Cord blood samples were collected from a birth cohort of 2631 infants to elucidate the association between genetic and environmental factors and fetal production of IgE. The cord blood IgE values were treated both as a continuous and as a dichotomous variable in the statistical analyses. Multivariate analysis was used to control for confounding factors. Infants with single and biparental atopic heritage had higher IgE concentrations in cord plasma than children of parents without atopy. Multiple logistic regression analysis revealed a significant association to maternal allergic eczema or perennial rhinitis. The cord blood IgE concentration varied with month of birth with peaks in late autumn. This seasonal variation was not related to parental atopic disease. Boys had significantly higher levels of IgE and more often elevated IgE values (> or = 0.5 kU/l) than girls. Alcohol and caffeine consumption by the mothers during pregnancy were both significantly associated with elevated IgE concentration. There was also a relation between mothers prepregnant weight and elevated CB-IgE levels. No significant association was observed between maternal smoking and cord plasma IgE levels. The fact that many factors presumably not related to child allergy seem to influence the regulation of fetal IgE production, could explain the questionable value of cord blood IgE in predicting allergy in childhood.
Untreated maternal CD increases the risk of reduced birthweight, the risk of delivering SGA and VSGA infants and preterm birth. Diagnosis and presumed treatment of maternal CD with a gluten-free diet appeared to result in a birthweight and preterm birth rate similar to those in women without CD.
Population A total of 19 282 singleton pregnancies in women with valid information about psychological stress during pregnancy.Methods Information about psychological stress during pregnancy was obtained from questionnaires and measured by the 12-item General Health Questionnaires (GHQ). A score was generated by the sum of all the answers, each contributing a value between 0 (low psychological stress) and 3 (high psychological stress). Women with an intermediate level of psychological stress (scores of 7-11) were considered the reference group. Scores of 0-6 were defined as a low level of psychological stress and scores of 12-36 as the highest level. The association between psychological stress and stillbirth was presented as relative risks with 95% CIs. Adjustment for potential confounding factors was carried out by logistic regression analyses.Main outcome measures Stillbirth (delivery of a dead fetus at >28 weeks of gestation).Results There were 66 stillbirths (3.4&) in the population studied. Compared with women with an intermediate level of psychological stress during pregnancy, women with a high level of stress had 80% increased risk of stillbirth (relative risk = 1.8; 95% CI 1.1-3.2). Adjustment for maternal age, parity, maternal prepregnancy body mass index, smoking habits, alcohol and caffeine intake during pregnancy, education and cohabitation failed to change the result. The results remained essentially unchanged after exclusion of preterm deliveries. Exclusion of women with complications during pregnancy such as diabetes, hypertension, vaginal bleeding, immunisation and imminent preterm delivery failed to change the results. Likewise, restriction to women's first pregnancy in the cohort did not change the results.Conclusion Psychological stress during pregnancy was associated with an increased risk of stillbirth.
Several studies have suggested that breastfeeding has a long‐term influence on brain development. However, interpretation of these findings is complicated by the presence of many potential confounding factors. Only a few studies have examined infants before 1 y of age, although very early assessment might reduce the role of environmental influence. We investigated the association between exclusive breastfeeding and three developmental milestones related to general and fine motor skills and early language development at the age of 8 mo. We followed 1656 healthy, singleton, term infants, with a birthweight of at least 2500 g, born between May 1991 and February 1992 in Aarhus, Denmark. Information was collected at 16 wk gestation, at delivery and when the infant was 8 mo old. Motor skills were evaluated by measurement of crawling and pincer grip. Early language development was defined as the ability to babble in polysyllables. The proportion of infants who mastered the specific milestones increased consistently with increasing duration of breastfeeding. The relative risk for the highest versus the lowest breastfeeding category was 1.3 (95% CI: 1.0‐1.6) for crawling, 1.2 (95% CI: 1.1‐1.3) for pincer grip and 1.5 (95% CI: 1.3–1.8) for polysyllable babbling. Little change was found after adjustment for confounding. In conclusion, our data support the hypothesis that breastfeeding benefits neurodevelopment.
Changes in the use of episiotomy induced by awareness of clinical practice among midwives seem to increase the incidence of parturients with intact perineum without a concomitant rise in tears of the anal sphincter. To avoid the increase of such tears these changes should probably be restricted to midwives with rates of episiotomies above 30%.
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