehavioral, and anatomic effects,” said lead researcher Marylou Behnke, M.D., a professor of pediatrics at the University of Florida, in an interview with Psychiatric News. “We don’t see the same somatic changes with other drugs, but you can see subtle neurobehavioral changes that can be hard to tease out because they don’t show up until the children grow older.”Behnke and coauthor Vincent Smith, M.D., M.P.H., both neonatologists, presented a technical report on the short- and long-term effects of prenatal substance abuse on the exposed fetus. They covered the most common substances used by pregnant women: nicotine, alcohol, marijuana, opiates, cocaine, and methamphetamine.Some health messages may be getting through to this cohort. For a start, only 4.4 percent of pregnant women aged 15 to 44 acknowledge use of any illicit drugs, 10.8 percent drink alcohol, and 16.3 percent smoke cigarettes, according to data from the National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration. Rates are significantly higher among nonpregnant women (see chart).Furthermore, drug use by a pregnant woman does not automatically lead to problems in the offspring, but it does increase the baby’s risks, Behnke pointed out.From a population perspective, the effects of these drugs on a baby may seem subtle but they should not be ignored.“Biologically and socially, drug addiction is not a good atmosphere to grow up in,” she said. Aside from its biological effects, addiction can change maternal behavior in ways that can affect the fetus by leading to poor nutrition or health care, or exposure to violence or infection.In addition, a mother’s use of more than one drug at a time only complicates effects on the child, said Behnke.Recent research indicates that the effects of drugs other than tobacco are less severe than was anticipated a couple of decades ago, when a nation obsessed with “crack babies” figured that children would be horribly damaged by maternal cocaine use, she said.The effects of each of these drugs vary. Nicotine is a risk factor for low birth weight and is associated with decreased weight gain in the infant, possibly because the fetus is actually exposed to more nicotine than the mother is. However, infants experience no serious withdrawal effects. The effects on long-term growth are not clear, but problems with impulsivity, concentration, language development, and learning and memory have been highlighted by other researchers.Alcohol is the best-studied of the drugs used by pregnant women. It has strong effects on fetal growth and anomalies, as well as influencing longer-term effects on growth, behavior, cognition, and academic achievement.Marijuana has minor effects on infant neurobehavioral responses but has longer-term effects on behavior, cognition, and achievement, said Behnke and Smith.“The most significant effect of prenatal opiate exposure is neonatal abstinence syndrome,” they noted. Behavior is affected, but there is either no consensus or a lack of data regarding cognition, language development, and academic achievement.Cocaine has long-term effects on behavior and possibly language, as well as on fetal growth and infant neurobehavior.“Studies of prenatal methamphetamine exposure are still in their infancy,” Behnke and Smith pointed out. Some effects have been noted on fetal growth and infant neurobehavior, but evidence is insufficient regarding most other outcomes.Behnke said that a full spectrum of medical professionals must intervene when needed to lessen the risk to the fetus and the developing child.“Whether we are ob/gyns, pediatricians, or psychiatrists, we as physicians have the opportunity to interact with patients at various points along the lifespan,” she said. “We should be in the business of trying to diagnose people and refer them to treatment. We may not have all the information yet, but we should state what we know and what we don’t know and develop therapies and places to refer our patients.” ■“Prenatal Substance Abuse: Short and Long-Term Effects on the Exposed Fetus” is posted at http://pediatrics.aappublications.org/content/131/3/e1009.long. ISSUES NewArchived

Is adolescent pregnancy a risk factor for low birth weight?

OBJECTIVE: The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW) babies. METHODS: This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS: We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (&lt; 20 years of age). Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS: Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.