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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.

Made available in DSpace on 2014-12-17T14:13:22Z (GMT). No. of bitstreams: 1 HiltonLC.pdf: 613137 bytes, checksum: 5fb2db6e3e506a15970d49908b77bf14 (MD5) Previous issue date: 2008-02-22 / Alterations in the neuropsychomotor development of children are not rare and can manifest themselves with varying intensity at different stages of their development. In this context, maternal risk factors may contribute to the appearance of these alterations. A number of studies have reported that neuropsychomotor development diagnosis is not an easy task, especially in the basic public health network. Diagnosis requires effective, low-cost, and easy - to-apply procedures. The Denver Developmental Screening Test, first published in 1967, is currently used in several countries. It has been revised and renamed as the Denver II Test and meets the aforementioned criteria. Accordingly, the aim of this study was to apply the Denver II Test in order to verify the prevalence of suspected neuropsychomotor development delay in children between the ages of 0 and 12 months and correlate it with the following maternal risk factors: family income, schooling, age at pregnancy, drug use during pregnancy, gestational age, gestational problems, type of delivery and the desire to have children. For data collection, performed during the first 6 months of 2004, a clinical assessment was made of 398 children selected by pediatricians and the nursing team of each public health unit. Later, the parents or guardians were asked to complete a structured questionnaire to determine possible risk indicators of neuropsychomotor development delay. Finally the Denver II Developmental Screening Test (DDST) was applied. The data were analyzed together, using Statistical Package for Social Science (SPSS) software, version 6.1. The confidence interval was set at 95%. The Denver II Test yielded normal and questionable results. This suggests compromised neuropsychomotor development in the children examined and deserves further investigation. The correlation of the results with preestablished maternal risk variables (family income, mother s schooling, age at pregnancy, drug use during the pregnancy and gestational age) was strongly significant. The other maternal risk variables (gestational problems, type of delivery and desire to have children) were not significant. Using an adjusted logistic regression model, we obtained the estimate of the greater likelihood of a child having suspected neuropsychomotor development delay: a mother with _75 4 years of schooling, chronological age less than 20 years and a drug user during pregnancy. This study produced two manuscripts, one published in Acta Cir?rgica Brasileira , in which an analysis was performed of children with suspected neuropsychomotor development delay in the city of Natal, Brazil. The other paper (to be published) analyzed the magnitude of the independent variable maternal schooling associated to neuropsychomotor development delay, every 3 months during the first twelve months of life of the children selected.. The results of the present study reinforce the multifactorial characteristic of development and the cumulative effect of maternal risk factors, and show the need for a regional policy that promotes low-cost programs for the community, involving children at risk of neuropsychomotor development delay. Moreover, they suggest the need for better qualified health professionals in terms of monitoring child development. This was an inter- and multidisciplinary study with the integrated participation of doctors, nurses, nursing assistants and professionals from other areas, such as statisticians and information technology professionals, who met all the requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte / As altera??es do desenvolvimento neuropsicomotor na crian?a n?o s?o raras e podem manifestar-se com intensidade vari?vel em diferentes etapas do seu desenvolvimento. Neste contexto, fatores de risco materno podem contribuir para o aparecimento daquelas altera??es. Alguns estudos t?m relatado que o diagn?stico neuropsicomotor n?o ? uma tarefa f?cil, sobretudo, na rede b?sica de sa?de. Isto requer procedimentos eficazes, de baixo custo e de f?cil aplicabilidade. O Teste de Triagem de Desenvolvimento de Denver, publicado pela primeira vez em 1967, hoje usado em diversos pa?ses, revisado e nominado atualmente como Teste de Denver II, preenche aqueles crit?rios. Dessa forma, o objetivo deste estudo foi aplicar o Teste de Denver II com a finalidade de verificar a preval?ncia de suspeita de atraso no desenvolvimento neuropsicomotor de crian?as de 0 a 12 meses de idade e correlacionar com fatores maternos de risco: renda familiar, escolaridade, idade ao engravidar, uso de drogas durante a gesta??o, idade gestacional, intercorr?ncias gestacionais, tipo de parto e o desejo de ter o filho. Para a coleta dos dados, realizada nos seis primeiros meses do ano de 2004, inicialmente foi feita a avalia??o cl?nica das 398 crian?as selecionadas com a participa??o de pediatras e equipe de enfermagem de cada posto de sa?de; posteriormente, os pais ou cuidadores responderam a um question?rio estruturado para determina??o de poss?veis indicadores de risco de desenvolvimento neuropsicomotor. Finalmente, aplicou-se o Teste de Triagem de Desenvolvimento de Denver II (Teste de Denver II). Os dados coletados foram analisados em conjunto, atrav?s do programa Statistical Package for Social Science SPSS, vers?o 6.1. Utilizou-se o intervalo de confian?a de 95%. Atrav?s da aplica??o do Teste de Denver II, obtivemos resultados Normais e Question?veis. Estes sugerem preju?zos no desenvolvimento neuropsicomotor da crian?a examinada e merece maior investiga??o. A correla??o dos resultados com as vari?veis de risco materno pr?-estabelecidas renda familiar, escolaridade da m?e, idade ao engravidar, uso de drogas durante a gesta??o e idade gestacional foi fortemente significativa. As outras vari?veis de risco materno - intercorr?ncias gestacionais, tipo de parto e desejo de ter filho - n?o foram significativas. Atrav?s da t?cnica multivariada de regress?o log?stica, chegamos ? estimativa de maior probabilidade de uma crian?a ser suspeita de atraso de desenvolvimento neuropsicomotor: m?e com instru??o escolar formal _ 4 anos, idade cronol?gica inferior a 20 anos e usu?ria de droga durante a gesta??o. Este estudo gerou dois manuscritos, um deles publicado na "Acta "Cir?rgica Brasileira , pela qual se faz uma an?lise de crian?as com suspeita de atraso no seu desenvolvimento neuropsicomotor na rede p?blica de sa?de, da cidade de Natal. O outro manuscrito, a ser publicado, analisa a magnitude da vari?vel independente escolaridade materna associada ? suspeita de atraso de desenvolvimento neuropsicomotor, trimestralmente, nos doze primeiros meses de vida das crian?as selecionadas. Os resultados apresentados neste estudo refor?am a caracter?stica multifatorial de neurodesenvolvimento e o efeito cumulativo dos fatores de risco ix materno; alertam para a necessidade de uma pol?tica regional que promovam programas de baixo custo e abordagem comunit?ria, envolvendo crian?as com riscos de atraso no seu desenvolvimento neuropsicomotor. Al?m disso, sugere um melhor preparo de todos os profissionais de sa?de em rela??o ? vigil?ncia do desenvolvimento da crian?a. Esta foi uma pesquisa inter e multidisciplinar pela participa??o integrada de profissionais da sa?de, como m?dicos, enfermeiros, auxiliares de enfermagem e profissionais de outras ?reas, como estat?sticos e profissionais de inform?tica, que preenchem todos os requisitos do Programa de P?sgradua??o em Ci?ncias da Sa?de da Universidade Federal do Rio Grande do Norte

Background: Prevalence and characteristics of fetal alcohol syndrome (FAS) and total fetal alcohol spectrum disorders (FASD) were studied in a second sample of three South African rural communities to assess change. Methods: Active case ascertainment focused on children with height, weight and/or head circumference <= 25th centile and randomly-selected children. Final diagnoses were based on dysmorphology, neurobehavioral scores, and maternal risk interviews. Results: Cardinal facial features, head circumference, and total dysmorphology scores differentiated specific FASD diagnostic categories in a somewhat linear fashion but all FASD traits were significantly worse than those of randomly-selected controls. Neurodevelopmental delays were significantly worse for children with FASD than controls. Binge alcohol use was clearly documented as the proximal maternal risk factor for FASD, and significant distal risk factors were: low body mass, education, and income; high gravidity, parity, and age at birth of the index child. FAS rates continue to extremely high in these communities at 89-129 per 1000 children. Total FASD affect 196-276 per 1000 or 20-28% of the children in these communities. Conclusions: Very high rates of FASD persist in these general populations where regular, heavy drinking, often in a binge fashion, co-occurs with low socioeconomic conditions.

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.