Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort

Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities. However, little is currently known about the association of the separate or concomitant use of alcohol and tobacco with infant motor and cognitive development. Thus, the objective of the present study was to investigate the association between maternal consumption of alcohol and/or tobacco during pregnancy and the motor and cognitive development of children starting from the second year of life. The study included 1006 children of a cohort started during the prenatal period (22-25 weeks of pregnancy), evaluated at birth and reevaluated during the second year of life in 2011/2013. The children were divided into four groups according to the alcohol and/or tobacco consumption reported by their mothers at childbirth: no consumption (NC), separate alcohol consumption (AC), separate tobacco consumption (TC), and concomitant use of both (ACTC). The Bayley Scale of Infant and Toddler Development Third Edition screening tool was used for the assessment of motor and cognitive development. Adjusted Poisson regression models were used to determine the association between groups and delayed development. The results indicated that only the ACTC group showed a higher risk of motor delay, specifically regarding fine motor skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol or tobacco consumption was not associated with delayed gross motor or cognitive development. However, the concomitant use of the two substances increased the risk of delayed acquisition of fine motor skills.     

Alcohol during pregnancy and atopic dermatitis in the offspring

BACKGROUND: There is evidence that antenatal factors play a role in the development of atopic dermatitis (AD). However, little is known about the effects of maternal lifestyle factors during pregnancy on the risk of AD in the offspring. OBJECTIVE: To investigate the effect of alcohol consumption during pregnancy on the incidence of AD in the offspring. METHODS: A total of 24 341 mother-child pairs enrolled in the Danish National Birth Cohort were followed prospectively. Information about alcohol consumption was obtained by interview at 12 and 30 weeks of gestation. Information about symptoms, time of onset, and doctor's diagnosis of AD in the offspring was obtained by interview at 18 months of age. The effect of alcohol consumption during pregnancy on the incidence of AD was analysed by Cox regression allowing for different effects of alcohol before (early infancy) and after 2 months (60 days) of age. RESULTS: Alcohol during pregnancy was associated with a significant and dose-dependent increased risk of AD in early infancy. This effect was mainly seen in high-risk infants (two parents with allergic disease). Thus, the highest risk of AD in early infancy was seen in high-risk infants of mothers who consumed four or more drinks per week at 30 weeks of gestation (adjusted relative risk 4.2, 95% confidence interval 1.7-10.1). There was no effect of alcohol during pregnancy beyond early infancy. CONCLUSIONS: The results suggest that alcohol during pregnancy increases the risk of early-onset AD in predisposed infants.     

Combined effects of chronic alcohol consumption and physical activity on bone health: study in a rat model

Chronic alcohol consumption may be deleterious for bone tissue depending on the amount of ethanol consumed, whereas physical activity has positive effects on bone. This study was designed to analyze the effects of moderate alcohol consumption on bone in trained rats. 48 male Wistar rats were divided into four groups: control (C), alcohol (A), exercise (E) and alcohol + exercise (AE). A and AE groups drank a solution composed of water and ethanol. E and AE groups were trained for 2 months (treadmill: 40 min/day, 5 times/week). Body composition and bone mineral density (BMD) were assessed by dual X-ray absorptiometry and microarchitectural parameters using micro-computed tomography. Serum osteocalcin and CTx were determined by ELISA assays. The body weight and lean mass gain were lower in group A, while the fat mass gain was lower in exercised groups. BMD and BMC were higher with alcohol after body weight adjustment. Trabecular thickness was significantly higher in AE and A groups compared to C and E; cross-sectional area was larger in A and C groups compared to AE and E. CTx levels were higher in A compared to C and in AE and E versus C and A. Osteocalcin levels were significantly greater in AE and E groups versus C and A. In conclusion, the light to moderate alcohol consumption over a short period increased the trabecular thickness, BMC and BMD in A and AE groups. However, we observed alterations in bone remodeling and body composition with alcohol, at the end of the protocol, which did not appear when alcohol was combined to exercise.     

Femoral bone mineral density and bone mineral content in bromocriptine-treated pregnant and lactating rats

Since hyperprolactinemia was found to induce osteopenia in the metaphysis of long bone in non-mated female rats, pregnant and lactating rats with sustainedly high plasma prolactin (PRL) levels might also exhibit some changes in their long bones. We performed a longitudinal study in pregnant, lactating and post-weaning rats, using dual-energy X-ray absorptiometry to demonstrate site-specific changes (i.e., metaphysis vs. diaphysis) in femoral bone mineral density (BMD) and content (BMC). The results showed that femoral metaphyseal BMD and BMC were higher when compared to their age-matched controls during pregnancy, before decreasing in late lactation and post-weaning. On the other hand, femoral diaphyseal BMC increased during pregnancy, early lactating and mid-lactating periods without change during late lactation and post-weaning. After 7 days of bromocriptine administration which inhibited endogenous PRL secretion, the lactation-induced increases in BMC during early and mid-lactating periods were abolished. Moreover, a decrease in metaphyseal BMD during late lactation was restored to the control levels by bromocriptine. However, bromocriptine did not antagonize the pregnancy-induced increases in BMD and BMC. It could be concluded that the effect of PRL on bone was variable during the reproductive periods. While having no effect on femoral BMD and BMC during pregnancy, PRL was responsible for bone gain in early and mid-lactating periods, but induced bone loss during late lactating period.     

A 12-month treatment with tenofovir does not impair bone mineral accrual in HIV-infected children

BACKGROUND: Short-term use of tenofovir (TDF) has been associated with bone mineral loss in adults and children. OBJECTIVE: To assess whether the substitution of stavudine with TDF would result in decreased bone mineral content (BMC) and bone mineral density (BMD) accrual in HIV-infected children. METHODS: The lumbar spine and whole-body BMC and BMD were measured by dual-energy x-ray absorptiometry in 16 HIV-infected children (age range: 6.4-17.9 years) on stable highly active antiretroviral therapy. Bone measurements were obtained 12 months before the switch, at baseline, and 12 months after switching to TDF. Expected changes in bone measurements were calculated from cross-sectional data obtained from 166 healthy children. RESULTS: The BMC and BMD increments observed before switching therapy did not differ from expected increments. Similarly, the changes detected during treatment with TDF did not differ significantly from those calculated in healthy controls. CONCLUSIONS: Substitution to a TDF-containing antiretroviral regimen does not seem to impair bone mineral accrual in children showing a good immunologic response to antiretroviral treatment.     

The relationship of prenatal alcohol exposure and the postnatal environment to child depressive symptoms

OBJECTIVE: This study examined the association between prenatal alcohol exposure and child depressive symptoms, and the mediating effects of maternal and child characteristics. METHODS: Participants were 42 children aged 4-5 years and their biological mothers. Prenatal alcohol consumption was assessed by self-report of maximum drinks per drinking occasion. The Pictorial Depression Scale (PDS) measured child depressive symptoms. Mother-child interactions were assessed using the family interaction puzzle task. RESULTS: Structural equation modeling indicated that prenatal alcohol exposure was associated with more negative child affect. In turn, mothers of more negative children were less emotionally connected to their children, and those children had higher levels of depressive symptomatology. Results could not be explained by current maternal drinking patterns or maternal depression. CONCLUSIONS: Study findings highlight the importance of examining prenatal alcohol exposure as a risk factor in the prediction of childhood-onset depression and the environmental mechanisms that may mediate that relationship.     

Maternal smoking and alcohol consumption during pregnancy as risk factors for sudden infant death

A population based case control study was conducted to examine alcohol consumption and maternal smoking during pregnancy and the risk of SIDS in an Irish population. Each SIDS case (n = 287) was compared with control infants (n = 832) matched for date and place of birth for infants born from 1994 to 2001. Conditional logistic regression was used to investigate differences between Cases and Controls establishing Odds Ratio's (OR) and 95% Confidence Intervals (CI). Mothers who smoked were 3 times more likely to have a SIDS Case, and a dose response effect was apparent, with mothers smoking 1-10 cigarettes/day OR 2.93 (CI 1.50-5.71), and those smoking > 10 cigarettes/day OR 4.36 (CI 2.50-7.61). More Case mothers consumed alcohol during pregnancy than Control mothers and, within drinkers, the amount of alcohol consumed was also greater (p < 0.05). A dose response with frequency of drinking was apparent. The adjusted odds ratio for those consuming alcohol in all three trimesters was 3.59 (CI:1.40-9.20). Both of these risk factors are modifiable and need to be incorporated into antenatal education from a SIDS point of view.     

Assessment of bone mineral status in children with Marfan syndrome

Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder with skeletal involvement. It is caused by mutations in fibrillin1 (FBN1) gene resulting in activation of TGF-β, which developmentally regulates bone mass and matrix properties. There is no consensus regarding bone mineralization in children with MFS. Using dual-energy X-ray absorptiometry (DXA), we evaluated bone mineralization in 20 children with MFS unselected for bone problems. z-Scores were calculated based on age, gender, height, and ethnicity matched controls. Mean whole body bone mineral content (BMC) z-score was 0.26?±?1.42 (P?=?0.41). Mean bone mineral density (BMD) z-score for whole body was -0.34?±?1.4 (P?=?0.29) and lumbar spine was reduced at -0.55?±?1.34 (P?=?0.017). On further adjusting for stature, which is usually higher in MFS, mean BMC z-score was reduced at -0.677?±?1.37 (P?=?0.04), mean BMD z-score for whole body was -0.82?±?1.55 (P?=?0.002) and for lumbar spine was -0.83?±?1.32 (P?=?0.001). An increased risk of osteoporosis in MFS is controversial. DXA has limitations in large skeletons because it tends to overestimate BMD and BMC. By adjusting results for height, age, gender, and ethnicity, we found that MFS patients have significantly lower BMC and BMD in whole body and lumbar spine. Evaluation of diet, exercise, vitamin D status, and bone turnover markers will help gain insight into pathogenesis of the reduced bone mass. Further, larger longitudinal studies are required to evaluate the natural history, incidence of fractures, and effects of pharmacological therapy. ? 2012 Wiley Periodicals, Inc.     

The genetic, environmental and phenotypic correlations of bone phenotypes at the spine and hip in Chinese

BACKGROUND: Bone mineral density (BMD), bone mineral content (BMC), and bone size have been widely studied individually as important risk factors for osteoporotic fracture, but little is known about the correlation and the degree of sharing genetic and environmental factors between the pairs of the three phenotypes. AIM: The study investigated genetic correlation (rhoG), environmental correlation (rhoE) and phenotypic correlation (rhoP) between BMD, BMC and bone size. SUBJECTS AND METHODS: Bivariate variance decomposition analyses were performed in 904 subjects from 287 Chinese nuclear families. RESULTS: Significant rhoE, rhoG and rhoP were detected between BMD, BMC and bone size, except for rhoE between BMD and bone size at the hip (rhoE = 0.121, p = 0.361). Common shared genetic factors explained 86.1% and 60% of BMD and BMC genetic variations at the spine and hip, respectively. However, the genetic and environmental correlations between BMD and bone size were limited. rhoE and rhoG at the spine were 0.392 and 0.381, and at the hip were 0.121 and -0.205, respectively. Only 14.5% and 4.2% of variations between BMD and bone size at the spine and hip may be due to the shared genetic factors. CONCLUSION: The obtained results suggested that bone size may be used as another surrogate phenotype independently of BMD for eventual elucidation of the pathogenesis of osteoporosis because of the limited correlations between BMD and bone size.     

Prevalence and correlates of early onset asthma and wheezing in a healthy birth cohort of 2- to 3-year olds

OBJECTIVE: The combined contribution of neonatal, perinatal, and maternal health, demographic, environmental, and family psychosocial factors to early onset asthma and wheezing in a healthy birth cohort was examined. METHODS: Participants included 1,158 ethnically and socioeconomically diverse parents of 2- and 3-year olds who completed mailed questionnaires. RESULTS: Asthma and wheezing prevalence was 8.4 and 8.1%, respectively. Asthma during pregnancy, smoking in the home, and being male increased risk for asthma diagnosis and wheezing whereas social support minimized risk for both. Shorter gestational age, exposure to violence, and maternal anxiety increased risk for wheezing. The negative impact of smoking in the home was greatest for children with shorter gestational ages and mothers with asthma during pregnancy. CONCLUSION: Findings confirm and extend previous work documenting demographic risks and highlight smoking, violent events, and social support in early onset asthma and wheezing. Findings illustrate the need for ecologically based interventions to treat asthma and wheezing in young children.     

Alcohol consumption during gestation reduces the histamine and triiodothyronine content of rat immune cells

Objective: Different factors acting during pregnancy can cause non-morphological alterations of cells which are manifested later, in adulthood. We studied the effect of maternal alcohol consumption for one day in early pregnancy on the hormone content of immune cells in the adult rat. Methods: Lactating dams were given 15% ethanol in the drinking water for 24 h on the 3rd day post partum, exposing their pups to ethanol in the breast milk. Some of the same dams had been successfully mated on the day of delivery, so that they were also 3 days pregnant on the treatment day, exposing embryos to alcohol on the third day of pregnancy. In 4 month old pups histamine and triiodothyronine (T₃) content of citrate elicited peritoneal immune cells (lymphocytes, monocyte-macrophage-granulocyte group, mast cells) as well as thymic cells were determined by flow cytometry and confocal microscopy using specific antibodies. Results: Alcohol treatment during pregnancy decreased highly significantly the content of both hormones in peritoneal cells of the 4 month old adult animals while it was ineffective by breast feeding after birth. Thymic cells did not show any changes. Conclusion: Since the immune system had not developed at the time of treatment (3rd day of pregnancy), stem cells were presumably imprinted. Our results indicate the deleterious effects of early maternal alcohol consumption on the hormone content of the immune system. Received 13 April 2005; returned for revision 23 May 2005; accepted by I. Ahnfelt-R?nne 2 June 2005     

The impact of alcohol use during pregnancy on maternal responses after birth

The aim of the study was to investigate the influence of alcohol exposure during pregnancy on a mother’s responsiveness towards her infant after birth. Using longitudinal data from a subsample of 687 mother–infant dyads from a UK cohort study (Avon Longitudinal Study of Parents and Children), we investigated the influence of alcohol use during mid- and late pregnancy on observed mother–infant interactions after birth. We found that women who drank one or more glasses of alcohol a week during their mid-trimester of pregnancy were 19?% (95?% CI, 1 to 40?%; p?=?0.033) more likely to show non-responsive behaviour towards their infant 12?months after birth. In contrast, we found that alcohol use during late pregnancy was not associated with later maternal responsiveness. This study adds to the growing evidence for the importance of factors during pregnancy on later maternal responsiveness. Further research is needed to replicate these findings and to examine potential mechanisms linking maternal responsiveness to alcohol use during pregnancy.     

Binge alcohol consumption by non-alcohol – dependent women during pregnancy affects child behaviour,but not general intellectual functioning; a prospective controlled study

Summary Effects of binge ethanol consumption during early gestation on child neurodevelopment have not been elucidated. To study whether binge drinking affects cognitive abilities and behavior of exposed children, a prospective observational study comparing 51 children exposed to binge drinking during the first trimester of pregnancy to 51 children not exposed to any teratogens was conducted. The childrens physical development, intelligence, language abilities and behavior were assessed.Temperament test results showed that children exposed in utero to maternal binge drinking displayed a greater degree of disinhibited behavior and that this behavior was associated with early drinking variables. Although binge alcohol drinking by non-alcohol-dependent women during the first trimester of pregnancy does not appear to affect intelligence or cognitive and language development of young children, binge drinking in pregnancy does increase the likelihood of certain behavioral characteristics that might predispose these children to later behavioral dysfunction.     

Neonatal data on a cohort of 2889 infants born after ICSI (1991-1999) and of 2995 infants born after IVF (1983-1999)

BACKGROUND: To evaluate the safety of ICSI, this study compared data of IVF and ICSI children by collecting data on neonatal outcome and congenital malformations during pregnancy and at birth. METHODS: The follow-up study included agreement to genetic counselling and eventual prenatal diagnosis, followed by a physical examination of the children after 2 months, after 1 year and after 2 years. 2840 ICSI children (1991-1999) and 2955 IVF children (1983-1999) were liveborn after replacement of fresh embryos. ICSI was carried out using ejaculated, epididymal or testicular sperm. RESULTS: In the two cohorts, similar rates of multiple pregnancies were observed. ICSI and IVF maternal characteristics were comparable for medication taken during pregnancy, pregnancy duration and maternal educational level, whereas maternal age was higher in ICSI and a higher percentage of first pregnancies and first children born was observed in the ICSI mothers. Birthweight, number of neonatal complications, low birthweight, stillbirth rate and perinatal death rate were compared between the ICSI and the IVF groups and were similar for ICSI and IVF. Prematurity was slightly higher in the ICSI children (31.8%) than in the IVF children (29.3%). Very low birthweight was higher in the IVF pregnancies (5.7%) compared with ICSI pregnancies (4.4%). Major malformations (defined as those causing functional impairment or requiring surgical correction), were observed at birth in 3.4% of the ICSI liveborn children and in 3.8% of the IVF children (P = 0.538). Malformation rate in ICSI was not related to sperm origin or sperm quality. The number of stillbirths (born > or =20 weeks of pregnancy) was 1.69% in the ICSI group and 1.31% in the IVF group. Total malformation rate taking into account major malformations in stillborns, in terminations and in liveborns was 4.2% in ICSI and 4.6% in IVF (P = 0.482). CONCLUSIONS: The comparison of ICSI and IVF children taking part in an identical follow-up study did not show any increased risk of major malformations and neonatal complications in the ICSI group.     

Maternal disease stage and child undernutrition in relation to mortality among children born to HIV-infected women in Tanzania

OBJECTIVE: To examine whether maternal HIV disease stage during pregnancy and child malnutrition are associated with child mortality. DESIGN: Prospective cohort study in Tanzania. METHODS: Indicators of disease stage were assessed for 939 HIV-infected women during pregnancy and at delivery, and children's anthropometric status was obtained at scheduled monthly clinic visits after delivery. Children were followed up for survival status until 24 months after birth. RESULTS: Advanced maternal HIV disease during pregnancy (CD4 count <350 vs. >or=350 cells/mm) was associated with increased risk of child mortality through 24 months of age (hazard ratio [HR] = 1.74, 95% confidence interval [CI]: 1.32 to 2.30). CD4 count <350 cells/mm was also associated with an increased risk of death among children who remained HIV-negative during follow-up (HR = 2.00, 95% CI: 1.36 to 2.94). Low maternal hemoglobin concentration and child undernutrition were related to an increased risk of mortality in this cohort of children. CONCLUSIONS: Low maternal CD4 cell count during pregnancy is related to increased risk of mortality in children born to HIV-infected women. Care and treatment for HIV disease, including highly active antiretroviral therapy to pregnant women, could improve child survival. Prevention and treatment of undernutrition in children remain critical interventions in settings with high HIV prevalence.     

Attitudes and behavior of pregnant women and health professionals towards alcohol and tobacco consumption

The objective of this study was to identify those factors that influence pregnant women's behavior towards alcohol consumption, so that they could be taken into account when developing alcohol prevention programs in prenatal care. Tobacco use was also studied to identify similarities and differences in attitudes and behavior. A sample of 176 women was interviewed using a structured questionnaire in the prenatal clinics or post-partum wards. Most women were aware that alcohol and tobacco could be harmful to their babies; however heavy drinkers recognized the influence of alcohol in pregnancy less often than the others. Sixty percent of the women, even among the light drinkers, thought that two drinks per day was a reasonable level of consumption during pregnancy. When asked who could be helpful in decreasing their alcohol consumption, most women mentioned their husband, and the doctor or midwife. This is in contrast to our finding that less than 20% of heavy drinkers were advised to reduce alcohol consumption, as compared to 70% of heavy smokers. The results point to the potential for more active interventions on alcohol reduction by health personnel during prenatal care.     

Relationship between body composition and bone mineral content in young and elderly women

PRIMARY OBJECTIVE: To study the relationship between bone mineral content (BMC), lean tissue mass (LTM) and fat mass (FM) in a large sample of young and elderly women. RESEARCH DESIGN: Cross-sectional. METHODS AND PROCEDURES: BMC, LTM and FM were measured by dual-energy X-ray absorptiometry in 2009 free-dwelling Caucasian women aged 63 +/- 7 years (mean +/- SD; range: 37-88 years). The majority of women were postmenopausal (96%). RESULTS: LTM explained 13% more variance of BMC than FM (R(2)(adj) = 0.39 vs 0.26, p < 0.0001) but weight (Wt) explained 5% more variance of BMC than LTM (R(2)(adj) = 0.44, p < 0.0001). The prediction of BMC obtained from LTM and FM (R(2)(adj)= 0.46, p < 0.0001) was only slightly better than that obtained from Wt. After the effects of age, Wt and height (Ht) on BMC were taken into account by multiple regression, the contribution of LTM and FM to BMC was just one-fifth of that of Wt (R(2)(adj) for full models < or =0.56, p < 0.0001). After a further correction for bone area (BA), the contribution of LTM and FM to BMC was just one-tenth of that of BA and not different from that of Wt and Ht on practical grounds (R(2)(adj) for full models = 0.84, p < 0.0001). Thus, after inter-individual differences in age, Wt, Ht (and bone size) are taken into account, the relationship between body composition and BMC is substantially weakened. CONCLUSIONS: In Caucasian women, (1) LTM is a stronger predictor of BMC than FM, but (2) Wt is a better predictor of BMC than body composition for practical purposes, and (3) Wt and body composition are not able to explain more than 46% of BMC variance.     

Relationship between body composition and bone mineral content in young and elderly women

Primary objective : To study the relationship between bone mineral content (BMC), lean tissue mass (LTM) and fat mass (FM) in a large sample of young and elderly women. Research design : Cross-sectional. Methods and procedures : BMC, LTM and FM were measured by dual-energy X-ray absorptiometry in 2009 free-dwelling Caucasian women aged 63 &#45 7 years (mean &#45 SD; range: 37-88 years). The majority of women were postmenopausal (96%). Results : LTM explained 13% more variance of BMC than FM ( R 2 adj = 0.39 vs 0.26, p < 0.0001) but weight (Wt) explained 5% more variance of BMC than LTM ( R 2 adj = 0.44, p < 0.0001). The prediction of BMC obtained from LTM and FM ( R 2 adj = 0.46, p < 0.0001) was only slightly better than that obtained from Wt. After the effects of age, Wt and height (Ht) on BMC were taken into account by multiple regression, the contribution of LTM and FM to BMC was just one-fifth of that of Wt ( R 2 adj for full models &#114 0.56, p < 0.0001). After a further correction for bone area (BA), the contribution of LTM and FM to BMC was just one-tenth of that of BA and not different from that of Wt and Ht on practical grounds ( R 2 adj for full models = 0.84, p < 0.0001). Thus, after inter-individual differences in age, Wt, Ht (and bone size) are taken into account, the relationship between body composition and BMC is substantially weakened. Conclusions : In Caucasian women, (1) LTM is a stronger predictor of BMC than FM, but (2) Wt is a better predictor of BMC than body composition for practical purposes, and (3) Wt and body composition are not able to explain more than 46% of BMC variance.     

A retrospective study of the relationship between childhood asthma and respiratory infection during gestation

BACKGROUND: Wheeze in children has been found to be associated with prior antepartum haemorrhage and raised levels of IgE in cord blood, and acute wheezing episodes are intimately linked with respiratory viral infections. OBJECTIVE: To assess the relationship between maternal presentation with respiratory tract infections in pregnancy and childhood asthma, taking into account factors which could affect presentation. METHODS: This was a case-control study of 200 asthmatic children, 5-16-year-old, age-matched with one control, having no recorded history of wheeze. Data on respiratory tract infections, maternal wheeze, atopy and smoking was collected from primary care records. Deprivation score was assessed according to small residential areas and subjects were equally distributed between four general practices in Plymouth, UK. RESULTS: Presentation with respiratory tract infections during pregnancy was significantly associated with childhood asthma (OR 1.69, 95% confidence interval 1.05-2.77, P = 0.03). The association was marginally stronger for infections in the first trimester (OR 2.30, 95% CI 1.05-5.41, P = 0.04) and for those with cough during pregnancy (OR 2.24, 95% CI 1.23-4.22, P = 0.007). The associations remained significant after allowing for the effect of the independent variables (gender, maternal smoking, maternal wheeze, allergic rhinitis, eczema, asthma treatment in pregnancy and deprivation [Townsend] score), using multiple logistic regression analysis (ORs and 95% CIs 1.91, 1.14-3.22; 2.32, 1.01-5.34 and 2.29, 1.17-4.48, respectively). There was also an association between numbers of presentations with respiratory infections and childhood asthma (test for trend, P = 0.02). CONCLUSIONS: This study has shown an association between presentation with respiratory infection during gestation and childhood asthma. The results were not affected by the other independent variable factors studied and therefore provide some evidence to support the theory that respiratory viruses may be implicated in the aetiology of asthma.     

Heterogeneity of growth of bone in children at the spine, radius and total skeleton.

Bone mineral content (BMC), density (BMD), and size were measured in 202 subjects ranging from 3 to 25 years of age (106 males and 96 females), half of which were children and half young adults. BMC and BMD were measured using single photon absorptiometry at the proximal and distal radius and dual photon absorptiometry at the lumbar spine and the total body. In the pre-pubertal age group (3-9 yrs), no differences were found in BMC nor BMD between males and females at any site. Growth of bone during puberty was characterized by an increase in BMC, bone size and BMD. The percent increase in BMC was greater at the lumbar spine and the total body (+200 to +390 %) than at the radius (+90 to +270 %). The increase in BMC was higher than the increase in BMD (+50 to +90 %). Overall bone growth in the total body was not reflected by changes in BMC of the appendicular skeleton. The increase in BMD was heterogeneous and was higher in the legs than in the arms. In males, the increase in BMC and size during growth was greater than in females resulting in a higher peak bone mass and size in males. The increase in BMD was similar between males and females at the distal radius, the lumbar spine and the total body, but higher at the proximal radius, the arms and the legs in males.(ABSTRACT TRUNCATED AT 250 WORDS)