ORCID Profile
0000-0003-1526-0801
Current Organisation
University of Adelaide
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Epidemiology | Paediatrics and Reproductive Medicine | Reproduction | Nutritional Physiology | Foetal Development and Medicine | Social and Cultural Anthropology |
ANZSRC Socio-Economic Objective (SEO)
Cardiovascular System and Diseases | Reproductive System and Disorders | Diabetes | Respiratory System and Diseases (incl. Asthma) | Endocrine Organs and Diseases (excl. Diabetes) | Immune System and Allergy
Related Links
Publications
Perinatal outcomes among young Indigenous Australian mothers: A cross‐sectional study and comparison with adult Indigenous mothers
Publisher: Wiley
Date: 22-04-2017
DOI: 10.1111/BIRT.12283
Abstract: The teenage pregnancy rate is high among Indigenous Australian women, yet little is known about their pregnancy outcomes. Moreover, against a background of extreme social disadvantage, the relative importance of age as a risk factor for adverse outcomes among Indigenous pregnancies is unclear. We compared perinatal outcomes for Indigenous teenagers (<20 years) with adult Indigenous women (20-34 years), and described outcomes in subgroups of teenagers. Data were analyzed for 2421 singleton births to Indigenous women aged <35 years in Australia's Northern Territory from 2003 to 2005. Regression was used to assess the effect of young maternal age on normal birth, healthy baby, preterm birth, low birthweight, special care admission, and mean birthweight, adjusting for covariates. Three-quarters of teenagers and 62% of adult mothers lived in remote areas. Smoking rates were around 50% in both groups. Teenagers were more likely to have a normal birth than adults (adjusted odds ratio 1.78 [95% CI 1.35-2.34]). The groups did not differ for healthy baby, preterm birth, or low birthweight. Babies of teenagers weighed 135 g less than those of adults however, adjustment for covariates eliminated this difference. Examination of teenage subgroups (≤16 years and 17-19 years) revealed risk behaviors being higher for 17-19 years olds than for the younger group, and more prevalent among urban-based mothers. Young maternal age is not a risk factor for adverse perinatal outcomes among Indigenous women. Rather, they are having babies in disadvantaged circumstances within a system challenged to support them socially and clinically.
Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study
Publisher: Oxford University Press (OUP)
Date: 30-10-2009
DOI: 10.1093/AJE/KWP315
Abstract: This study aimed to investigate the effect of the timing, dose, and source of folate during pregnancy on childhood asthma by using data from an Australian prospective birth cohort study (n = 557) from 1998 to 2005. At 3.5 years and 5.5 years, 490 and 423 mothers and children participated in the study, respectively. Maternal folate intake from diet and supplements was assessed by food frequency questionnaire in early (<16 weeks) and late (30-34 weeks) pregnancy. The primary outcome was physician-diagnosed asthma, obtained by maternal-completed questionnaire. Asthma was reported in 11.6% of children at 3.5 years (n = 57) and in 11.8% of children at 5.5 years (n = 50). Folic acid taken in supplement form in late pregnancy was associated with an increased risk of childhood asthma at 3.5 years (relative risk (RR) = 1.26, 95% confidence interval (CI): 1.08, 1.43) and with persistent asthma (RR = 1.32, 95% CI: 1.03, 1.69). The effect sizes did not change with adjustment for potential confounders. The association was similar at 5.5 years but did not reach statistical significance (RR = 1.17, 95% CI: 0.96, 1.42) in univariable models. These findings on childhood asthma support previous observations that supplementation with folate in pregnancy leads to an allergic asthma phenotype in mice via epigenetic mechanisms and is associated with poorer respiratory outcomes in young children.
THE AUTHORS REPLY
Publisher: Oxford University Press (OUP)
Date: 09-02-2010
DOI: 10.1093/AJE/KWQ009
The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review
Publisher: Oxford University Press (OUP)
Date: 05-01-2007
Abstract: This evidence-based review focuses on the impact of potentially modifiable, non-communicable lifestyle factors on reproductive performance in the general population and the infertile population undergoing assisted reproductive technology (ART) treatment. The impact of several lifestyle factors including age, weight, smoking, diet, exercise, psychological stress, caffeine consumption, alcohol consumption and exposure to environmental pollutants are included in the review. The databases of Medline, PubMed and Cinahl were searched to identify relevant publications. There is strong evidence that age, weight and smoking impact on general health and adversely on reproductive performance. However there is a need for further research focusing specifically on the relationship between diet and various levels of exercise on reproductive performance. There are several other factors such as psychological stress, caffeine consumption, alcohol consumption and exposure to environmental pollutants that have been implicated but the evidence is equivocal. It is concluded that lifestyle modification can assist couples to conceive spontaneously or optimize their chances of conception with ART treatment.
Trends and correlates of male sex among assisted reproductive technology births in the united states
Publisher: Elsevier BV
Date: 09-2017
Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2010
Is precarious employment associated with women remaining childless until age 35 years? Results from an Australian birth cohort study
Publisher: Oxford University Press (OUP)
Date: 19-11-2014
Abstract: Does time in casual employment (while not studying full time) affect the likelihood of a woman having a child by age 35? Duration of time spent in casual employment is associated with an increased likelihood of childlessness at age 35 years, irrespective of socio-economic background as indicated by educational level. Precarious employment conditions have become increasingly prevalent in recent decades in Western countries. The relationship between precarious employment conditions and age at first childbirth has been examined in several European countries with varying results. A retrospective cross-sectional component (n = 663) was added to an existing study based on a cohort of women born during 1973-1975. An event history calendar instrument was used to obtain data regarding a range of life domains over a 20-year period. Using data from the Life Journeys of Young Women Project carried out in Adelaide, South Australia, Cox proportional hazards models were applied to investigate the research questions. The likelihood of childbirth by around age 35 was reduced for every year spent in casual employment, irrespective of socioeconomic status, partner's education and parents' birthplace. The likelihood was reduced by 8, 23 and 35% for 1, 3 and 5 years spent in casual employment, respectively. Women with longer employment histories (and greater age at first birth) had more opportunities for errors in recall, but it is unlikely that such errors were systematic and led to bias in the results. While we included variables reflecting partner's education and length of time with a live-in partner, partner's employment histories were not taken into account. Duration of time spent in casual employment is associated with an increased likelihood of childlessness at age 35 years, and this association is present across the spectrum of socioeconomic status. We suggest that upstream labour market reforms could be considered in order to reduce barriers to childbearing.
Developmental Perturbation Induced by Maternal Asthma during Pregnancy: The Short- and Long-Term Impacts on Offspring
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/741613
Abstract: Maternal asthma is a common disease to complicate human pregnancy. Epidemiological studies have identified that asthma during pregnancy increases the risk of a number of poor outcomes for the neonate including growth restriction, lower birthweight, preterm delivery, neonatal resuscitation, and stillbirth. Asthma therefore represents a significant health burden to society and could have an impact on the lifelong health of the children of women with asthma. Our research has identified that maternal asthma in pregnancy induces placental dysfunction and developmental perturbation in the fetus in a sex specific manner. These alterations in development could increase the risk of metabolic disease in adulthood of children of asthmatic mothers, especially females. In this paper, we will discuss the evidence currently available that supports the hypothesis that children of mothers with asthma may be at risk of lifelong health complications which include diabetes and hypertension.
Diet around conception and during pregnancy – effects on fetal and neonatal outcomes
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/S1472-6483(10)61178-9
Abstract: Substrate supply to the fetus is a major regulator of prenatal growth. Maternal nutrition influences the availability of nutrients for transfer to the fetus. Animal experiments demonstrate that restriction of maternal protein or energy intake can retard fetal growth. Effects of maternal nutrition vary with the type and timing of the restriction and the species studied. Maternal undernutrition before conception and/or in early pregnancy can alter fetal physiology in late gestation, and influence postnatal function, often without measurable effects on birth size. In contrast, to date, observational and intervention studies in humans provide limited support for a major role of maternal nutrition in determining birth size, except where women are quite malnourished. However, recent studies report associations between newborn size and the balance of macronutrients in women's diets in Western settings. Associations between maternal dietary composition and adult blood pressure of the offspring are also reported in human populations. Most studies in women have focused on dietary content or supplementation during mid-late pregnancy. Further investigation of how maternal dietary composition, before conception and throughout pregnancy, affects fetal physiology and health of the baby will increase the understanding of how maternal diet and nutritional status influence fetal, neonatal and longer-term outcomes.
Fetal Growth and the Fetal Origins Hypothesis in Twins — Problems and Perspectives
Publisher: Cambridge University Press (CUP)
Date: 10-2001
Improving reproductive performance in overweight/obese women with effective weight management
Publisher: Oxford University Press (OUP)
Date: 05-2004
Nutritional aspects of polycystic ovary syndrome
Publisher: Cambridge University Press (CUP)
Date: 03-2001
DOI: 10.1017/S0962279901000217
Abstract: There is le evidence from animal and human observations that extremes of body weight influence reproductive processes. Women who are under a certain weight or body mass index are less likely to cycle regularly, have more difficulty in getting pregnant and have smaller babies. Those who are overweight also suffer serious reproductive problems in that they have a greater risk of oligo- or amenorrhoea, infertility and gestational diabetes. Several large epidemiological studies indicate that reproduction is adversely affected by excess weight. Two of the largest studies (Nurses' Health Study and the British Birth Cohort Study) that convincingly show that being overweight impairs menstrual and fertility function indicate that the greater the body weight and body mass index (BMI), the more significant the effect. Being overweight in adolescence appears to affect reproductive function later in life.
The effects of house moves during early childhood on child mental health at age 9years
Publisher: Springer Science and Business Media LLC
Date: 08-2012
Neurological sequelae in in-vitro fertilisation babies
Publisher: Elsevier BV
Date: 08-2002
Reproductive Technologies and the Risk of Birth Defects
Publisher: Massachusetts Medical Society
Date: 30-08-2012
DOI: 10.1056/NEJMC1206859
Altered Glucose Metabolism in Mouse and Humans Conceived by IVF
Publisher: American Diabetes Association
Date: 15-09-2014
DOI: 10.2337/DB14-0103
Abstract: In vitro fertilization (IVF) may influence the metabolic health of children. However, in humans, it is difficult to separate out the relative contributions of genetics, environment, or the process of IVF, which includes ovarian stimulation (OS) and embryo culture. Therefore, we examined glucose metabolism in young adult humans and in adult male C57BL/6J mice conceived by IVF versus natural birth under energy-balanced and high-fat–overfeeding conditions. In humans, peripheral insulin sensitivity, as assessed by hyperinsulinemic-euglycemic cl (80 mU/m2/min), was lower in IVF patients (n = 14) versus control subjects (n = 20) after 3 days of an energy-balanced diet (30% fat). In response to 3 days of overfeeding (+1,250 kcal/day, 45% fat), there was a greater increase in systolic blood pressure in IVF versus controls (P = 0.02). Mice conceived after either OS alone or IVF weighed significantly less at birth versus controls (P & 0.01). However, only mice conceived by IVF displayed increased fasting glucose levels, impaired glucose tolerance, and reduced insulin-stimulated Akt phosphorylation in the liver after 8 weeks of consuming either a chow or high-fat diet (60% fat). Thus, OS impaired fetal growth in the mouse, but only embryo culture resulted in changes in glucose metabolism that may increase the risk of the development of metabolic diseases later in life, in both mice and humans.
Integrating History and Measurement Into a Case for Site Release
Publisher: ASMEDC
Date: 2011
Abstract: The United Kingdom nuclear research programme started in the 1940s. Research Sites Restoration Limited (RSRL) is responsible for the restoration of two sites which were at the forefront of this research, under a programme funded by the UK Nuclear Decommissioning Authority (NDA). These are the 100 hectare Harwell site in Oxfordshire and the 84 hectare Winfrith site on the south coast of England. The work performed on these sites covered a huge range of nuclides, combinations of nuclides, chemical and physical processes, far more complicated than a power station, for ex le. The sites have a complex history with records of hundreds of buildings, many kilometres of drainage systems, groundwater contamination issues and land areas which require remediation. Formal work towards site release began in the 1990s, but demolition and clearance for re-use started many years earlier. An efficient restoration programme requires appropriate quality data. It is vital to decide what you need to know and how well you need to know it. As part of this, a challenging number of factors need to be considered in its design. This paper discusses these factors using the ex les of the approach used at the Harwell and Winfrith sites including: • historical knowledge and associated uncertainties • relevant clearance criteria • availability and limitations of surveying equipment • effective targeted and validation s ling with appropriate analytical methods • data capture and analysis techniques • effective communication between RSRL and the relevant technical teams • mapping technologies (Global Positioning Systems, Geographical Information Systems) • use of Babcock’s IMAGES land quality software tool • integration of the above over long time scales. The RSRL programme of works at the Harwell and Winfrith Sites is producing large volumes of different types of information from decommissioning, site investigation and remediation projects. This will be required to be accessible and understandable to support the process of site release which will continue over many years. The paper illustrates the methods by which RSRL is using effective knowledge management to compile a verifiable record to support site release as the site restoration works progress.
What is the most relevant standard of success in assisted reproduction?: Assessing the BESST index for reproduction treatment
Publisher: Oxford University Press (OUP)
Date: 25-03-2004
Corticosteroid therapy in assisted reproduction – immune suppression is a faulty premise
Publisher: Oxford University Press (OUP)
Date: 02-09-2016
Abstract: There is ongoing interest in immune-suppressant corticosteroid drugs such as prednisolone to treat infertility in women with repeated IVF failure and recurrent miscarriage. The rationale draws on the pervasive but flawed view that immune activation is inconsistent with normal pregnancy. This ignores clear evidence that controlled inflammation and activation of the immune response is essential for embryo implantation. Generally, the immune response actively promotes reproductive success - by facilitating endometrial receptivity and tolerance of the foreign embryo, and promoting vascular adaptation to support placental morphogenesis. The peri-conception immune response also establishes developmental trajectories that can impact on fetal growth and gestational age at birth. Here, we describe immune changes accompanying conception that could be impeded by inappropriate corticosteroid administration. While women with specific clinical conditions may benefit from the anti-inflammatory and immune-deviating actions of prednisolone and related drugs, it is incorrect to assume a 'one-size-fits-all' approach. Better diagnostics and more preclinical studies are essential to define patient groups, build evidence for efficacy and fine-tune treatments so as not to inhibit essential actions of immune cells. We argue that unless overt immune pathology is evident, utilization of corticosteroids is not warranted and may be harmful. In most women, perturbing immune adaptation at implantation is expected to adversely influence placental development and impair immune-mediated quality control mechanisms, potentially elevating risk of altered fetal growth and developmental programming, congenital anomalies and preterm birth.
O23-2 Application of a shift work job-exposure matrix to investigate occupational differences in women’s accessing of fertility treatment and infertility diagnosis
Publisher: BMJ Publishing Group Ltd
Date: 09-2016
The life journeys of young women project: Objectives, design, and recruitment results
Publisher: Oxford University Press (OUP)
Date: 30-05-2011
DOI: 10.1093/AJE/KWR047
Abstract: The Life Journeys of Young Women Project is the first population-based study to examine the role of economic uncertainty throughout early adulthood on age at first childbirth. A retrospective cross-sectional component was added to an existing cohort study that is based on a birth cohort of women born during 1973-1975 in Adelaide, South Australia (n ∼ 1,000). An event history calendar instrument was used to obtain data regarding a range of life domains including partnering, educational attainment, home ownership, higher education debt, employment, and pregnancies over a 20-year period (sometimes as detailed as at monthly intervals). Interviews were conducted between 2007 and 2009. An analysis framework applying time-varying and time-constant survival analysis techniques within a life-course framework was developed that will guide analyses to examine the role of duration and life-course timing of economic uncertainty on age at first childbirth. This paper discusses study objectives and design, fieldwork procedures, planned statistical analyses, and recruitment outcomes, focusing on novel features that would facilitate analogous epidemiologic research.
Commentary: Early lessons in life: maternal education and fetal growth
Publisher: Oxford University Press (OUP)
Date: 24-07-2010
DOI: 10.1093/IJE/DYQ107
Birthweight and thinness at birth independently predict symptoms of polycystic ovary syndrome in adulthood
Publisher: Oxford University Press (OUP)
Date: 28-02-2012
Abstract: The aetiology of polycystic ovary syndrome (PCOS) is unknown and contested. While it has been suggested that PCOS could have origins in perturbed development, epidemiological findings have been inconclusive. We aimed to examine potential fetal origins of PCOS. A retrospective birth cohort of 948 singleton female babies born at one hospital in South Australia in 1973-1975 was assembled. Birth characteristics were obtained from hospital records and PCOS symptoms were identified through interview and clinical examination when women were ~30 years old. Based on the combination of PCOS symptoms, women formed seven outcome groups. A multinomial logistic regression analysis was used to investigate associations between birth characteristics and these outcome groups. After adjusting for gestational age, two distinct birth characteristics were associated with two PCOS symptom groups. Each 100 g increase in birthweight increased the risk of hyperandrogenism (as a single symptom) in adulthood by 5% [relative risk ratio: 1.05, 95% confidence interval (CI): 1.01-1.09]. In contrast, each one unit increase in the ponderal index at birth decreased the risk of all three key PCOS symptoms (hyperandrogenism, menstrual dysfunction and polycystic ovaries) by 21% (0.79, 95% CI: 0.66-0.93). These results suggest two discrete fetal programming pathways (related to high birthweight and to thinness at birth) are operating. Our findings point to differing aetiologies for symptom clusters, and inform the debate over symptoms that best represent the disorder.
The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria
Publisher: Oxford University Press (OUP)
Date: 12-11-2009
Abstract: Polycystic ovary syndrome (PCOS) is considered to be the most common endocrine disorder in women of reproductive age, yet debate over appropriate diagnostic criteria and design limitations with s ling methodology have left some doubt as to the actual prevalence in the community. The objective of this study was to create a representative prevalence estimate of PCOS in the community under the National Institutes of Health (NIH) criteria and the more recent Rotterdam consensus criteria and Androgen Excess Society (AES) criteria. A retrospective birth cohort study was carried out in which 728 women born during 1973-1975 in a single maternity hospital were traced and interviewed in adulthood (age = 27-34 year n = 728). Symptoms of PCOS (hyperandrogenism, menstrual dysfunction and polycystic ovaries) were identified by examination and the presence of polycystic ovaries in those that did not consent to the ultrasound were imputed. The estimated prevalence of PCOS in this birth cohort using the NIH criteria was 8.7 +/- 2.0% (with no need for imputation). Under the Rotterdam criteria, the prevalence was 11.9 +/- 2.4% which increased to 17.8 +/- 2.8% when imputed data were included. Under the AES recommendations, PCOS prevalence was 10.2 +/- 2.2%, and 12.0 +/- 2.4% with the imputed data. Of the women with PCOS, 68-69% did not have a pre-existing diagnosis. The Rotterdam and AES prevalence estimates were up to twice that obtained with the NIH criteria in this, as well other prevalence studies. In addition, this study also draws attention to the issue of many women with PCOS in the community remaining undiagnosed.
Association between maternal marginalization and infants born with congenital heart disease in Ontario Canada.
Publisher: Springer Science and Business Media LLC
Date: 28-04-2023
DOI: 10.1186/S12889-023-15660-5
Abstract: This study aims to evaluate the impact of socioeconomic status (SES) on the risk of congenital heart disease (CHD) since previous studies have yielded inconsistent results. We conducted a population-based retrospective cohort study, including all singleton live and still births in Ontario hospitals from April 1, 2012, to March 31, 2018. We used linked records from the Better Outcomes Registry & Network Information System, the Canadian Institute for Health Information databases, and the Ontario Marginalization Index (ON_Marg). ON_Marg was estimated at a dissemination area level using Canadian Census 2016 data and categorized into quintiles. Multivariable logistic regression models were performed to examine the relationships between four ON_Marg indices (material deprivation, dependency, ethnic concentration, residential instability), as proxies for maternal SES and the risk of infant CHD. We adjusted for maternal age at birth, assisted reproductive technology, obesity, pre-existing health conditions, substance use during pregnancy, mental health conditions before and during pregnancy, rural residence, and infant’s sex in the analysis. Among the cohort of 776,799 singletons, 9,359 infants had a diagnosis of CHD. Of those, 3,069 were severe CHD and 493 cases were single ventricle CHD. The prevalence of all infant CHD types was higher for males relative to females. Compared to mothers living in neighbourhoods with the lowest material deprivation, mothers with highest material deprivation had a 27% (adjusted OR = 1.27 95% CI: 1.18–1.37) higher odds of having an infant diagnosed with CHD. Mothers living in neighbourhoods with the highest minority ethnic and immigrant concentration tend to have infants with 11% lower odds of CHD (adjusted OR = 0.89 95% CI: 0.82–0.97) as compared to those living in the least ethnically erse communities. Maternal dependency and residential stability quintiles were not significantly associated with the risk of CHD. Higher maternal material deprivation was associated with increasing odds of infant CHD, whereas neighbourhood minority ethnic concentration was inversely associated with the odds of infant CHD. Our study further confirms that poverty is associated with CHD development. Future investigations might focus on the causal pathways between social deprivation, immigrant status, ethnicity, and the risk of infant CHD.
Trends in dental caries experience of school children in Australia ‐ 1977 to 1993
Publisher: Wiley
Date: 12-1997
DOI: 10.1111/J.1834-7819.1997.TB06083.X
Abstract: Data on the dental health of Australian school children from 1977 to 1985 have previously been reported. Significant features included a secular decline in caries experience as defined by the number of decayed, missing and filled teeth in both the deciduous dentition (dmft index) and permanent dentition (DMFT index), and a change in the distribution of caries experience within the child population in Australia, indicated by increasingly smaller percentages of children accounting for greater proportions of total disease experience. The aim of the present paper was to extend the annual reporting on caries experience in Australia up to and including 1993, and to document the change in the distribution of caries within the child population since 1977. In addition, the data are compared with dental targets for children for the year 2000 in Australia and internationally. Caries data were obtained for the years 1977-1993 for children who were patients at School Dental Services in each State and Territory of Australia. Caries experience was recorded by uncalibrated dentists and dental therapists during routine dental examinations. From 1977-89 data were weighted by State and Territory estimated resident populations. From 1989, the data were stratified according to age, year, and State, and weighted to reflect proportions in the national estimated resident population for each State/age stratum. Between 1977 and 1993 there has been a decline in caries experience for 6 year old children from a dift++ of 3.13 to a dmft of 1.90, and an increase in the per cent with dmft = 0 from 33.1 per cent to 53.2 per cent with dmft = 0 in 1993. Over the same time period the DMFT for 12 year olds reduced from 4.79 to 1.10 and the per cent while DMFT = 0 increased from 10.5 per cent to 53.1 per cent. Projection of the decline in DMFT indicates the dental health target for 12 year old children of DMFT = 1.0 by the year 2000 should have been achieved by the end of 1995.
High-level classification of the Fungi and a tool for evolutionary ecological analyses
Publisher: Springer Science and Business Media LLC
Date: 05-2018
Maternal body size prior to pregnancy, gestational diabetes and weight gain: Associations with insulin resistance in children at 9-10 years
Publisher: Wiley
Date: 05-12-2015
DOI: 10.1111/DME.12637
Abstract: To investigate whether maternal body size pre-pregnancy, gestational diabetes and weight gain are independently associated with subsequent insulin resistance in children and to examine the potential mediating role of child's body size in any associations. At 9-10 years, 443 children took part in a follow-up of a prospective cohort. Of those, 163 children elected to provide a fasting blood s le and child insulin resistance was estimated by homeostasis model assessment. Generalized linear models with log link function and Gaussian family were used to assess associations with antenatal exposures. Potential confounders were considered as well as the role of the child's size. Prior to pregnancy, 23% of mothers were overweight and another 17% obese. All women were screened for gestational diabetes, with 6% diagnosed. On average, women gained an estimated 14 kg during pregnancy. Gestational diabetes was positively associated with child insulin resistance. In addition, maternal pre-pregnancy body mass index (BMI) was associated with child insulin resistance in a non-linear manner: a positive, progressive association was observed until BMI of 30 kg/m² was reached, but not thereafter. Estimated gestational weight gain was not associated with child insulin resistance. These findings were not accounted for by size of the child at birth or at 9-10 years. Maternal body size prior to pregnancy is positively associated with increases in child insulin resistance, at least until the 'obese' category is reached. This is independent of gestational diabetes and not mediated by body size of the child, suggesting genetic and/or developmental programming origins.
Maternal depressive symptoms and child care during toddlerhood relate to child behavior at age 5 years
Publisher: American Academy of Pediatrics (AAP)
Date: 07-2011
Abstract: Disentangling the effects of maternal depression in toddlerhood from concurrent maternal depression on child behavior is difficult from previous research. Child care may modify any effects of maternal depression on subsequent child behavior, but this has not been widely investigated. We examined the influence of maternal depressive symptoms during toddlerhood on children's behavior at the age of 5 years and investigated if formal or informal child care during toddlerhood modified any relationship observed. Data were available from 438 mothers and their children (227 girls and 211 boys) the mothers who completed questionnaires during the children's infancy, in toddlerhood, and at the age of 5 years. Recurrent maternal depressive symptoms in toddlerhood (when study children were aged 2 and 3½ years) was a significant risk factor for internalizing, externalizing, and total behavior problems when children were aged 5 years. Intermittent maternal depressive symptoms (study child age 2 or 3½ years) did not significantly affect child behavior problems. Formal child care at the age of 2 years modified the effect of recurrent maternal depressive symptoms on total behavior problems at age 5 years. Informal child care in toddlerhood did not significantly affect child behavior problems. Recurrent, but not intermittent, maternal depressive symptoms when children were toddlers were associated with child behavior problems at age 5 years. As little as half a day in formal child care at the age of 2 years significantly modified the effect of recurrent maternal depressive symptoms on total behavior problems. Formal child care for toddlers of depressed mothers may have positive benefits for the child's subsequent behavior.
Perinatal outcomes by mode of assisted conception and sub-fertility in an Australian data linkage cohort
Publisher: Public Library of Science (PLoS)
Date: 08-01-2014
Complex diseases and co-morbidities: polycystic ovary syndrome and type 2 diabetes mellitus
Publisher: Bioscientifica
Date: 03-2019
DOI: 10.1530/EC-18-0502
Abstract: Many complex diseases exhibit co-morbidities often requiring management by more than one health specialist. We examined cross-speciality issues that ultimately affect the health and wellbeing of patients with polycystic ovary syndrome (PCOS). PCOS was originally described as a reproductive condition but is now recognised to also be a metabolic and psychological condition affecting 8–13% of women of reproductive age. With a four-fold increased risk of type 2 diabetes (DM2), the Population Attributable Risk of DM2 that could be avoided if PCOS were eliminated is a substantial 19–28% of women of reproductive age. To determine the extent to which PCOS is an important consideration in diabetes development, we examined publications, funding, guidelines and predictors of risk of developing DM2. We found that the topic of PCOS appeared in specialist diabetes journals at only 10% the rate seen in endocrinology journals – about 1 in 500 articles. We found research funding to be substantially less than for diabetes and found that diabetes guidelines and predictive tools for DM2 risk mostly ignore PCOS. This is surprising since insulin resistance in women with PCOS has a different aetiology and additionally women with PCOS are at increased risk of becoming overweight or obese – high risk factors for DM2. We consider the causes of these concerning anomalies and discuss current activities to address the co-morbidities of PCOS, including the recent development of international guidelines, an international PCOS awareness program and potentially changing the name of PCOS to better reflect its metabolic consequences.
Lower age at menarche affects survival in older Australian women: Results from the Australian Longitudinal Study of Ageing
Publisher: Springer Science and Business Media LLC
Date: 15-06-2010
Growth trajectories in early childhood, their relationship with antenatal and postnatal factors, and development of obesity by age 9 years: Results from an Australian birth cohort study
Publisher: Springer Science and Business Media LLC
Date: 26-05-2015
DOI: 10.1038/IJO.2015.42
Abstract: In an era where around one in four children in the United Kingdom, the United States, and Australia are overweight or obese, the development of obesity in early life needs to be better understood. We aimed to identify groups of children with distinct trajectories of growth in infancy and early childhood, to examine any association between these trajectories and body size at age 9, and to assess the relative influence of antenatal and postnatal exposures on growth trajectories. Prospective Australian birth cohort study. In total, 557 children with serial height and weight measurements from birth to 9 years were included in the study. Latent class growth models were used to derive distinct groups of growth trajectories from birth to age 3½ years. Multivariable logistic regression models were used to explore antenatal and postnatal predictors of growth trajectory groups, and multivariable linear and logistic regression models were used to examine the relationships between growth trajectory groups and body size at age 9 years. We identified four discrete growth trajectories from birth to age 3½ years, characterised as low, intermediate, high, or accelerating growth. Relative to the intermediate growth group, the low group had reduced z-body mass index (BMI) (-0.75 s.d. 95% confidence interval (CI) -1.02, -0.47), and the high and accelerating groups were associated with increased body size at age 9 years (high: z-BMI 0.70 s.d. 95% CI 0.49, 0.62 accelerating: z-BMI 1.64 s.d. 95% CI 1.16, 2.11). Of the antenatal and postnatal exposures considered, the most important differentiating factor was maternal obesity in early pregnancy, associated with a near quadrupling of risk of membership of the accelerating growth trajectory group compared with the intermediate growth group (odds ratio (OR) 3.72 95% CI 1.15, 12.05). Efforts to prevent childhood obesity may need to be embedded within population-wide strategies that also pay attention to healthy weight for women in their reproductive years.
Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials
Publisher: BMJ
Date: 21-12-2010
DOI: 10.1136/BMJ.C6945
Bodies, mothers and identities: rethinking obesity and the BMI
Publisher: Wiley
Date: 30-08-2007
DOI: 10.1111/J.1467-9566.2007.01029.X
Abstract: Despite the intense level of attention directed towards obesity, there has been limited success in addressing the rising rates of this public health phenomenon. This paper argues that current approaches to obesity fail to consider concepts of embodiment, and in particular, that gendered and class-based experiences of embodiment are ignored in health promotion practices and policies. Drawing on Bourdieu's concept of habitus, this ethnographic study sought to locate obesity within the biographies and everyday experiences of two groups of women from differing socio-economic settings. Rather than identify with the clinical category of obesity, these women constructed identities that were refracted through a gendered and classed habitus, and in particular, through their role as mothers. Food provision and practices were central to constructs of mothering, and these relational identities were at odds with the promotion of in idual behavioural changes. Moreover, these women's daily lives were shaped by different class-based aspects of habitus, such as employment. In demonstrating the ways in which obesity is enmeshed in participants' taken-for-granted, everyday practices, we problematise the universality of health-promotion messages and highlight the integral role that the critical theory of habitus has in understanding the embodiment of obesity.
Overweight infertile patients have a higher fecundity than normal-weight women undergoing controlled ovarian hyperstimulation with intrauterine insemination
Publisher: Elsevier BV
Date: 06-2004
Risk of multiple pregnancy when infertility is treated with ovulation induction by gonadotropins
Publisher: Elsevier BV
Date: 09-2003
Intergenerational associations of chronic disease and polycystic ovary syndrome
Publisher: Public Library of Science (PLoS)
Date: 04-10-2011
Smokers' preferences for assistance with cessation
Publisher: Elsevier BV
Date: 07-1990
DOI: 10.1016/0091-7435(90)90040-Q
Abstract: An important issue for public health approaches to smoking control is determining smokers' preferences for the different types of services available to assist with smoking cessation. In a population survey in the state of South Australia, smokers were asked to nominate the forms of assistance that they thought would help them to stop: a stop-smoking group a lecture a telephone counseling service a book, a p hlet, or a quit kit a television program or a video program conducted through the mail a program through their doctor a program through another health professional or none of these options. Forty-six percent of current smokers stated that they were interested in none of the options. Among the preferences that were expressed for the different forms of assistance, 67% were for services from a medical practitioner or other health professional 12.4% for a stop-smoking group 23.1% for a book, a p hlet, or a quit kit and 2.9% for mail or telephone services. The strong preferences for indirect methods that an earlier study and recent commentators have identified did not emerge in this survey. Preferences for personalized, as opposed to indirect forms of assistance, were more likely to be expressed by heavy smokers, those with less confidence of success at stopping, those with greater perceived difficulty of stopping, and those who had reported shorter periods of previous abstinence from smoking.
Programming and reproductive functioning
Publisher: Elsevier BV
Date: 11-2002
DOI: 10.1016/S1043-2760(02)00691-4
Abstract: Here, we explore the influence of fetal programming and early life exposures on lifelong reproductive health through modification of the hypothalamic-pituitary-gonadal axis. A range of programming issues are considered with ex les from the literature demonstrating that environmental or nutritive exposures have a crucial role in reproductive performance, fetal growth, postnatal development and reproduction-related disease risk. We pay particular attention to recent research on associations between indicators of fetal and postnatal growth and the etiology of polycystic ovary syndrome in women. We conclude that the concept of programming can be applied to reproductive development and related health outcomes, and that the complex potential for interactions between parameters controlling fetal development and postnatal exposures invokes a need to adopt a perspective across the life course of an in idual.
Polycystic ovary syndrome - diagnosis and etiology
Publisher: Elsevier BV
Date: 04-2004
Mental disorders in children conceived after fertility treatment
Publisher: BMJ
Date: 28-08-2013
DOI: 10.1136/BMJ.F5257
Low and Very Low Birth Weight after Use of Assisted Reproductive Technology
Publisher: Massachusetts Medical Society
Date: 31-10-2002
Validity of a simplified measure of participation in vigorous physical activity
Publisher: AMPCo
Date: 06-1988
DOI: 10.5694/J.1326-5377.1988.TB93824.X
Abstract: We assessed in a case-control study the test-validity of Aedes larval indices for the 2000 Havana outbreak. "Cases" were blocks where a dengue fever patient lived during the outbreak. "Controls" were randomly s led blocks. Before, during, and after the epidemic, we calculated Breteau index (BI) and house index at the area, neighborhood, and block level. We constructed receiver operating characteristic (ROC) curves to determine their performance as predictors of dengue transmission. We observed a pronounced effect of the level of measurement. The BI(max) (maximum block BI in a radius of 100 m) at 2-month intervals had an area under the ROC curve of 71%. At a cutoff of 4.0, it significantly (odds ratio 6.00, p<0.05) predicted transmission with 78% sensitivity and 63% specificity. Analysis of BI at the local level, with human-defined boundaries, could be introduced in control programs to identify neighborhoods at high risk for dengue transmission.
Self-reported physical health status of donor sperm-conceived adults
Publisher: Cambridge University Press (CUP)
Date: 28-08-2020
DOI: 10.1017/S204017442000080X
Abstract: Donor-conceived neonates have poorer birth outcomes, including low birth weight and preterm delivery that are associated with poorer long-term health in adulthood through the developmental origins of health and disease (DOHaD) theory. The aim of this study was to conduct the first investigation of the adult health outcomes of donor-conceived people. An online health survey was completed by 272 donor sperm-conceived adults and 877 spontaneously conceived adults from around the world. Donor and spontaneously conceived groups were matched for age, sex, height, smoking, alcohol consumption, exercise, own fertility and maternal smoking. Donor sperm-conceived adults had significantly higher reports of being diagnosed with type 1 diabetes ( P = 0.031), thyroid disease ( P = 0.031), acute bronchitis ( P = 0.008), environmental allergies ( P = 0.046), sleep apnoea ( P = 0.037) and having ear tubes/grommets surgically implanted ( P = 0.046). This is the first study to investigate the health outcomes of adult donor sperm-conceived people. Donor sperm-conceived adults self-reported elevated frequencies of various health conditions. The outcomes are consistent with birth defect data from donor sperm treatment and are consistent with the DOHaD linking perturbed early growth and chronic disease in adulthood.
The role of lifestyle modification in polycystic ovary syndrome
Publisher: Elsevier BV
Date: 08-2002
DOI: 10.1016/S1043-2760(02)00612-4
Abstract: Polycystic ovary syndrome (PCOS) is a common endocrine condition with reproductive and metabolic consequences, including anovulation, infertility and an increased prevalence of diabetes mellitus. Obesity, central obesity and insulin resistance are strongly implicated in its etiology and reduction of these risk factors should be a central treatment focus. Short-term weight loss has been consistently successful in reducing insulin resistance and restoring ovulation and fertility. However, problems arise with maintaining weight loss and precisely quantifying the associated long-term benefits of risk factor change. Although recent research indicates modest long-term lifestyle changes might reduce the extent of impaired glucose tolerance and delay the conversion to diabetes mellitus in the general population, this has not yet been examined in women with PCOS. Current conservative treatment should emphasize sustainable weight loss through dietary modification and exercise. Modifying additional lifestyle factors, including alcohol consumption, psychosocial stressors and smoking, are also crucial in long-term treatment of PCOS.
Neurological sequelae in in-vitro fertilisation babies
Publisher: Elsevier BV
Date: 08-2002
Abstract book of the 31stESHRE Annual Meeting, Lisbon, Portugal, 14–17 June 2015
Publisher: Oxford University Press (OUP)
Date: 06-2015
Structured Regression Analyses of Life Course Processes: An Example Exploring How Maternal Depression in Early Childhood Affects Children's Subsequent Internalizing Behavior
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.ANNEPIDEM.2011.04.002
Abstract: One of the specific aims of life course epidemiology is to assess the explanatory utility of three general hypotheses, namely the critical period hypothesis, the accumulation of risk hypothesis, and the effect modification hypothesis. A structured regression approach to this problem is illustrated with data from an ongoing longitudinal study of children and their families established in Adelaide in 1998-2000. A series of nested models that correspond to the alternative life course hypotheses were fit in an investigation of the effects of maternal depressive states in early childhood on internalizing child behavior at 9.5 years. Both linear and logistic regression models were considered. The structured regression framework showed the accumulation hypothesis was most plausible for these data. The analyses also provided some evidence of a critical period for the effect of maternal depressive status around child age 2 years on internalizing behavior at 9.5 years. The findings of this study suggest that comparing a suite of nested models to a full model can be useful in attempting to disentangle life course processes.
Body mass and probability of pregnancy during assisted reproduction treatment: retrospective study
Publisher: BMJ
Date: 25-11-2000
Maternal factors and the risk of birth defects after IVF and ICSI: A whole of population cohort study
Publisher: Wiley
Date: 17-10-2016
Abstract: To assess the contribution of maternal factors to major birth defects after in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), and natural conception. Retrospective cohort study in South Australia for the period January 1986 to December 2002. A whole of population study. A census of all IVF and ICSI linked to registries for births, pregnancy terminations, and birth defects (diagnosed before a child's fifth birthday). Odds ratios (ORs) for birth defects were calculated among IVF, ICSI, and natural conceptions for maternal age, parity, pre-pregnancy BMI, smoking, pre-existing diseases, and conditions in pregnancy, with adjustment for confounding factors. Birth defects classified by International Classification of Diseases (ninth revision) and British Paediatric Association (ICD9-BPA) codes. There were 2211 IVF, 1399 ICSI, and 301 060 naturally conceived births. The unadjusted prevalence of any birth defect was 7.1, 9.9, and 5.7% in the IVF, ICSI, and natural conception groups, respectively. As expected, the risk of birth defects increased with maternal age among the natural conceptions. In contrast, for IVF and ICSI combined, relative to natural conceptions, births to women aged ≤29 years had a higher risk (adjusted odds ratio, aOR 1.42 95% confidence interval, 95% CI 1.04-1.94), births to women aged 35-39 years had no difference in risk (aOR 1.01 95% CI 0.74-1.37), and births to women aged ≥40 years had a lower risk of defects (aOR 0.45 95% CI 0.22-0.92). Defects were also elevated for nulliparity, anaemia, and urinary tract infection in births after ICSI, but not after IVF. The usual age-birth defect relationship is reversed in births after IVF and ICSI, and the associations for other maternal factors and defects vary between IVF and ICSI. Risk of birth defects in women over 40 years is lower after infertility treatment than for natural conceptions.
Consumption of nonpublic water: implications for children's caries experience.
Publisher: Wiley
Date: 06-07-2004
Changes in affect and state anxiety across an in vitro fertilization/intracytoplasmic sperm injection cycle
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.FERTNSTERT.2008.12.054
Abstract: To identify pattern of change in average positive affect (PA), negative affect (NA), and state anxiety (St ANX) across three biological end points of an IVF/intracytoplasmic sperm injection (ICSI) procedure and to examine whether the pattern varied across sociodemographic and biomedical subgroups. Longitudinal follow-up study of PA, NA, and St ANX at three different time points: before start of study, before ovum pick-up (OPU), and before embryo transfer. Three infertility centers in northern India. Baseline data were obtained from a consecutive s le of 85 women. However, final analysis was done on data obtained from 74 women who reached the embryo transfer stage and completed the questionnaires at both OPU and embryo transfer. The PA, NA, and St ANX scores. Change in PA, NA, and St ANX scores at three stages of the treatment: baseline (T(0)), before OPU (T(1)), before embryo transfer (T(2)). The PA scores before OPU and embryo transfer were significantly lower than those at baseline. The mean NA and St ANX scores before OPU and embryo transfer were significantly higher than baseline scores. Furthermore, mean NA before embryo transfer was significantly higher than mean NA before OPU. The PA and St ANX scores showed statistically insignificance within cycle variations. Furthermore, the mean PA and St ANX for a subgroup of women who reported more than moderate level of burden were less variable. The OPU and embryo transfer stages are more stressful than the baseline stage for most women across various sociodemographic and biomedical subgroups. Women with more than a moderate level of financial burden were relatively more stable.
Musculoskeletal status of men and women who entered a fitness programme
Publisher: AMPCo
Date: 04-1988
DOI: 10.5694/J.1326-5377.1988.TB115962.X
Abstract: The musculoskeletal status at entry into a fitness programme and the incidence of injuries during the first four months of the programme were evaluated in 991 men and women who were aged 20-63 years. At entry, about half of the subjects reported having received treatment for musculoskeletal ailments previously, or that currently they were experiencing musculoskeletal pain and/or discomfort, and about one-third of the subjects reported one or more movement limitations. New injuries during the first four months of the programme were reported by 38% of subjects, with an average duration of impairment of 3.8 weeks, and 43% of those who were injured sought medical treatment. The most frequent type, location, and cause of injury were "joint sprains/strains" (66%), the lower leg (70%), and jogging (33%), respectively. Musculoskeletal problems (previous treatment, current pain or discomfort or movement limitations) in the leg did not predict leg injuries during the programme, but back problems did predict back injuries. Age, sex, body mass index, a parental history of musculoskeletal disease, a sporting history, and the frequency of vigorous exercise during the first four months did not predict injury. The study emphasized: first, the vulnerability of previously-sedentary persons to musculoskeletal injury and the consequent need for care in the management of fitness programmes secondly, the need for the evaluation of such programmes if they are to have a rational rather than an intuitive basis and thirdly, the need for epidemiological research on the musculoskeletal system as a basis for systematic efforts, partly through education and ergonomics, to reduce wear and tear on the musculoskeletal system.
A meta-analysis of sperm donation offspring health outcomes
Publisher: Cambridge University Press (CUP)
Date: 30-08-2016
DOI: 10.1017/S2040174416000489
Abstract: Although the use of donor sperm as a treatment modality for male infertility has become common place, the health outcomes for those conceived has been poorly studied. A structured search of the literature using PubMed, EMBASE and Cochrane Reviews was performed to investigate the health outcomes of offspring conceived from donor sperm. Eight studies were eligible and included in the review, and of these, three were included in a meta-analysis. Meta-analysis of clinical outcomes showed that donor sperm neonates are not at increased risk of being born of low birth weight ( g), preterm ( weeks) or with increased incidences of birth defects, than spontaneously conceived neonates.
Fertility treatments and the young women who use them: An Australian cohort study
Publisher: Oxford University Press (OUP)
Date: 11-11-2011
Abstract: In Australia, fertility treatment is partly or wholly reimbursable under federal benefits schemes, without restrictions on age, number of treatment cycles or existing family size. In this study, we aimed to characterize the potential need for and use of fertility treatments in a population-based cohort of young Australian women. We conducted structured interviews with 974 members of a cohort constructed by tracing all female infants born at a single general hospital in Adelaide between 1973 and 1975. The main outcome measures were pregnancy history, difficulty becoming pregnant and assistance sought to become pregnant. Of 657 women aged 30-32 who had sought pregnancy, 24% reported difficulty becoming pregnant and 26% had lost at least one pregnancy. Ovulatory problems (16%) and male fertility problems (13%) were common among those with difficulty. Over half of the women who had difficulty conceiving (58%) sought assistance, largely from specialists (53%). Consultations, tests and education only were common (22%), as were IVF/ICSI (17%). Close to a third (28%) of those seeking assistance were treated only with clomiphene, as were two-thirds (67%) of women with ovulatory problems. In this study, almost a quarter of women in their early 30s reported difficulty conceiving, and over a quarter reported pregnancy loss. This suggests that a significant proportion of young women experience substantial difficulties becoming pregnant. Our findings highlight the need to continue to document the range of women's reproductive experiences and to monitor fertility and treatment-seeking trends.
Prevention of multiple gestation in IVF: Introduction to Theme
Publisher: Wiley
Date: 14-11-2006
Assisted reproductive technologies: a hierarchy of risks for conception, pregnancy outcomes, and treatment decisions – ERRATUM
Publisher: Cambridge University Press (CUP)
Date: 05-10-2017
Development of Hypertension in a Rat Model of Diet-Induced Obesity
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2000
Abstract: Abstract —Although obesity is a risk factor for hypertension, the relationship between these 2 conditions is not well understood. Therefore, we examined some parameters of hypertension and cardiovascular disease in a dietary model of obesity. Male Sprague-Dawley rats were provided either a control diet (C) or a diet containing 32% kcal as fat (similar to a Western diet) for 1, 3, or 10 weeks. Rats in the latter group erged based on body weight gain into obesity-prone (OP) and obesity-resistant (OR) groups. Systolic blood pressure in OP rats was significantly higher after 10 weeks of the diet (149±4.8 mm Hg) compared with both OR and C groups (131±3.7 and 129±4.5 mm Hg, respectively). The aortic wall area of OP rats was significantly increased, indicating arterial hypertrophy, and a 2-fold increase in plasma renin activity was found in OP rats compared with OR and C rats. The lipid profile showed a significant increase in plasma and VLDL triglycerides of OP versus OR and C groups as early as 3 weeks on the diet. Plasma and LDL-cholesterol levels were increased in the OP group versus the OR and C groups after 3 weeks of the diet, but the difference was blunted after 10 weeks. Lipid peroxidation (thiobarbituric acid–reactive substances) in OP rats was increased 2-fold in LDL and 1.5-fold in aortic wall compared with OR rats, suggesting an increased oxidative stress in these animals. Periodic acid–Schiff staining of the kidney showed mesangial expansion and focal sclerosis that were more prominent in OP rats than in OR rats. The results suggest that hypercholesterolemia, but not hypertriglyceridemia, is linked to the diet that hypertension and renin-angiotensin system activation are associated with obesity and that lipid peroxidation and renal damage are the results of both factors.
Measuring Trends in Infant Mortality Due to Unintentional Suffocation
Publisher: American Medical Association (AMA)
Date: 09-2018
Waist-to-Height Ratio is not a Predictor of Systolic Blood Pressure in 3-Year-Old Children
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.JPEDS.2011.05.017
Abstract: Waist:height has been proposed as an indicator of cardiovascular risk. We investigated the association of waist:height with systolic BP (sBP) in 3 year old children. Body mass index was a significant predictor of sBP, whereas waist:height was not: suggesting waist:height is not a useful indicator of sBP in this age group.
Relationships between change in aerobic fitness and changes in blood pressure and plasma lipids in men and women: The “Adelaide 1000” 4-year follow up
Publisher: Elsevier BV
Date: 02-1993
DOI: 10.1016/0895-4356(93)90052-3
Abstract: The aim was to assess relationships between increased aerobic fitness sustained over 4 years, and changes in blood pressure (SBP and DBP) and lipids. Measurements were made of BP, lipids, weight, and fitness in 1000 middle-aged men and women entering a fitness programme, and were repeated 2 and 4 years later. The 342 men and women selected for this 4-year follow-up were either consistent fitness "gainers" (improved by > 5%) or "non-gainers" (improved by < or = 5%) at 2 and 4 year stages. For men, comparisons of these groups and multiple regression analyses failed to show significant relationships between changes in fitness and risk factors over the 4 year period. For women, "gainers" improved more than "non-gainers" in SBP (by 4 mmHg, p < 0.03), HDL/cholesterol ratio (by 0.01 mmol l-1, p < 0.0001), and triglycerides (by 0.02 mmol l-1, p < 0.05) regression analyses resulted in a significant relationship between changes in fitness and SBP (B = 0.012, p < 0.05). The study gave weak support to the existence of causal relationships between aerobic fitness and CHD risk factors for women, and no support for men.
Passive Smoking and Dental Caries in Children—Reply
Publisher: American Medical Association (AMA)
Date: 11-06-2003
Associations between exposure to fluoridated drinking water and dental caries experience among children in two Australian states
Publisher: Wiley
Date: 09-1995
DOI: 10.1111/J.1752-7325.1995.TB02373.X
Abstract: This study assessed associations between exposure to fluoride in water and dental caries experience among children in two Australian states. Cross-sectional data were obtained from 9,690 South Australian children aged 5-15 years and 10,195 Queensland children aged 5-12 years. School dental service practitioners recorded DMFS and dmfs data. A questionnaire to parents gained information about residential history that was used to calculate children's percent of lifetime exposed to fluoridated water. Greater exposure to fluoride in water was associated with lower dmfs and DMFS in both states (P < .01), although in South Australia the effect for DMFS was statistically significant only after controlling for extent of unknown fluoridation exposure and for fluoride supplements. Caries-fluoridation associations were stronger for dmfs compared with DMFS and for Queensland (5% of population fluoridated) compared with South Australia (70% of population fluoridated). Effects for DMFS persisted after controlling for socioeconomic factors. Fluoridation was associated with lower caries experience. The weaker association with DMFS in South Australia may be due to less caries and more fissure sealants in that state, and is consistent with a "diffusion" effect, whereby a high proportion of the population exposed to fluoridation diminishes differences among exposure groups.
The impact of specific fertility treatments on cognitive development in childhood and adolescence: a systematic review
Publisher: Oxford University Press (OUP)
Date: 04-05-2017
Abstract: Does fertility treatment influence cognitive ability in school aged children, and does the impact vary with the type of treatment? The available high-quality evidence indicates that specific treatments may give rise to different effects on cognitive development, with certain treatments, including ICSI, associated with cognitive impairment. Previous reviews of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally 'reassuring', but limited attention has been paid to the quality of this research. In addition, no review has separately assessed the range of treatment modalities available, which vary in invasiveness, and thus, potentially, in their effects on developmental outcomes. A systematic review was undertaken. We searched PubMed, PsycINFO and the Educational Resources Information Centre database to identify English-language studies published up until 21 November 2016. Two authors independently reviewed identified articles, extracted data and assessed study quality. Studies were eligible if they assessed cognitive development from age 4 years or more, among children conceived with fertility treatment compared with either children conceived naturally or children born from a different type of fertility treatment. Where available, data were extracted and reported separately according to the various components of treatment (e.g. mode of fertilization, embryo freezing, etc.). Risk of bias was assessed using the Newcastle-Ottawa Scale, with a score ≥7/9 indicative of high quality. The search identified 861 articles, of which 35 were included. Of these, seven were rated high quality. Most studies (n = 22) were subject to selection bias, due to the exclusion of children at increased risk of cognitive impairment. Among high-quality studies, there was no difference in cognitive outcomes among children conceived with conventional IVF and those conceived naturally. Findings among high-quality studies of children conceived with ICSI were inconsistent: when compared with children conceived naturally, one study reported lower intelligence quotient (IQ 5-7 points, on average) among ICSI children whereas the remaining two high-quality studies reported no difference between groups. Furthermore, among the three high-quality studies comparing children conceived with ICSI compared with conventional IVF, one reported a significant increase in the risk of mental retardation, one reported a small difference in IQ (3 points lower, on average) and one no difference at all. There were scant studies examining exposure to embryo freezing, or less invasive treatments such as ovulation induction without IVF/ICSI. Most existing studies had methodological limitations including selection bias and/or failure to address confounding by family background. In addition, a meta-analysis could not be performed due to heterogeneity in the assessment of cognitive outcomes. These factors impeded our ability to synthesize the evidence and draw reliable conclusions. The conflicting findings among studies of children conceived with ICSI require clarification, in light of the increasing use of this technique for reasons other than male-factor infertility. Further population-based studies are needed that utilize contemporary data to examine specific aspects of treatment and combinations of techniques (e.g. ICSI with frozen embryo cycles). Importantly, studies should include the complete group of children exposed to treatment. A.R.R. is supported by a Career Development Fellowship from the National Health and Medical Research Council of Australia. L.J.M. is funded by a fellowship from the Heart Foundation of Australia. The authors declare there are no competing interests. Not applicable.
Obesity Increases the Risk of Spontaneous Abortion during Infertility Treatment
Publisher: Wiley
Date: 06-2002
DOI: 10.1038/OBY.2002.74
Abstract: This study examines the relationship between body mass and the risk of spontaneous abortion in a large cohort of patients who received infertility treatment. This is a retrospective study using data on pregnancies (n = 2349) achieved after treatment in a tertiary medical center from 1987 to 1999. One pregnancy per subject was included, and the subjects were stratified into five body mass groups based on body mass index (BMI): underweight, or =35 kg/m(2). Logistical regression analysis was used. The overall incidence of spontaneous abortion was 20% (476 of 2349). The effect of BMI on the risk of spontaneous abortion was significant after adjusting for several independent risk factors. Compared with the reference group (BMI 18.5 to 24.9 kg/m(2)), underweight women had a similar risk of spontaneous abortion, whereas there was progressive increase of risk in overweight, obese, and very obese groups (p < 0.05, p < 0.01, and p < 0.001, respectively). Of all known risk factors for spontaneous abortion, the control of obesity has great significance because it is noninvasive, potentially modifiable, possibly amenable to low cost, and self-manageable by patients. This study established a positive relationship between BMI and the risk of spontaneous abortion in women who became pregnant after assisted reproductive technology treatment.
The use of computer-assisted telephone interviewing for health surveys
Publisher: Elsevier BV
Date: 02-1996
DOI: 10.1111/J.1467-842X.1996.TB01349.X
Abstract: Hepatocellular carcinoma (HCC) is one of the most common malignancies with high mortality. The key genes involved in initiation and development of HCC is not entirely clear. We performed a meta-analysis of available transcriptome data from 6 independent HCC datasets [5 datasets from the Gene Expression Omnibus (GEO) and 1 dataset from The Cancer Genome Atlas (TCGA)]. The associations of the nucleolar and spindle-associated protein 1 (NUSAP1) expression level with clinicopathological factors and survival times were analyzed. Two representative HCC cell models were built to observe the proliferation capacity of HCC cells when NUSAP1 expression was inhibited by shNUSAP1. Based on the transcriptome and survival data in the GEO and TCGA databases, Our study provides evidence that NUSAP1 may serve as a candidate prognostic marker and a target for future therapeutic intervention in HCC.
Preterm Birth and Small Size for Gestational Age in Singleton, In Vitro Fertilization Births Using Donor Oocytes
Publisher: Oxford University Press (OUP)
Date: 09-03-2018
DOI: 10.1093/AJE/KWY051
Abstract: We used 2006-2015 US National Assisted Reproductive Technology Surveillance System data to compare preterm birth and fetal growth for liveborn singletons (24-42 weeks' gestation) following in vitro fertilization with donor versus autologous oocytes. Using binary and multinomial logistic regression, we computed adjusted odds ratios and 95% confidence intervals for associations between use of donor oocytes and preterm delivery, being small for gestational age (SGA), and being large for gestational age (LGA), stratified by fresh and thawed embryo status and accounting for maternal characteristics and year of birth. There were 204,855 singleton births from fresh embryo transfers and 106,077 from thawed embryo transfers. Among fresh embryo transfers, donor oocyte births had higher odds of being preterm (adjusted odd ratio (aOR) = 1.32, 95% confidence interval (CI): 1.27, 1.38) or LGA (aOR = 1.27, 95% CI: 1.21, 1.33) but lower odds of being SGA (aOR = 0.81, 95% CI: 0.77, 0.85). Among thawed embryo transfers, donor oocyte births had higher odds of being preterm (aOR = 1.57, 95% CI: 1.48, 1.65) or SGA (aOR = 1.22, 95% CI: 1.14, 1.31) but lower odds of being LGA (aOR = 0.87, 95% CI: 0.82, 0.92). Use of donor oocytes was associated with increased odds of preterm delivery irrespective of embryo status odds of being SGA were increased for donor versus autologous oocyte births among thawed embryo transfers only.
Towards less confusing terminology in reproductive medicine - Clarifying medical ambiguities to the benefit of all
Publisher: Oxford University Press (OUP)
Date: 21-07-2005
Abstract: It has been argued that terminology in reproductive medicine related to reproductive success is ambiguous, confusing and misleading. A proposed solution is the conditional use of the term 'fertility' which is qualified according to statements concerning description, diagnosis and prognosis, and for which a grading system is proposed. We argue that there already exists (from 1989) a well-articulated conceptualization of fertility that does not appear to have been well disseminated within reproductive medicine. Within this conceptualization there is an important place for separate terms that clearly distinguish aetiology from outcome. We therefore see a central role for maintaining and articulating the terms fecundity and fertility. It is also suggested that one source of confusion within reproductive medicine stems from the conflation of interests for clinicians and patients when discussing infertility as both a cause and an outcome. Unpacking the meaning of the term 'infertility' reveals a complex of interdependent concepts that are both social and biological in origin.
Time to initiation of oral antihyperglycemic and statin therapy in previously untreated patients with type 2 diabetes in the United States
Publisher: Informa Healthcare
Date: 10-05-2013
DOI: 10.1185/03007995.2013.800473
Abstract: To assess the time from the first observed diagnosis of type 2 diabetes (T2DM) to initiation of an oral antihyperglycemic agent (OAHA) and statin. In a retrospective US cohort study using the GE electronic medical record database, patients ≥18 years were included if they had a T2DM diagnosis between January 1, 2004 and December 31, 2005 (index period), had a last pre-index HbA1c value ≥7%, and had not received antihyperglycemic agents within one year prior to diagnosis (index date). Patients were eligible for statin therapy but not on a statin within one year before the index date. Patients had medical records for one year prior to (baseline) and two years after (follow up) diagnosis. Of the 2254 eligible patients, 58% were male, mean age was 58 years, mean HbA1c was 8.5%, and mean LDL cholesterol was 115 mg/dL (2.97 mmol/L) at baseline. Additionally, 21% of patients had pre-existing overt cardiovascular disease, 40% had dyslipidemia, 37% were obese, and 11% were smokers. During follow-up, 66.1% and 41.9% of patients initiated an OAHA and a statin, respectively. Among the treated patients, median time from the first observed diabetes diagnosis to therapy initiation was 3 months (interquartile range: 1, 9) for OAHAs and 6 months (2, 13) for statins. Treatment initiation with injectable antihyperglycemic agents and/or non-statin lipid-modifying therapies as well as contraindications to OAHAs or statins were not assessed, therefore their impact on our study results cannot be determined. Laboratory measurements were not available for every patient and thus many patients were excluded from the analysis. Treatment initiation with OAHAs and/or statins was suboptimal in patients with T2DM who were treatment eligible and previously untreated with OAHAs and statins. Of those treated, patients initiated treatment with an OAHA more often and earlier than with a statin.
Mothers' views on feeding infants around the time of weaning
Publisher: Cambridge University Press (CUP)
Date: 09-2006
DOI: 10.1079/PHN2005915
Abstract: To describe women's views about aspects of infants' diets around the time of weaning, making comparisons with national guidelines. A survey of women with a 9-month-old child. Adelaide, South Australia. Five hundred and five women who joined a longitudinal study during pregnancy. Sources of information varied, with written material most commonly used (37%). Cows' milk was considered suitable as the main drink for weaned infants by 14% of women. There were ergent views about the suitability of eggs, with many women concerned about allergy. The majority of women (84%) viewed fruit juice as suitable although many qualified their response, often by stating that fruit juice should be diluted. Almost all women considered the amount of sugar mattered, primarily because of tooth decay, and that salt mattered although the reason was often uncertain. It was widely believed (77%) that additives in food could cause health problems, in particular hyperactivity and allergies, and half of the women reported avoiding specific foods because of concerns about allergies. Many women thought that giving their child food that was high in fat would encourage a liking for ‘junk’ food or lead to fatness in adulthood. There is considerable ersity in the views women express about aspects of infant feeding that have been the subject of guidelines. Further health promotion efforts are needed to achieve greater consistency with recommendations and to address other concerns women have. This will entail greater engagement with parents and shared development of responses.
The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis
Publisher: Wiley
Date: 31-10-2013
Impact of male factor infertility on offspring health and development
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.FERTNSTERT.2019.05.006
Abstract: Monitoring the safety of intracytoplasmic sperm injection (ICSI) has been impeded by uncertainties regarding the extent to which offspring health is influenced by paternal characteristics linked to male infertility or the processes that ICSI treatment entails. Few studies examining long-term health and developmental outcomes in children conceived with ICSI have considered the influence of paternal infertility adequately. In the available literature, large population-based studies suggest underlying male factors, and the severity of male factor infertility, increase the risk of mental retardation and autism in offspring, as does the ICSI procedure itself, but these findings have not been replicated consistently. Robust evidence of the influence of male factors on other health outcomes is lacking, with many studies limited by s le size. Nevertheless, emerging evidence suggests children conceived with ICSI have increased adiposity, particularly girls. Further, young men conceived with ICSI may have impaired spermatogenesis the mechanisms underlying this remain unclear, with inconclusive evidence of inheritance of Y chromosome microdeletions. The current inconsistent and often sparse literature concerning the long-term health of children conceived with ICSI, and the specific influence of male infertility factors, underscore the need for concerted monitoring of children conceived with this technique across the lifespan. With the rapid expansion of use of ICSI for non-male factors, sufficiently large studies that compare outcomes between groups conceived with this technique for male factors versus non-male factors will provide critical evidence to elucidate the intergenerational impact of male infertility.
Assisted reproductive technologies: a hierarchy of risks for conception, pregnancy outcomes and treatment decisions
Publisher: Cambridge University Press (CUP)
Date: 19-07-2017
DOI: 10.1017/S2040174417000526
Abstract: The use of assisted reproductive technologies (ART) for the treatment of infertility has grown exponentially over the last 20 years, and now accounts for 4% of all births in Australia, and over 1 m births annually around the globe. There is consistent reporting of increased risk of adverse perinatal outcomes and birth defects following infertility treatment. However, change in practice has been stymied by critical knowledge gaps with regards to (a) the relative contribution of patient and treatment factors to adverse outcomes, (b) the independent contribution of specific contemporary treatments and treatment combinations to outcomes, (c) the impact of innovations in laboratory and clinical practice on treatment success and observed risk and (d) changes over time in patient characteristics. Here we summarize key findings from the South Australian Birth Cohort, which is a whole-of-population cohort of over 300,000 births from 1986 to 2002. Relative to spontaneous conceptions, singletons from assisted conception were more likely to be stillborn [odds ratio (OR)=1.82 95% confidence interval (CI) 1.34–2.48], while survivors as a group were comprehensively disadvantaged at birth, including lower birth weight (OR=2109 g 95% CI 2129–289), very low birth weight (OR=2.74 95% CI 2.19–3.43), very preterm birth (OR=2.30 95% CI 1.82–2.90) and neonatal death (OR=2.04 95% CI 1.27–3.26). Major birth defects, including cardiac, urogenital and musculoskeletal defects are doubled after fresh ICSI cycles, which is a particular concern as ICSI now accounts for 70% of all treatment cycles globally. Future study is needed to provide contemporary, precise evidence to inform patient and clinic decision making, and generate knowledge for future innovation in ART laboratory methods and clinical practice, thereby optimizing treatment and health outcomes while reducing adverse events.
Assessment of exposure to shiftwork mechanisms in the general population: The development of a new job-exposure matrix
Publisher: BMJ
Date: 06-08-2014
DOI: 10.1136/OEMED-2014-102101
Abstract: To develop a job-exposure matrix (JEM) that estimates exposure to eight variables representing different aspects of shiftwork among female workers. Occupational history and shiftwork exposure data were obtained from a population-based breast cancer case-control study. Exposure to light at night, phase shift, sleep disturbances, poor diet, lack of physical activity, lack of vitamin D, and graveyard and early morning shifts, was calculated by occupational code. Three threshold values based on the frequency of exposure were considered (10%, 30% and 50%) for use as cut-offs in determining exposure for each occupational code. JEM-based exposure classification was compared with that from the OccIDEAS application (job-specific questionnaires and assessment by rules) by assessing the effect on the OR for phase shift and breast cancer. Using data from the Australian Workplace Exposure Study, the specificity and sensitivity of the threshold values were calculated for each exposure variable. 127 of 413 occupational codes involved exposure to one or more shiftwork variables. Occupations with the highest probability of exposure shiftwork included nurses and midwives. Using the 30% threshold, the OR for the association between phase shift exposure and breast cancer was decreased and no longer statistically significant (OR=1.14, 95% CI 0.92 to 1.42). The 30% cut-off point demonstrated best specificity and sensitivity, although results varied between exposure variables. This JEM provides a set of indicators reflecting biologically plausible mechanisms for the potential impact of shiftwork on health and may provide an alternative method of exposure assessment in the absence of detailed job history and exposure data.
Research Priorities for Fertility and Conception Research as Identified by Multidisciplinary Health Care Practitioners and Researchers
Publisher: MDPI AG
Date: 13-01-2016
DOI: 10.3390/NU8010035
Early life influences on later health: the role of nutrition
Publisher: Wiley
Date: 06-2001
Evidence for effects of weight on reproduction in women
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/S1472-6483(10)61180-7
Abstract: Body weight, and its constituent components of fat mass and lean tissue, plays an important role modulating reproductive development and functioning. Body weight influences the timing of menarche and the capacity to achieve a pregnancy. The nature of this relationship appears to be some variant on a 'U' shape. Extremes in body weight are associated with infertility and a range of adverse outcomes for both mother and baby across the course of pregnancy and perinatal period. Whereas underweight is associated with poor fetal growth and elevated pregnancy loss, overweight is more strongly associated with diseases in pregnancy, pregnancy loss and stillbirth and high birth weight. An emerging area of interest is the role of obesity on fertility, and the intergenerational 'tracking' of high maternal body weight into the second and subsequent generations, resulting not only in an increased risk of metabolic disease, but also perturbed reproductive functioning in the offspring.
Telescoping the origins of obesity to women's bodies: How gender inequalities are being squeezed out of Barker's hypothesis
Publisher: Informa UK Limited
Date: 22-06-2011
DOI: 10.3109/03014460.2011.591829
Abstract: This paper traces the genealogy of the Barker hypothesis and its intersections with popular representations of scientific discourses about pregnancy and maternal obesity. Drawing on Foucault's genealogical method, this study examines the historical 'descent' of the developmental origins of adult disease and its initial grounding in structural factors of gender inequality and low socioeconomic status. In the more recent reproductive medicine literature, Barker's hypothesis has been used to understand the causes and consequences of foetal over-nutrition and has shifted its focus from social determinants to in idual, gendered bodies. The print media has gainfully employed this conceptualization of obesity and, in doing so, placed women, and mothers in particular, as causal agents in the reproduction of obesity across generations. Such a 'common sense' understanding of obesity production and reproduction means that both the scientific literature and the public understanding of science has inadvertently assisted in putting women forward as the transmitters of obesity across generations. This powerful telescoping of the origins of obesity to women's bodies and their appetites is in stark contrast to earlier foci on gender inequalities and changing women's circumstances.
Fetal programming: the perspective of single and twin pregnancies
Publisher: CSIRO Publishing
Date: 2005
DOI: 10.1071/RD04101
Abstract: Multiple pregnancy is associated with increased risk of adverse consequences for both mother and fetus(es), including increased rates of maternal hypertension and pre-ecl sia, spontaneous abortion, Caesarean delivery, low birthweight, birth prematurity, perinatal mortality, admission to neonatal intensive care and extended length of care, respiratory distress, cerebral palsy, developmental delay, contact with disability services and mortality to age 5 years. Premature birth, which affects 97% of triplets and 53.3% of twins in Australia, is not the sole factor involved. The rate of multiple pregnancy in Australia is 1.7%. This compares to 22.1% for pregnancies resulting from assisted reproduction technology (ART). As a result, 21.8% of babies born from ART are from a multiple pregnancy, in comparison to the USA where the majority of babies born from ART are from a multiple pregnancy. Additionally, the population rate of multiple births is rising due to the more frequent use of ART and continued multi-embryo transfers, which is operating against a background of rising implantation rates within ART clinics. Twins have been of interest from a programming perspective. However, analysis of associations between crude birthweight and subsequent metabolic risk factors or mortality in adulthood from chronic disease indicate that adaptations in pregnancy to support multi-fetal growth are not identical to fetal growth restriction in singleton pregnancies. Indeed, the process of ‘maternal constraint’ is incompletely understood and confounds such comparisons. From a programming perspective, it is a challenge to identify in twin pregnancies the transition from physiological adaptation to pathological growth restriction. Growth disparity between twins has been more illuminating of subtle adverse effects for the smaller of twin pairs in both blood pressure and insulin resistance in adulthood. Interestingly, these effects can be observed in both dizygotic and to a lesser degree in monozygotic twins, which indicates a role for both genetic and environmental factors in these measures. This suggests that, consistent with experimental studies in other species, the relationship between impaired growth in utero and chronic disease in later life is not simply mediated by a common genetic pathway.
A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)
Publisher: Springer Science and Business Media LLC
Date: 08-01-2014
Abstract: Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal Asthma Management Service. Design: Multicentre, randomized controlled trial. Inclusion criteria: Women with physician diagnosed asthma, which is not currently in remission, who are less than 20 weeks gestation with a singleton pregnancy and do not have a chronic medical condition. Trial entry and randomization: Eligible women with asthma, stratified by treatment site, disease severity and parity, will be randomized into either the ‘Standard Care Group’ or the ‘Intervention Group’. Study groups: Both groups will be followed prospectively throughout pregnancy. Women in the ‘Standard Care Group’ will receive routine obstetric care reflecting current clinical practice in Australian hospitals. Women in the ‘Intervention Group’ will receive additional care through the nurse-led Antenatal Asthma Management Service, based in the antenatal outpatient clinic. Women will receive asthma education with a full assessment of their asthma at 18, 24, 30 and 36 weeks gestation. Each antenatal visit will include a 60 min session where asthma management skills are assessed including: medication adherence and knowledge, inhaler device technique, recognition of asthma deterioration and possession of a written asthma action plan. Furthermore, subjects will receive education about asthma control and management skills including trigger avoidance and smoking cessation counseling when appropriate. Primary study outcome: Asthma exacerbations during pregnancy. S le size: A s le size of 378 women will be sufficient to show an absolute reduction in asthma exacerbations during pregnancy of 20% (alpha 0.05 two-tailed, 90% power, 5% loss to follow-up). The integration of an asthma education program within the antenatal clinic setting has the significant potential to improve the participation of pregnant women in the self-management of their asthma, reduce asthma exacerbations and improve perinatal health outcomes. ACTRN12613000244707
Spontaneous loss of a co-twin and the risk of birth defects after assisted conception
Publisher: Cambridge University Press (CUP)
Date: 04-07-2016
DOI: 10.1017/S2040174416000301
Abstract: The study of very early pregnancy loss is impractical in the general population, but possible amongst infertility patients receiving carefully monitored treatments. We examined the association between fetal loss and the risk of birth defects in the surviving co-twin in a retrospective cohort study of infertility patients within an infertility clinic in South Australia from January 1986 to December 2002, linked to population registries for births, terminations and birth defects. The study population consisted of a total of 5683 births. Births from singleton pregnancies without loss were compared with survivors from (1) pregnancies with an empty fetal sac at 6–8 weeks after embryo transfer, (2) fetal loss subsequent to 8-week ultrasound and (3) multiple pregnancy continuing to birth. Odds ratios (OR) for birth defects were calculated with adjustment for confounders. Amongst infertility patients, the prevalence of birth defects was 7.9% for all twin pregnancies without fetal loss compared with 14.6% in pregnancies in which there had been an empty sac at ultrasound, and 11.6% for pregnancies with fetal loss after 6–8 weeks. Compared with singleton pregnancies without loss, the presence of an empty sac was associated with an increased risk of any defect (OR=1.90, 95% confidence intervals (CI)=1.09–3.30) and with multiple defects (OR=2.87, 95% CI=1.31–6.28). Twin pregnancies continuing to birth without loss were not associated with an overall increased prevalence of defects. We conclude that the observed loss of a co-twin by 6–8 weeks of pregnancy is related to the risk of major birth defects in the survivor.
P1-18 Studying early pregnancy during infertility treatment may identify novel risk factors for congenital malformations
Publisher: BMJ
Date: 08-2011
Adjustment to infertility: the role of intrapersonal and interpersonal resources/vulnerabilities
Publisher: Oxford University Press (OUP)
Date: 26-12-2008
Abstract: Great variability exists in the degree of adjustment to infertility, which in turn is known to influence wellbeing. The main objective of this study is to identify intrapersonal [neuroticism, adult attachment style (AAS), perceived internal control, meaning of parenthood and intrinsic religiosity] and interpersonal (social support and marital adjustment) associates of adjustment to infertility. A cross-sectional analysis of 85 consecutive heterosexual women, attending three infertility clinics in northern India during July 2005-March 2006, participated in the study. A range of scales were used to measure the intrapersonal and interpersonal attributes. The degree of adjustment to infertility was assessed using the Fertility Adjustment Scale. The data were analysed using multiple regression. The intrapersonal model (49.3%) explained a larger proportion of variance than did the interpersonal model (28.4%). Perception of children as necessary for marital completion, and the avoidance type of AAS was associated with poorer adjustment and constituted intrapersonal vulnerabilities. In contrast, intrinsic religiosity, sexual satisfaction and familial support were associated with better adjustment and were identified as helpful intrapersonal and interpersonal coping resources. The findings of the study highlight the merit of understanding intra- and interpersonal attributes for achieving better wellbeing outcomes. These findings would also prove valuable for researchers and practioners involved in designing and implementing psychosocial interventions.
Oxidative Stress in a Rat Model of Obesity-Induced Hypertension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2001
Abstract: The mechanisms underlying the development of hypertension in obesity are not yet fully understood. We recently reported the development of hypertension in a rat model of diet-induced obesity. When Sprague-Dawley rats (n=60) are fed a moderately high fat diet (32 kcal% fat) for 10 to 16 weeks, approximately half of them develop obesity (obesity-prone [OP] group) and mild hypertension (158±3.4 mm Hg systolic pressure), whereas the other half (obesity-resistant [OR] group) maintains a body weight equivalent to that of a low fat control group and is normotensive (135.8±3.8 mm Hg). We examined the potential role of oxidative stress in the development of hypertension in this model. Lipid peroxides measured as thiobarbituric acid–reactive substances showed a significant increase in the LDL fraction of OP rats (2.8±0.32 nmol malondialdehyde/mg protein) compared with OR and control rats (0.9±0.3 nmol malondialdehyde/mg protein). Also, aortic and kidney thiobarbituric acid–reactive substances showed a significant (3- and 5- fold) increase in OP rats after 16 weeks of diet. In addition, superoxide generation by aortic rings, measured by lucigenin luminescence, showed a 2-fold increase in the OP group compared with both the OR and control groups. In addition, free isoprostane excretion and nitrotyrosine in the kidney showed an increase in OP rats only. The urine and plasma nitrate/nitrite measured by the LDH method showed a 1.8-fold decrease in OP rats compared with OR rats. However, endothelial NO synthase expression in the kidney cortex and medulla assessed by reverse transcriptase–polymerase chain reaction showed a strong increase in the OP rats versus OR and control rats (endothelial NO synthase/β-actin ratio 1.3±0.04 in OP rats versus 0.44±0.02 in OR rats), suggesting a possible shift toward superoxide production by the enzyme. Collectively, the data show a decreased NO bioavailability in OP animals that is due in part to the increased oxidative stress.
Gestation and birthweight in dizygotic twins
Publisher: Elsevier BV
Date: 2002
Decreased insulin sensitivity in young adults born through in vitro fertilisation (IVF) and higher systolic blood pressure following high fat overfeeding
Publisher: Elsevier BV
Date: 09-2013
Parental work schedules and child overweight and obesity
Publisher: Springer Science and Business Media LLC
Date: 20-12-2012
DOI: 10.1038/IJO.2011.252
Abstract: Studies in school-age children have consistently shown a positive association between maternal paid work hours and child obesity. However, there is conflicting evidence about the impact of maternal work hours scheduled at nonstandard times (for ex le, evenings, nights or weekends), and no previous examination of paternal work schedules and child weight. We examined the associations between maternal, paternal and combined parental paid work schedules and overweight/obesity in children at age 9 years. Data were analysed from the most recent follow-up of 9-year-old children (n=434) in an Australian birth cohort study. Children were measured and classified as overweight/obese using the International Obesity Taskforce body mass index cutoff points. Current working conditions of parents were obtained from a structured interview with the primary caregiver. Logistic regression analyses were used to investigate the effect of parental work schedules on child overweight/obesity with adjustment for a range of sociodemographic and household factors associated with parental employment and child weight. At 9 years of age, 99 children (22.8%) were overweight or obese. When parental work schedules were examined separately, child overweight/obesity was significantly associated with paternal nonstandard work schedules (adjusted odds ratio (OR) 1.97, 95% confidence interval (CI) 1.08-3.61). There was no association with any type of maternal work schedule. We also found an association between child overweight/obesity and circumstances in which both parents worked nonstandard schedules however, this was of borderline statistical significance in the adjusted models (adjusted OR 2.26, 95% CI 0.99-5.16). Work hours scheduled at nonstandard times, when worked by the father or both parents, were associated with child overweight and obesity. These findings indicate the potential importance of fathers' paid work arrangements for child overweight/obesity, which until recently has largely been ignored.
Lifestyle Factors and Polycystic Ovary Syndrome
Publisher: Informa Healthcare
Date: 03-04-2002
Relative risk of conversion from normoglycaemia to impaired glucose tolerance or non-insulin dependent diabetes mellitus in polycystic ovarian syndrome
Publisher: Oxford University Press (OUP)
Date: 09-2001
Abstract: Cross-sectional studies have shown a high frequency of impaired glucose tolerance (IGT) and non-insulin dependent diabetes mellitus (NIDDM) in women with polycystic ovarian syndrome (PCOS). However, little is known about the change in glucose tolerance that occurs over a period of several years in women with PCOS. Sixty-seven women with PCOS received a 75 g glucose tolerance test and measurement of lipids at baseline and at follow-up after an average time of 6.2 years. All women followed prospectively had normal glucose tolerance (n = 54) or IGT (n = 13) at the start of the study. Change in glycaemic control from baseline was frequent, with 5/54 (9%) of normoglycaemic women at baseline developing IGT and a further 4/54 (8%) moving directly from normoglycaemic to NIDDM. For women with IGT at baseline, 7/13 (54%) had NIDDM at follow-up. Body mass index (BMI) at baseline was an independent significant predictor of adverse change in glycaemic control. Women with PCOS, particularly those with a high BMI, should be reviewed regularly with respect to IGT or NIDDM, as the frequency of impaired glycaemic control is high, and that the rate of conversion from normal glucose tolerance to IGT or NIDDM, or from IGT to NIDDM is substantial.
Fixed or Rotating Night Shift Work Undertaken by Women: Implications for Fertility and Miscarriage
Publisher: Georg Thieme Verlag KG
Date: 08-02-2016
Abstract: This review summarizes the evidence concerning effects of night shift work on women's reproductive health, specifically difficulty in conceiving and miscarriage. We distinguish between fixed night shift and rotating night shift, as the population subgroups exposed, the social and biological mechanisms, and the magnitude of effects are likely to differ of note, women working fixed night shift are known to have high tolerance for this schedule. We identified two relevant systematic reviews with meta-analyses and five additional studies. Night shift work may give rise to menstrual cycle disturbances, but effect sizes are imprecise. Endometriosis may be elevated in night shift workers, but evidence is only preliminary. Adequate data are lacking to assess associations between night shift work and infertility or time to pregnancy. The weight of evidence begins to point to working at night, whether in fixed or rotating shifts, as a risk factor for miscarriage. There are many methodological problems with this literature, with substantial variation in the definitions of night shift and schedule types making comparisons between studies difficult and pooling across studies questionable. Nevertheless, there appears to be grounds for caution and counselling where women have concerns about night shift work and their reproductive health.
Effects of birth size, post-natal growth and current size on insulin resistance in 9-year-old children: a prospective cohort study
Publisher: Springer Science and Business Media LLC
Date: 08-05-2013
DOI: 10.1007/S00431-013-2017-4
Abstract: The influence of pre-natal conditions on later type 2 diabetes risk factors such as insulin resistance (IR) may be mediated by post-natal growth trajectory. We aimed to investigate the association of body size at birth and 9 years with IR at 9 years. Using data from a prospective Australian cohort study, we examined the influence of body size from birth to 9 years [z-score for weight or body mass index (BMI)] on IR at 9 years (estimated by homeostasis model assessment). At age 9 years, 151 children provided a fasting blood s le. z-BMI at age 9 was positively associated with IR. Birth z-BMI was inversely associated with IR only after adjustment for z-BMI at age 9 years. This may be interpreted as an effect of accelerated growth between birth and 9 years on IR. There was a statistically significant interaction between birth and 9-year z-BMI. Results from regression models including z-BMI at all available time points (birth, 6 and 12 months, and 2, 3.5 and 9 years) indicate a possible inverse association between body size at 3.5 years and HOMA-IR at 9 years. Results were similar when the analyses were repeated with z-weight substituted for z-BMI. These results add to the body of evidence concerning the importance of growth in early life for later IR, and highlight a possible interaction between pre- and post-natal growth. The potential influence of growth at around 3.5 years for HOMA-IR at 9 years warrants further investigation.
Associations of Assisted Reproductive Technology and Twin Pregnancy With Risk of Congenital Heart Defects
Publisher: American Medical Association (AMA)
Date: 05-2020
Early pregnancy loss following assisted reproductive technology treatment
Publisher: Oxford University Press (OUP)
Date: 12-2002
DOI: 10.1093/HUMREP/17.12.3220
Abstract: In women treated by assisted reproductive technology (ART), early pregnancy loss (EPL) reduces the initial success. Risk factors for EPL, however, have not been comprehensively studied. This study assesses some potential risk factors in ART pregnancies. Altogether 1196 pregnancies, defined as serum hCG >or=10 IU/l on day 16 +/- 1 after oocyte retrieval, were included in this study. EPL was defined as pregnancy loss that occurred before 6-7 weeks gestation. Risk factors investigated were maternal age, body mass index (BMI), smoking and polycystic ovary syndrome (PCOS) status, infertility aetiology, response to stimulation, quality and number of embryos replaced and treatment type. Overall EPL was 16%. The risk of EPL was not linearly related to either age or BMI. Though women >40 years old had an increased risk, this was not significant after adjusting for other factors. The risk in both lean (BMI 35 kg/m(2)) women was also not significantly higher in multivariate analysis. There was no effect of PCOS. Smoking or transfer of 'poor quality' embryo(s) was associated with a significant increased risk of EPL after adjusting for other factors. Smoking and transferring poor quality embryos increased EPL, while the effects of age, obesity and other risk factors were not significant in a multivariate analysis.
Caries experience among children in fluoridated Townsville and unfluoridated Brisbane
Publisher: Elsevier BV
Date: 12-1996
DOI: 10.1111/J.1467-842X.1996.TB01077.X
Abstract: Fluoridation of community water supplies constitutes the main public health strategy for prevention of dental caries in Australia. In recent years questions have been raised about the effectiveness of water fluoridation. The aim of this paper was to examine differences in caries experience of children aged 5 to 12 years who were lifetime residents either of Brisbane (the unfluoridated Queensland capital) or Townsville (fluoridated since 1965). Children from each city were s led from patients of the school dental service. Dental therapists and dentists from the school dental service recorded data describing dental caries experience and parents were asked to complete a questionnaire about their children's residential history and exposure to other fluorides. Of the 18,348 children s led, 10,195 (55.6 per cent) provided completed questionnaires, and 4588 were lifetime residents of their respective cities. Caries rates were significantly lower (P < 0.01) among children in Townsville than in Brisbane, both in the deciduous dentition (according to age 32 to 55 per cent fewer tooth surfaces affected) and permanent dentition (20 to 65 per cent fewer tooth surfaces affected). Significantly lower rates in Townsville persisted (P < 0.01) in multivariate analyses that controlled for oral hygiene practices, exposure to fluoride supplements and household income. Water fluoridation appears to provide a substantial public health benefit for children in Townsville.
Infertility treatment at the edge: discovery and risk converge at the limits of knowledge
Publisher: BMJ
Date: 07-12-2012
Has the twin rate after in vitro fertilisation really decreased in Australia?
Publisher: Wiley
Date: 10-2016
DOI: 10.1111/AJO.12500
Consuming bodies: Mall walking and the possibilities of consumption
Publisher: Informa UK Limited
Date: 08-2008
Birthweight and the effects of culture media.
Publisher: Oxford University Press (OUP)
Date: 29-12-2017
Food and nutrient intakes of 9-month-old infants in Adelaide, Australia
Publisher: Cambridge University Press (CUP)
Date: 30-04-2009
DOI: 10.1017/S1368980009005552
Abstract: To describe the food and nutrient intakes of 9-month-old infants. A survey undertaken as part of a longitudinal study of child growth and development. Infant diet was characterised through a structured interview in which consumption frequency and portion size of foods were obtained. This method was compared with a 4 d diary and had adequate relative validity. Adelaide, Australia. Three hundred and forty-one infants for whom dietary data were plausible according to pre-specified criteria. At 9 months of age, the median body weights for 161 girls and 180 boys were 8·8 and 9·6 kg, respectively. Differences in intakes between boys and girls largely reflected differences in size. Median daily energy intake was 3541 kJ and median contributions of protein, fat and carbohydrate to total energy were 13 %, 36 % and 50 %. Using published Estimated Average Requirements, Zn intake was inadequate for % of children not breast-fed at this age while Fe intake was inadequate for 9 %. Infants who were still breast-fed (35 %) had more ersity in the foods that provided additional energy, compared with those not receiving breast milk, and were less likely to consume nutrient-displacing drinks such as juice or cordial. Cow’s milk was the main drink for 5 % of infants. In a group of Australian-born children, an important proportion had weaning diets that were low in Fe. Fat intake of many children was below current recommendations and cow’s milk was the main milk source for a small minority.
Diet during pregnancy, neonatal outcomes and later health
Publisher: CSIRO Publishing
Date: 2005
DOI: 10.1071/RD04094
Abstract: Renewed interest in nutrition during pregnancy has been generated by the hypothesis that adult disease has origins in early life. Animal experiments clearly show that altering maternal diet before and during pregnancy can induce permanent changes in the offspring’s birth size, adult health and lifespan. Among women living in Western societies, cigarette smoking is the most important factor known to reduce fetal growth, followed by low pre-pregnancy weight and low gestational weight gain. Obesity is also associated with pregnancy complications and adverse neonatal outcomes, so inadequate or excessive energy intake is not optimal for the developing fetus. Against a history of inconsistent results, several recent studies suggest that in Western settings the balance of macronutrients in a woman’s diet can influence newborn size. Effects appear to be modest, but this relationship may not encapsulate the full significance for health of the child, as there is emerging evidence of associations with long-term metabolic functioning that are independent of birth size. Consequences of inadequate maternal nutrition, for the offspring, may depend on timing during gestation, reflecting critical windows for fetal development. Where women are not malnourished, changing a woman’s nutritional plane during pregnancy may be detrimental to the unborn baby, and systematic reviews of the literature on dietary supplementation during pregnancy indicate few benefits and possible risks. In view of this, improved diet before pregnancy deserves greater attention.
Sleep disturbances in a community-based sample of women with polycystic ovary syndrome
Publisher: Oxford University Press (OUP)
Date: 28-11-2015
Abstract: Is there an excess of sleep disturbances in women with polycystic ovary syndrome (PCOS) in a community-based s le? Sleep disturbances are almost twice as common in women with PCOS compared with women of similar age without PCOS, with the association slightly accounted for by body weight and, to a greater extent, by depressive symptoms. There is an excess of sleep-disordered breathing in clinical s les of women with PCOS, after accounting for their profile of body weight. Poor sleep patterns increase insulin resistance and thus may exacerbate PCOS symptoms and longer-term risk of metabolic disease. A cross-sectional study of 724 women, comprising 74% of a cohort study established retrospectively when women were around age 30 years. Comparisons were made between 87 women with PCOS, diagnosed using the Rotterdam criteria, and 637 women without this diagnosis in Adelaide, South Australia. Differences in sleep disturbances, assessed using a modified version of the Jenkins questionnaire, were investigated using ordered logistic regression. Sleep disturbances were twice as common in women with PCOS compared with those without. Specifically, PCOS was associated with increasing occurrence of difficulty falling asleep (odds ratio (OR) 1.94, 95% confidence interval (CI) 1.28-2.95) this association was attenuated but still statistically significant after accounting for BMI and depressive symptoms. Increasing occurrence of difficulty maintaining sleep (OR 1.92 95% CI 1.12-3.31) was mediated by obesity and depressive symptoms, together. Other factors did not change these findings. The cross-sectional nature of the study means that the direction of associations between PCOS and sleep disturbances is unclear, although bi-directionality for the mediators is likely based on data in the wider literature. Our results indicate that assessment and management of both sleep and mental health problems in women with PCOS should be undertaken. Longitudinal data would be valuable to see how poor sleep affects longer-term health profiles.
Sperm donation perinatal outcomes in an Australian population cohort
Publisher: Wiley
Date: 17-08-2017
DOI: 10.1111/JOG.13449
Abstract: To compare perinatal outcomes for neonates conceived with donated sperm with those for neonates conceived spontaneously in an Australian population cohort. Perinatal outcomes for all births in South Australia for the period January 1986-December 2002 were linked with assisted reproductive treatment records to determine those conceived from donated sperm. Birth outcome measures were analyzed using Student's t-test and logistic regression using generalized estimating equations to determine statistical significance. Donor sperm neonates were not significantly different from their spontaneously conceived counterparts in terms of mean birthweight, low birthweight, preterm delivery, small for gestational age, or large for gestational age. They were, however, significantly more likely to be born at lower mean gestational age (P = 0.012), and to have preterm delivery with low birthweight (P = 0.008), when controlling for maternal age, parity, ethnicity, socioeconomic quartile and baby's sex. These associations were not apparent when singletons and twins were considered separately. There was some evidence of compromised perinatal outcomes for donor sperm neonates compared with their spontaneously conceived counterparts, which appeared to be partly attributable to multiplicity.
The influence of exposure to fluoridated water on socio-economic inequalities in children's caries experience
Publisher: Wiley
Date: 04-1996
DOI: 10.1111/J.1600-0528.1996.TB00822.X
Abstract: This study aimed to evaluate inequalities in children's dental caries experience among socioeconomic status (SES) groups and to investigate effects of exposure to fluoride in water on those inequalities. Cross-sectional data were obtained from 6704 Queensland children aged 5-12 years and 6814 South Australian children aged 5-15 years. School dental therapists and dentists recorded dmfs and DMFS data. A questionnaire to parents sought information about household SES and each child's lifetime exposure to fluoridated drinking water. SES fluoride exposure and multiplicative interactions between the two were used as explanatory variables in least squares models in which dmfs and DMFs were dependent variables. Additive interactions were evaluated by calculating the excess rate of disease. In both states, children from low SES groups (categorized by household income or parental education) had higher mean dmfs and DMFS values than children from high SES groups (P < 0.01). Independent effects of income and education remained significant (P < 0.01) after controlling for exposure to fluoride in drinking water. In Queensland, there was a significant multiplicative interaction whereby SES inequalities were lower among children exposed to fluoride: dmfs ratios between low- and high-income groups ranged among ages from 1.54 to 3.56 for children with no exposure to fluoride and from 0.84 to 2.07 for children with lifetime exposure to fluoride. Multiplicative interactions were not statistically significant in South Australia or when DMFS was the dependent variable. However, additive interactions were consistent and most pronounced for deciduous teeth in both States. Absolute differences in caries experience between low and high SES children were greater among non-exposed groups due to the higher underlying levels of caries experience of children with no exposure to fluoride in water.
Reproductive technologies: the alchemy of life
Publisher: AMPCo
Date: 09-2012
DOI: 10.5694/MJA12.10865
Prepregnancy Obesity and Fetal Death
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2005
Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies
Publisher: Informa UK Limited
Date: 02-2018
DOI: 10.2147/NSS.S127475
Postnatal depression in a community-based study of women with polycystic ovary syndrome
Publisher: Wiley
Date: 13-03-2018
DOI: 10.1111/AOGS.13332
Abstract: Women with polycystic ovary syndrome are susceptible to depression and anxiety and so may also be at risk for postnatal depression. This study investigates whether women with polycystic ovary syndrome have an elevated risk of postnatal depression. Cross-sectional data for parous women (n = 566) were available from a birth cohort. Polycystic ovary syndrome was diagnosed using the Rotterdam criteria. Details of reproductive history, pregnancy, birth, and postnatal depression were obtained through structured interview. Comparisons were made between women with and without polycystic ovary syndrome using logistic regression analysis, including the investigation of interactions. A positive but statistically non-significant association was found between polycystic ovary syndrome and postnatal depression (odds ratio 1.6, 95% confidence interval 0.9-2.9). Compared with their counterparts, women with polycystic ovary syndrome were substantially more likely: to have difficulty conceiving (odds ratio 5.2, 95% confidence interval 2.9-9.4), to have conceived with medical assistance (odds ratio 11.6, 95% confidence interval 5.5-24.4), and to have pregnancy complications (gestational diabetes, pregnancy-induced hypertension, or preecl sia odds ratio 2.0, 95% confidence interval 1.1-3.5). Where women with polycystic ovary syndrome had a history of miscarriage or conceived with medical assistance, the combination interacted (p = 0.06 and p < 0.05, respectively), with over half of such women having postnatal depression. Although women with polycystic ovary syndrome may not have an excess risk of postnatal depression overall, those who had suffered a miscarriage or required medical assistance to conceive were at substantially elevated risk. Findings point to vulnerability inherent in polycystic ovary syndrome being lified, either by stressful experiences on the pathway to pregnancy/childbirth or by specific fertility treatment regimens.
Growth in early life and the development of obesity by age 9 years: are there critical periods and a role for an early life stressor?
Publisher: Springer Science and Business Media LLC
Date: 15-01-2013
DOI: 10.1038/IJO.2012.219
Abstract: Rapid growth, possibly occurring in critical periods in early life, may be important for the development of obesity. It is unknown whether this is influenced by postnatal exposures such as age-relevant sources of stress. Frequent house moves may be one such stressor. We aimed to examine if there is a period of growth in early life critical for the development of child obesity by age 9 years and assess the role of house moves in modifying any relationships between early life growth and obesity at age 9 years. Prospective Australian birth cohort study. In all, 392 children with serial body size measurements from birth to age 9 years. Standardized body mass index (z-BMI) was available for six time points (spanning birth to 3½ years), and the total number of house moves between birth and 3½ years. The outcomes considered were z-BMI and % body fat (%BF) at age 9 years. Linear regression models were used to estimate the effects of serial measurements of z-BMI and number of house moves on the outcomes. Life-course plots showed that z-BMI at 3½ years was a statistically significant predictor of z-BMI at 9 years (β=0.80 standard error (s.e.), 0.04), whereas z-BMI at 9 months (β=-1.13 s.e., 0.40) and 3½ years (β=4.82 s.e., 0.42) were significant predictors of %BF at age 9 years. There were statistically significant interactions between the number of house moves and change in z-BMI between 9 and 12 months, such that ≥ 3 house moves in early life lified the detrimental effects of earlier rapid growth on both body size and composition at age 9 years. In the absence of evidence for a single critical period, efforts to prevent overweight and obesity are required throughout childhood. In addition, modifiable postnatal stressors may exacerbate effects of early growth on obesity in later childhood.
Neurological sequelae in in-vitro fertilisation babies
Publisher: Elsevier BV
Date: 08-2002
Obesity may confound relation of early pregnancy loss to risk of heart disease
Publisher: BMJ
Date: 22-05-2003
Reproductive Technologies and the Risk of Birth Defects
Publisher: Massachusetts Medical Society
Date: 10-05-2012
Epigenetics and Obesity
Publisher: SAGE Publications
Date: 08-07-2016
Abstract: Bourdieu suggested that the habitus contains the ‘genetic information’ which both allows and disposes successive generations to reproduce the world they inherit from their parents’ generation. While his writings on habitus are concerned with embodied dispositions, biological processes are not a feature of the practical reason of habitus. Recent critiques of the separate worlds of biology and culture, and the rise in epigenetics, provide new opportunities for expanding theoretical concepts like habitus. Using obesity science as a case study we attempt to conceptualise the enfolding of biological and social processes (via a Deleuzian metaphor) to develop a concept of biohabitus – reconfiguring how social and biological environments interact across the life course, and may be transmitted and transformed intergenerationally. In conclusion we suggest that the enfolding and reproduction of social life that Bourdieu articulated as habitus is a useful theoretical frame that can be enhanced to critically develop epigenetic understandings of obesity, and vice versa.
Nutrition before birth, programming and the perpetuation of social inequalities in health
Publisher: Wiley
Date: 12-2002
DOI: 10.1046/J.1440-6047.11.SUPP3.16.X
Abstract: The need to explain social inequalities in health has led to the theory that chronic disease is due, in part, to a legacy of adverse experiences in early life. Epidemiological studies show consistently that in iduals who are small at birth have an increased risk of cardiovascular disease in adulthood. There is growing consensus that this association reflects a causal relationship and is not simply the product of bias or confounding. The concept of programming is invoked as the biological mechanism birth size is thus a proxy for fetal programming. Recent findings suggest that fetal programming interacts with the post-birth environment. The adverse exposures that are thought to underlie and potentiate programming cluster in socially patterned ways, thus creating substantial inequalities in health. Experiments in animals demonstrate that nutritional interventions before or during pregnancy can produce programming phenomena in the offspring, sometimes without an impact on birth size. However, the extent to which maternal nutrition contributes to programming in contemporary developed countries is uncertain.
Factors and perceptions that influence women's decisions to have a single embryo transferred
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/S1472-6483(10)60384-7
Abstract: The aim of this study was to identify factors that inhibit or promote the adoption of single embryo transfer (SET). A cohort of 163 women patients receiving IVF/intracytoplasmic sperm injection treatment, comprising 87 women choosing SET and 63 women choosing double embryo transfer (DET), were interviewed using a structured questionnaire. The data were compared using logistic regression analysis. Confidence in the chance of pregnancy with SET, younger age and first treatment were predictive of a decision for SET. Preference for a healthy and singleton pregnancy was predictive but perceptions of the incidence or risk of multiple gestation were not. Factors such as a sense of time urgency and past experience of treatment were significant and predictive of diminished choice of SET. The clinic doctor was an important influencing factor. The results of this study confirm that improved pregnancy rates in SET coupled with an official clinic policy to promote SET in younger, first cycle patients influenced many women to choose SET. However, repeated treatment, advancing age and urgency to become pregnant are factors that moderate a woman's choice for SET.
Insulin Resistance in Prepubertal Children in Relation to Intrauterine Exposure to Overnutrition
Publisher: Springer Science and Business Media LLC
Date: 11-2011
DOI: 10.1038/PR.2011.609
In the name of the child
Publisher: SAGE Publications
Date: 23-11-2010
Abstract: This paper investigates the ways in which ‘the child’ is positioned in obesity debates and, in doing so, examines the discursive relations between childhood obesity, mothering and child neglect. Using legal cases of parental neglect and an analysis of representations of obesity in Australian print media, we argue that a particular constellation of ‘child politics’ in which children are represented as innocent victims of poor parenting is at play. Parenting, however, is a code for mothers and it is their gendered responsibility for food and families for which they are now being held legally culpable in cases of neglect. The relationship between children and mothers has become the focus of moral discourses around childhood obesity, containing contradictory elements of innocence and risk, responsibility and danger. The intersection of child politics, mothering and in idualized responsibility not only illuminates the ways in which gender is absent yet centrally implicated in obesity debates and policy, but also highlights how models of neoliberal governance encompass both State and decentralized forms of power in their attempt to regulate excess bodies.
Reproductive Technologies and the Risk of Birth Defects
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2012
Cross-sectional and longitudinal relationships between physical fitness and risk factors for coronary heart disease in men and women: ?The Adelaide 1000?
Publisher: Elsevier BV
Date: 1989
DOI: 10.1016/0895-4356(89)90055-3
Abstract: Measurements of aerobic fitness, weight, blood pressure, and lipids were made in 1000 sedentary men and women entering a fitness programme, and were repeated 2 years later in 733 subjects. Cross-sectional analyses including (a) comparisons of CHD risk factors in subjects grouped as "low", "low/moderate", "moderate/high", and "high" fitness, and (b) multiple regression analyses of relationships between fitness and risk factors showed that fitter subjects had better risk profiles than less fit. Longitudinal analyses including (a) comparisons of risk factor changes in subjects grouped as fitness "losers", "stable", "small gain", and "large gain", and (b) multiple regression analyses of relationships between fitness change and risk factor changes showed that fitness change was largely unrelated to risk factor changes. The study supported the existence of beneficial associations between fitness and risk factors but not cause and effect relationships.
Prepregnancy Obesity and Fetal Death: A Study Within the Danish National Birth Cohort
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2006
Mothers as smoking guns: Fetal overnutrition and the reproduction of obesity
Publisher: SAGE Publications
Date: 16-05-2012
Abstract: Mothers are expected to monitor their children’s dietary intakes and physical activities and are blamed for over feeding their children if they are obese. Women are also urged to manage their own weight in preparation for conception and during pregnancy in order to reduce complications associated with maternal obesity at childbirth. Through a theoretical lens of maternal blame, we argue that Australian media representations of scientific studies of the fetal overnutrition hypothesis extend behavioural maternal blame to the interiority of women’s bodies. Women’s intrauterine environments are positioned in the media as central to the intergenerational transmission of obesity, with women portrayed as responsible for passing obesity on to their children (and grandchildren) via biology and ill-informed ‘lifestyle choices’. Linking in with historical and contemporary discourses of maternal bodies and in idual responsibility, the implications of the ‘double damage’ caused by women entails a concerning return to essentialism in which women’s bodies are being largely blamed for producing and reproducing obesity across generations.
Dietary Composition of Pregnant Women Is Related to Size of the Baby at Birth
Publisher: Elsevier BV
Date: 07-2004
Abstract: The fetal origins theory of adult disease suggests that term infants who are small for their gestational age have an increased susceptibility to chronic disease in adulthood as a consequence of physiologic adaptations to undernutrition during fetal life. Consistent evidence for an influence of women's dietary composition during pregnancy on growth of their babies is lacking, despite robust effects in animal experiments. We undertook a prospective observational study of 557 women aged 18-41 y, living in Adelaide, South Australia. Diet was assessed in early and late pregnancy using an FFQ. In early pregnancy, medians for energy intake, the proportion of energy derived from protein and from carbohydrate were 9.0 MJ, 17 and 48%, respectively. In late pregnancy the corresponding medians were 9.2 MJ, 16 and 49%. In early pregnancy, the percentage of energy derived from protein was positively associated with birth weight (P = 0.02) and placental weight (P = 0.07), independently of energy intake and weight gain during pregnancy, and after adjustment for potential confounders, including maternal age, parity, and smoking. Effects were stronger among women (n = 429) who had reliable data, based on prespecified criteria including the plausibility of dietary data when referenced against estimated energy expenditure. In addition, for this subgroup, the percentage of energy from carbohydrate in early and late pregnancy was negatively associated with ponderal index of the baby, and a specific effect of protein from dairy sources was identified. These data support the proposition that maternal dietary composition has an effect on fetal growth. Maternal diet in Western societies may therefore be important for the long-term health of the child.
EFFECTS OF PHYSICAL ACTIVITY ON RISK FACTORS FOR CORONARY HEART DISEASE IN PREVIOUSLY SEDENTARY WOMEN: A FIVE-YEAR LONGITUDINAL STUDY
Publisher: Wiley
Date: 06-1988
DOI: 10.1111/J.1445-5994.1988.TB00131.X
Abstract: Fitness, weight, blood-pressure, and lipids were measured in 290 women joining a fitness programme. Five years later, 110 (38%) had remained active, and the others had become sedentary again. The net effect of being active was to increase fitness by 18% and to reduce weight by 1.9 kg, diastolic blood pressure by 3 mmHg, and triglycerides by 0.15 mmol/L-1. After controlling for age, weight and fitness, physical activity accounted for 1% and 3% of the variance of changes in systolic and diastolic blood pressure respectively, and was not associated with changes in lipids. Change in fitness accounted for only 1% of change in diastolic blood pressure. More 'active' women gave up smoking than 'inactive' (70% versus 10%). Hypertensive women were more sensitive to changes in weight and fitness than normotensive women. It was concluded that physical activity and change in fitness were only weakly related to changes in blood pressure and were unrelated to changes in lipids.
Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis
Publisher: Oxford University Press (OUP)
Date: 04-07-2012
Abstract: BACKGROUND Polycystic ovary syndrome (PCOS) is closely associated with obesity but the prevalence of obesity varies between published studies. The objective of this research was to describe the prevalence of overweight, obesity and central obesity in women with and without PCOS and to assess the confounding effect of ethnicity, geographic regions and the diagnostic criteria of PCOS on the prevalence. METHODS MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL) and PSYCINFO were searched for studies reporting the prevalence of overweight, obesity or central obesity in women with and without PCOS. Data were presented as prevalence (%) and risk ratio (RR) [95% confidence interval (CI)]. Random-effect models were used to calculate pooled RR. RESULTS This systematic review included 106 studies while the meta-analysis included 35 studies (15129 women). Women with PCOS had increased prevalence of overweight [RR (95% CI): 1.95 (1.52, 2.50)], obesity [2.77 (1.88, 4.10)] and central obesity [1.73 (1.31, 2.30)] compared with women without PCOS. The Caucasian women with PCOS had a greater increase in obesity prevalence than the Asian women with PCOS compared with women without PCOS [10.79 (5.36, 21.70) versus 2.31 (1.33, 4.00), P < 0.001 between subgroups). CONCLUSIONS Women with PCOS had a greater risk of overweight, obesity and central obesity. Although our findings support a positive association between obesity and PCOS, our conclusions are limited by the significant heterogeneity between studies and further studies are now required to determine the source of this heterogeneity. Clinical management of PCOS should include the prevention and management of overweight and obesity.
A meta-analysis of neonatal health outcomes from oocyte donation
Publisher: Cambridge University Press (CUP)
Date: 27-11-2015
DOI: 10.1017/S2040174415007898
Abstract: Donated oocytes are a treatment modality for female infertility which is also associated with increased risks of preecl sia. Subsequently it is important to evaluate if there is concomitant increased risks for adverse neonatal events in donated oocyte neonates. A structured search of the literature using PubMed, EMBASE and Cochrane Reviews was performed to investigate the perinatal health outcomes of offspring conceived from donor oocytes compared with autologous oocytes. Meta-analysis was performed on comparable outcomes data. Twenty-eight studies were eligible and included in the review, and of these, 23 were included in a meta-analysis. Donor oocyte neonates are at increased risk of being born with low birth weight ( g) [risk ratio (RR): 1.18, 95% confidence interval (CI): 1.14–1.22, P -value ( P ) .00001], very low birth weight ( g) (RR: 1.24, CI: 1.15–1.35, P .00001), preterm ( weeks) (RR: 1.26, CI: 1.23–1.30, P .00001), of lower gestational age (mean difference −0.3 weeks, CI: −0.35 weeks to −0.25 weeks, P .00001), and preterm with low birth weight (RR: 1.24, CI: 1.19–1.29, P .00001), when compared with autologous oocyte neonates. Conversely, low birth weight outcomes were improved in term donor oocyte neonates (RR: 0.86, CI: 0.8–0.93, P =0.0003). These negative outcomes remained significant when controlling for multiple deliveries. The donor oocyte risk rates are higher than those found in general ART outcomes, are important considerations for the counselling of infertile patients and may also influence the long term health of the offspring.
Simplistic physical activity guidelines: the need for trials
Publisher: Wiley
Date: 02-2000
Addressing knowledge gaps in long term outcomes following embryo freezing.
Publisher: Wiley
Date: 11-12-2018
Core food intakes of Australian children aged 9–10 years: nutrients, daily servings and diet quality in a community cross‐sectional sample
Publisher: Wiley
Date: 29-03-2016
DOI: 10.1111/JHN.12358
Abstract: The present study aimed to evaluate core food intakes in 9–10‐year‐old Australian children by considering adequacy of nutrient intakes, comparing servings of core food groups with Australian recommendations and scoring overall diet quality. Children from an established community‐based cohort study completed a semi‐quantitative food frequency questionnaire. Daily intakes of energy, macronutrients, micronutrients, servings of core (i.e. nutrient‐rich) foods and a diet quality index were calculated and compared with appropriate standards. Sex and socio‐economic differences were examined. The 436 children participating were from low to high socio‐economic status families. As a group, over half of the children met estimated average requirements for key macro‐ and micronutrients, with the exception of fibre (inadequate in 41% of boys and 24% of girls). Children obtained 55% of their daily energy from core foods. Most children had fewer than the recommended servings of vegetables (91%) and meat/alternatives (99.8%), whereas boys generally ate fewer servings of grains and cereals than recommended (87%), and girls ate fewer servings of dairy (83%). Diet quality scores indicated room for improvement (median score of 26 for boys and 25 for girls, out of a maximum of 73 points). As a group, a large proportion of children were able to meet their daily nutrient requirements. However, achieving this through noncore foods meant that diets were high in salt, saturated fat and sugar more servings of core foods and greater dietary ersity would be preferable. These results suggest that families need more support to optimise dietary patterns of children in this age group.
Changes over four years in musculoskeletal impairment in men and women
Publisher: AMPCo
Date: 10-1994
DOI: 10.5694/J.1326-5377.1994.TB127561.X
Abstract: To measure changes over four years in musculoskeletal impairment in a group of healthy adults. Longitudinal intervention study with repeated questionnaire assessments at entry, two and four years. Adults who volunteered for a fitness program and complied with all three assessments (373 men and 259 women mean age 42 years). The general four-year trend was an acceleration of musculoskeletal impairment of about 10% per year for three indicators. Movement limited activities increased to a similar extent in men and women women showed greater increases in pain or discomfort and specialist consultations. For both sexes the most vulnerable anatomical locations were the lower back, neck and knees, while the most common activities associated with movement limitations were jogging and lifting. Pain or discomfort and movement limited activities were age related. The findings justify anxieties about the increasing costs of musculoskeletal impairment, and highlight important questions about the nature, monitoring and control of such impairment.
Polycystic ovarian syndrome and the risk of spontaneous abortion following assisted reproductive technology treatment
Publisher: Oxford University Press (OUP)
Date: 12-2001
DOI: 10.1093/HUMREP/16.12.2606
Abstract: A high proportion of infertile patients have polycystic ovarian syndrome (PCOS) with a reportedly greater risk of spontaneous abortion. Because of the close link between PCOS and obesity and the independent association of obesity with poor pregnancy outcomes, it is important to distinguish the possible confounding effect of body mass index (BMI) or other variables from that of PCOS. This study aims to determine the effect of PCOS status on the risk of spontaneous abortion with adjustment for body mass and several other confounding factors in a large cohort of pregnant infertile women. The patients (n = 1018) were treated in a tertiary infertility centre. Their PCOS status was determined by standard criteria and their BMI had been taken less than 1 year before the pregnancy. Patients whose PCOS status or BMI measurements were not assessed were excluded. Student's t-test or chi2 test were used to test the difference between the PCOS and non-PCOS groups while a multivariate logistical regression model was used to assess the effect of PCOS, BMI and other confounding factors. Overall, the incidence of PCOS was 37% in this cohort. The overall incidence of spontaneous abortion in the study population was 21%. Univariate analysis showed that women with PCOS had a significantly greater risk of spontaneous abortion compared with non-PCOS women (25 versus 18%, P < 0.01). However, using multivariate logistic regression analysis this effect was reduced to a non-significant level [odds ratio (OR) = 1.10, 95% confidence interval (CI) 0.85-1.36] after adjusting for obesity and patients/treatment combination factor, and to nil after adjusting for all confounding factors considered in this study (OR = 0.98, 95% CI 0.75-1.28). The results of this study suggest that the higher risk of spontaneous abortion observed in women with PCOS is likely to be due to their high prevalence of obesity and the type of treatment they receive.
Intra-oral distribution and impact of caries experience among South Australian school children
Publisher: Wiley
Date: 10-1996
DOI: 10.1111/J.1834-7819.1996.TB03144.X
Abstract: This report describes the intra-oral distribution of caries and frequency of reported toothache using data from 9690 South Australian children aged 5-15 years. School dental therapists and dentists recorded dmfs and DMFS data and a questionnaire to parents sought information about toothache and its impact. There were higher levels of caries experience in deciduous teeth (mean 6-year-old dmfs = 2.61) compared with permanent teeth (mean 12-year-old DMFS = 1.15). In the deciduous dentition: between 11.4 per cent (9-year-olds) and 37.7 per cent (5-year-olds) of total dmfs was present as untreated decay between 39.1 per cent (7-year-olds) and 42.8 per cent (10-year-olds) occurred on interproximal surfaces and between 2.0 per cent (10-year-olds) and 27.8 per cent (5-year-olds) occurred in anterior teeth. In the permanent dentition, the majority of permanent caries experience occurred as fillings in pits and fissures of first molars and involved a single surface. Between 11.8 per cent (5-year-olds) and 31.8 per cent (12-year-olds) of children had a reported history of toothache, although the figure exceeded 50 per cent among children with all three forms of pit/fissure, interproximal and smooth-surface caries experience. The observed pattern of caries provides the basis for continued use of fissure sealants as a preventive measure among school children.
Lower risk of hypoglycemia with sitagliptin compared to glipizide when either is added to metformin therapy: a pre-specified analysis adjusting for the most recently measured HbA1cvalue
Publisher: Informa Healthcare
Date: 06-07-2012
DOI: 10.1185/03007995.2012.703134
Abstract: In a previously-published study, adding sitagliptin or glipizide to ongoing metformin therapy provided similar HbA(1c) improvement (both groups, -0.7%) after 52 weeks in patients with type 2 diabetes (T2DM). Significantly fewer patients experienced symptomatic hypoglycemia with sitagliptin (5% of 588 patients) compared to glipizide (32% of 584 patients). Glycemic efficacy and patient characteristics may influence hypoglycemic events. The present analysis evaluated the risk of hypoglycemia with sitagliptin or glipizide after adjusting for the most recently measured HbA(1c) value. Data for this analysis were from the aforementioned 52-week, randomized, double-blind, active-controlled study. The primary endpoint was confirmed hypoglycemia (i.e., symptomatic hypoglycemia confirmed with a concurrent fingerstick glucose ≤70 mg/dL [3.9 mmol/L]) the secondary endpoint was severe hypoglycemia (requiring medical or non-medical assistance or symptoms of neuroglycopenia). Complementary log-log regression random effects models with terms for treatment, most recently measured HbA(1c) value, time (i.e., days since randomization), gender, and age (< or ≥65 years) were used to assess adjusted subject-specific treatment effects. Over the full range of HbA(1c) levels and follow-up time, the risk of confirmed hypoglycemic events was lower with sitagliptin compared with glipizide (31 vs. 448 events adjusted hazard ratio [HR] = 0.05 [95% CI: 0.03, 0.09], p < 0.001). The risk was also lower with sitagliptin in the younger (HR = 0.06 [95% CI: 0.03, 0.12], p < 0.001) and older (HR = 0.02 [0.01, 0.08], p < 0.001) age groups compared with glipizide. For severe hypoglycemia events (2 vs. 22), the risk was lower with sitagliptin (HR = 0.08 [95% CI: 0.01, 0.47] p = 0.005). The actual time between the HbA(1c) measurement and the hypoglycemic event was variable and not controlled for in the analysis. In pre-specified analyses adjusting for the most recently measured HbA(1c) value, there was a substantial reduction in risk for confirmed hypoglycemia with sitagliptin compared to glipizide when added to ongoing metformin therapy in patients with T2DM. The risk of confirmed hypoglycemia was very low in younger and older patients treated with sitagliptin.
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