Low 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.

Association of low birthweight and small for gestational age with maternal ferritin levels: A retrospective cohort study in China.

BackgroundBirthweight have profound impacts on health status throughout lifetime, however, the relationship between maternal ferritin level in pregnancy and birthweight of the newborn remains controversial.ObjectiveThis retrospective cohort research was to analyze the association between maternal ferritin levels during pregnancy with birthweight outcomes, primarily for low birthweight (LBW) and small for gestational age (SGA).MethodsNewborns weighing lower than 2,500 grams were defined as LBW. SGA is defined as birthweight lower than the 10th percentile of the distribution of newborns' birthweight of the same gestational age. Multivariable logistic regressions have been used to explore the association of maternal ferritin levels and birthweight related outcomes, in which the ferritin concentration was logarithm transformed in the model. We further used restricted cubic spline models to explore linear/non-linear dose–response manners of ferritin level and birthweight outcomes.ResultsA total of 3,566 pregnant women were included in the study. In the results of the present study, we observed that maternal ferritin levels were linearly associated with the risk of LBW (p-trend = 0.005) and SGA (p-trend = 0.04), with the adjusted odds ratios (ORs) of 1.78 (95% CI 1.37–2.32) for LBW and 1.87 (95% CI 1.38–2.54) for SGA with an increase in Ln-ferritin concentrations per unit. The adjusted ORs across quartiles of ferritin levels were 2.14 (95% CI 1.03–4.47) for Quartile 2, 3.13 (95% CI 1.47–6.69) for Quartile 3, and 3.63 (95% CI 1.52–8.68) for Quartile 4 for LBW. The adjusted ORs of LBW and SGA among women using supplemental iron were 0.56 (95% CI 0.38, 0.85) and 0.65 (95% CI 0.40, 1.05) compared with non-users, respectively.ConclusionsOur findings found a linear dose–response relationship between ferritin levels and an increased risk of poor birthweight outcomes, suggesting that maternal ferritin level during pregnancy may provide an additional predictor for differentiating poor birthweight related outcomes. Further exploration should be conducted to ensure maternal ferritin thresholds and iron supplement doses.

Temporal Association Between Interracial Couples and Odds of Low Birth Weight Infants: Trends in National Vital Statistics Data from 1971 to 2016.

Our study explores the temporal association between low birth weight (LBW) infants and the increasing population prevalence of interracial relationships. Our hypothesis was that the odds of LBW would decrease as the population prevalence of interracial relationships increased. National Center for Health Statistics Natality data for 1971-2016 was analyzed. LBW was defined as birth weight less than 2500gm. We restricted our analyses to singleton births by White and Black mothers with reported White or Black partners of the neonate. Logistic regression was used to calculate the odds ratios of LBW, both unadjusted and adjusted for maternal education and parental ages. The proportion of couples coded as interracial increased annually from 0.36% in 1971 to 3.86% in 2016 for White mothers and 0.59% to 8.63% for Black mothers during the same period. In each year the odds ratio of LBW was significant. As the proportion of White mothers with Black partners increased, their odds of LBW declined (OR1.75 to 1.30, p < 0.001). The odds ratio of LBW among Black mothers with White partners did not change and remained stable between 0.70 and 0.80 (p = 0.22) over the same time period. As the annual proportion of White mothers with Black partners increased, their odds of LBW decreased when compared to White couples. Black mothers with White partners did not exhibit a similar change when compared to Black couples, with the odds ratio of LBW remaining stable.

Effects of early maternal cancer and fertility treatment on the risk of adverse birth outcomes

SummaryBackgroundEarly maternal cancer and fertility treatment each increase the risk for adverse birth outcomes, but the joint effect of these outcomes has not yet been reported. Thus, the aim was to assess the individual and joint effect of maternal cancer and fertility treatment on the risk for adverse birth outcomes.MethodsThis population-based cohort study included 5487 live-born singletons identified in the Danish Medical Birth Register (1994–2016) of mothers with previous cancer (<40 years) recorded in the Danish Cancer Registry (1955–2014). We randomly selected 80,262 live-born singletons of mothers with no cancer <40 years matched to mothers with cancer by birth year and month. We calculated odds ratios (ORs) for preterm birth, low birth weight (LBW) (<2500 g) and small for gestational age (SGA), mean differences in birth weight in grams, and additional cases of preterm birth (gestational age<259 days) per 100,000 person-years. Multiplicative and additive interaction of maternal cancer and fertility treatment was compared with outcomes of children conceived naturally to mothers with no maternal cancer (reference group).FindingsAmong 84,332 live-born singletons, increased ORs for preterm birth were observed among children born to mothers with previous cancer (1·48, 95% confidence interval [CI] 1·33–1.65) or after fertility treatment (1·43, 95% 1·28–1–61), with 22 additional cases of preterm birth among both group of children (95% CI 15–29; 95% CI 14–30). In the joint analyses, the OR for SGA for children born after fertility treatment to mothers with previous cancer was similar to that of the reference group (OR 1·02, 95% CI 0·72–1·44, P for interaction=0·52). Children with both exposures had increased ORs for LBW (1·86, 95% CI 1·17–2·96, P for interaction=0·06) and preterm birth (2·31, 955 CI 1·66–3·20, P for interaction = 0·56), with 61 additional cases of preterm birth (95% CI 27–95, P for interaction=0.26) over that of children in the reference group. The mean birth weight was also lower in children born to mothers with both exposures (-140 g, 95% CI -215; -65) (P for interaction=0.06) but decreased to -22 g (95% CI -76; 31) after adjustment for GA.InterpretationAlthough we did not find any statistically significant additive interaction between maternal cancer and fertility treatment, children born after fertility treatment of mothers with previous cancer were at increased risk for adverse birth outcomes. Thus, pregnant women with both exposures need close follow-up during pregnancy.FundingThe Danish Cancer Society and the Danish Childhood Cancer Foundation.

Prevalence and risk factors associated with low birth weight babies-a cross sectional study

Background: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as low birth weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million LBW babies are born every year throughout the world. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns. Across the world, neonatal mortality is 20 times more likely for LBW babies compared to normal birth weight (NBW) babies (&gt;2.5 kg).Methods: A cross sectional study was conducted in neonatal intensive care unit (NICU) of ACS Medical College and Hospital, Chennai from December 2019 to October 2020. Altogether 350 babies were taken who were delivered at ACS hospital.Results: The number of times of ANC attendance was also significantly associated with LBW, odds ratio (OR)=1.296, and p=0.001. The number of meals was not associated with LBW OR=0.946, and p=0.831. The gestational age assessed as completed weeks of pregnancy was significantly associated with LBW OR=3.302; p=0.00001.Conclusions: This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age and gestational age) and antenatal care are more important.

Exposure to ambient particulate matter and biomass burning during pregnancy: associations with birth weight in Thailand

BackgroundThere is a growing evidence that exposure to ambient particulate air pollution during pregnancy is associated with adverse birth outcomes, including reduced birth weight (BW). The objective of this study was to quantify associations between BW and exposure to particulate matter (PM) and biomass burning during pregnancy in Thailand.MethodsWe collected hourly ambient air pollutant data from ground-based monitors (PM with diameter of <10 µm [PM10], Ozone [O3], and nitrogen dioxide [NO2]), biomass burning from satellite remote sensing data, and individual birth weight data during 2015–2018. We performed a semi-ecological analysis to evaluate the association between mean trimester exposure to air pollutants and biomass burning with BW and low-birth weight (LBW) (<2500 g), adjusting for gestation age, sex, previous pregnancies, mother’s age, heat index, season, year, gaseous pollutant concentrations, and province. We examined potential effect modification of PM10 and biomass burning exposures by sex.ResultsThere were 83,931 eligible births with a mean pregnancy PM10 exposure of 39.7 µg/m3 (standard deviation [SD] = 7.7). The entire pregnancy exposure was associated with reduced BW both for PM10 (−6.81 g per 10 µg/m3 increase in PM10 [95% CI = −12.52 to −1.10]) and biomass burning (−6.34 g per 1 SD increase in fires/km2 [95% CI = −11.35 to −1.34]) only after adjustment for NO2. In contrast with these findings, a reduced odds ratio (OR) of LBW was associated with PM10 exposure only in trimesters one and two, with no relationship across the entire pregnancy period. Associations with biomass burning were limited to increased ORs of LBW with exposure in trimester three, but only for male births.ConclusionBased on our results, we encourage further investigation of air pollution, biomass burning and BW in Thailand and other low-income and middle-income countries.

235 Temporal association between interracial couples and odds of low birth weight infants

Women coded as being in interracial relationships have altered odds of low birthweight (LBW). This is likely secondary to societal stressors rather than a biologic basis. Thus, the association should vary over time with sociocultural changes as the proportion of couples coded as interracial has increased. Our aim was to evaluate the association between the odds of LBW in couples coded as interracial and their population incidence over time. Our hypothesis was that the odds of LBW would decrease as the population incidence increased. National Center for Health Statistics Natality data for 1971-2016 was analyzed. LBW was defined as less than 2500 grams. We restricted our analyses to singleton births by White and Black mothers with reported White or Black fathers of the neonate. Logistic regression was used to calculate the odds ratios (OR) of LBW adjusted for maternal education and parental ages and unadjusted. The association between the OR of LWB within a given year and that year’s prevalence of interracial couples was evaluated via meta-regression with random effects. The proportion of couples coded as interracial increased annually from 0.36% in 1971 to 3.86% for White mothers and 0.59% to 8.63% for Black mothers. In each year the OR of LBW was significant. Figures 1 and 2 show each individual year’s OR with a circle proportional to the standard error as well as the metaregression trend line. As the proportion of White mothers with Black partners increased, their OR of LBW declined (1.75 to 1.30, p<0.001). The OR of LBW among Black mothers with White partners, however, did not change (p=0.22). As the annual proportion of White mothers with Black partners increased, their odds of LBW decreased, though was always lower than Black mothers. Black mothers with White partners did not exhibit a similar change. Though causation cannot be established, changes in the proportion of interracial couples over decades is associated with decreasing odds of LBW amongst White women but not Black women.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Is the socioeconomic status of immigrant mothers in Brussels relevant to predict their risk of adverse pregnancy outcomes?

BackgroundUnderstanding and tackling perinatal health inequities in industrialized countries requires analysing the socioeconomic determinants of adverse pregnancy outcomes among immigrant populations. Studies show that among certain migrant groups, education is not associated with adverse pregnancy outcomes. We aim to extend this analysis to further dimensions of socioeconomic status (SES) and to other settings. The objective of this study is to identify sociodemographic characteristics associated with adverse pregnancy outcomes, according to the origin of mothers residing in Brussels.MethodsWe analysed all singleton live births in Brussels between 2005 and 2010 (n = 97,844). The data arise from the linkage between three administrative databases. Four groups of women were included according to their place of birth: Belgium, EU, North Africa, and Sub-Saharan Africa. For each group, logistic regression was carried out to estimate the odds ratios of low birthweight (LBW) and small for gestational age (SGA) according to SES indicators (household income, maternal employment status, maternal education) and single parenthood.ResultsThree key findings emerge from this study: 1) 25% of children were born into a household under the poverty threshold. This proportion was much higher for mothers born outside of the EU. 2) For North African immigrants, SES indicators didn’t influence the pregnancy outcomes, whereas their risk of LBW increased with single parenthood. 3) For Sub-Saharan Africans the risk of LBW increased with low household income.ConclusionIn a region where immigrant mothers are at high poverty risk, we observe a classic social gradient in perinatal outcomes only for mothers born in Belgium or the EU. In the other groups, SES influences perinatal outcomes less systematically. To develop interventions to reduce inequities from birth, it’s important to identify the determinants of perinatal health among immigrants and to understand the underlying mechanisms in different contexts.

Perfluoroalkyl Substances and Birth Outcomes: A Pool Analysis in the Danish National Birth Cohort

BACKGROUND: Perfluoroalkyl substances (PFASs) are widespread persistent organic pollutants. Animal studies indicated that in-utero PFAS exposure may affect fetal growth, but human studies findings are inconclusive. Few human studies evaluated adverse birth outcomes primarily due to small sample size. METHODS: We conducted a pooled analysis using data of 3,535 mothers and infant pairs from three sub-samples originating from the Danish National Birth Cohort (DNBC), with 1398, 545, and 1592 mutually exclusive births respectively. All sub-samples have first trimester maternal plasma concentrations of PFOS and PFOA, and 4 additional PFAS (PFHxS, PFNA, PFHpS and PFDA) were available in sub-sample 2 and 3. PFAS measures were analyzed as continuous variables after natural-log (LN) transformation or categorized into tertiles. We estimated changes in birth weight (grams) or gestational age (days), odds ratios (OR) and 95% confidence intervals (CI) for infants born preterm (&amp;lt; 37 gestational week) or low birth weight (&amp;lt; 2500 gram). Potential confounders were included, and sampling weights of each sub-sample were accounted in statistical analyses. RESULTS: We estimated that each LN-ng/ml increase in PFOS, PFOA and PFHpS was associated with a 64g, 51g or 55g decrease in average birth weight. Several PFASs (PFOS, PFNA, and PFHpS) were also associated with a small decrease in gestational age at delivery. Moreover, we estimated elevated ORs for PFOS and PFHpS and low birth weight and preterm. For instance, OR for low birth weight and preterm were 1.7 (95% CI 0.9, 3.2) and 2.0 (95% CI 1.2, 3.2) respectively comparing the highest to the lowest exposure tertile. CONCLUSION: Our pooled analyses demonstrated that several prenatal PFASs are inversely associated with birth weight and gestational age, and prenatal PFOS and PFHpS exposure may affect the risks of being born low birth weight and preterm. Our findings strengthen the evidence that in-utero PFAS exposures may affect fetal growth.

Afternoon napping during pregnancy and low birth weight: the Healthy Baby Cohort study

ObjectiveAlthough afternoon napping is very common, particularly in China, there are limited data regarding the potential health effects of afternoon napping during pregnancy on perinatal outcomes. We aimed to investigate the relationship between afternoon napping during late pregnancy and low birth weight (LBW). MethodsA total of 10,111 women aged 15–50 years were recruited from the ongoing Healthy Baby Cohort study in China, in 2012–2014. Information on sleep habits during pregnancy was obtained by questionnaires at the time of institutional delivery. Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). ResultsCompared with women who reported no napping, the multivariate-adjusted ORs for LBW were 0.83 (95% CI 0.58–1.18) and 0.61 (0.44–0.83) for those who reported ≤1 h and >1 h of napping, respectively (P for trend <0.001). LBW risk reached a threshold at approximately 1.5 h of afternoon napping. The inverse relationship between afternoon napping during late pregnancy and LBW was stronger among women with lower educational level (P for interaction = 0.011). For frequency of afternoon napping, the multivariate analysis suggested a significant inverse association between LBW and napping 5–7 days/week (OR 0.68; 95% CI 0.50–0.92). ConclusionTo our knowledge, this is the first study to estimate the association between afternoon napping and frequency of afternoon napping during late pregnancy and LBW risk. Our findings suggest that appropriate afternoon napping and frequency of afternoon napping for pregnant women might reduce the risk of LBW.

3.3-O6Is the socioeconomic status of immigrant mothers in Brussels relevant to predict their risk of adverse pregnancy outcomes?

Understanding and tackling perinatal health inequities in industrialized countries requires analysing the socioeconomic determinants of adverse pregnancy outcomes among immigrant populations. Studies show that among certain migrant groups, education is not associated with adverse pregnancy outcomes. We aim to extend this analysis to further dimensions of socioeconomic status (SES) and to other settings. The objective of this study is to identify sociodemographic characteristics associated with adverse pregnancy outcomes, according to the origin of mothers residing in Brussels. We analysed all singleton live births in Brussels between 2005 and 2010 (n = 97,844). The data arise from the linkage between three administrative databases. Four groups of women were included according to their place of birth: Belgium, EU, North Africa, and Sub-Saharan Africa. For each group, logistic regression was carried out to estimate the odds ratios of low birthweight (LBW) and small for gestational age (SGA) according to SES indicators (household income, maternal employment status, maternal education) and single parenthood. Three key findings emerge from this study: 1) 25% of children were born into a household under the poverty threshold. This proportion was much higher for mothers born outside of the EU. 2) For North African immigrants, SES indicators didn’t influence the pregnancy outcomes, whereas their risk of LBW increased with single parenthood. 3) For Sub-Saharan Africans the risk of LBW increased with low household income. In a region where immigrant mothers are at high poverty risk, we observe a classic social gradient in perinatal outcomes only for mothers born in Belgium or the EU. In the other groups, SES influences perinatal outcomes less systematically. To develop interventions to reduce inequities from birth, it’s important to identify the determinants of perinatal health among immigrants and to understand the underlying mechanisms in different contexts.

Parity Conditions the Risk for Low Birth Weight after Maternal Exposure to Air Pollution

ABSTRACTMultiparous mothers have greater umbilical blood flow and thus more efficient transport of pollutants than primiparous mothers. We tested a hypothesis that multiparous mothers are more prone to have an infant with low birth weight (LBW) after prenatal exposure to air pollution. A study was conducted on a representative group of more than 74,000 singleton, live, full-term infants. Birth data were obtained from the birth registry, while pollution data were from an environmental monitoring system (Poland). Multiple comparisons were controlled by the false discovery rate procedure (FDR). After standardization, the harmful effect of carbon monoxide (CO) on the odds ratio (OR) for LBW was seen among the multiparous mothers (OR = 1.28; 95% CI 1.06–1.54), while in primiparous mothers it was nonsignificant. The effect of CO on the OR for LBW differed according to parity, which was confirmed by the test for interaction (FDR-adjusted p = 0.03). The interaction between parity and sulfur dioxide (SO2) was statistically nonsignificant (FDR-adjusted p = 0.08). Multiparous mothers may be more vulnerable to CO than primiparous mothers. Parity may be the modifier of the association between pollutants and the risk of LBW.

Prepregnancy diabetes, hyperglycaemic status, and adverse pregnancy outcomes in Chinese women: a population-based mega-cohort study

BackgroundGestational diabetes is a well established risk factor for adverse pregnancy outcomes including preterm birth, low birthweight, and macrosomia. However, few studies have assessed the association of prepregnancy diabetes and fasting glucose levels with risk of adverse pregnancy outcomes. We aimed to examine the relations of prepregnancy diabetes and impaired fasting glucose with preterm birth, low birthweight, and macrosomia, using data from a mega cohort of women of reproductive age. MethodsThe China National Free Preconception Health Examination Project, established in 2010, included 1 464 523 couples from 220 counties who planned to conceive within 4–6 months of study entry to assess prepregnancy risk factors for birth defects. Participants had comprehensive physical examinations, responded to structured questions, and provided fasting blood samples for biomarker (including glucose) measurements before pregnancy and were followed up until 42 days after delivery. Diabetes was defined as self-reported diagnosed diabetes or fasting glucose concentrations of at least 7·0 mmol/L, and impaired fasting glucose as fasting glucose concentrations 6·1–7·0 mmol/L. Pregnancy outcomes were collected from 1 095 316 mothers between Jan 10, 2010 and Dec 31, 2015. Preterm birth was defined as live birth at 28–37 weeks gestational age, low birthweight as less than 2500 g regardless of gestational age, and macrosomia as birthweight of more than 4000 g. We used multivariate logistic regression models to estimate the odds ratios (ORs) and 95% CIs, with adjustment for covariates using normal live births as the denominators. This study was approved by the Institutional Research Review Board at the National Health and Family Planning Commission and National Research Institute for Family Planning. Written informed consent in Chinese was obtained from all participants or their legal representatives. Findings79 686 preterm births, 15 354 cases of low birthweight, and 33 667 cases of macrosomia were recorded. Compared with women whose blood glucose was less than 6·1 mmol/L before pregnancy, the risk of preterm birth was increased for those with impaired fasting glucose (OR 1·08, 95% CI 1·03–1·13) and those with diabetes (1·15, 1·08–1·22; ptrend<0·0001). The ORs of low birthweight were 1·16 (1·06–1·27) for women with impaired fasting glucose and 1·10 (0·97–1·26) for those with diabetes (ptrend=0·0023). The ORs of macrosomia were 1·00 (0·93–1·08) for those with impaired fasting glucose and 1·20 (1·09–1·31) for those with diabetes (ptrend<0·0001). InterpretationPrepregnancy diabetes and impaired fasting glucose are associated with an increased risk of adverse pregnancy outcomes. Therefore, early screening and preconception care for women with diabetes and impaired fasting glucose are important for optimisation of pregnancy outcomes. FundingFive-twelfth National Science and Technology Support Program.

Maternal Caffeine Consumption during Pregnancy and Risk of Low Birth Weight: A Dose-Response Meta-Analysis of Observational Studies.

Epidemiologic studies have shown inconsistent conclusions about the effect of caffeine intake during pregnancy on the risk of low birth weight (LBW). We performed a meta-analysis and linear-dose response analysis examining the association between caffeine consumption during pregnancy and risk of LBW. PubMed and EMBASE were searched for relevant articles published up to March 2014. Eight cohort and four case-control studies met all inclusion criteria. Using a random-effects model of the twelve studies, the pooled odds ratio (OR) for the risk of LBW comparing the highest versus lowest level of caffeine intake during pregnancy was 1.38 (95% CI: 1.10, 1.73). Linear dose-response analysis showed that every additional 100 mg of caffeine intake (1 cup of coffee or 2 cups of tea) per day during pregnancy was associated with a 3.0% increase in OR for LBW. There was a moderate level of overall heterogeneity with an I-squared value of 55% (95% CI: 13, 76%), and no evidence of publication bias based on Egger’s test (P = 0.20) and the funnel plot. Thus, high caffeine intake during pregnancy is associated with a significant increase in the risk of LBW, and this risk appears to increase linearly as caffeine intake increases.

Levels and determinants of low birth weight in infants delivered under the national health insurance scheme in Northern Ghana.

This research determined the levels and odds ratios for low birth weight (LBW) infants delivered under the National Health Insurance Scheme (NHIS) compared to LBW infants delivered under the previous "Cash and Carry" system in Northern Ghana. Birth records of infants delivered before and after implementation of the NHIS in Northern Ghana were examined. Records of each day's births during the identified periods were abstracted. Days with fewer or no births were accommodated by oversampling from days before or after. Chi squared tests of independence were used to examine the bivariate association between categorical independent variables and LBW. Multiple logistic regression models were used to examine the relationships among selected variables for mothers and infants and the odds ratios for LBW. Infants delivered under NHIS had lower rates of LBW (16.8 %) compared to infants born under Cash and Carry (23.3 %). Mothers who delivered under NHIS were significantly less likely to have infants at LBW (unadjusted OR 0.65; 95 % CI 0.49, 0.86). The rate of LBW among infants delivered under NHIS is significantly lower than among infants delivered under Cash and Carry. The rate of LBW under Cash and Carry in 2000 fell by 27 % in relation to the NHIS in 2010. These findings confirm that the NHIS, which gives pregnant women in Northern Ghana four antenatal visits and access to skilled health professionals for delivery at no cost to the mother, significantly improved birth weight outcomes.

The Association Between Childhood Abuse and Neglect and Clinical Severity in Mood Disorders

The Association Between Childhood Abuse and Neglect and Clinical Severity in Mood Disorders

Umbilical choline and related methylamines betaine and dimethylglycine in relation to birth weight

Low birth weight (LBW) is associated with increased morbidity and mortality for the newborn and risk of chronic disease in adulthood. Choline plays an essential role in the integrity of cell membranes, methylation reactions, and memory development. We examined whether choline, betaine, and dimethylglycine (DMG) concentrations were associated with LBW in Dutch women. Blood was sampled from umbilical cords (UCs) at delivery in singleton pregnancies (n = 1,126). Maternal blood was sampled at 30-34 wk of gestational age (GA) (n = 366). We calculated birth weights standardized for GA and defined LBW as standardized birth weight ≤ 2,500 g. Maternal concentrations were lower as compared with UC concentrations and were not associated with birth weight. UC choline and betaine were inversely associated with birth weight (β = -60 (-89, -31) and β = -65 (-94, -36), respectively), whereas UC DMG was positively associated with birth weight (β = 35 (6.1, 63)). Odds ratios for LBW were 4.12 (1.15, 14.78), 5.68 (1.24, 25.91), and 0.48 (0.09, 2.65) for the highest UC choline, betaine, and DMG quartiles, respectively, as compared with the lowest quartiles. We observed an increased risk of LBW with increased umbilical choline and betaine in venous UC blood. These results might reflect a change in choline consumption or metabolism or a disturbed placental function.

Systematic Review and Meta-analysis on the Effects of Thiopurines on Birth Outcomes from Female and Male Patients with Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) affects people during their prime reproductive years. The thiopurines (6-mercaptopurine and azathioprine), commonly used for induction and maintenance of remission, are U.S. Food and Drug Administration (FDA) pregnancy category D, raising concern for fetal risk. We performed a systematic review and meta-analysis to evaluate the effects of thiopurine exposure during pregnancy or at the time of conception on three measures of fetal risk in women and men with IBD. A systematic search of PubMed and Web of Science using a combination of Mesh and text terms was performed to identify studies reporting birth outcomes from IBD women and men exposed to thiopurines within 3 months of conception and/or during pregnancy. A meta-analysis was performed using the random effects model to pool estimates and report odds ratio (OR) for three outcomes in women: low birth weight (LBW), preterm birth, and congenital abnormalities and one in men: congenital abnormalities. In women with IBD exposed to thiopurines, the pooled ORs for LBW, preterm birth, and congenital abnormalities were 1.01 (95% confidence interval [CI] 0.96, 1.06), 1.67 (95% CI 1.26, 2.20), and 1.45 (95% CI 0.99, 2.13), respectively. In men, the pooled OR for congenital abnormality was 1.87 (95% CI 0.67, 5.25). Thiopurine exposure in women with IBD was not associated with LBW or congenital abnormalities, but was associated with preterm birth. Exposure in men at the time of conception was not associated with congenital abnormalities.

Umbilical Choline and Related Methylamines Betaine and Dimethylglycine in Relation to Birth Weight

Background: Low birth weight (LBW) is associated with increased morbidity and mortality for the newborn and increased risk on chronic diseases in adulthood. Choline has an essential role in the integrity of cell membranes, methylation reactions and memory development.Objective: We examined whether umbilical and maternal choline and related methylamines betaine and dimethylglycine (DMG) concentrations were associated with LBW in Dutch women and newborns.Methods: Blood was sampled from umbilical cords at delivery (n=1126). Maternal blood was sampled at 30-34 weeks of gestational age (n=366). We calculated birth weights standardised for gestational age (SBW) and defined LBW as SBW < 2500 grams.Results: Maternal concentrations of all analytes were lower compared to umbilical cord concentrations. Plasma betaine and DMG between mothers and newborns were strongly correlated. Higher umbilical cord choline and betaine were associated with lower birth weight (β= -60[-89;-31] and β= -65[-94;-36]). Odds ratio for LBW was 4.12 [1.15;14.78] and 5.68 [1.24;25.91] for the highest umbilical choline and betaine quartile respectively compared to the lowest quartiles.Conclusion: In contrast to our expectations, we observed an increased risk of lower birth weight with increased umbilical choline and betaine in venous umbilical cord blood. These results might reflect a change in choline consumption or metabolism or a disturbed placental function.

Impact of Reduced Maternal Exposures to Wood Smoke from an Introduced Chimney Stove on Newborn Birth Weight in Rural Guatemala

Background: A growing body of evidence indicates a relationship between household indoor air pollution from cooking fires and adverse neonatal outcomes, such as low birth weight (LBW), in resource-poor countries.Objective: We examined the effect of reduced wood smoke exposure in pregnancy on LBW of Guatemalan infants in RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects).Methods: Pregnant women (n = 266) either received a chimney stove (intervention) or continued to cook over an open fire (control). Between October 2002 and December 2004 we weighed 174 eligible infants (69 to mothers who used a chimney stove and 105 to mothers who used an open fire during pregnancy) within 48 hr of birth. Multivariate linear regression and adjusted odds ratios (ORs) were used to estimate differences in birth weight and LBW (< 2,500 g) associated with chimney-stove versus open-fire use during pregnancy.Results: Pregnant women using chimney stoves had a 39% reduction in mean exposure to carbon monoxide compared with those using open fires. LBW prevalence was high at 22.4%. On average, infants born to mothers who used a stove weighed 89 g more [95% confidence interval (CI), –27 to 204 g] than infants whose mothers used open fires after adjusting for maternal height, diastolic blood pressure, gravidity, and season of birth. The adjusted OR for LBW was 0.74 (95% CI, 0.33–1.66) among infants of stove users compared with open-fire users. Average birth weight was 296 g higher (95% CI, 109–482 g) in infants born during the cold season (after harvest) than in other infants; this unanticipated finding may reflect the role of maternal nutrition on birth weight in an impoverished region.Conclusions: A chimney stove reduced wood smoke exposures and was associated with reduced LBW occurrence. Although not statistically significant, the estimated effect was consistent with previous studies.