Sudden Infant Death Syndrome (SIDS) is the third leading cause of infant mortality between birth and the first year of life in the United States. Along with the identification of various maternal risk factors, the role of fetal hypoxia has been hypothesized to be one of many causal factors associated with SIDS. The purpose of this study was to develop a profile of the SIDS infant and assess whether six pregnancy complications consistent with fetal hypoxia were associated with the increased outcome of SIDS. The secondary data analysis of Florida linked birth to death certificate data specific to Hillsborough County and Duval County were analyzed retrospectively for the period of time between 1998 and 2000. Of the 86, 342 births, 69 SIDS cases were identified, 34 in Hillsborough County and 35 in Duval County. A majority of the infants were White males with an average age of death of 80 days. The Chi-Square test for Independence with Cramer's V, odds ratios and 95% confidence intervals were calculated to determine if an association existed between pregnancy complications, specific maternal risk factors and SIDS. Eclampsia was the only statistically significant prenatal complication found in this cohort (OR=4.67: 95% CI 1.49, 14.57). Maternal tobacco use (OR= 3.13: 95% CI 1.83, 5.36) and late initiation into prenatal care were also found to be significant in the SIDS cases, with the greatest risk occuring in women who did not receive prenatal care (OR=4.37: 95% CI 1.38, 13.89). These findings will assist with the development of a profile of infants who are at greater risk of dying of SIDS in Hillsborough County and Duval County as well as contribute to what is currently known about the association between fetal hypoxia and SIDS.

Ph.D., Faculty of Health Sciences, University of the Witwatersrand, 2011 / Fetal Alcohol Spectrum Disorder (FASD) is a preventable cause of intellectual delay. Highly prevalent in South Africa, it has become a public health concern. Effective screening measures to identify women at risk of producing a FASD child is therefore important. This study postulated that a distinctive maternal profile may exist for mothers with FASD infants compared to a comparison group. Consequently, the study investigated the occurrence of maternal depression and its potential association with maternal risk factors and infant development respectively; differences in the profiles of mothers; as well as developmental differences in FASD and No FASD groups of children. An ex-post facto design was implemented, where the sample comprised of dyads that completed initial (infants 9-18 months) and follow-up (children 18-45 months) assessments. Severity of maternal depression (measured on the Beck Depression Inventory); maternal current mood states (measured on the Profile of Mood States) and infant developmental differences (measured with the Griffiths Mental Developmental Scales) were assessed. The results showed no distinct patterns in maternal depression in the FASD versus the No FASD groups; maternal depression was not significantly correlated with infant development; infants with FASD showed impaired overall development, with especially poor social adjustment; and all infants (FASD and No FASD) performed lower than the expected developmental norms. Maternal alcohol use was the only significant covariate associated with infant development. Identifying the predictors of high risk behaviour during pregnancy is complex, where prenatal alcohol exposure cannot be viewed in isolation from contextual factors, as limited resources, historical factors, cultural/community knowledge, a lack of stimulation and malnutrition prevail in many areas of South Africa. Profiling maternal predisposition to prenatal alcohol use is essential in reducing the incidence of FASD in South Africa and implementing social skills intervention programs could aid the long-term adjustment of FASD infants.

Congenital Heart Disease (CHD) is one of the most common birth defects. It is the single most modifiable cause of infant mortality under one year of age. Therefore, the causes of CHD have been extensively researched in the past but the etiology remains largely unknown. Environmental risks, particularly maternal risk factors for congenital cardiac malformation have been evaluated in the original BWIS previously. However, in this research we examined one of the additional risk factors. We sought to determine whether maternal headache during six months prior to conception and throughout gestation until birth is a risk factor for CHD in the BWIS dataset. Among 3274 singleton cases and 3519 controls, a maternal report of headache was found to be associated with a nearly 20% increase in the risk of a congenital heart defect (OR= 1.2 p=0.001). Moreover, any medications use for headache 1-6 months prior to conception increased the risk of abnormal cardiac development by 1.3 fold (OR = 1.3, p=0.0004). Aspirin or aspirin containing analgesics were found to increase the risk for CHD at the defined risk period. According to subgroup analysis, aspirin or aspirin containing analgesics and acetaminophen or acetaminophen containing analgesics were found to be the risk factor for CTD i.e. Conotruncal defects. Furthermore, aspirin or aspirin containing analgesics increased the risk for PVSD i.e. Peri-membranous Ventricular Defect in offspring when the mother uses these drugs 1-6 months prior to conception. Additionally, the risk for CVD i.e. critical valve disease were found to be increased when women were exposed to aspirin or aspirin containing analgesics during third trimester after pregnancy. In conclusion, maternal headache increased the risk for CHD by 20% and the use of headache medications specifically pain relievers during 1-6 months prior to conception modulated type of defect was observed.

Title from PDF of title page. / Document formatted into pages; contains 62 pages. / Thesis (M.S.P.H.)--University of South Florida, 2003. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: Sudden Infant Death Syndrome (SIDS) is the third leading cause of infant mortality between birth and the first year of life in the United States. Along with the identication of various maternal risk factors, the role of fetal hypoxia has been hypothesized to be one of many causal factors associated with SIDS. The purpose of this study was to develop a profile of the SIDS infant and assess whether six pregnancy complications consistent with fetal hypoxia were associated with the increased outcome of SIDS. The secondary data analysis of Florida linked birth to death certificate data specific to Hillsborough County and Duval County were analyzed retrospectively for the period of time between 1998 and 2000. Of the 86, 342 births, 69 SIDS cases were identified, 34 in Hillsborough County and 35 in Duval County. / A majority of the infants were White males with an average age of death of 80 days. The Chi-Square test for Independence with Cramer's V, odds ratios and 95% confidence intervals were calculated to determine if an association existed between pregnancy complications, specific maternal risk factors and SIDS. Eclampsia was the only statistically significant prenatal complication found in this cohort (OR=4.67: 95% CI 1.49, 14.57). Maternal tobacco use (OR= 3.13: 95% CI 1.83, 5.36) and late initiation into prenatal care were also found to be significant in the SIDS cases, with the greatest risk occuring in women who did not receive prenatal care (OR=4.37: 95% CI 1.38, 13.89). These findings will assist with the development of a profile of infants who are at greater risk of dying of SIDS in Hillsborough County and Duval County as well as contribute to what is currently known about the association between fetal hypoxia and SIDS. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Thesis (MPH.) -- University of Limpopo, 2022 / Background: Stillbirth rates are a health problem and they cause distractions in the families. There are more than 5 million perinatal deaths occurring each year, ending preventable stillbirths and neonatal deaths continues to form a significant part of the international public health agenda beyond 2015. There are several risk factors which are associated with stillbirths and this could be classified as maternal, foetal and external risk factors. Therefore, the focus of the study was on the prevalence and determinants of stillbirths in Dilokong Hospital of the Limpopo Province. Methods: A retrospective descriptive study was conducted which followed a quantitative approach. This study used secondary data from patient clinical records from the maternity ward in Dilokong Hospital. Comparison between groups for continuous and categorical variables was performed using student t-test, and chisquare test, respectively. P-value less than 0.05 at 95% confidence level was regarded as significant. Findings: The prevalence of stillbirth amongst women who delivered at Dilokong hospital between period 2016 and 2019 was 13.5 % (CI: 0.12 – 15.2). The prevalence of stillbirth is stratified by year and it shows that highest prevalence was in 2018 at 42.5% followed by 2017, 2019 and 2016 at 23.2%, 19.7% and 14.6 respectively. The prevalence of stillbirth increased with increasing maternal age from 0.4% in the age group ≤14 years to 26.2% then decreased to 21.5% in the age group 30 – 34 years. The prevalence of macerated stillbirth between period 2016 and 2019 was 11.0%, for fresh stillbirth was 2.6 %. There was significant association of age, marital status of pregnant women, level of education, parity, gravidity, syphilis and HIV status. Older women at age 18 years and above were 1.4 times more likely to have stillbirth and 1.9 times more likely to have fresh stillbirth at p<0.05. Single women were 3.3 times more likely to have stillbirth and 3 times more likely to have macerated stillbirth as compared to married women. Fresh stillbirth was not significantly associated with marital status of pregnant women. Educational level was significantly associated with both stillbirth and macerated stillbirth as those women with no education or having primary educational level were 12.3 times more likely to have stillbirth and 14 times more likely to have macerated stillbirth as compared to women with tertiary educational level. vi Women who had pregnancies that have each resulted in the birth of an infant capable of survival (parity) for four or more times were 2.4 times more likely to have stillbirth and women who were in their fifth or more pregnancies (gravida) were 1.8 times more likely to have stillbirth and 3 times more likely to have fresh stillbirth. Lastly, women who had tested positive for syphilis were 4.1 times more likely to have stillbirth and 3.7 times more likely to have macerated stillbirth and women who were HIV positive were 3.1 times more likely to have stillbirth and 2.3 times more likely to have macerated stillbirth. CONCLUSION: The prevalence of stillbirth was very high in the current study and there is a need for studies on stillbirth and related factors in rural areas of Limpopo Province. This study showed that maternal age, low educational level, marital status of pregnant women, high parity, gravidity, syphilis and HIV status were statistically associated with stillbirth. The factors associated with stillbirth in the current study are preventable if quality focused antenatal care, intrapartum care is provided. Therefore, identification of pregnancy complications and facilitation of proper method of delivery is key to improve quality of care. Efforts to reduce unacceptably high stillbirth in the current study are needed. This study recommends that pregnant mothers need to be educated about the dangers in pregnancy and importance of antenatal visits.

Cleft lip with or without cleft palate (CLP) is an ongoing public health issue across the globe, and in the United States. The estimated number of babies born each year in the United States with cleft palate (CP) is about 2,650, while CLP affects approximately 4,440 babies. The purpose of this quantitative cross-sectional study was to determine if there is a relationship between CLP and maternal characteristics such as reproductive history (advanced maternal age, maternal obesity, prenatal visits, month prenatal care began, number of pregnancies, gestational age at birth, assisted reproductive technology used, gestational diabetes, and hypertension), socioeconomic status of the mother (marital status, education, mother's race, payment source for delivery, and place where birth occurred), and admission to the Neonatal Intensive Care Unit (NICU) in U.S. hospitals from January 2016 to December 2016. The epidemiological triad theory served as the study's framework. A secondary dataset from the National Vital Statistics System was used for this study. Logistic regression was used to test the hypothesized associations. Results indicated that many maternal characteristics such as mother's age (p = .000), maternal obesity (p = .020), number of prenatal visits (p = .001), total birth order (p = .001), gestational age at birth (p = .000), gestational diabetes (p = .002), and gestational hypertension (p = .032), mother's education (p = .000), marital status (p = .018), race (p = .000), and admission to NICU (p = .000) were significantly associated with CLP. Results of this study may help health care professionals identify the determinants of the risk of CLP so as to design and implement effective CLP preventive measures among United States populations that are disproportionately affected by this condition.

L’étiologie de l’obésité infantile est multifactorielle et complexe. Le patrimoine génétique tout comme l’environnement d’un enfant peuvent favoriser l’apparition d’un surplus de poids. C’est pourquoi plusieurs études se sont penchées sur le lien entre l’environnement familial et en particulier le rôle de la mère et le risque d’obésité chez l’enfant. L’objectif est de mieux comprendre quels sont les facteurs de risque maternels spécifiques à chaque population afin de mieux prévenir ce fléau. Ce projet a donc cherché à identifier quelles sont les relations entre les facteurs de risque maternels et l’indice de masse corporelle d’enfants québécois avec surcharge pondérale. Parmi les facteurs de risque étudiés, on note des liens entre le niveau de scolarité de la mère, son statut familial et son niveau d’insécurité alimentaire. Sur le plan cognitif et comportemental, le lien entre l’indice de masse corporelle (IMC) de l’enfant et la perception maternelle du poids de son enfant ainsi que le niveau de restriction alimentaire maternel ont également été analysés. Au total, 47 entrevues ont été complétées par téléphone auprès des mères d’enfants obèses ou en embonpoint grâce à un large questionnaire destiné à décrire le profil des familles consultant les cliniques externes du CHU Ste Justine. Les tests de Fisher pour les variables catégorielles, le test de T de comparaison des moyennes du Z-score de l’IMC des enfants ont permis d’effectuer les analyses statistiques. Les résultats obtenus démontrent qu’un lien existe entre le niveau de scolarité maternel et la présence d’insécurité alimentaire. De même, il a été possible de constater que les enfants avec une mère restrictive des apports alimentaires de leur enfant avaient un Z-score de l’IMC significativement plus élevé. Ces résultats suggèrent qu’il existe des liens entre le profil socio-économique et comportemental de la mère et le surplus de poids de l’enfant. Des tests auprès d’un plus large échantillon seront nécessaires afin de confirmer ces résultats, l’objectif étant, entre autres, de mieux cibler les enfants à risque d’embonpoint ou d’obésité et de mieux outiller les professionnels de la santé en contact avec ces familles. / The etiology of childhood obesity is multifactorial and complex. Both the genetic inheritance and the environment of the child can contribute to overweight. As a result several studies have focused on the link between the family environment and in particular the role of the mother, and the child’s risk of obesity, in order to understand the maternal risk factors specific to each type of population and prevent this public health problem. This project aims to identify the relationships between maternal risk factors and the body mass index of overweight Quebecois children. Among the risk factors studied, relationship were observed among the mother’s level of education, her family status and the level of food insecurity. On the cognitive and behavioral level, we analysed the relation between the child’s body mass index (BMI) and the maternal perception of the child’s weight as well as the maternal level of dietary restriction. Forty seven telephone interviews were completed with mothers of obese or overweight children with a large questionnaire aimed to describe the profile of the family during their visit to Sainte Justine Hospital outpatient clinic. The tests of Fisher for category-specific variables and the T test for the comparison of the averages of children’s BMI Z-score were used to perform the statistical analyses. The results show that there is a significant correlation between the mother’s level of education and the presence of food insecurity in families of overweight children. Concerning the cognitive aspect, children whose mother restricted their food consumption had obtained a significantly higher BMI Z-score than those whose mother did not restrict food. These results suggest that there are links between the socioeconomic and behavioural profil of the mother and the child’s body mass index. Tests taken over a larger sample will be necessary in order to confirm those results. The objective, among other things, is to better target children with risks regarding stoutness or obesity and to improve tools for health professionals that are in contact with those families.

L’étiologie de l’obésité infantile est multifactorielle et complexe. Le patrimoine génétique tout comme l’environnement d’un enfant peuvent favoriser l’apparition d’un surplus de poids. C’est pourquoi plusieurs études se sont penchées sur le lien entre l’environnement familial et en particulier le rôle de la mère et le risque d’obésité chez l’enfant. L’objectif est de mieux comprendre quels sont les facteurs de risque maternels spécifiques à chaque population afin de mieux prévenir ce fléau. Ce projet a donc cherché à identifier quelles sont les relations entre les facteurs de risque maternels et l’indice de masse corporelle d’enfants québécois avec surcharge pondérale. Parmi les facteurs de risque étudiés, on note des liens entre le niveau de scolarité de la mère, son statut familial et son niveau d’insécurité alimentaire. Sur le plan cognitif et comportemental, le lien entre l’indice de masse corporelle (IMC) de l’enfant et la perception maternelle du poids de son enfant ainsi que le niveau de restriction alimentaire maternel ont également été analysés. Au total, 47 entrevues ont été complétées par téléphone auprès des mères d’enfants obèses ou en embonpoint grâce à un large questionnaire destiné à décrire le profil des familles consultant les cliniques externes du CHU Ste Justine. Les tests de Fisher pour les variables catégorielles, le test de T de comparaison des moyennes du Z-score de l’IMC des enfants ont permis d’effectuer les analyses statistiques. Les résultats obtenus démontrent qu’un lien existe entre le niveau de scolarité maternel et la présence d’insécurité alimentaire. De même, il a été possible de constater que les enfants avec une mère restrictive des apports alimentaires de leur enfant avaient un Z-score de l’IMC significativement plus élevé. Ces résultats suggèrent qu’il existe des liens entre le profil socio-économique et comportemental de la mère et le surplus de poids de l’enfant. Des tests auprès d’un plus large échantillon seront nécessaires afin de confirmer ces résultats, l’objectif étant, entre autres, de mieux cibler les enfants à risque d’embonpoint ou d’obésité et de mieux outiller les professionnels de la santé en contact avec ces familles. / The etiology of childhood obesity is multifactorial and complex. Both the genetic inheritance and the environment of the child can contribute to overweight. As a result several studies have focused on the link between the family environment and in particular the role of the mother, and the child’s risk of obesity, in order to understand the maternal risk factors specific to each type of population and prevent this public health problem. This project aims to identify the relationships between maternal risk factors and the body mass index of overweight Quebecois children. Among the risk factors studied, relationship were observed among the mother’s level of education, her family status and the level of food insecurity. On the cognitive and behavioral level, we analysed the relation between the child’s body mass index (BMI) and the maternal perception of the child’s weight as well as the maternal level of dietary restriction. Forty seven telephone interviews were completed with mothers of obese or overweight children with a large questionnaire aimed to describe the profile of the family during their visit to Sainte Justine Hospital outpatient clinic. The tests of Fisher for category-specific variables and the T test for the comparison of the averages of children’s BMI Z-score were used to perform the statistical analyses. The results show that there is a significant correlation between the mother’s level of education and the presence of food insecurity in families of overweight children. Concerning the cognitive aspect, children whose mother restricted their food consumption had obtained a significantly higher BMI Z-score than those whose mother did not restrict food. These results suggest that there are links between the socioeconomic and behavioural profil of the mother and the child’s body mass index. Tests taken over a larger sample will be necessary in order to confirm those results. The objective, among other things, is to better target children with risks regarding stoutness or obesity and to improve tools for health professionals that are in contact with those families.