Are incidence and severity of clubfoot related to the season of birth?

Background

This study was designed to determine whether the occurrence of clubfoot follows a seasonal pattern in neonates from eastern and south-eastern China and to speculate the potential etiology of clubfoot.

Methods

We reviewed 239 neonates with clubfeet during a period of 4 years as well as the monthly neonatal population of the Sixth National Population Census. Seasonal variations in terms of month of birth and severity were analyzed.

Results

The incidence of clubfoot in neonates from eastern and south-eastern China showed seasonal variations, and the incidence was higher in autumn with a reference to the average birth rate in this corresponding area. No significant difference was found in severity of clubfoot.

Conclusions

This seasonal pattern is of significant value to further understanding the etiology and pathogenesis of clubfoot in the corresponding area of China.

     

How is maternal recollection of the birth experience related to the behavioral and emotional outcome of preterm infants?

OBJECTIVES: To investigate how mother's recollections of birth experiences and first contact with the newborn relate to the child's behavioral and emotional problems at five to six years of age. METHODS: The study included 28 mothers of preterm (birth weight 相似文献   

Does the duration of oxygen dependence after birth influence subsequent respiratory morbidity?

The relationship of respiratory morbidity at follow up to the development and type of neonatal chronic lung disease has been assessed. Three groups, each of ten infants matched for gestational age and gender, were compared. Group A had Type I chronic lung disease and group B bronchopulmonary (BPD), the most severe form of neonatal chronic lung disease (Type II CLD); group C had developed neither Type I or Type II CLD. Group B compared to group A compared to group C required a significantly longer duration of oxygen therapy on the neonatal unit. All three groups were prospectively followed; the occurrence of symptoms was documented in each of the first 3 years of life and lung function was measured using a plethysmographic technique at the end of year 1. In all 3 years a significantly greater proportion of groups A and B were symptomatic compared to group C, but there was no significant difference in the proportion so affected between groups A and B. Airway resistance was higher in both groups A and B compared to C but only reached statistical significance on comparing groups A and C. We conclude oxygen dependency beyond 1 month of age, irrespective of the development of BPD, significantly increases respiratory morbidity at follow up.     

Can neurobehavioral examination predict the presence of cerebral injury in the very low birth weight infant?

This study examined in a regional cohort of 66 term age very low birth weight infants, the relationship between qualitative magnetic resonance imaging (MRI) measures of cerebral white and gray matter abnormalities and infant neurobehavioral functioning assessed by structured neurological examination. The diagnostic utility of the Dubowitz neonatal neurological examination in identifying children with severe cerebral abnormalities was also evaluated. Examination results revealed the presence of high rates of neurological abnormality, with 60% of infants scoring in the suboptimal range relative to infants born full term. Linear associations were found between the severity of structural cerebral abnormality on MRI and the quality of clinically rated infant neurobehavioral functioning, with increasing abnormalities being significantly associated with poorer neurological functioning. In particular, white matter abnormalities were significantly associated with lower mean tone and tone pattern scores and a tendency toward lower mean reflex scores. Gray matter abnormalities were significantly associated with lower tone and tone pattern scores and a tendency toward lower spontaneous movements and orientation/behavior scores. Finally, the Dubowitz Neonatal Neurological Examination was found to have relatively good sensitivity (88%; negative predictive value, 92%) but poor specificity (46%; positive predictive value, 34%) for identifying children with significant MRI abnormalities. Implications of these findings for the neurological evaluation of the very low birth weight infant are discussed.     

Diagnosis of congenital toxoplasmosis at birth: what is the value of testing for IgM and IgA?

Recommandations vary on the best combination of tests to use for the diagnosis of subclinical congenital toxoplasmosis at birth. The diagnostic accuracy of IgM and IgA tests was assessed in the context of routine clinical practice on 233 newborns with congenital toxoplasmosis and 661 healthy controls. IgM/IgA sensibility and specificity were compared in cord and postnatal samples. Both tests were considerably more specific in neonatal blood (IgM: 98%; IgA: 100%) than in cordblood (IgM: 85%; IgA: 88%). Sensitivity for IgM and IgA was not significantly different in neonatal blood (61% and 60%, respectively) and cord blood (67% and 54%, respectively). Combining IgM and IgA increased the overall sensitivity to 73% without any significant loss in specificity (98%). The influence of the date of maternal infection on the sensitivity and negative predictive value was also clearly demonstrated. Conclusion Because of their relatively low cost compared to more sophisticated methods, IgM and IgA tests should remain the main method for the routine diagnosis of congenital toxoplasmosis although follow up is essential to identify the Ca. 25% of infected children who are missed at birth on the basis of these tests. Received: 13 August 1998 / Accepted: 9 March 1999     

Are domestic violence and the excessive use of alcohol risk factors for preterm birth?

Violence has been associated with adverse pregnancy outcome, which led us to determine whether patients who deliver preterm, experience more domestic violence than those who deliver at term. Two groups of patients were assessed, a preterm labour group and a low-risk group.A total of 229 patients were interviewed: 99 in the low-risk (LR) group and 130 in the preterm labour (PTL) group. The PTL group experienced significantly more violence throughout their lives than the LR group. Experiences of violence within the last year or during the pregnancy were also higher for the PTL group. This group smoked significantly more cigarettes per day, used more alcohol, and had a higher incidence of syphilis than the LR group. Violence alone does not seem to cause PTL directly, but is part of a low socioeconomic lifestyle. The fact that alcohol-use is so high among these women needs to be addressed and the need for education on values and respect, family planning use, and low-risk sexual behaviour is once again challenged.