Bea J. van den Berg

An evaluation of the teratogenicity of certain antinauseant drugs.

In a large, prospective, observational study of pregnancy and child development, the antinauseant drugs prescribed to gravides for nausea and vomiting in the first 84 days of pregnancy were evaluated for their teratogenic potential. The severe congenital anomaly rates per 100 liveborn children and ther perinatal death rates of this group did not differ from the rates of the group with untreated nausea and vomiting. There was no indication that the phenothiazine derivatives, specifically the prochlorperazine derivative, as well as meclizine, cylizine, and Bendectin were associated with teratogenicity. The trimethobenzamide drug gave a slight suggestion of an excess of severe congenital anomalies.

The relationship of the rate of intrauterine growth of infants of low birth weight to mortality, morbidity, and congenital anomalies**

The purpose of this investigation is to determine the relationship of the intrauterine growth rate of low-birth-weight infants to neonatal mortality, congenital anomalies, and other factors related to the well-being of the neonate. A method has been developed which classifies infants of approximately 1,600 to 2,500 grams (3 pounds, 9 ounces, to 5 pounds, 8 ounces) in 4 gestation quartiles which have been made to be identical in their birth weight and sex distribution and to differ widely in their length of gestation. These 4 gestation quartiles, denoted short, intermediate short, intermediate long, and long, provide 4 groups of different rate of intrauterine growth from the very fast to the very slow. The data relate to 367 single white low-birth-weight infants in the Child Health and Development Studies in Oakland, California, and 20,408 such infants in New York City.

Effects of Prenatal Meprobamate and Chlordiazepoxide Hydrochloride on Human Embryonic and Fetal Development

Abstract To examine the teratogenic potential of the minor tranquilizers, the incidence of severe congenital anomalies per 100 live births was studied in children of mothers who had received prescriptions for meprobamate, chlordiazepoxide, other drugs, or no drug for minor psychoneurotic complaints (anxiety) during pregnancy. These four populations were from a prospective longitudinal study of pregnancy and child health that included 19,044 live births. Rates of the anomalies after prescription of meprobamate or chlordiazepoxide in early pregnancy (the first 42 days) were higher 12.1 per 100 and 11.4 per 100 respectively than in children of the other-drug, 4.6 per 100, or no-drug cohorts, 2.6 per 100. When the reference date was later in pregnancy (43 days to termination), statistically insignificant differences in rates of the anomalies were observed among the four groups. These data suggest that meprobamate, and possibly chlordiazepoxide, may be teratogenic when taken during the first six weeks of gesta...

Studies on Convulsive Disorders in Young Children

In a prospective study of some 19,500 newborn children, all those with an initial febrile convulsion (FC) were identified. Before the age of 6 yr, 368 children had one or more FC, representing an incidence for boys and girls, respectively, of 26.2 and 20.6 per 1,000. Thirty‐seven percent of children with an initial FC had a recurrence within 3 yr, and 40% within 5 yr. The recurrence rate depended on the age at the time of the initial FC: if it occurred in the first year of life, the recurrence rate within 3 yr was 45%; if in the second year, 42%; if in the third or fourth year, 25%. After two FC, the risk of a third was, on the average, 40%; after three FC, the risk of a fourth was again 40%. The incidence of nonfebrile convulsions was 4% within 5 yr following the initial FC. The rate of recurrence was higher in girls than in boys. Except for the age at first seizure, no characteristics of the initial seizure predicted the recurrence of febrile convulsions or the occurrence of nonfebrile seizures.

A Medical Record Linkage Analysis of Abortion Underreporting

Inaccuracy in womens reports of their abortion histories affects many areas of interest to reproductive health professionals and researchers. The identification of characteristics that affect the accuracy of reporting is essential for the improvement of data collection methods. A comparison of the medical records of 104 American women aged 27-30 in 1990-1991 with their self-reported abortion histories revealed that 19% of these women failed to report one or more abortions. Results of logistic regression analysis indicate that nonwhite women were 3.3 times as likely as whites to underreport. With each additional year that had elapsed since the first recorded abortion, women became somewhat more likely to underreport (odds ratio of 1.3), while each additional year of a womans education slightly decreased the likelihood of underreporting (odds ratio of 0.7).

Effects of antenatal exposure to anorectic drugs

In a large prospective, observational study of pregnancy and child development, the anorectic drugs (amphetamines and phenmetrazine) prescribed to gravid women during different stages of pregnancy were evaluated for their teratogenicity. The severe congenital anomaly rate (SCA) per 100 live-born children at age five years did not differ from the SCA rate of the group of children whose mothers did not use these drugs. There was, however, an excess of oral clefts in the offspring of mothers who had amphetamines prescribed in the first 56 days from the last menstrual period. A rought test of efficacy of anorectic drugs by comparing mean weight gains in four-week periods before and after the prescription showed only short-term and limited reduction of weight gain.

The Relationship of the Rate of Intrauterine Growth of Low-Birth-Weight Infants to Later Growth.

The relationship of the rate of intrauterine growth of low-birth-weight infants (1,501 to 2,500 gm) to their postnatal growth up to 10 years of age was investigated. Each child was assigned to one of four gestation quartiles which have identical birth weight distributions but differ widely in their length of gestation. The mean heights and weights of the children in each of the four quartiles were compared with similar data of a control group of children who had birth weights above 2,500 gm. Only infants in the long gestation quartile failed to catch up in height and weight to the control group by the end of the 10-year period. The same results that were obtained for the total cohort were also found separately for white and black children and for boys and girls. The data relate to 488 single white and black low-birth-weight infants and 488 normal-birth-weight infants.

A fertility table for the analysis of human reproduction.

Abstract Birth order instead of age of women is considered the basic variable in the study of human reproduction. In the proposed table, parity of women is the main criterion used to summarize the reproductive experience of a study population. The elements of the table serve to describe the fertility pattern of a female population; to determine the population distribution by completed family size; and to estimate the parity progression ratios, the parity specific fertility rates, the mean waiting time between the i th birth and the completion of family, and others. The table can be used to test the temporal difference and difference between countries in fertility and to evaluate the effectiveness of family planning programs. A fertility table based on current U.S. data has been constructed for illustration.

Prospective study of antibody to human papilloma virus type 16 and risk of cervical, endometrial, and ovarian cancers (United States)

Objective: Human papilloma virus (HPV) is frequently detectable in cancers of the cervix, vagina, and vulva, but its role in endometrial and ovarian cancers is less certain. This analysis aimed to examine the association of presence of HPV type 16 (HPV-16) antibodies with subsequent risk of cervical, endometrial, and ovarian cancers. Methods: In a prospective study enrolling over 15,000 pregnant women, pre-cancer sera from women who developed cervical (n = 83), endometrial (n = 34), and ovarian (n = 35) cancers were compared with sera from 172 control women frequency-matched by age group and race. Results: HPV-16 seropositivity (OR = 2.0, 95% CI 1.0–3.4) was associated with cervical cancer, with the association more prominent for cancers occurring within 10 years of serum sampling (OR = 2.3, 95% CI 1.0–5.3) than cancers occurring later (OR = 1.6, 95% CI 0.75–3.6). Overall, the associations between HPV-16 seropositivity and endometrial (OR = 1.6, 95% CI 0.64–3.8) and ovarian cancers (OR = 1.1, 95% CI 0.43–2.8) were not significant, although the odds ratios for those cancers occurring within 20 years after serum sampling were similar to that for cervical cancer (OR = 2.2 for both). Conclusions: Our results confirm that HPV-16 infection precedes the development of cervical cancer. Predictability of HPV-16 seropositivity for risk of other female cancers warrants further investigation.

The effect of forceps delivery on cognitive development

OBJECTIVE We evaluated the influence of forceps delivery on cognitive development of preschool children. STUDY DESIGN A cohort of 3413 children who were born at the Kaiser Permanente Medical Center in Oakland, California, were selected at age 5 for intelligence quotient testing with the Peabody Picture Vocabulary Test and the Raven Coloured Progressive Matrices. Data were analyzed by means of the Student t test to compare mean intelligence quotient scores of intervention modes of delivery with spontaneous delivery. RESULTS No significant difference in intelligence quotient was seen in 1192 children delivered by forceps (114 midforceps) compared with 1499 who were delivered spontaneously. CONCLUSION The association of forceps delivery with adverse cognitive development cannot be supported.