Purpose To investigate associations between maternal use of selected medications during early pregnancy and the risk of hypospadias in male infants. Methods We used data from the National Birth Defects Prevention Study, a multi-site, population-based, case-control study. We analyzed data from 1,537 case infants with second or third degree isolated hypospadias and 4,314 male control infants born from 1997-2007. Exposure was based on reported use of any prescription or over-the-counter medication or herbal product, for which there were at least 5 exposed cases, from 1 month before to 4 months after conception, excluding topicals, vitamins, minerals, and products for which the components were unknown. Adjusted odds ratios (aORs) and 95% confidence intervals (CI) were estimated using multivariable logistic regression, adjusting for several confounders. Results Of the 195 medication components with at least 5 exposed cases, 89 components met the inclusion criteria and were assessed-28 herbal and 61 non-herbal components. Hypospadias was associated with reported use of cephalexin (aOR 3.06; 95% CI 1.02, 9.18), phenylpropanolamine HCl (aOR 2.68; 95% CI 1.06, 6.80), and ibuprofen (aOR 1.16; 95% CI 1.00, 1.34), in primary analyses. Conclusions We replicated a previously observed association between maternal exposure to phenylpropanolamine HCl and hypospadias. The associations with cephalexin and ibuprofen have not previously been reported. Given the exploratory nature of the analyses, these results should be considered hypothesis-generating. Better understanding of the potential fetal effects will allow clinicians and women of childbearing age to make more informed decisions regarding the use of medications during pregnancy.

The title of this study is: The Swedish assimilation of Scania during the period 1658-1720 - In descriptions of Danish and Swedish popular historians` during 20th century to current view. View of history, nationalism and science .                                                                                                          The study concerns the Swedish, after the conquest of Scania 1658, attempts to induce feelings of Swedish nationality to the people in former Danish province of Scania 1658-1720. The goal of this study was to analyze 20th century and present Swedish and Danish historians’ descriptions of the Swedish and Danish treatment of the native Scania population. The aim was further to describe this historians` view of native rebellious group called “snapphanar” and which measures were taken to assimilate the Scanian population to Swedish realm. Lastly, the historians view above concerning a presence of a native Scanian regional or national identity was studied.                I studied writings of three popular historians from Denmark and from Sweden respectively. To compensate for the influence of nationalism on historiography, sources from three periods during the 20th and the current century was used.                                            In the attempt to reach these main goals I have analyzed the authors’ books and the Swedish and Danish versions of the website Wikipedia. All the popular historians´ mean that the people of Scania felt national identity, except Åberg which mean that they also had a regional identity. The Swedish scholarship had a big influence of making the native population citizens of the Swedish crown. Also the punishment had a big impact, which mainly affected the partisan group called snapphanar. This is in detail described by Wikipedia. 20th century Danish popular historians` describe the abuses on the natives by the Swedish realm while the Swedish historians mostly describe snapphanars rubies on them.

AFRIKAANS: Gedurende die Tweede Wêreldoorlog het die Suid-Afrikaanse Lugmag op verskeie fronte aktief aan die oorlog deelgeneem. Afgesien van maritieme operasies langs die Afrikaanse kus en die vervoer van personeel en voorrade in Afrika en Europa, het die Suid-Afrikaanse Lugmag in drie oorlogsarenas in Oos-Afrika, Noord-Afrika en die Middellandse Seegebied opgetree. Die vraag ontstaan egter: in hoe ‘n mate het die Suid-Afrikaanse Lugmag hulle van hul taak gekwyt? Was die operasies wat hulle uitgevoer het effektief en in welke mate het hulle ‘n bydrae tot die uiteindellke onderwerping van die Spilmoondhede gelewer? Om ‘n antwoord op hierdie vrae te kry, is die optrede van die verskillende Suid-Afrikaanse Lugmageskaders onder die loep geneem. Operasionele krygsvlugte is ontleed en die bydrae van die lugmag in die oorlog is na waarde geskat. Dit is dus duidelik dat dit hier nie bloot om ‘n chronologiese beskrywing van die rol van die Suid-Afrikaanse Lugmag gedurende die Tweede Wêreldoorlog gaan nie, maar veel eerder om ‘n evaluering van hulle werkswyse, operasionele vernuf en doelmatigheid. Nadat die bydraes van die onderskeie Suid-Afrikaanse eskaders ontleed is, het die ondersoeker tot die volgende slotsom geraak. In die eerste plek het die Suid-Afrikaanse Lugmag gedurende die oorlog tot ‘n gedugte gevegsmag ontwikkel wat die vyand die stryd op alle terreine met moderne toerusting sou aansê. In die tweede plek het die Lugmag 'n substantiewe bydrae tot die vernietiging van die Spilmoondhede se magte gelewer. In Oos- en Noord-Afrika sowel as in die Middellandse Seegebied het die Suid-Afrikaanse eskaders uitgemunt in die ondersteuning van land- en seemagoperasies terwyl hulle ook instrumenteel in die verkryging van lugsuperioriteit was. Dit was egter nie alleen die eskaders wat aan die oorlogsfront suksesvol was nie. Eweneens het eskaders belas met maritieme verkenningsvlugte en die vervoer van voorrade ook met eer uit die stryd getree. In sy wese handel dit in die geskiedenis om die verhaal van die mens: sy stryd, sy prestasies, sy oorwinnings; ook sy teleurstellings en sy nederlae. Dit is ook waar ten opsigte van die geskiedenis van die Suid-Afrikaanse Lugmag. Die tydperk onder bespreking gee egter meer blyke van prestasie as teleurstelling, meer blyke van oorwinning as nederlaag met betrekking tot werklike oor logsdeelname maar meer so betreffende persoonlike taakvervulling. Dit kan toegeskryf word aan individuele deursettingsvermoe, ywer, toewyding en idealisme ¬eienskappe wat dien tot herinnering maar ook tot besieling vir toekomstige geslagte. ENGLISH: The South African Air Force actively participated on different fronts during the Second World War. Apart from maritime operations along the African coast and the transport of personnel and material in Africa and Europe, they also operated in three theatres of war in East Africa, North Africa and the countries bordering the Central Mediterranean. However, the question now arises how effective these operations were and to which extent the South African Air Force contributed towards the ultimate destruction of the Axis Powers. To answer these questions the different operations of the Air Force Squadrons during the war were analized and evaluated. The researcher arrived at the following conclusions: In the course of the war the South African Air Force played a substantial role in the subjugation of the Axis Powers. In Eastern and Northern Africa, as well as in the Mediterranean area, the South African Squadrons excelled in assisting land and sea force operations while they were also instrumental in the attainment of air superiority. At the same time squadrons involved in maritime reconnaissance and transportation also took honours for their efforts. This magnificent record was achieved through supreme courage, fortitude and idealism on the part of the men and women involved. South Africa could therefore be justly proud of the more than 44 000 men who volunteered for service in the South African Air Force during the war. / Thesis (DPhil)--University of Pretoria, 2010. / Jurisprudence / unrestricted

The wet method of deep mixing constructs binder-treated soil columns by mixing a binder-water slurry with soft soil in-situ to improve the engineering properties of the soil. The strength of binder-treated soil is affected by characteristics of the in-situ soil and binder, mixing conditions, and curing conditions.The study presented herein aims to investigate the influences of curing time, curing temperature, mix design proportion, organic matter in the soil, and curing stress on the strength of cement-treated soil. Fabricated and natural soft soils were mixed with a cement-water slurry to mimic soil improved by the wet method of deep mixing. Laboratory-size samples were cured under various curing conditions and tested for unconfined compressive strength (UCS).The experimental test results showed that (1) a higher curing temperature and longer curing time generally increase the strength; (2) organic matter in cement-treated soil decrease and/or delay the strength development; and (3) curing stress affects the strength but its effect is influenced by drainage conditions. Based on the test results, strength-predicting correlations for cement-treated soil that account for various curing conditions and organic contents were proposed and validated.This research contributes to advancing the knowledge about the effects of strength-controlling factors of soil improved by cement and to improving the reliability of strength predictions with the proposed correlations. Therefore, the number of sample batches that need to be prepared and tested in a deep mixing project can be reduced, thereby saving the project's time and costs while achieving the target strength of the improved soil. / Doctor of Philosophy / The deep mixing method has gained popularity in the U.S. as a ground improvement technique since the late 1990s. This method involves blending the native soil that needs to be improved with a binder such as cement and/or lime. Two types of deep mixing methods are available, depending on how to add binder to the soil: the wet method injects a binder-water slurry, while the dry method uses a powder form of binder.The binder reacts with water and soil thereby enhancing the engineering properties of the soil. The strength of binder-treated soil is influenced by many factors: (1) characteristics of native soil and binder; (2) mixing conditions (e.g., the amount of binder added and mixing energy); and (3) curing conditions (e.g., curing time, temperature, and stress). In this dissertation, the effects of curing conditions and organic matter in the soil on the strength of cement-treated soil were investigated. Fabricated and natural soils were mixed with cement-water slurry to simulate the wet method, and the prepared samples were cured under various conditions. The strength results of cured samples showed that the characteristics of cement-treated soil are significantly affected by the amount of cement in the mixture, curing time, curing temperature, organic matter in soil, and curing stress. The test results were also used to derive correlations that account for the influences of curing conditions and organic matter.The findings and strength-predicting correlations presented in this research are expected to improve the knowledge about the deep mixing method and the reliability of strength prediction in a deep mixing project. This research, eventually, contributes to reducing time and cost of the project.

No description available.

Man has a limited ability to accurately and continuously analyse large amounts of data. Observers are typically required to monitor displays over extended periods and to execute overt detection responses to the appearance of low probability critical signals. The signals are usually clearly perceivable when observers are alerted to them, but they can be missed in the operating environment. The challenge is to develop a computer application that will accumulate information on a variable, or several variables, over time and identify when the trend in observations has changed. In recent years, there has been a rapid growth in patient monitoring and medical data analysis using decision support systems, smart alarm monitoring systems, expert systems and many other computer aided protocols. The expert systems have the potential to improve clinician performance by accurately executing repetitive tasks, to which humans are ill-suited. Anaesthetists working in the operating theatre are responsible for carrying out a multitude of tasks which requires constant vigilance and thus a need for a smart decision support system has arisen. The decision support tools capable of detecting pathological events can enhance the anaesthetist’s performance by providing alternative diagnostic information. The main goal of this research was to develop a clinically useful diagnostic alarm system using two different techniques for monitoring a pathological event during anaesthesia. Several techniques including fuzzy logic, artificial neural networks, control and monitoring techniques were explored. Firstly, an industrial monitoring system called Supervisory Control and Data Acquisition (SCADA) software is used and implemented in the form of a prototype system called SCADA monitoring system (SMS). The output of the system in detecting hypovolaemia was classified into three levels; mild, moderate and severe using SCADA’s InTouch software. In addition, a new GUI display was developed for direct interaction with the anaesthetists. Secondly, a fuzzy logic monitoring system (FLMS) was developed using the fuzzy logic technique. New diagnostic rules and membership functions (MF) were developed using MATLAB. In addition, fuzzy inference system FIS, adaptive neuro fuzzy inference system ANFIS and clustering techniques were explored for developing the FLMS’s diagnostic modules. The raw physiological patient data acquired from an S/5 monitor were converted to a readable format using the DOMonitor application. The data was filtered, preprocessed, and analysed for detecting anaesthesia related events like hypovolaemia. The accuracy of diagnoses generated by SMS and FLMS was validated by comparing their diagnostic information with the one provided by the anaesthetist for each patient. Kappa-analysis was used for measuring the level of agreement between the anaesthetist’s, SMS’s, and FLMS’s diagnoses. In offline analysis both systems were tested with data from 15 patients. The SMS and FLMS achieved an overall agreement level of 87 and 88 percent respectively. It implies substantial level of agreement between SMS or FLMS and the anaesthetists. These diagnostic alarm systems (SMS and FLMS) have shown that evidence-based expert diagnostic systems can diagnose hypovolaemia, with a substantial degree of accuracy, in anaesthetized patients and could be useful in providing decision support to anaesthetists.

Man has a limited ability to accurately and continuously analyse large amounts of data. Observers are typically required to monitor displays over extended periods and to execute overt detection responses to the appearance of low probability critical signals. The signals are usually clearly perceivable when observers are alerted to them, but they can be missed in the operating environment. The challenge is to develop a computer application that will accumulate information on a variable, or several variables, over time and identify when the trend in observations has changed. In recent years, there has been a rapid growth in patient monitoring and medical data analysis using decision support systems, smart alarm monitoring systems, expert systems and many other computer aided protocols. The expert systems have the potential to improve clinician performance by accurately executing repetitive tasks, to which humans are ill-suited. Anaesthetists working in the operating theatre are responsible for carrying out a multitude of tasks which requires constant vigilance and thus a need for a smart decision support system has arisen. The decision support tools capable of detecting pathological events can enhance the anaesthetist’s performance by providing alternative diagnostic information. The main goal of this research was to develop a clinically useful diagnostic alarm system using two different techniques for monitoring a pathological event during anaesthesia. Several techniques including fuzzy logic, artificial neural networks, control and monitoring techniques were explored. Firstly, an industrial monitoring system called Supervisory Control and Data Acquisition (SCADA) software is used and implemented in the form of a prototype system called SCADA monitoring system (SMS). The output of the system in detecting hypovolaemia was classified into three levels; mild, moderate and severe using SCADA’s InTouch software. In addition, a new GUI display was developed for direct interaction with the anaesthetists. Secondly, a fuzzy logic monitoring system (FLMS) was developed using the fuzzy logic technique. New diagnostic rules and membership functions (MF) were developed using MATLAB. In addition, fuzzy inference system FIS, adaptive neuro fuzzy inference system ANFIS and clustering techniques were explored for developing the FLMS’s diagnostic modules. The raw physiological patient data acquired from an S/5 monitor were converted to a readable format using the DOMonitor application. The data was filtered, preprocessed, and analysed for detecting anaesthesia related events like hypovolaemia. The accuracy of diagnoses generated by SMS and FLMS was validated by comparing their diagnostic information with the one provided by the anaesthetist for each patient. Kappa-analysis was used for measuring the level of agreement between the anaesthetist’s, SMS’s, and FLMS’s diagnoses. In offline analysis both systems were tested with data from 15 patients. The SMS and FLMS achieved an overall agreement level of 87 and 88 percent respectively. It implies substantial level of agreement between SMS or FLMS and the anaesthetists. These diagnostic alarm systems (SMS and FLMS) have shown that evidence-based expert diagnostic systems can diagnose hypovolaemia, with a substantial degree of accuracy, in anaesthetized patients and could be useful in providing decision support to anaesthetists.

To understand the ‘osmorespiratory compromise’ (the trade-off in gill function between ion and respiratory gas exchange) during hypoxia in freshwater fish, a species-specific approach was utilized where general ionoregulatory responses to hypoxia were compared in rainbow trout (Oncorhynchus mykiss, a hypoxia-intolerant freshwater fish), and in two hypoxia-tolerant species (the goldfish Carassius auratus and the Amazonian oscar Astronotus ocellatus). In the latter two species, the dual stress situation of hypoxia plus feeding was also explored. Measurements included unidirectional and net Na^+ flux rates, ammonia excretion rates, net K^+ loss rates, branchial Na^+/K^+- ATPase and H^+- ATPase activities, and branchial morphology by scanning electron microscopy (trout and oscar only). In trout, environmental hypoxia induced complex changes in gill ionoregulatory function, where the direction and magnitude varied with both the extent and duration of the hypoxia regime. The changes in ion-regulation observed in trout in response to hypoxia indicated that the osmorespiratory compromise in this hypoxia-intolerant species was different and more complex compared to its manifestation in oscar and goldfish. This could be attributed to the adaptive physiology of the trout to oxygen-rich environments and its intolerance to low environmental oxygen availability. In both of the hypoxia-tolerant species (oscar and goldfish), there was a general reduction in gill permeability in response to severe hypoxia regardless of feeding regime, rather different from the complex patterns seen in the hypoxia-intolerant trout. However, the effects of feeding on this phenomenon differed between these species. Fed goldfish had elevated branchial fluxes that were effectively turned down during hypoxia compared to baseline flux rates maintained by starved goldfish. In contrast, fed oscars had lower fluxes compared to starved fish. Although both fed and starved fish suppressed their branchial fluxes with severe hypoxia, fed oscars delayed the turning down of fluxes. Overall, our results indicate that feeding exerts opposite effects on gill ionoregulatory function in these two hypoxia-tolerant species, and thereby differentially modulates the responses to hypoxia. These differences may relate to differences in water chemistry. Furthermore, the manifestation of the osmorespiratory compromise during hypoxia appears to be rather different from the phenomenon during exercise. / Thesis / Master of Science (MSc)

Introdução: A exposição do feto a grandes quantidades de componentes tóxicos decorrente do consumo de tabaco e álcool durante a gestação pode acarretar problemas tais como prematuridade, baixo peso ao nascer, aborto e distúrbios no desenvolvimento infantil. Essa associação tem sido recentemente objeto de diversos estudos, porém os resultados são contraditórios devido aos métodos e amostras distintos. Objetivo: Estudar a associação entre o consumo de tabaco e/ou álcool pela gestante e o desenvolvimento infantil entre 13 e 30 meses de idade. Método: Estudo descritivo e analítico, prospectivo, de uma coorte de conveniência iniciada no pré-natal (2010), avaliada no nascimento e a partir do início do segundo ano de vida (2011/2013) no município de Ribeirão Preto, SP. A variável dependente foi o escore médio do desempenho dos filhos nas cinco subescalas da Bayley Scales of Infant and Toddler Development ® third edition - screening test (Bayley - III®). A variável exploratória foi o consumo de tabaco e/ou álcool na gestação, classificado como nenhum consumo, consumo isolado de tabaco ou álcool e consumo concomitante das substâncias. As diferenças entre as médias nos escores das cinco subescalas foram comparadas por meio de regressão linear, em quatro modelos: ajustado pelas faixas etárias de aplicação do teste, propostas no manual técnico da escala (modelo 1); ajustado pelas faixas etárias, por consumo de tabaco e/ou álcool na gestação e características da mãe, da gestação e do parto (modelo 2); ajustado pelas faixas etárias, por consumo de tabaco e/ou álcool na gestação e variáveis do seguimento das crianças (modelo 3); ajustado por todas as variáveis dos modelos anteriores (modelo 4). Resultados: Foram estudadas 998 mulheres, das quais 121 (12,1%) fumaram e 246 (24,6%) referiram ter consumido bebida alcoólica na gravidez. O consumo isolado de álcool foi três vezes maior (18,6%) do que o consumo apenas de tabaco (6,1%). O consumo combinado de tabaco e álcool durante a gestação foi de 6,0%, sem diferença segundo a faixa etária das crianças avaliadas (p>0.05). Não houve diferença nas médias do escore cognitivo segundo o consumo das substâncias em nenhum modelo. Consumo concomitante foi associado a menor média dos escores em ambas as subescalas de comunicação (diferença de 1,12 pontos para comunicação receptiva, IC95% 0,45 a 1,79; 1,19 pontos para comunicação expressiva, IC95% 0,31 a 2,07) e motoras (diferença de 1,20 pontos na subescala motora fina, IC95% 0,55 a 1,85; 0,70 pontos para subescala motora grossa, IC95% 0,13 a 1,28), em torno de um ponto em média, comparado com nenhum consumo de tabaco e álcool. Conclusão: Consumo concomitante de tabaco e álcool teve efeito significativo, porém pequeno, na média dos escores de comunicação e motores, mas não na subescala cognitiva. / Introduction: Fetal exposure to large amounts of toxic compounds resulting from the consumption of tobacco and alcohol during pregnancy can lead to problems such as preterm birth, low birth weight, miscarriage and disorders in child development. This association has recently been the subject of several studies, but the results are contradictory due to differences in methods and samples. Objective: To study the association between the consumption of tobacco and/or alcohol by pregnant women and child development between 13 and 30 months of age. Methods: This is a descriptive and analytical, prospective study of a cohort of convenience initiated prenatally (2010), assessed at birth and from the beginning of the second year of life (2011-2013) in the city of Ribeirão Preto, Brazil. The dependent variable was the mean score of the performance of children in the five subscales of the Bayley Scales of Infant and Toddler Development ® third edition - screening test (Bayley - III®). The explanatory variable was the use of tobacco and/or alcohol during pregnancy rated as no consumption, isolated consumption of tobacco and alcohol and concomitant consumption of the substances. The differences between the mean scores in the five subscales were compared using linear regression in four models: adjusted for age of test application proposed in the technical manual of the scale (model 1); adjusted by age groups, for tobacco and/or alcohol use during pregnancy and maternal characteristics of pregnancy and childbirth (model 2); adjusted by age groups, for tobacco and/or alcohol use during pregnancy and variables related to children in the follow-up (model 3); adjusted for all the variables of the previous models (model 4). Results: 998 women were studied, 121 of them (12.1%) smoked and 246 (24.6%) reported having consumed alcohol in pregnancy. The isolated alcohol consumption was three times higher (18.6%) than the consumption of tobacco only (6.1%). The combined use of tobacco and alcohol during pregnancy was 6.0%, with no difference according to the child\'s age group (p> 0.05). There was no difference in mean cognitive score based on consumption of substances in any model. Concomitant intake was associated with lower mean scores in both communication subscales (1.12 points difference for receptive communication, 95% CI 0.45 to 1.79; 1.19 points for expressive communication, 95% CI 0.31 to 2.07) and motor subscale (1.20 points difference in the fine motor subscale, 95% CI 0.55 to 1.85; 0.70 points for gross motor subscale, 95% CI 0.13 to 1.28), around a point on average compared with no consumption of tobacco and alcohol. Conclusion: concomitant consumption of tobacco and alcohol had a significant effect, however small, in the mean score of the communication and motor subscales, but not in the cognitive subscale.

Introdução: A exposição do feto a grandes quantidades de componentes tóxicos decorrente do consumo de tabaco e álcool durante a gestação pode acarretar problemas tais como prematuridade, baixo peso ao nascer, aborto e distúrbios no desenvolvimento infantil. Essa associação tem sido recentemente objeto de diversos estudos, porém os resultados são contraditórios devido aos métodos e amostras distintos. Objetivo: Estudar a associação entre o consumo de tabaco e/ou álcool pela gestante e o desenvolvimento infantil entre 13 e 30 meses de idade. Método: Estudo descritivo e analítico, prospectivo, de uma coorte de conveniência iniciada no pré-natal (2010), avaliada no nascimento e a partir do início do segundo ano de vida (2011/2013) no município de Ribeirão Preto, SP. A variável dependente foi o escore médio do desempenho dos filhos nas cinco subescalas da Bayley Scales of Infant and Toddler Development ® third edition - screening test (Bayley - III®). A variável exploratória foi o consumo de tabaco e/ou álcool na gestação, classificado como nenhum consumo, consumo isolado de tabaco ou álcool e consumo concomitante das substâncias. As diferenças entre as médias nos escores das cinco subescalas foram comparadas por meio de regressão linear, em quatro modelos: ajustado pelas faixas etárias de aplicação do teste, propostas no manual técnico da escala (modelo 1); ajustado pelas faixas etárias, por consumo de tabaco e/ou álcool na gestação e características da mãe, da gestação e do parto (modelo 2); ajustado pelas faixas etárias, por consumo de tabaco e/ou álcool na gestação e variáveis do seguimento das crianças (modelo 3); ajustado por todas as variáveis dos modelos anteriores (modelo 4). Resultados: Foram estudadas 998 mulheres, das quais 121 (12,1%) fumaram e 246 (24,6%) referiram ter consumido bebida alcoólica na gravidez. O consumo isolado de álcool foi três vezes maior (18,6%) do que o consumo apenas de tabaco (6,1%). O consumo combinado de tabaco e álcool durante a gestação foi de 6,0%, sem diferença segundo a faixa etária das crianças avaliadas (p>0.05). Não houve diferença nas médias do escore cognitivo segundo o consumo das substâncias em nenhum modelo. Consumo concomitante foi associado a menor média dos escores em ambas as subescalas de comunicação (diferença de 1,12 pontos para comunicação receptiva, IC95% 0,45 a 1,79; 1,19 pontos para comunicação expressiva, IC95% 0,31 a 2,07) e motoras (diferença de 1,20 pontos na subescala motora fina, IC95% 0,55 a 1,85; 0,70 pontos para subescala motora grossa, IC95% 0,13 a 1,28), em torno de um ponto em média, comparado com nenhum consumo de tabaco e álcool. Conclusão: Consumo concomitante de tabaco e álcool teve efeito significativo, porém pequeno, na média dos escores de comunicação e motores, mas não na subescala cognitiva. / Introduction: Fetal exposure to large amounts of toxic compounds resulting from the consumption of tobacco and alcohol during pregnancy can lead to problems such as preterm birth, low birth weight, miscarriage and disorders in child development. This association has recently been the subject of several studies, but the results are contradictory due to differences in methods and samples. Objective: To study the association between the consumption of tobacco and/or alcohol by pregnant women and child development between 13 and 30 months of age. Methods: This is a descriptive and analytical, prospective study of a cohort of convenience initiated prenatally (2010), assessed at birth and from the beginning of the second year of life (2011-2013) in the city of Ribeirão Preto, Brazil. The dependent variable was the mean score of the performance of children in the five subscales of the Bayley Scales of Infant and Toddler Development ® third edition - screening test (Bayley - III®). The explanatory variable was the use of tobacco and/or alcohol during pregnancy rated as no consumption, isolated consumption of tobacco and alcohol and concomitant consumption of the substances. The differences between the mean scores in the five subscales were compared using linear regression in four models: adjusted for age of test application proposed in the technical manual of the scale (model 1); adjusted by age groups, for tobacco and/or alcohol use during pregnancy and maternal characteristics of pregnancy and childbirth (model 2); adjusted by age groups, for tobacco and/or alcohol use during pregnancy and variables related to children in the follow-up (model 3); adjusted for all the variables of the previous models (model 4). Results: 998 women were studied, 121 of them (12.1%) smoked and 246 (24.6%) reported having consumed alcohol in pregnancy. The isolated alcohol consumption was three times higher (18.6%) than the consumption of tobacco only (6.1%). The combined use of tobacco and alcohol during pregnancy was 6.0%, with no difference according to the child\'s age group (p> 0.05). There was no difference in mean cognitive score based on consumption of substances in any model. Concomitant intake was associated with lower mean scores in both communication subscales (1.12 points difference for receptive communication, 95% CI 0.45 to 1.79; 1.19 points for expressive communication, 95% CI 0.31 to 2.07) and motor subscale (1.20 points difference in the fine motor subscale, 95% CI 0.55 to 1.85; 0.70 points for gross motor subscale, 95% CI 0.13 to 1.28), around a point on average compared with no consumption of tobacco and alcohol. Conclusion: concomitant consumption of tobacco and alcohol had a significant effect, however small, in the mean score of the communication and motor subscales, but not in the cognitive subscale.