ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00018.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary..Thomas McKeown and RG Record were colleagues in Birmingham, England, from 1947 to 1977. During their first decade together, they laid the foundations of epidemiological research on malformations with a series of case‐control studies of the commoner major defects. They found evidence of numerous trends of birth prevalence with variables such as season and year of birth, maternal age, birth rank, and socioeconomic status, suggesting that environmental factors played an important part in causation. The work that has led recently to the use of folate to reduce the risk of neural tube defects is among the lines of research that can be traced back to these case‐control studies. McKeown and Record also initiated, in Birmingham, the first population‐based register of malformations to be set up as an on‐going activity. As well as paving the way for the international networks of registers that now exist, the Birmingham register has been used in a variety of cohort studies. This work has confirmed many of the case‐control study findings and continues to yield new observations, including evidence that enteroviruses are involved in

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00019.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Human institutions are so imperfect by their nature that in order to destroy them it is almost always enough to extend their underlying ideas to the extreme.

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00020.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00021.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.The objective was to evaluate the rates of congenital malformation in children born in a population living around a smelter and to employees at the smelter, in a community in northern Sweden. By means of record linkage of the birth register and various registers of congenital malformations, a retrospective study of a birth cohort according to place of parental residence and employment was carried out to assess rates of congenital malformation occurring between 1973–1990. Neither a general, nor specific, significantly increased risk of congenital malformation was seen in the 2724 children born to women living close to the smelter or to employees of the smelter compared with the 15191 children in the reference population. No increased risk could be ascertained although there are reservations concerning the small sample size of the study grou

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00022.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary..The literature indicates that exposure to electro‐magnetic fields (EMF) may result in an increased incidence of cancer and spontaneous abortion. The aim of the present study was to determine whether living closer to high voltage power lines (HVPL) increased the risk of congenital anomalies. We studied residential exposure in any municipality in the Central‐East Region of France where there was at least one residence within 500 metres of a HVPL. This was a matched case‐control design. The cases consisted of all children with congenital anomalies, identified to the population‐based registry in Central‐East France between 1988‐91. We chose two random controls, matched for birth year and municipality, for each case. For every case and control, we measured the distance from the HVPL to the maternal residence at the time of birth of the child as a surrogate for EMF exposure. Using 100 metres from an HVPL as the cut‐point between exposure and non‐exposure to electromagnetic fields produced by HVPL, yielded an odds ratio of 0.95 (95% (confidence interval) CI: 0.45‐2.03). Using 50 metres as the cut‐point, yielded an OR of 1.25 (95% CI: 0.49‐3.22). Among the 11 cases within 100 metres, there were 2 children with chromosomal anomalies, but otherwise there was no pattern in the occurrence of specific anomalies. These data indicate a lack of association between distance

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00023.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary..A nested case‐control study of cryptorchidism (i.e. undescended testicles) was undertaken as part of a hospital‐based cohort study of 6699 singleton male neonates in New York City. Since some of the cryptorchid infants experienced spontaneous descent of their testes, separate analysis was performed for this third group of late descenders' (n= 140). Cases (n= 63) represented infants whose testes remained undescended at the one year assessment. Controls (n=219) represented the next male infant who was delivered immediately after an infant who was cryptorchid at birth. The only independent risk factors for cryptorchidism were Asian ethnic group (adjusted odds ratio (OR) = 3.90,95% confidence interval (CI) = 1.22‐12.41), swollen legs or feet during pregnancy (adjusted OR=2.16, 95% CI = 1.15‐4.04), a family history of cryptorchidism (adjusted OR=4.32, 95% CI = 1.91‐9.80), low birthweight (adjusted OR = 4.10, 95% CI = 1.39‐12.08), and use of analgesics during pregnancy (adjusted OR = 1.93/95% CI = 1.03‐3.62). Multiple logistic regression analysis was also performed to identify those factors that were associated with late testicular descent. In this analysis the independent risk factors were black or Hispanic ethnicity (adjusted OR = 2.05, 95% CI = 1.09‐3.83), a family history of cryptorchidism (adjusted OR = 4.25,95% CI = 1.84‐9.78), consumption of cola‐containing drinks during the pregnancy (adjusted OR = 2.09, 95% CI = 1.10‐3.99), a low birthweight delivery (adjusted OR = 9.78, 95% CI = 3.39‐28.20), and preterm birth (adjusted OR = 4.

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00024.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00025.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.We examined the relationship between diabetes in pregnancy and the development of congenital malformations, in a population‐based retrospective study using birth certificate data for all livebom children delivered from 1984 until 1991 in Washington State. Births to mothers with established and gestational diabetes numbered 1511 and 8869 respectively. For comparison we selected 8934 births to mothers without diabetes. The prevalence of congenital malformations in neonates was 7.2%, 2.8% and 2.1% among mothers with established diabetes, gestational diabetes, and without diabetes, respectively. Newborns of mothers with established diabetes were more likely to have a congenital malformation than newborns of non‐diabetic mothers (prevalence odds ratio = 4.0; 95% confidence interval 3.1–5.1). In contrast, there was only a slightly higher prevalence of congenital malformations among newborns of mothers with gestational diabetes (prevalence odds ratio = 1.3; 95% CI 1.0–1.6). The association with maternal established diabetes was greater for neonates with multiple malformations (7.8; 95% CI 3.3–18.1) than for single malformations (2.9–95% CI 2.1–3.9). Four to seven fold associations were observed with skeletal, cleft lip/palate, neural tube and heart abnormalities. The association of established diabetes with congenital malformations was nearly twice as strong among female neonates (prevalence odds ratio = 5.4; 95% CI 3.7–8.0) than among male neonates (prevalence odds ratio = 3.1; 95% CI 2.2–4.5). No such variation was observed for associations with gestational diabetes. This study enlarges on previous work relating congenital anomalies to established diabetes and supports the possibility of a weak association with ges

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00026.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.Prior studies suggest that diagnosis of gestational diabetes is associated with increased risk for development of gestational diabetes in future pregnancies, and with subsequent onset of established diabetes. The magnitudes of these risks have not been measured. Using linked birth certificate data from Washington State it is possible to identify all women with two or more births occurring during 1984‐91. All women with gestational diabetes (n= 1375) or with established diabetes (n= 220), during their pregnancy for the second or greater birth were identified, and a control group consisting of women whose second or greater birth was not complicated by either condition was randomly selected (n = 6380). Data from the birth certificate, for the previous birth, were compared in order to estimate the risks of developing gestational or established diabetes in a subsequent pregnancy among women with prior gestational diabetes relative to women without gestational diabetes. The age‐adjusted risk of developing gestational diabetes in the pregnancy for the subsequent birth associated with prior gestational diabetes was 23.2 (95% (confidence interval) CI = 17.2–31.2); the risk of having developed established diabetes by the time of the subsequent birth was 55.5 (95% CI = 34.4–89.4). Women who had a macrosomic infant (>4000 gm) in the prior birth were also at increased risk for developing gestational diabetes (odds ratio OR = 3.3, 95% CI = 2.9‐3.8) or established diabetes (OR = 5.8, 95% CI = 4.0–8.5). When data were restricted to patients with only one prior birth, to patients with early prenatal care, to delivery at facilities with long‐established protocols for diagnosing gestational diabetes, or to more recent years, the risk estimates remained similarly elevated. The 23‐fold increased risk of gestational diabetes associated with having gestational diabetes indicated on the birth certificate of a woman's previous baby, although not unexpected, is still remarkable and reinforces the importance of careful monitoring of women with this history. Although changes in how screening is conducted may account for some of the elevation in risk, our results stayed consistently elevated even when restrictions were made within the data to control for this. The fact that there was a 56‐fold increased risk of having developed established diabetes by the time of the subsequent birth on record, associated with prior gestational diabetes, and a 6‐fold increased risk associated with a macro‐somic infant, supports the idea that these may be early steps in the development of established diabetes, and identifies a group that may benefit from close monitoring and

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00027.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY