المؤلفون: Seabrook, Jamie A.^1,2,3,4,5,6 (AUTHOR), Smith, Alexandra¹ (AUTHOR), Clark, Andrew F.^4,6,7 (AUTHOR), Gilliland, Jason A.^{1,2,3,4,5,6,7,8} (AUTHOR) jgillila@uwo.ca

المصدر: Environmental Research. May2019, Vol. 172, p18-26. 9p.

مصطلحات موضوعية: *CHILDBIRTH, *PREMATURE labor, *PREGNANT women, *LOW birth weight, *GEOGRAPHIC information systems, *FOOD consumption, *FETAL macrosomia

مصطلحات جغرافية: ONTARIO, CANADA

مستخلص: A growing body of research has examined the association between exposure to environmental factors during pregnancy and adverse birth outcomes; however, many studies do not control for potential covariates and findings vary considerably. To test the relative influence of environmental factors including exposure to air pollution, major roads, highways, industry, parks, greenspaces, and food retailers on low birth weight (LBW) and preterm birth (PTB) in Southwestern Ontario (SWO), Canada, while accounting for medical (e.g., previous preterm birth, gestational diabetes), behavioral (e.g., alcohol, smoking), demographic (e.g., maternal age, body mass index), and neighborhood-level socioeconomic (e.g., household income, education) factors. This retrospective cohort study consisted of a large sample of pregnant women from SWO who gave birth to singleton newborns between February 2009 and February 2014 at London Health Sciences Centre. Data on maternal postal codes were entered into a Geographic Information System to map the distribution of maternal residences and determine selected characteristics of their neighborhood environments (i.e., socioeconomic, built, natural). These variables were developed based on postal codes where the mothers lived prior to giving birth. Logistic regression was used to assess the relative effects of the physical environment, socioeconomic status, clinical history, and behavioral risk factors on mothers having a LBW or PTB infant. Out of 25,263 live births, 5.7% were LBW and 7.5% were PTB. Exposure to sulfur dioxide was a top predictor of both LBW and PTB. For every one-unit increase in sulfur dioxide, the odds of a LBW and PTB were 3.4 (95% CI: 2.2, 5.2) and 2.0 (95% CI: 1.4, 3.0) times higher, after controlling for other variables in the model, respectively (p < 0.001). Previous PTB was also highly associated with both birth outcomes. Health care providers should be informed about the hazards of air pollution to developing fetuses so that recommendations can be made to their pregnant patients about limiting exposure when air quality is poor. • Out of 25,263 live births, 5.7% were low birth weight and 7.5% were preterm birth. • Maternal exposure to sulfur dioxide was a top predictor of adverse birth outcomes. • Previous preterm birth was also highly associated with both birth outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Zhong-Cheng Luo, Senécal, Sacha, Simonet, Fabienne, Guimond, Éric, Penney, Christopher, Wilkins, Russell

المصدر: Canadian Medical Association Journal (CMAJ); 2/23/2010, Vol. 182 Issue 3, p235-242, 8p, 1 Diagram, 4 Charts, 1 Graph

مصطلحات موضوعية: CHILDBIRTH, HEALTH outcome assessment, SUDDEN infant death syndrome, PREMATURE labor, CONFIDENCE intervals, INUIT

مصطلحات جغرافية: CANADA

مستخلص: Background: Information on health disparities between Aboriginal and non-Aboriginal populations is essential for developing public health programs aimed at reducing such disparities. The lack of data on disparities in birth outcomes between Inuit and non-Inuit populations in Canada prompted us to compare birth outcomes in Inuit-inhabited areas with those in the rest of the country and in other rural and northern areas of Canada. Methods: We conducted a cohort study of all births in Canada during 1990-2000 using linked vital data. We identified 13 642 births to residents of Inuit-inhabited areas and 4 054 489 births to residents of all other areas. The primary outcome measures were preterm birth, stillbirth and infant death. Results: Compared with the rest of Canada, Inuit- inhabited areas had substantially higher rates of preterm birth (risk ratio [RR] 1.45, 95% confidence interval [CI] 1.38-1.52), stillbirth (RR 1.68, 95% CI 1.38-2.04) and infant death (RR 3.61, 95% CI 3.17-4.12). The risk ratios and absolute differences in risk for these outcomes changed little over time. Excess mortality was observed for all major causes of infant death, including congenital anomalies (RR 1.64), immaturityrelated conditions (RR 2.96), asphyxia (RR 2.43), sudden infant death syndrome (RR 7.15), infection (RR 8.32) and external causes (RR 7.30). Maternal characteristics accounted for only a small part of the risk disparities. Substantial risk ratios for preterm birth, stillbirth and infant death re mained when the comparisons were restricted to other rural or northern areas of Canada. Interpretation: The Inuit-inhabited areas had much higher rates of preterm birth, stillbirth and infant death compared with the rest of Canada and with other rural and northern areas. There is an urgent need for more effective interventions to improve maternal and infant health in Inuit-inhabited areas. [ABSTRACT FROM AUTHOR]

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المؤلفون: Tough, Suzanne, Fraser-Lee, Nonie, Benzies, Karen, Faber, Alexandra, Newburn-Cook, Christine, Sauve, Reg, Tofflemire, Karen

المصدر: Canadian Journal of Public Health; Jul/Aug2006, Vol. 97 Issue 4, p330-334, 5p

مصطلحات موضوعية: PREGNANCY complications, CHILDBIRTH, PREMATURE labor, HEALTH outcome assessment, BIRTH weight, COMPUTER assisted research

مصطلحات جغرافية: CANADA

الملخص (بالإنجليزية): Background: Women aged 35 and older account for an increasing proportion of births and are at increased risk of pregnancy complications and poor infant outcomes. The objectives of the study were: 1) to determine what women know about delayed childbearing, including pregnancy complications and outcomes associated with low birthweight (LBW, <2500 grams), preterm delivery (<37 weeks) and multiple birth, and 2) to assess the characteristics of women with limited knowledge of risks. Methods: A computer-assisted telephone interview survey was conducted with 1,044 randomly selected women who delivered their first live-born infant, between July 2002 and September 2003, in two urban centres, Calgary and Edmonton, in Alberta, Canada. Results: The proportion of women aware of specific childbearing risks associated with advanced maternal age were as follows: conception difficulties (85.3%), multiple birth (24.0%), caesarean section (18.8%), preterm delivery (21.8%), and LBW (11.2%). Knowledge of specific developmental and health-related risks of suboptimal infant outcomes ranged between 18.0% and 46.5%. Logistic regression revealed that limited knowledge of maternal age-related pregnancy risks were associated with unplanned pregnancy (OR, 1.48; 95% CI, 1.03-2.14), smoking (OR, 1.83; 95% CI, 1.29-2.60) and non-use of fertility treatment (OR, 2.15; 95% CI, 1.44-3.19). Characteristics associated with limited knowledge of the risks associated with suboptimal birth outcomes were: age 35-39 years (OR, 2.98; 95% CI, 1.35-6.58), less than post-graduate education (

Abstract (French): Contexte : Une proportion croissante de bébés naissent de femmes de 35 ans et plus, lesquelles risquent davantage d'avoir des complications durant la grossesse et d'accoucher de nourrissons d'un poids sous-optimal. Notre étude visait : 1) à déterminer ce que les femmes savent au sujet de la procréation tardive, notamment des complications de la grossesse et des résultats associés à l'insuffisance de poids à la naissance (IPN, <2 500 g), à l'accouchement prématuré (<37 semaines) et à l'accouchement multiple, et 2) à évaluer les caractéristiques des femmes qui connaissent mal ces risques. Méthode : Nous avons mené un sondage téléphonique assisté par ordinateur auprès de 1 044 femmes, sélectionnées au hasard, ayant accouché d'un premier enfant vivant entre juillet 2002 et septembre 2003 dans deux centres urbains de l'Alberta (Calgary et Edmonton). Résultats : Les femmes connaissaient les risques de la procréation à un âge avancé dans les proportions suivantes : difficultés à concevoir (85,3 %), accouchement multiple (24 %), accouchement par césarienne (18,8 %), accouchement prématuré (21,8 %), et IPN (11,2 %). Entre 18 % et 46,5 % des répondantes connaissaient les risques développementaux et sanitaires auxquels est exposé un nouveau-né de poids sous-optimal. Une analyse de régression logistique a montré que la connaissance limitée des risques de la grossesse à un âge maternel avancé était associée à la grossesse non planifiée (RC = 1,48; IC de 95 % = 1,03-2,14), au tabagisme (RC = 1,83; IC de 95 % = 1,29-2,60) et au fait de ne pas avoir subi de traitement de l'infertilité (RC = 2,15; IC de 95 % = 1,44-3,19). Les caractéristiques associées à la connaissance limitée des risques de l'IPN étaient les suivantes : avoir entre 35 et 39 ans (RC = 2,98; IC de 95 % = 1,35-6,58), ne pas avoir fait d'études postsecondaires (moins qu'un diplôme d'études secondaires : RC = 2,14; IC de 95 % = 1,20-3,82), et ne pas être inscrite en tant qu'étudiante (RC = 1,75; IC de 95 % = 1,02-3,00). Conclusions : Nombre de femmes ont peu conscience des répercussions possibles de la procréation tardive. Il y aurait des lacunes à combler sur le plan du counselling et de l'éducation avant la grossesse pour favoriser une prise de décisions plus éclairée en matière de planning familial. [ABSTRACT FROM AUTHOR]

: Copyright of Canadian Journal of Public Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)