Neonatal and Infant Mortality Risk Associated with Preterm and Small for Gestational Age Births in Tanzania: Individual Level Pooled Analysis Using the Intergrowth Standard

BackgroundData on the effects of extremely low frequency electromagnetic fields (ELF-EMF) on pregnancy outcomes are inconclusive.ObjectiveTo study the relation between maternal cumulative exposure to ELF-EMF during pregnancy and the risk of prematurity or small for gestational age (SGA) in a pooled analysis of two French birth cohorts.MethodsElfe and Epipage2 are both population-based birth cohorts initiated in 2011 and included 18 329 and 8400 births, respectively. Health data and household, mother and child characteristics were obtained from medical records and questionnaires at maternity and during follow-up. A job exposure matrix was used to assess cumulative exposure to ELF-EMF during three periods: (1) until 15 weeks of gestation, (2) until 28 weeks of gestation and (3) until 32 weeks of gestation. Analyses were restricted to single live births in mainland France and to mothers with documented jobs (N=19 894). Adjusted logistic regression models were used.ResultsAccording to the period studied, 3.2%–4% of mothers were classified as highly exposed. Results were heterogeneous. Increased risks of prematurity were found among low exposed mothers for the three periods, and no association was observed among the most exposed (OR1=0.92 (95% CI 0.74 to 1.15); OR2=0.98 (95% CI 0.80 to 1.21); OR3=1.14 (95% CI 0.92 to 1.41)). For SGA, no association was observed with the exception of increased risk among the low exposed mothers in period 2 and the most exposed in period 3 (OR=1.25 (95% CI 1.02 to 1.53)).ConclusionSome heterogeneous associations between ELF-EMF exposure and prematurity and SGA were observed. However, due to heterogeneity (ie, their independence regarding the level of exposure), associations cannot be definitely explained by ELF-EMF exposure.

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A comparison of four prenatal care indices in birth outcome models: Comparable results for predicting small-for-gestational-age outcome but different results for preterm birth or infant mortality

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2008.08.001 ◽

2009 ◽

Vol 62 (4) ◽

pp. 438-445 ◽

Cited By ~ 48

Author(s):

Tyler J. VanderWeele ◽

John D. Lantos ◽

Juned Siddique ◽

Diane S. Lauderdale

Keyword(s):

Preterm Birth ◽

Infant Mortality ◽

Prenatal Care ◽

Gestational Age ◽

Small For Gestational Age ◽

Birth Outcome

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The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis

BMC Public Health ◽

10.1186/1471-2458-13-s3-s3 ◽

2013 ◽

Vol 13 (Suppl 3) ◽

pp. S3 ◽

Cited By ~ 59

Author(s):

Naoko Kozuki ◽

Anne CC Lee ◽

Mariangela F Silveira ◽

Cesar G Victora ◽

Linda Adair ◽

...

Keyword(s):

Infant Mortality ◽

Gestational Age ◽

Small For Gestational Age ◽

Meta Analysis ◽

Birth Intervals

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Prenatal exposure to endocrine disrupting chemicals and risk of being born small for gestational age: Pooled analysis of seven European birth cohorts

Environment International ◽

10.1016/j.envint.2018.03.017 ◽

2018 ◽

Vol 115 ◽

pp. 267-278 ◽

Cited By ~ 26

Author(s):

Eva Govarts ◽

Nina Iszatt ◽

Tomas Trnovec ◽

Marijke de Cock ◽

Merete Eggesbø ◽

...

Keyword(s):

Prenatal Exposure ◽

Gestational Age ◽

Small For Gestational Age ◽

Endocrine Disrupting Chemicals ◽

Pooled Analysis ◽

Birth Cohorts ◽

Endocrine Disrupting

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One-year outcomes of infants born with congenital diaphragmatic hernia: a national population cohort study

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2018-316396 ◽

2019 ◽

Vol 104 (6) ◽

pp. F643-F647 ◽

Cited By ~ 4

Author(s):

Anna-May Long ◽

Kathryn J Bunch ◽

Marian Knight ◽

Jennifer J Kurinczuk ◽

Paul Damian Losty

Keyword(s):

Cohort Study ◽

Infant Mortality ◽

Congenital Diaphragmatic Hernia ◽

Gestational Age ◽

Small For Gestational Age ◽

Primary Closure ◽

Postoperative Morbidity ◽

Patch Repair ◽

Factors Associated ◽

High Incidence

ObjectiveTo report outcomes to 1 year, in infants born with congenital diaphragmatic hernia (CDH), explore factors associated with infant mortality and examine the relationship between surgical techniques and postoperative morbidity.DesignProspective national population cohort study.SettingPaediatric surgical centres in the UK and Ireland.MethodData were collected to 1 year for infants with CDH live-born between 1 April 2009 to 30 September 2010. Factors associated with infant mortality are explored using logistic regression. Postoperative morbidity following patch versus primary closure, minimally invasive versus open surgery and biological versus synthetic patch material is described. Data are presented as n (%) and median (IQR).ResultsOverall known survival to 1 year was 75%, 95% CI 68% to 81% (138/184) and postoperative survival 93%, 95% CI 88% to 97% (138/148). Female sex, antenatal diagnosis, use of vasodilators or inotropes, being small for gestational age, patch repair and use of surfactant were all associated with infant death. Infants undergoing patch repair had a high incidence of postoperative chylothorax (11/54 vs 2/96 in infants undergoing primary closure) and a long length of hospital stay (41 days, IQR 24–68 vs 16 days, IQR 10–25 in primary closure group). Infants managed with synthetic patch material had a high incidence of chylothorax (11/34 vs 0/19 with biological patch).ConclusionThe majority of infant deaths in babies born with CDH occur before surgical correction. Female sex, being born small for gestational age, surfactant use, patch repair and receipt of cardiovascular support were associated with a higher risk of death. The optimum surgical approach, timing of operation and choice of patch material to achieve lowest morbidity warrants further evaluation.

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