Search

Copyright of Epidemiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Bisphenol A (BPA) has been associated with variable metabolic effects in animal models. It is unknown whether BPA exposure affects glucose tolerance in pregnancy. We aimed to investigate whether maternal urinary BPA concentration is associated with gestational diabetes mellitus (GDM).Methods: This study included 620 pregnant women from Shanghai, China 2012-2013. Maternal urinary BPA concentration was measured by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). GDM (n = 79) was diagnosed according to the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Multivariate regressions were used to explore the relationships of urinary BPA with GDM, plasma glucose levels in the 75-g 2-hour oral glucose tolerance test (OGTT), birth weight, and ponder index.Results: The geometric mean of BPA was 1.32 μg/L. After adjustment for maternal age, education, husband smoking status, prepregnancy body mass index (BMI), and urinary creatinine concentration, plasma glucose at 2 hours in the 75-g OGTT was 0.36 mmol/L lower (95% confidence index [CI] = -0.73, 0.01) for women with urine BPA in the high versus the low tertile. For each unit increase in natural log-transformed BPA, the odds of GDM was reduced by 27% (odds ratio (OR) = 0.73; 95% CI = 0.56, 0.97), the birth weight decreased by 25.70 g (95% CI = -54.48, 3.07), and ponder index was decreased by 0.02 (100 g/cm) (95% CI = -0.03, 0.00).Conclusions: Higher maternal urinary BPA concentrations were associated with reduced risk of GDM and marginally lower birth weight and ponder index. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate whether women who themselves were born preterm are at increased risk of preterm delivery and, if so, whether known maternal complications of preterm birth such as hypertension or diabetes explain this risk. METHODS: We conducted a population-based cohort study of all women born preterm (51,148) and term (823,991) in Québec, Canada, between 1976 and 1995; after frequency matching 1:2 preterm to term, we examined the relationship of preterm birth between women and their offspring. RESULTS: The study included 7,405 women who were born preterm (554 before 32 weeks of gestation and 6,851 at 32-36 weeks of gestation) and 16,714 women born term, who delivered 12,248 and 27,879 newborns, respectively. Overall, 14.2% of women born before 32 weeks of gestation, 13.0% of 32-36 weeks of gestation, and 9.8% of those born term delivered prematurely at least once during the study period, including 2.4%, 1.8%, and 1.2%, respectively, who delivered very preterm (both P<.001 for trend). After adjustment for factors including own birth weight for gestational age and pregnancy complications, the overall odds of preterm first live delivery associated with being born preterm was elevated by 1.63-fold (95% confidence interval [CI] 1.22-2.19) for women born before 32 weeks of gestation and 1.41-fold (95% CI 1.27-1.57) for those born at 32-36 weeks of gestation relative to women born term. CONCLUSION: Women who themselves were born preterm are at increased risk of delivering their neonates prematurely. This is independent of prematurity risks associated with hypertension and diabetes. [ABSTRACT FROM AUTHOR]

The article presents the findings of a study regarding the effects of early augmentation with oxytocin for slow progress of labor on the delivery method. Early oxytocin augmentation was defined as immediate oxytocin administration when dystocia was defined. It was found that women in the early oxytocin group had higher levels of pain and discomfort in labor. The study revealed that augmentation in labor is associated with an increase in vaginal delivery.

The article presents a study which tests hypothesis that gestational hypertension may have a more benign effect on neonatal outcomes in twins compared with singleton pregnancies, because the elevated pressure in twin pregnancies may partly or merely reflect the extra demand for blood supply. Results of the study indicated that gestational hypertension has more effect on neonatal outcomes in twin compared with singleton pregnancies.

BACKGROUND:: Knowledge of socioeconomic disparities in health is of interest to both the general public and public health policymakers. It is unclear how disparities in birth outcomes by socioeconomic status have changed over time, particularly in settings with universal health insurance and favorable socioeconomic conditions.METHODS:: We identified a cohort of all births (n = 713,950) registered in British Columbia, 1985–2000. We compared rates and relative risks (RRs) of preterm birth, small-for-gestational-age (SGA), stillbirth, and neonatal and postneonatal death across neighborhood-income quintiles from Q1 (richest, the reference) to Q5 (poorest) by 4-year intervals in rural and urban areas. Logistic regression was used to control for maternal and pregnancy characteristics.RESULTS:: Maternal characteristics varied widely across neighborhood-income quintiles in both rural and urban areas. There were moderate and persistent disparities in birth outcomes across neighborhood-income quintiles in urban but not rural areas. The relative disparities in urban areas did not diminish over time for all birth outcomes and actually rose for postneonatal mortality. For example, crude RRs (95% confidence intervals) for Q5 versus Q1 in urban areas for SGA were 1.44 (1.37–1.52) in 1985–1988 and 1.41 (1.33–1.49) in 1997–2000; for postneonatal death, the corresponding results were 1.61 (1.17–2.20) and 2.20 (1.24–3.92), respectively. Most of the observed disparities could not be explained by observed maternal and pregnancy characteristics.CONCLUSION:: Moderate disparities in birth outcomes by neighborhood income persist in urban areas (although not rural areas) of British Columbia, despite a universal health insurance system and generally favorable socioeconomic conditions. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the risks and trends of adverse pregnancy outcomes among mothers in common-law unions versus traditional marriage relationships. METHODS: We conducted a birth cohort-based study of all 720,586 births registered in Quebec for the years 1990 to 1997. RESULTS: The proportion of births to common-law mothers more than doubled from 20% in 1990 to 44% in 1997. Preterm birth, low birth weight, small for gestational age, and neonatal and postneonatal mortality rates increased progressively from mothers legally married, to unions, to lone mothers with father information, to lone mothers without father in common-law formation on birth registrations. Adjusted odd ratios with 95% confidence intervals (CIs) for common-law versus legally married mothers were 1.14 (95% CI 1.11, 1.17) for preterm birth, 1.21 (95% CI 1.18, 1.25) for low birth weight, 1.18 (95% CI 1.16, 1.20) for small for gestational age, 1.07 (95% 0.97, 1.19) for neonatal death, and 1.23 (95% CI 1.04, 1.44) for postneonatal death after controlled for observed individual- and community-level characteristics. The crude and adjusted odds ratios were virtually unchanged over time. CONCLUSION: Pregnancy outcomes are worse among mothers in common-law unions versus traditional marriage relationships but better than among mothers living alone. Modest disparities in pregnancy outcomes in common-law versus traditional marriage relationships have persisted despite the striking rise in common-law unions. [ABSTRACT FROM AUTHOR]

BACKGROUND The timing and magnitude of pubertal growth in relation to fetal, infancy and childhood growth have not been explored.METHODS We used data from a longitudinal growth study of 3650 full-term healthy children who were born in Gothenburg, Sweden in 1973-1975. This analysis included 2738 children with height and weight measurements available both in early life and during adolescence.RESULTS We found that faster linear growth during infancy and childhood was associated with earlier peak height velocity during adolescence. In contrast, greater height and body mass index (BMI) at birth were associated with later peak height velocity in adolescence. Children with faster linear growth and greater BMI in infancy and childhood had less height gain between ages 8 and 18. However, greater height and BMI at birth were associated with more height gain between ages 8 and 18 after adjusting for height and BMI in childhood.CONCLUSIONS Both length and BMI (at birth, in infancy and during childhood) are associated with the timing and magnitude of pubertal growth. Being small at birth is associated with early puberty and a reduced height gain during adolescence. [ABSTRACT FROM AUTHOR]