This paper addresses two questions: 1) What is the relation of hemoglobin in the second gestational month to preterm birth and low birth weight? 2) How does the relation differ when hemoglobin in the fifth or eighth month or the lowest pregnancy hemoglobin are examined in place of first trimester values? These relations were examined prospectively in 829 women from Shanghai, China in 1991-1992. The population was nearly homogeneous by race, parity, antenatal care, and smoking. Rates of birth outcomes were compared between hemoglobin categories based on 10 g/liter groupings, with 110-119 g/liter as the reference group. Rates of low birth weight and preterm birth (but not small-for-gestational age) were related to early pregnancy hemoglobin concentration in a U-shaped manner. The relative risks (95% confidence intervals) for preterm birth in women by g/liter of hemoglobin were 2.52 (0.95-6.64) for > or = 130 g/liter, 1.11 (0.41-2.99) for 120-129 g/liter, 1.64 (0.77-3.47) for 100-109 g/liter, 2.63 (1.17-5.90) for 90-99 g/liter, and 3.73 (1.36-10.23) for 60-89 g/liter. Use of hemoglobin values in the fifth or eighth month attenuated the association with preterm birth. When lowest pregnancy hemoglobin values were used, the association of anemia with both outcomes was obscured, and risk of preterm birth at high hemoglobin values increased dramatically.

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OBJECTIVE -We sought to evaluate whether maternal diabetes or weight status attenuates a previously reported beneficial effect of breast-feeding on childhood obesity.RESEARCH DESIGN AND METHODS -Growing Up Today Study (GUTS) participants were offspring of women who participated in the Nurses' Health Study II. In the present study, 15,253 girls and boys (aged 9 -14 years in 1996) were included. Maternal diabetes and weight status and infant feeding were obtained by maternal self-report. We defined maternal overweight as BMI Ն25 kg/m 2 . Childhood obesity, from self-reported height and weight, was based on the Centers for Disease Control and Prevention definitions as normal, at risk for overweight, or overweight. Maternal status categories were nondiabetes/normal weight, nondiabetes/overweight, or diabetes. Logistic regression models used generalized estimating equations to account for nonindependence between siblings.RESULTS -For all subjects combined, breast-feeding was associated with reduced overweight (compared with normal weight) in childhood. Compared with exclusive use of formula, the odds ratio (OR) for exclusive breast-feeding was 0.66 (95% CI 0.53-0.82), adjusted for age, sex, and Tanner CONCLUSIONS -Breast-feeding was inversely associated with childhood obesity regardless of maternal diabetes status or weight status. These data provide support for all mothers to breast-feed their infants to reduce the risk for childhood overweight.

This study examined the differences in the frequency and type of injury for children with autism and pervasive developmental disorder (PDD) compared with typically developing peers, when both groups are insured by Medicaid. The relative rate (RR) of emergency/hospital treatment of injury for children with autism or PDD compared to controls was 1.20 [95% Confidence Interval (CI) 1.04-1.39] after controlling for age and gender. Children with autism or PDD had a higher rate for head, face, and neck injuries (RR 1.47, 95% CI 1.13-1.90) and lower rate for sprains and strains (RR 0.54, 95% CI 0.32-0.91). Treatment for poisoning was 7.6 times as frequent, and self-inflicted injury was also 7.6 times as frequent for children with autism or PDD.

BackgroundThe relation between infant feeding and growth has been extensively evaluated, but studies examining the volume of formula milk consumption on infant growth are limited. This study aimed to examine the effects of early feeding of larger volumes of formula on growth and risk of overweight in later infancy.MethodsIn total, 1093 infants were studied prospectively. Milk records collected at 3 mo of age were used to define the following 3 feeding groups: breast milk feeding (BM, no formula), lower-volume formula milk feeding (LFM, <840 ml formula/d), and higher-volume formula milk feeding (HFM, ≥840 ml formula/d). Body weight and length were measured at 3 time points of 3, 6 and 12 mo of age.ResultsThe results showed that the difference in weight and length between the HFM and BM infants was significant at 3 mo of age (P < 0.05) and continued until 12 mo of age (P < 0.001). The adjusted mean changes in weight-for-length z-scores (WLZ) and BMI-for-age z-scores (BAZ) from 3 to 6 mo of age were significantly higher in HFM and LFM group than in BM group. Two-way interactions between feeding practice and age intervals were significant for WLZ changes (P = 0.002) and BAZ changes (P = 0.017). Compared with BM-fed infants, infants fed with HFM had 1.60-fold (95% CI 1.05–2.44) higher odds of greater body weight (1SD < WLZ ≤2 SD) at the age of 6 mo and 1.55-fold (95% CI 1.01–2.37) higher odds of greater body weight and 2.13-fold (95% CI 1.03–4.38) higher odds of overweight (WLZ > 2 SD) at the age of 12 mo.ConclusionFeeding higher volumes of formula in early infancy is associated with greater body weight and overweight in later infancy.

CD is an independent risk factor for the inability to initiate and sustain breastfeeding. It is desirable to reduce the CD rate and provide specific breastfeeding support during early postpartum period to CD mothers.

PURPOSE Few studies have tested the hypothesis that children with sensory disabilities such as deafness may be at increased risk of injuries. To test this hypothesis, this study compared rates of emergency department or hospital treatment for injury among Medicaid-insured South Carolina children with and without a diagnosis of hearing loss. Diseases, Ninth Revision, Clinical Modifi cation billing codes were used to identify children with and without hearing loss, and episodes of injury-related emergency department or hospital treatment were compared for the 2 groups. METHODS RESULTSRates of injury treatment in children with hearing loss were more than twice that of the control group (17.72 vs 8.58 per 100, respectively). The relative rate (RR) remained signifi cantly higher (RR = 1.51, 95% confi dence interval, 1.30-1.75) after adjusting for age, race, sex, and the number of hospital or emergency department encounters for treatment of non-injury-related conditions. Children with hearing loss had signifi cantly higher treatment rates for every injury type, bodily location, and external cause, with a cell size suffi cient for valid comparison.CONCLUSIONS Children with hearing loss may be at increased risk of injury. Additional study is needed to determine whether children with hearing loss are at increased risk (as opposed to simply seeking hospital care for injuries more often). If so, targeted injury prevention efforts for these children and their families would be warranted. INTRODUCTIONI njury is the leading cause of death in children in the United States, accounting for more than 14,000 deaths in children aged 18 years or younger in 2004.1 It is estimated that more than 18 million nonfatal injuries occur annually in Americans younger than 20 years, with 13 million of these occurring in children younger than 15 years.2 The estimated annual cost for medical care owing to injuries in children is approximately $17 billion; when estimated costs resulting from lost future work and loss in quality of life are included, the cost increases to more than $300 billion. 2It has been hypothesized that children with sensory disabilities (blindness or deafness) may be at increased risk of injuries as a result of diffi culties identifying and responding to hazards in the environment.3 Although the prevalence of moderate to profound, bilateral, permanent hearing loss in newborns in industrialized nations is between 1 in 900 and 1 in 2,500, 4 at least some hearing loss may be found in as many as 11% of school-aged American children. 5 There is a general lack of surveillance and research regarding injuries in children with disabilities, 5 and we were able to identify only 1 article about the risk of injury in children with hearing loss. Roberts and Norton studied the risk of pedestrian-motor vehicle collisions INJURY A ND CHIL DR EN W I T H HE A R ING LOS Sin children in New Zealand and found that the odds of death or hospitalization caused by such an injury was approximately twice as high in children with hearing ...

Background: Assessing the effectiveness and safety of traditional Chinese medicine (TCM) for symptoms of upper respiratory tract of coronavirus disease 2019 is the main purpose of this systematic review protocol. Methods: The following electronic databases will be searched from inception to Sep 2020: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, TCM, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database (VIP database), and Wan-Fang Database. Search dates: from inception dates to June 2020. Language: English. Publication period: from inception dates to June 2020. The primary outcome is the time and rate of appearance of main symptoms (including coughing, pharyngalgia, and nasal obstruction). The secondary outcome is the length of hospital stay. Two independent reviewers will conduct the study selection, data extraction and assessment. RevMan V.5.3 will be used for the assessment of risk of bias and data synthesis. Results: The results will provide a high-quality synthesis of current evidence for researchers in this subject area. Conclusion: The conclusion of our study will provide an evidence to judge whether TCM is effective and safe for the patients with symptoms of upper respiratory tract of coronavirus disease 2019. Ethics and dissemination: This protocol will not evaluate individual patient information or affect patient rights and therefore does not require ethical approval. Results from this review will be disseminated through peer-reviewed journals and conference reports. PROSPERO registration number: CRD42020187422.