Early childhood nutrition, education and fertility milestones in Guatemala.
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Data on fertility milestones were collected in 1994 and linked to information collected in a trial conducted in eastern Guatemala between 1969 and 1977, to examine whether early childhood nutrition was associated with the timing of fertility milestones. In the original trial, two pairs of villages were randomly allocated to receive either a high energy, high protein supplement (Atole) or a low energy, no-protein supplement (Fresco). Mean age at follow-up was 23.47 y (n = 240). About 62% of women had experienced first birth (median age at first birth = 19.83 y). The median intervals from menarche to first intercourse and from first intercourse to first birth were 5.67 and 0.95 y; they were 1.68 and 0.06 y shorter, respectively, for the Atole group than for the Fresco group. Women who had received Atole in utero and/or during early childhood experienced earlier milestones even after adjusting for socioeconomic status (SES), education and age at the prior event. Median age at first birth was 1.17 y earlier for the Atole group. Better growth during early childhood (not severely stunted) led to earlier milestones (median age at first birth was 1.04 y earlier), primarily among women with illiterate fathers. Completion of primary school significantly delayed fertility milestones; the median age at first birth was 4.27 y later for those who completed primary school compared with those who did not (P < 0.05). In sum, improved nutrition during early childhood results in earlier fertility milestones, but the effects of schooling in delaying fertility milestones are greater in magnitude. Intervention programs that improve early childhood nutrition should be accompanied by investments in education that ensure that girls complete primary school. (+info)
Growth in utero and during childhood among women who develop coronary heart disease: longitudinal study.
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OBJECTIVE: To examine whether women who develop coronary heart disease have different patterns of fetal and childhood growth from men in the same cohort who develop the disease. DESIGN: Follow up study of women whose body size at birth was recorded and who had an average of 10 measurements of height and weight during childhood. SETTING: Helsinki, Finland. SUBJECTS: 3447 women who were born in Helsinki University Central Hospital during 1924-33 and who went to school in Helsinki. MAIN OUTCOME MEASURES: Hazard ratios for hospital admission for or death from coronary heart disease. Results Coronary heart disease among women was associated with low birth weight (P=0.08 after adjustment for gestation, P=0.007 after adjustment for placental weight) and was more strongly associated with short body length at birth (P=0.001 and P<0.0001, respectively). The hazard ratio for women developing coronary heart disease increased by 10.2% (95% confidence interval 4.3 to 15.7) for each cm decrease in length at birth. The effect of short length at birth was greatest in women whose height "caught up" after birth so that as girls they were tall. Such girls tended to have tall mothers. In contrast, men in the same cohort who developed the disease were thin at birth rather than short, showed "catch up" growth in weight rather than height, and their mothers tended to be overweight rather than tall. CONCLUSION: Coronary heart disease among both women and men reflects poor prenatal nutrition and consequent small body size at birth combined with improved postnatal nutrition and "catch up" growth in childhood. The disease is associated with reductions in those aspects of body proportions at birth that distinguish the two sexes-short body length in women and thinness in men. (+info)
Age-related changes in body composition of 3- to 6-year-old Japanese children.
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This study was undertaken to establish an approach for the investigation of age-related changes in indices of body composition during childhood in Japan. It provides current reference values for total body fat mass (TBFM) and lean body mass (LBM) as indices of body composition in an urban population of 3- to 6-year-old Japanese children. Moreover, we assessed the age-specific patterns of body fat distribution [subcutaneous fat mass (SFM) and internal fat mass (IFM)] during childhood. Measurements of body composition by bioelectrical impedance were made in 141 boys and 139 girls, all apparently healthy, aged 3-6 years. Determinations of impedance were made using a four-terminal impedance analyzer (TP-95K; Toyo Physical, Inc., Fukuoka, Japan). LBM was calculated using the equation of Kushner et al. (1992) and Goran et al. (1993). SFM was calculated using a modification of the equation derived by Skerjl et al. (1953). IFM was calculated as the difference between TBFM and SFM. From ages 3 through 6 years, the mean LBM increased with age in boys and girls, and showed significant age differences. Between the ages of 3 and 6, the average increment in LBM was 5.1 kg in boys and 4.4 kg in girls. On average, boys gained 0.5 kg of TBFM each year, whereas girls gained 0.4 kg of TBFM each year. Furthermore, both groups gained 0.3 kg of SFM each year. Percentage body fat decreased in both genders until approximately the age of 5, and increased again slightly at the age of 6. The age-specific pattern of fat accumulation during childhood was characterized by an almost linear increase in SFM in girls, but a transient decrease in IFM in boys. We conclude that further research is required, including longitudinal assessment of body composition variables, in order to unravel the dynamics of body composition change in Japanese children. (+info)
Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil.
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To determine potential, long-term deficits associated with early childhood diarrhea and parasitic infections, we studied the physical fitness (by the Harvard Step Test) and cognitive function (by standardized tests noted below) of 26 children who had complete surveillance for diarrhea in their first 2 years of life and who had continued surveillance until 6-9 years of age in a poor urban community (favela) in Fortaleza in northeast Brazil. Early childhood diarrhea at 0-2 years of age correlated with reduced fitness by the Harvard Step Test at 6-9 years of age (P = 0.03) even after controlling for anthropometric and muscle area effects, anemia, intestinal helminths, Giardia infections, respiratory illnesses, and socioeconomic variables. Early childhood cryptosporidial infections (6 with diarrhea and 3 without diarrhea) were also associated with reduced fitness at 6-9 year of age, even when controlling for current nutritional status. Early diarrhea did not correlate with activity scores (P = 0.697), and early diarrhea remained significantly correlated with fitness scores (P = 0.035) after controlling for activity scores. Early diarrhea burdens also correlated in pilot studies with impaired cognitive function using a McCarthy Draw-A-Design (P = 0.01; P = 0.017 when controlling for early helminth infections), Wechsler Intelligence Scale for Children coding tasks (P = 0.031), and backward digit span tests (P = 0.045). These findings document for the first time a potentially substantial impact of early childhood diarrhea and cryptosporidial infections on subsequent functional status. If confirmed, these findings have major implications for calculations of global disability adjusted life years and for the importance and potential cost effectiveness of targeted interventions for early childhood diarrhea. (+info)
Dandy-Walker syndrome successfully treated with cystoperitoneal shunting--case report.
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A neonate presented with Dandy-Walker syndrome manifesting as a large posterior cranial fossa cyst, aplasia of the lower cerebellar vermis, and elevation of the confluence of the sinuses but without hydrocephalus. A cystoperitoneal shunt was placed at one month after birth. The cyst diminished in size, and marked development of the cerebellar hemispheres and descent of the confluence of sinuses were observed, but not vermis development. The primary pathology of Dandy-Walker syndrome is posterior cranial fossa cyst formation due to passage obstruction in the fourth ventricle exit area and aplasia of the lower cerebellar vermis. The first choice of treatment in patients with Dandy-Walker syndrome in whom the cerebral aqueduct is open is cystoperitoneal shunt surgery, regardless of the presence or absence of hydrocephalus. (+info)
Modeling growth and maturation changes in peak oxygen uptake in 11-13 yr olds.
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The influence of gender, growth, and maturation on peak O(2) consumption (VO(2 peak)) in 11-13 yr olds were examined by using multilevel regression modeling. Subjects were 119 boys and 115 girls, aged 11.2 +/- 0.4 (SD) yr at the onset of the study. Sexual maturation was classified according to Tanner's indexes of pubic hair. VO(2 peak) was determined annually for 3 yr. The initial model identified body mass and stature as significant explanatory variables, with an additional positive effect for age and incremental effects for stage of maturation. A significant gender difference was apparent with lower values for girls, and an age-by-gender interaction indicated a progressive divergence in boys' and girls' VO(2 peak). Subsequent incorporation of the sum of two skinfold thicknesses into the model negated stature effects, reduced the gender term, and explained much of the observed maturity effects. The body mass exponent almost doubled, but the age-by-gender interaction term was consistent with the initial model. (+info)
Brief report: frequency of maternal cocaine use during pregnancy and infant neurobehavioral outcome.
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OBJECTIVE: To examine the effects of frequency of prenatal maternal cocaine use on infant neurobehavioral outcome beyond the immediate postpartum period, controlling for other substance use. METHODS: At 2 weeks postpartum, the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) was administered to infants (N = 55) and their mothers were asked about their prenatal drug use. Mother/infant dyads were placed in one of two groups based on the number of days of reported cocaine use during pregnancy: high frequency (n = 23, > 75th percentile reported days of use) or low frequency (n = 32, < 75th percentile). RESULTS: Infants in the high frequency cocaine group had worse BNBAS excitability scores than infants in the low frequency cocaine group, when other substance use was controlled statistically. CONCLUSIONS: High frequency of maternal cocaine use during pregnancy is associated with poorer infant neurobehavioral outcome beyond the early postpartum period, when other substance use is controlled. (+info)
Infants' sensitivity to statistical distributions of motion direction and speed.
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Adults combine different local motions to form a global percept of motion. This study explores the origins of this process by testing how perturbations of local motion influence infants' sensitivity to global motion. Infants at 6-, 12-, and 18-weeks of age viewed random dots moving with a gaussian distribution of dot directions defined by a mean of 0 degree (rightward) or 180 degrees (leftward) and a standard deviation (SD) of 0, 34, or 68 degrees. A well-practiced observer used infants' optokinetic responses to judge the direction of stimulus motion. Infants were studied both cross-sectionally and longitudinally. Direction discrimination was relatively high at all ages when the SD was 0 degree. When the SD was 34 or 68 degrees, performance declined with age. Adult performance was nearly perfect at these SDs. A similar developmental pattern was found with distributions of dot speed. The decline in infant performance is consistent with the development of both neural tuning and receptive field size. The subsequent improvement by adulthood suggests the development of additional processes such as long-range interactions. (+info)