Exceeding the recommended BMI-specific IOM GWG ranges has an adverse impact on the risk of childhood overweight and abdominal adiposity, whereas suboptimal GWG conveys no benefit or risk, reflecting a nonlinear relationship between absolute GWG and the risk of childhood overweight and adiposity. Strategies focussing on the awareness and prevention of excessive GWG and its consequences are justified.

Higher effect estimates for maternal smoking in pregnancy compared with paternal smoking in mutually adjusted models may suggest a direct intrauterine effect.

Background: the duration of protection after hepatitis B vaccination in early infancy is unclear and may be related to vaccination schedule, dosage, vaccine type and population characteristics. Factors potentially influencing waning immunity were assessed. Methods: a systematic review was performed. the main outcomes were prevalence of anti-hepatits B antibodies ≥ 10 miu/ml after primary or booster vaccination. Factors potentially influencing protection were assessed in an adjusted random-effects meta-analysis model by age for both outcomes. results of both meta-analyses were combined in a prognostic model. Results: Forty-six studies reporting on the anti-hepatits B antibodies ≥ 10 miu/ml 5 to 20 years after primary immunization and 29 on booster response were identified. the adjusted meta-analyses identified maternal carrier status (odds ratio [Or]: 2.37 [1.11; 5.08]), lower vaccine dosage than presently recommended (Or: 0.14 [0.06; 0.30]) and gap time between last and preceding dose of the primary vaccine series (Or: 0.44 [0.22; 0.86]) as determinants for persistence of anti-hepatits B antibodies ≥ 10. a lower vaccine dosage was also associated with failure to respond to booster (Or: 0.20 [0.10; 0.38]). the prognostic model predicted long-term protection of 90% [77%; 100%] at the age of 17 years for offspring of noncarrier mothers vaccinated with a presently recommended dose and vaccination schedule. Conclusions: Based on meta-analyses, predictors of waning immunity after hepatitis B vaccination in infancy could be identified. a prognostic model for long-term protection after hepatitis B vaccination in infancy was developed.Key Words: hepatitis B, infant vaccination, booster, long-term protection, determinants of protection (Pediatr Infect Dis J 2013;32: 307-313) A lthough hepatitis B vaccination is highly effective, vaccination failures leading to acute [1][2][3][4][5] and sometimes chronic infection [5][6][7][8] have been observed. although infections occurring within a short time interval after vaccination are likely to reflect primary vaccination failure 1,4 due to nonresponse, those occurring after decades are likely to reflect secondary vaccination failure due to waning immunity. anti-hepatits B antibodies [anti-HBs] ≥ 10 miu/ ml either after primary vaccination or as response to booster if the antibody concentrations have fallen below are widely accepted marker of protection after hepatitis B vaccination. 9-11 immunity against hepatitis B gives protection against infection and protection against disease. 12-14 Protection against infection is based on the presence of anti-HBs ≥ 10 miu/ml. after vaccination against hepatitis B, the proportion of individuals with anti-HBs ≥10 miu/ ml is highly dependent on the time elapsed since primary vaccination. individuals whose anti-HBs concentrations dropped below a level of 10 miu/ml are not protected any more against infection with hepatitis B virus. However, they are not at risk of hepatic disease as long as they have hepatitis B surface antigen (HBsag)-spe...

MCIDMinimum clinically important differences ROBERT Robot-enhanced repetitive treadmill therapy AIM The aim of the study was to evaluate patient-specific determinants of responsiveness to robot-enhanced repetitive treadmill therapy (ROBERT) in patients with early-developed movement disorders.METHOD Patients were treated over 12 sessions during a 3-week period. Gross Motor Function Measure-66 (GMFM-66) scores 1 day before ROBERT were compared with scores recorded 1 day after ROBERT. The association of GMFM-66 baseline score, age, sex, aetiology, and add-on botulinum toxin therapy to response to treatment was assessed. were each treated for a total of 7.2 (SD 1.9) treadmill walking hours. Aetiology was bilateral spastic cerebral palsy (BS-CP; n=69), unilateral CP (n=3), ataxic CP (n=3), hereditary spastic paraparesis (n=6), and genetic syndrome including spasticity (n=2). Meaningful improvements were observed in GMFM-66 (+2.5; 95% CI 2.0-3.0), GMFM-D (+5.2; 95% CI 3.6-6.8), and GMFM-E (+4.0; 95% CI 2.8-5.3). There was a high inter-individual variability in treatment response. After multivariable adjustment, the improvements in GMFM-66 and GMFM-E scores were positively associated with the GMFM-66 baseline score. The effect on GMFM-D improvement was inversely associated with age. RESULTS

Background: Children of mothers who smoked during pregnancy have a lower birth weight but have a higher chance to become overweight during childhood.Objectives: We followed children longitudinally to assess the age when higher body mass index (BMI) z-scores became evident in the children of mothers who smoked during pregnancy, and to evaluate the trajectory of changes until adolescence.Methods: We pooled data from two German cohort studies that included repeated anthropometric measurements until 14 years of age and information on smoking during pregnancy and other risk factors for overweight. We used longitudinal quantile regression to estimate age- and sex-specific associations between maternal smoking and the 10th, 25th, 50th, 75th, and 90th quantiles of the BMI z-score distribution in study participants from birth through 14 years of age, adjusted for potential confounders. We used additive mixed models to estimate associations with mean BMI z-scores.Results: Mean and median (50th quantile) BMI z-scores at birth were smaller in the children of mothers who smoked during pregnancy compared with children of nonsmoking mothers, but BMI z-scores were significantly associated with maternal smoking beginning at the age of 4–5 years, and differences increased over time. For example, the difference in the median BMI z-score between the daughters of smokers versus nonsmokers was 0.12 (95% CI: 0.01, 0.21) at 5 years, and 0.30 (95% CI: 0.08, 0.39) at 14 years of age. For lower BMI z-score quantiles, the association with smoking was more pronounced in girls, whereas in boys the association was more pronounced for higher BMI z-score quantiles.Conclusions: A clear difference in BMI z-score (mean and median) between children of smoking and nonsmoking mothers emerged at 4–5 years of age. The shape and size of age-specific effect estimates for maternal smoking during pregnancy varied by age and sex across the BMI z-score distribution.Citation: Riedel C, Fenske N, Müller MJ, Plachta-Danielzik S, Keil T, Grabenhenrich L, von Kries R. 2014. Differences in BMI z-scores between offspring of smoking and nonsmoking mothers: a longitudinal study of German children from birth through 14 years of age. Environ Health Perspect 122:761–767; http://dx.doi.org/10.1289/ehp.1307139