Month of birth and offspring count of women: data from the Southern hemisphere

BACKGROUND: Several studies indicate that the month of birth affects laterreproductive output of women in the Northern hemisphere. METHODS: To investigate whether a comparable but time-shifted effectis also present in the Southern hemisphere where the seasonalvariation of the environment is reversed, we analysed the associationbetween birth month and offspring count in post-reproductiveNew Zealand women. We further examined whether this associationdiffered with the hemisphere of birth as well as the socio-economicbackground. RESULTS: We find that the association between birth month and offspringcount of New Zealand women born in the Southern, albeit notNorthern, hemisphere is a mirror image of the pattern reportedfrom Austrian women: on average, women born during the Southernhemisphere summer months have fewer children than women bornin winter. This association is highly significant within thelowest family income category but insignificant within higherfamily income categories. CONCLUSIONS: This study provides evidence for a causal link between the seasonalityof the environment during the pre- and perinatal period andoffspring count of women. It further indicates that the maincontribution of the birth month effect found in the presentstudy comes from the lowest family income category.     

Increased frequency of cystic fibrosis among infants with jejunoileal atresia

There appears to be an increased frequency of cystic fibrosis (CF) among infants with jejunoileal atresia (JIA). However, the figures vary widely, and no population-based data exist. The purpose of this study was to quantitate the magnitude of the association between JIA and CF in Atlanta using population-based data from 1968 to 1995. Case subjects included all infants with isolated JIA born during 1968–1995 to mothers residing in the five-county metropolitan Atlanta area at the time of birth. To ascertain cases, we reviewed records of the Metropolitan Atlanta Congenital Defects Program (MACDP), a population-based birth defects registry. Caucasian JIA cases were cross-referenced with patients in the CF registry at the Egleston Cystic Fibrosis Center at Emory University to more completely ascertain the diagnosis of CF among JIA cases. During 1968–1995, MACDP ascertained a total of 94 isolated JIA cases, for a birth prevalence of 1.8/10,000 live births. Among the cases, 38 were Caucasian, 52 were African-American, and 4 were of Asian or Hispanic ethnicity. Four of the 38 Caucasian JIA cases (11%) also had CF. The expected number of JIA cases with CF is 0.019 based on the estimated population incidence of 1/2,000 for CF. The observed to expected (O/E) ratio of Caucasian JIA cases with CF is greater than 210 (P < 0.0001). Caucasian infants with JIA have more than 210 times the risk for CF compared with Caucasian infants in the general population. The results of this study have implications for the management of infants born with JIA and genetic counseling for families with affected infants. Am. J. Med. Genet. 78:446–449, 1998. Published 1998 Wiley-Liss, Inc.

1 This article was prepared by a group of United States government employees and non-United States government employees, and as such is subject to 17 U.S.C. Sec. 105.

     

Multifactorial inheritance of non-syndromic macrocephaly

Objective: To reevaluate previous claims that non-syndromic macrocephaly is usually inherited as an autosomal dominant trait. Design: Head size was measured in the parents and sibs of children with non-syndromic macrocephaly. Outcome measures: If autosomal dominant inheritance is involved, the frequency distribution should be bimodal. Results: Head circumference of parents and sibs of the macrocephalic probands had a mean significantly greater than the population norm, and a unimodal distribution. Probands with psychomotor impairment had bigger heads, and more had a history of birth difficulty, than did unimpaired probands. Conclusions: The usual genetic basis for non-syndromic macrocephaly is multifactorial with a polygenic genetic basis, rather than autosomal dominant. Risk of recurrence appears to be much lower than if it would be on the assumption ot autosomal dominant inheritance. Macrocephaly in a parent or sib of an unborn child may present a risk for birth injury to that child. A larger series of patients will be necessary | to resolve this question.     

Genetic epidemiology of cystic fibrosis in Saguenay-Lac-St-Jean (Quebec, Canada)

Cystic fibrosis (CF) is an autosomal recessive disorder with a prevalence at birth estimated at 1/2000-1/2500 livebirths in Caucasian populations. Some 127 CF individuals are known in Saguenay-Lac-St-Jean (SLSJ), a geographically isolated region of Quebec. The prevalence at birth was estimated at 1/902 live borns, and the carrier rate was estimated at 1/15 inhabitants in the SLSJ region. The mean inbreeding coefficient was only slightly elevated in the CF group compared with three control groups, and was due to remote consanguinity. The mean kinship coefficient was 2.4 times higher in the CF group than in the control groups. In SLSJ region, the places of origin of the CF individuals and their parents did not show a clustered nonuniform distribution. Endogamy was not higher in the CF group than in control groups.     

Fatty acids in colostrum from mothers of children at high risk of atopy in relation to clinical and laboratory signs of allergy in the first year of life

BACKGROUND: It remains controversial whether fatty acid (FA) composition of breast milk relates to development of atopy in the infant. This study evaluates FA in colostrum from mothers of children at high risk of atopy in association with atopy at the age of 1 year. METHODS: The FA of colostrum were analyzed for 218 children (60 with low birth weight between 1500 and 2500 g, 84 with a history of maternal atopy, and 74 with an elevated cord blood immunoglobulin (Ig)E of >0.9 IU/ml). Total lipids were extracted, methylated and separated by gas-liquid chromatography. Laboratory screening for allergic sensitization and clinical examination took place within the Leipzig Allergy Risk Children's Study (LARS). RESULTS: Low birth weight was correlated with low percentage levels of 20:2n-6, 22:2n-6, and 22:3n-3 (r = 0.14, P < 0.05; r = 0.14, P < 0.05 and r = 0.20, P < 0.01, respectively) and low gestational age at birth was correlated with low 22:3n-3 (r = 0.15, P < 0.05). There was no association between FA and atopic eczema at the age of 1 year. However, high linoleic acid (LA, 18:2n-6) was linked to high specific IgE against cow's milk protein (P < 0.05), and low docosapentaenoic acid (DPA, 22:5n-3) was associated with elevated total serum IgE (P < 0.05) at the age of 1 year, respectively. CONCLUSIONS: The polyunsaturated fatty acid composition of colostrum in a high risk newborn population shows associations with atopic sensitization at the age of 1 year and may be predictive for later atopic disease.     

Organization of climbing fibre projections to the cerebellar cortex from trigeminal cutaneous afferents and from the SI face area of the cerebral cortex in the cat.

1. In cats anaesthetized with pentobarbitone, the projection of climbing fibres (CFs) to the cerebellar cortex from trigeminal cutaneous branches and from the face area of the sensorimotor (SI) cortex was mapped, using the technique of laminar field potential analysis. 2. The CF projections from both the trigeminal nerve and the SI face area were found to be localized to the same cerebellar folia, viz. chiefly the ipsilateral lobule HVI, with a small overlap on to the adjacent folia of lobule V and crus Ia of HVIIA. Frequently a projection from the superficial radial nerve to part or all of this area, was also found. 3. A correspondence in the distribution and amplitudes of CF potentials evoked at most points by stimulation of the trigeminal nerve and the SI cortex was found. This implies a convergence of afferents from these two sources at or before the inferior olive. 4. In more than half of the cats, a small area of the cerebellar hemisphere was found, in which contralateral as well as ipsilateral trigeminal stimulation would evoke CF potentials. Usually inputs from the superficial radial nerve and the SI cortex also converged upon this area. 5. The organization of CF projections from trigeminal and superficial radial nerve afferents to the cerebellar hemisphere was found to occur in the same 'patchy' pattern of somatotopy that has been described for spinal nerve inputs to the anterior lobe. 6. One constant factor was found in the pattern of organization of CF projections to this area from cutaneous afferent nerves. That is, only the afferents from overlapping areas of skin projected to a given recording point: no instance of CF projections from trigeminal branches innervating discontinuous skin areas was observed.     

早产男婴和早产女婴的早产率及预后分析

目的探讨早产男婴和早产女婴的早产率及预后。方法198例单胎早产儿的母婴临床资料进行回顾性分析。结果(1)男婴早产率、自然早产率分别为3.25%(115例)、2.43%(86例)均显著高于女婴组的2.40%(83例)、1.73%(60例),P均<0.05。(2)早产男婴母亲的本次孕期先兆流产率15.65%(18例)均明显高于女婴组的6.02%(5例),P<0.05。(3)早产男婴的围产儿死亡率(8.70%)是早产女婴的1.80倍(4.82%)。结论早产男婴的早产率、先兆流产率高,胎儿因素是分娩机制中的一个重要因素。早产男婴的围产儿死亡率相对较高。严禁进行非医学需要的胎儿性别鉴定和选择性别的人工终止妊娠。     

Reproductive attitudes of couples having a child with cystic fibrosis in Brittany (France)

Cystic fibrosis (CF) has an incidence of one in 2,636 livebirths and a carrier rate of one in 26 inhabitants in Brittany. One objective of a major enquiry among parents having a CF child as well as CF adolescents and adults was to evaluate the reproductive behavior of 124 couples attending a CF care center. Knowledge of recurrence risk resulted in deciding against further progeny or in reducing the number of children (average number of children: 1.96; ideal mean number of children: 3.7). Thirty-five percent adopted or changed their method of contraception after the birth of their affected child, but the change was due to the birth of the CF child in only 14.3% of the couples. Prenatal diagnosis (PD) was favored by 95.1%, and 41.2% had used it; 68.6% were in favor of pregnancy interruption for CF and 76.2% would interrupt the pregnancy should PD reveal that their fetus had CF. All 123 respondents thought that genetic counseling was useful, but only 87.1% knew of its availability. Our results are quite different from those previously published. Although results could be population-specific, one cannot exclude the fact that they reflect a change of attitudes among parents, the other studies being much older.     

Late Neuropsychological Outcomes in Preterm Infants of Normal IQ: Selective Vulnerability of the Visual System

Evaluated neuropsychological outcomes in 635 children, ages7 to 10 years, in relation to birth weight group: 1,000 g;1,001–1,500 g; 1,501–2,500 g, and > 2,500 g.The prevalence of low IQ (<85) was related to birth weight.Among children with IQ > 84 (N = 475): (a) Birth weight wasunrelated to Verbal IQ, Performance IQ, Full-scale IQ, or readingachievement; (b) extremely low birth weight (ELBW) childrenachieved more poorly in mathematics than did other birth weightgroups (p < .05); (c) ELBW and very low birth weight childrenperformed more poorly on the Rey-Osterrieth Complex Figure,a complex visual processing task, than did heavier birth weightchildren (p < .05), but performance on the Beery Test ofVisuomotor Integration was not related to birth weight. Resultsare consistent with heightened neurobehavioral vulnerabilityof visual processing to preterm birth.     

Longitudinal changes in family outcomes of very low birth weight

OBJECTIVES: Although children with very low birth weight (VLBW, <1500 g) are at high risk for developmental impairments, we know little about the long-term effects of VLBW on families. This study examined long-term family outcomes and their stability over time. METHODS: Participants were the families of 64 children with <750 g birth weight, 54 with 750-1499 g birth weight, and 66 term-born controls. Family burden and parental distress were assessed annually as part of longitudinal follow-up of the children from mean ages 11-14 years. RESULTS: Family burden and parental distress were higher in the <750 g group than in the term-born group, but differences varied with the child's age and family environment. CONCLUSIONS: The findings document long-term effects of VLBW on families that are moderated by the degree of low birth weight, child's age, and family environment.     

Positive skin tests to aero-allergens and month of birth

The month of birth distribution for 1301 French patients born between 1953 and 1975 with at least one positive skin test was compared to that of the whole population. A chisquare test was performed, and the expected birth month distribution of the groups calculated from the INSEE * data for 1953-1975. All patients underwent skin testing with house dust, Dermatophagoides pternyssinus (Dpt), cat and dog allergens, grass, tree and weed pollens, and moulds. The only study criterion was a positive skin test unrelated to any specific disorder. A significant difference in month of birth distribution was observed 1) for patients with positive skin test to grass pollen, with a high rate of births from January to May, and 2) for patients with mould sensitization, with a low rate of births in April, May and December. Tree and weed pollens, house dust and Dpt showed no significant relation with month of birth. For cat and dog allergens, the observed and expected distributions of birth month were similar. For the whole sensitized population the birth rate tended to be low in December except for the cat and dog sensitized. Our study confirms the well-known seasonal peak of births in the first 5 months of the year for grass pollen sensitized patients. No consistent monthly or seasonal tendency could be statistically demonstrated for other allergens except moulds.     

Outcome and follow-up of children born after IVF-surrogacy

This study addresses various outcomes and follow-up of children born after IVF-surrogacy. Recent reports on perinatal outcome after IVF-surrogacy and on data generated by the Society of Assisted Reproductive Technology (SART) Registry between 1991 and 1995 were examined. A review of recently published perinatal outcomes of children born after IVF-surrogacy, including the developmental information of 110 children after the first 2 years of life, was undertaken. The birth weights for singleton pregnancies following IVF-surrogacy and IVF were similar, whereas the birth weights of twins and triplets born from the IVF-surrogates were significantly heavier than those delivered from conventional IVF patients. Preterm delivery was increased in twin and triplet gestations in all segments analysed. The incidence of low birth weight was significantly lower in children born after IVF surrogacy than in those born after IVF, for all births recorded. The incidence of congenital abnormalities following IVF and IVF-surrogacy was within the expected range for spontaneous conceptions. Speech delays were predominant in the multiple births, but neither speech nor motor delays persisted at 2 years of age in children born after IVF-surrogacy. These findings would imply that a gestational carrier would provide potential environmental benefits for the infant.     

Disease burden due to enterotoxigenic Escherichia coli in the first 2 years of life in an urban community in Bangladesh

A cohort of 321 children was followed from birth up to 2 years of age to determine the incidence of enterotoxigenic Escherichia coli (ETEC) in Bangladesh. The average number of diarrheal days and incidence rates were 6.6 and 2.3/child/year, respectively. ETEC was the most common pathogen and was isolated in 19.5% cases, with an incidence of 0.5 episode/child/year. The prevalence of rotavirus diarrhea was lower (10%). ETEC expressing the heat-stable enterotoxin (ST) was predominant. Strains isolated from diarrheal cases were positive for colonization factors (CFs) in higher frequency (66%) than from healthy children (33%) (P < 0.001). The heat-labile toxin (LT)-positive strains from healthy children were more often CF negative (92%) than those isolated from children with diarrhea (73%) (P < 0.001). In children with symptomatic or asymptomatic infections by CFA/I, CS1 plus CS3, CS2 plus CS3, or CS5 plus CS6 strains, a repeat episode of diarrhea or infection by the homologous CF type was uncommon. Repeat symptomatic infections were noted mostly for LT- and ST-expressing ETEC. ETEC diarrhea was more prevalent in children in the A and AB groups than in those in the O blood group (P = 0.032 to 0.023). Children with ETEC diarrhea were underweight and growth stunted at the 2-year follow-up period, showing the importance of strategies to prevent and decrease ETEC diarrheal morbidity in children.     

Innate inflammatory responses of pediatric cystic fibrosis airway epithelial cells: effects of nonviral and viral stimulation

There is controversy regarding whether cystic fibrosis (CF) airway epithelial cells (AECs) are intrinsically proinflammatory. The objective of the current study was to characterize the inflammatory profiles of AECs from children with CF compared with cells from healthy control subjects. We obtained AECs from healthy children (12) and children with CF (27). Biochemical and functional characteristics were assessed by stimulating cells with IFNγ, LPS, a cocktail referred to as cytomix, which consists of IFNγ, IL-1β, TNF-α, and LPS, or with human rhinovirus (HRV). Cytokine production was assessed using ELISA. Apoptotic responses to HRV infection were measured via production of single-stranded DNA. Our results indicated that CF and healthy cells exhibited similar morphology in monolayer culture. CF cells constitutively produced greater amounts of IL-6, IL-1β, and prostaglandin E(2), but similar levels of IL-8 and soluble intracellular adhesion molecule-1 compared with healthy cells, and this profile was maintained through repeated passage. Stimulation with LPS or cytomix elicited similar levels of IL-8 in CF and non-CF cells. In contrast, exposure to HRV1b resulted in a marked increase in IL-8 production from CF compared with non-CF cells. CF cells also exhibited reduced apoptosis and increased viral replication compared with non-CF cells after exposure to HRV1b. We conclude that CF and healthy AECs have similar basal and stimulated expression of IL-8 in response to proinflammatory stimuli, but elevated IL-8 release in response to HRV infection. The elevated IL-8, together with dampened apoptotic responses by CF cells to HRV, could contribute to augmented airway inflammation in the setting of recurrent viral infections early in life.     

Respiratory syncytial virus prophylaxis in cystic fibrosis: the Canadian registry of palivizumab data (2005–2016)

Respiratory syncytial virus (RSV) may cause severe illness in cystic fibrosis (CF) children, but recommendations vary on prophylaxis. CARESS is a prospective registry of children who received palivizumab in 32 Canadian sites from 2005 to 2016. Demographic data were collected at enrollment and respiratory illness-related events recorded monthly. We reviewed respiratory illness hospitalization (RIH) and RSV hospitalization (RSVH) in CF children aged <?24 months versus those prophylaxed for standard indications (SI; prematurity, chronic lung disease [CLD] and congenital heart disease [CHD]), and complex medical disorders (CM). Of 23,228 children analyzed, 19,452 (83.8%) were SI, 3349 (14.4%) were CM, and 427 (1.8%) were CF. CF children were more likely to be Caucasian, heavier at birth and enrollment, and less likely to have a sibling or live in crowded conditions. CF children were similar to the other groups in daycare attendance, history of atopy, and exposure to smoking. RIH incidences were 4.3% (premature), 13.8% CLD, 11.5% CHD, 11.7% CM, and 6.8% CF. RSVH incidence in CF children was similar to that in the SI and CM groups: 1.1, 1.5, and 2.0% groups respectively. Cox regression analyses showed that compared to CF children, the HRs for RSVH in SI (HR 2.0 95% CI 0.5–8.3, p?=?0.3) and CM (HR 2.4, 95% CI 0.6–9.8, p?=?0.2) did not differ. CF children are equally at risk for RSVH relative to those prophylaxed for other indications. Pending robust evidence from prospective trials, palivizumab could perhaps be considered in the interim, for young CF patients born early during the RSV season with evidence of serious lung disease.     

Brief communication: birth month influences reproductive performance in contemporary women

BACKGROUND: Season of birth has been reported to affect later reproduction in samples of pre-modern women and contemporary men. METHODS: To examine whether the effect of birth date is also valid in contemporary women, we investigated the association between birth month and measures of reproductive performance (number of live-born children, % childless individuals) in a representative sample of contemporary Austrian women. RESULTS: Among reproducing women, birth month is significantly associated with the number of live-born children (n = 2839, P = 0.032). On average, women born in summer months have fewer children than women born during the remainder of the year. No association between birth month and the percentage of childless individuals was found. CONCLUSIONS: As has been reported in pre-modern women, month of birth also appears to affect later reproduction in contemporary women.     

山西省出生缺陷高发区重大体表出生缺陷的流行状况研究

目的了解山西省出生缺陷高发地区目前各种体表出生缺陷患病水平及流行特征.方法以人群为基础对山西省的4个县24种体表重大出生缺陷进行监测.结果 2003年四个县共监测到孕满20周以上的出生11534名,总出生缺陷患病率分别为232.4/万.神经管畸形患病率为138.7/万,占全部出生缺陷病例的59.7%.患病率高于10/万的出生缺陷有7种,依次为:无脑儿(65.9/万)、脊柱裂(58.1/万)、脑积水(47.7/万)、多指(26.0/万)、腭裂(21.7/万)、脑膨出(14.7/万)、唇裂(10.4/万).产妇文化程度低和女性胎婴神经管畸形的患病率显著增高.此外,居住在农村,妇女年龄不足20岁或30岁以上神经管畸形患病率有升高的趋势.结论神经管畸形仍然为山西省出生缺陷高发区最常见的先天畸形,目前其患病率仍然处于我国乃至世界最高的水平.居住在农村、文化程度低、怀孕年龄太小或较大的妇女生育出生缺陷儿的危险性较大.     

Equipoise of recent estimated Down syndrome live births in Japan

To support people with Down syndrome (DS), it is essential to know and predict the number of live births of children with this condition. In this study, we estimated DS live birth rates on the basis of maternal age distribution and numbers of births in the general population, the maternal‐age specific chance for a live birth of a child with DS, and the prenatal diagnosis/termination rate. The total number of live births in Japan decreased to less than 1 million in 2016 and the percentage of women aged 35 years old or over giving birth has increased by sixfold. Prenatal genetic testing in Japan has gradually become more widespread, and 20% of all cases of DS were diagnosed prenatally in 2016. Meanwhile, the annual projected number of DS live births has remained steady at around 2,200 (22 per 10,000 births). In 2016, it was estimated that 70% of all DS babies were born to women of advanced maternal age (AMA). Given that Japan is facing a decreasing birth rate and an aging population, adoption of the practice of prenatal genetic testing for AMA has balanced the number of DS births over the last 7 years from 2010.     

Differential cytokine profile in children with cystic fibrosis

The previously observed occurrence of antineutrophil cytoplasmic autoantibodies (ANCA) in patients who have cystic fibrosis (CF), together with the reported decrease in IgG2, a Th1-controlled isotype, suggests a potential for Th1/Th2 imbalance in CF patients with a possible Th2 predominance. 48 CF patients and 16 controls had levels of IFNgamma, IL-4, and IL-10 measured in supernatants of whole blood cell cultures stimulated by lipopolysaccharide (LPS) and phytohemaglutinine (PHA). The patients were divided into 2 groups: "low responders", having negligible secretion of cytokines (IFNgamma: 10.0-200.0 pg/ml, IL-4: 0.0-0.3 pg/ml) and "high responders", producing high levels of both IFNgamma (500.0-2000.0 pg/ml) and IL-4 (1.0-200.0 pg/ml). There was a statistically significant (P < 0.01) deterioration of lung function measured by an FEV(1) decline by 11.2% over 3 years in the "low responder" group. 10 of 16 "low responders" had chronic lung infections with P. aeruginosa while such infection was less prevalent in the "high responder" group where only 13 of 32 CF patients had positive cultures. A shift towards Th2 response was observed in the "high responder" group as children chronically infected with P. aeruginosa had greater IL-4 production than non-infected CF patients within the same cohort. ANCA autoantibodies were found only in the "high responder" group. Th2 immune response predominance in a subset of CF patients is associated with chronic P. aeruginosa infection.