Follow-up of Children of Insulin-dependent and Gestational Diabetic Mothers: Neuropsychological Outcome

ABSTRACT. Ninety-four infants of 28 weeks gestation or more were born to 85 women, 64 type I and 21 gestational diabetics, between 1969–1972 at Sabbatsberg's Hospital, Stockholm. Perinatal mortality rate was 6.3%. The follow-up study was conducted when the children were approximately 5 years of age and included a physical and a neurological evaluation, IQ determination of mother and child, and an interview of mother by a psychologist. Fifty-three infants of insulin-dependent (IDM) and 20 infants of gestational diabetic mothers (IGDM) (83 %) participated, 3 families could not be traced and 12 were unwilling. The group lost to follow-up (13 IDM, 2 IGDM) had more perinatal complications induding congential malformations than the follow-up group. All children had normal physical and neurological development. IQ was normal, the majority were above 100, the average in IDM was 115 (range 89–144) and 112 in IGDM (range 95–133). No obvious relationship was found between maternal acetonuria during pregnancy, infant birthweight, blood glucose during first hours after birth or neonatal complications and IQ of the children. A correlation (r= 0.364, p<0.01) was found between maternal and child IQ. Mothers exhibiting emotional disorders (anxiety, depression) had significantly higher life stress scores based on 29 stress variables and reported more frequently about conduct and behavioural disorders in their children than mothers without emotional disturbances.     

Follow-up of Children of Insulin-dependent and Gestational Diabetic Mothers: Neuropsychological Outcome

ABSTRACT. Ninety-four infants of 28 weeks gestation or more were born to 85 women, 64 type I and 21 gestational diabetics, between 1969–1972 at Sabbatsberg's Hospital, Stockholm. Perinatal mortality rate was 6.3%. The follow-up study was conducted when the children were approximately 5 years of age and included a physical and a neurological evaluation, IQ determination of mother and child, and an interview of mother by a psychologist. Fifty-three infants of insulin-dependent (IDM) and 20 infants of gestational diabetic mothers (IGDM) (83 %) participated, 3 families could not be traced and 12 were unwilling. The group lost to follow-up (13 IDM, 2 IGDM) had more perinatal complications induding congential malformations than the follow-up group. All children had normal physical and neurological development. IQ was normal, the majority were above 100, the average in IDM was 115 (range 89–144) and 112 in IGDM (range 95–133). No obvious relationship was found between maternal acetonuria during pregnancy, infant birthweight, blood glucose during first hours after birth or neonatal complications and IQ of the children. A correlation (r= 0.364, p<0.01) was found between maternal and child IQ. Mothers exhibiting emotional disorders (anxiety, depression) had significantly higher life stress scores based on 29 stress variables and reported more frequently about conduct and behavioural disorders in their children than mothers without emotional disturbances.     

Socio-Economic Variables and Pregnancy Outcome

ABSTRACT. The effects of various social indicators on infant and child mortality were studied in Sweden with the use of a medical birth register to which census information was linked. Two years were studied: 1976 births linked to the 1975 census, and 1981 births linked to the 1980 census. Survival was followed to the age of 5 by linkage of the birth register with the death certificate register. The only statistically significant effect of a single socio-economic variable was that of housing conditions on perinatal death rate and postperinatal death rate up to the age of one. The family situation (e. g., cohabitation or not) had some effect, although it was not statistically significant. On the basis of cohabitation status and other social indicators, including housing conditions, we selected two groups: one privileged and the other underprivileged. Using crude mortality rates, we found no definite difference. There was evidence that the mortality rate had decreased more between 1976 and 1981 in the privileged than in the underprivileged group, but the difference may have been coincidental. After standardization for maternal age and parity, however, a difference appeared with a ratio of 1.14 between the underprivileged and the privileged groups, which was valid for deaths up to the age of one. After that age, no difference was seen. Following standardization for birthweight, the opposite was found: a higher weight-specific mortality rate in the privileged group than in the underprivileged group. The interpretation of these findings is discussed.     

Pregnancy Outcome and Social Indicators in Sweden

ABSTRACT. Perinatal mortality, birth weight, the distribution of gestational age, and the relationship between gestational age and birth weight have been studied with regard to births reported to the Register of Births during 1976–77. In order to determine the influence of socio-economic factors on the parameters studied, the information from the birth register has been combined with that from the 1975 census in Sweden (including occupation of the mother, income of the family, type of family and housing standard). The total population of 190024 infants was divided into three groups; 6915 infants (3.6 %) were assigned to the most privileged group (group I) and 26430 (13.9 %) to the less privileged group (group III). The perinatal mortality rate did not differ significantly between group I and III. A comparison of the three groups showed a socio-economic difference as regards birth weight and the incidence of preterm as well as of postterm births. The less privileged group had a greater proportion of infants of low birth weight and of infants that were small for gestational age.     

妊娠期社会心理应激对子代心理行为发育的影响

妊娠期是一个特殊时期,此期间发生的社会心理应激事件,会通过心理中介机制,引起母体内以下丘脑-垂体-肾(?) 腺(HPA)轴为主的代谢改变,使胎儿暴露于循环中高水平的糖皮质激素中,从而影响胎儿记忆、认知、气质、行为等多方面发育, 成为日后心理问题可能的危险因素。通过回顾有关动物实验和流行病学研究,对妊娠期社会心理应激影响子代心理行为发育的机制和结果进行综述。     

The Effect of Ramadan Fasting on Outcome of Pregnancy

Objective

Pregnancy is a physiological condition that its concurrence with fasting introduces some controversies about condition of mother and fetus. This study was conducted to evaluate the effect of fasting on pregnancy outcome.

Methods

The historical cohort paradigm of this study was conducted on referrals of one of the Tehran''s hospitals in 2004. All pregnant women at one of the trimesters in holy month of Ramadan were included in the study. The women were divided into non-fasting, 1-10 days fasting, 11-20 days fasting, and 21-30 days fasting. For statistical analysis of data, covariance analysis and SPSS package was used.

Findings

In this study, 189 cases were evaluated and their mean age, weight, and body mass index (BMI) were 25.9 years, 61.7 kg, and 23.9 kg/m² respectively. The mean for number of days on fasting was 13 days and 66 cases (34.9%) had not been on fasting. In addition, there was no significant difference between BMI at the beginning of pregnancy, mother''s age, number of pregnancies, and a history of abortion in different groups. Meanwhile, there was also no significant difference between means of weight, height, and head circumference of infants with number of days on fasting. Furthermore, there was no significant difference between pregnancy outcome parameters and fasting at different trimesters.

Conclusion

According to these findings, in healthy women with appropriate nutrition, Islamic fasting has no inappropriate effect on intrauterine growth and birth-time indices. Meanwhile, relative risk of low weight birth was 1.5 times in mothers on fasting at first trimester as compared to non-fasting mothers.     

Socio-economic Variables and Pregnancy Outcome Birthweight in Singletons

Ericson, A., Eriksson, M., Källén, B. and Zetterström, R. (The National Board of Health and Social Welfare, Department of Paediatrics, St. Göran's Hospital, Stockholm, and Department of Embryology, Lund, Sweden). Socio-economic variables and pregnancy outcome. Birthweight in singletons. Acta Paediatr Scand Suppl 360: 48, 1989.
The effect of various social indicators on birthweight in singletons was studied in Sweden with the use of a medical birth registry to which census information was linked. Two years were studied: 1976 births linked to the 1975 census, and 1981 births linked to the 1980 census. The strongest social indicator affecting birthweight was family situation: whether the woman cohabited or not. After standardization for this variable, effects were still seen for occupation and type of housing. They were not secondary to maternal age or parity. By using cohabitation status, enhanced with other social indicators, two groups were selected: one privileged and one underprivileged. Distributions of birthweight and pregnancy duration in the two groups were compared with those formed in women being neither privileged nor under privileged and also working outside the home (because occupation entered the definitions of the two former groups). There were marked differences: underprivileged women had shorter pregnancy duration and, at term, their infants weighed slightly less than those of privileged women. These differences remain after standardization for maternal age and parity.     

Health and Development of 8-Year-Old Children Whose Mothers Abused Amphetamine during Pregnancy

ABSTRACT. Sixty-five children whose mothers were addicted to amphetamine during pregnancy were followed prospectively until eight years of age, when they were tested in their homes. Only 21 children (30 %) remained in the custody of thier biological mothers. Their physical health, including growth, was normal. Their IQ and their performance in several psychometric tests were within normal limits. Increased incidences of aggressive behaviour and peer-related problems were found, especially in the groups that had been exposed to amphetamine throughout pregnancy. No correlation was found with socio-environmental factors.