Objective To provide a statistically sound criterion for identifying implausibly large birthweights for gestational age. Design Review of ISTAT 1990-1994 national newborn records.
Setting ItalyPopulation Forty-two thousand and twenty-nine single first and second liveborn preterm babies.Methods Two-component Gaussian mixture models are used to describe the birthweight distributions stratified by gestational age. Implausibly large babies are identified through model-based probabilistic clustering. Main outcome measures Gestational age misclassification and weight-for-gestational age centile curvesResults Gestational age appears under-estimated by about six weeks in 12.3% of the cases. Large babies are equally present in males and females, but are more frequent in second-borns than in first-borns, even when parity-specific models are fitted. Conclusions The approach allows for a quantification of the gestational age under-estimate error and for data correction through model-based clustering. Correct birthweight distributions and growth curves are also provided.
This study confirms that paternal age contributes to the risk of preterm birth. The effect is stronger on very preterm births but also influences moderate preterm births.
The effect of paternal ageing on stillbirth risk is revealed in mothers aged > or =30 years and is modified by family education. In mothers aged 30-34 years from families with high education, the increase imputable to paternal ageing might be indicative of a genetic component.
A comprehensive case-control study was conducted in an Italian region in order to compare the influence of family history of cardiovascular events, socioeconomic factors, social networks, and their joint associations with major risk factors, on the risk, of myocardial infarction (MI), unstable angina (UA) and ischemic stroke (IS). A total of 513 patients with MI, 178 with UA, 237 with IS, and 928 hospitalised controls were recruited. The odds ratio (OR) of MI for two or more relatives with a positive history of MI was 3.6 (95% CI: 1.8-7.3). Family history of MI was predictive for UA (OR = 5.8; 95% CI: 1.2-28.7), but not for IS. A family history of stroke was more associated with the risk of MI than of IS. After adjustment for known risk factors, the OR of MI for more educated people was 2.1 (1.3-3.6) compared with less-educated people. Large family size seemed to be protective for MI. The effect of major risk factors on MI ranged from additive (diabetes) to multiplicative jointly with high education and family history of MI. A family history of stroke increased IS risk threefold jointly with smoking and hyperlipidemia, and eightfold with diabetes. Besides a family history of MI and IS, in this community a higher educational status seems to better identify groups at increased risk of MI. The joint associations have important preventive implications since by identifying high-risk individuals (for MI and IS) a more careful assessment and control of risk factors amenable to intervention may be performed.
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