Objectives To compare pregnancy outcomes between women who stopped smoking in early pregnancy and those who either did not smoke in pregnancy or continued to smoke. Design Prospective cohort study. Setting Auckland, New Zealand and Adelaide, Australia. Participants 2504 nulliparous women participating in the Screening for Pregnancy Endpoints (SCOPE) study grouped by maternal smoking status at 15 (±1) week's gestation. Main outcome measures Spontaneous preterm birth and small for gestational age infants (birth weight <10th customised centile). We compared odds of these outcomes between stopped smokers and non-smokers, and between current smokers and stopped smokers, using logistic regression, adjusting for demographic and clinical risk factors. Results 80% (n=1992) of women were non-smokers, 10% (n=261) had stopped smoking, and 10% (n=251) were current smokers. We noted no differences in rates of spontaneous preterm birth (4%, n=88 v 4%, n=10; adjusted odds ratio 1.03, 95% confidence interval l0.49 to 2.18; P=0.66) or small for gestational age infants (10%, n=195 v 10%, n=27; 1.06, 0.67 to 1.68; P=0.8) between non-smokers and stopped smokers. Current smokers had higher rates of spontaneous preterm birth (10%, n=25 v 4%, n=10; 3.21, 1.42 to 7.23; P=0.006) and small for gestational age infants (17%, n=42 v 10%, n=27; 1.76, 1.03 to 3.02; P=0.03) than stopped smokers. Conclusion In women who stopped smoking before 15 weeks' gestation, rates of spontaneous preterm birth and small for gestational age infants did not differ from those in non-smokers, indicating that these severe adverse effects of smoking may be reversible if smoking is stopped early in pregnancy.
SummaryApplication of a Harpenden caliper to a neonate's skinfold results in an exponential decline of the skinfold thickness, stabilizing within 50-60 sec. In order to elucidate the meaning of this decline, simultaneous measurements of skinfold thickness (SFT, by Harpenden caliper connected to a chart recorder), corrected bromide space (CBS, in ml/kg), plasma volume (ml/kg, by T-1824 dilution) and interstitial water (IW, in ml/kg = CBS-plasma volume) were obtained in 18 term and 18 preterm neonates. Skinfold thickness was measured at the midtricipital (MT) and subscapular (SS) sites. The magnitude of SFT decline was estimated as the difference between 0-60 sec readings expressed in % of 0 second reading (%ASFT). The rate of SFT decline was estimated as the slope of the semilogarithmic plot from 4-20 sec after caliper application (SASFT).The 36 neonates whose birthweights ranged from 620-3700 g and whose gestational ages ranged from 27-41 wk were studied within 12 h of birth. Mean CBS, IW, %AMT, %ASS, SAMT and SASS were higher in preterm than in term neonates (P < 0.001).Mean plasma volume was higher in preterm neonates (P = 0.009), but the difference disappeared after exclusion of six polycythemic term neonates from the calculations. The magnitude of SFT decline correlated well with both CBS (%AMT versus CBS: r = 0.71 and %ASS versus CBS: r = 0.71) and IW (%AMT versus IW: r = 0.71 and %ASS versus IW: r = 0.70). The rate of decline correlated moderately but highly significantly with both CBS (SAMT versus CBS: r = 0.50 and SASS versus CBS: r = 0.42) and IW (SAMT versus 1W: r = 0.51 and SASS versus IW: r = 0.43). Exclusion of five neonates less than 30 wk in gestation improved the correlations with both %ASFT and SASFT.These data suggest that the decline in SFT measurements after caliper application results from the expression of subcutaneous IW from the skinfold and that both the amount of water expressed and the rate of its expression increase linearly with the amount of extracellular and IW in the body.
SpeculationBoth the magnitude and the rate of skinfold thickness compressibility or expressibility appear to be intimately related to extracellular and interstitial water contents of the neonatal body. Dynamic skinfold thickness measurements may therefore be noninvasive estimates that are representative of body hydration and that may be used in research on neonatal body composition as well as clinically to evaluate hydration status of sick neonates.Skinfold thickness measurements are commonly used in anthropometric studies. Our earlier data indicated that in neonates a rapid decrease in measured skinfold thickness occurred after application of a Harpenden caliper, but that readings stabilized by 60 sec (3). We speculated that the difference between the 15-and 60-sec readings, expresed in % of the 15-sec reading, provided a noninvasive estimate of subcutaneous interstitial water. In order to define the relationship between decrease in skinfold thickness and body water contents, a Harpenden caliper was modified to...
Radiographs obtained at definitive and boost irradiation in 50 patients with stage I-II breast cancer were retrospectively examined. Tangent target fields planned on the basis of surgical clips placed at excision biopsy were evaluated with simulation radiographs. Four (8%) of 50 tangent target fields would have been inadequate without clips, and 23 (46%) of the boost targets would have been missed (12 [24%], totally; 11 (22%), marginally). Radiopaque surgical clips placed at excision biopsy help plan boost-irradiation target fields.
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