Passive immunisation against respiratory syncytial virus: a cost-effectiveness analysis.

Aim: The cost-effectiveness of passive immunisation against respiratory syncytial virus (RSV) in the Netherlands was studied by assessing incremental costs to prevent one hospitalisation in high-risk children using a novel individualised monthly approach.

Methods: Cost-effectiveness analysis was performed by combining estimates of individual hospitalisation costs and monthly hospitalisation risks, with immunisation costs, parental costs and efficacy of passive immunisation for a reference case with the highest hospitalisation risks and costs of hospitalisation during the RSV season (male, gestational age < or =28 weeks, birth weight < or =2500 g, having bronchopulmonary dysplasia (BPD), aged 0 months at the beginning of the season (October)). Various sensitivity analyses and a cost-neutrality analysis were performed.

Paroxysmal disorders in infancy and their risk factors in a population-based cohort: the Generation R Study.

Aim: To examine the incidence of paroxysmal epileptic and non-epileptic disorders and the associated prenatal and perinatal factors that might predict them in the first year of life in a population-based cohort.

Method: This study was embedded in the Generation R Study, a population-based prospective cohort study from early fetal life onwards. Information about the occurrence of paroxysmal events, defined as suddenly occurring episodes with an altered consciousness, altered behaviour, involuntary movements, altered muscle tone, and/or a changed breathing pattern, was collected by questionnaires at the ages of 2, 6, and 12 months.

Mother's educational level and fetal growth: the genesis of health inequalities.

Background: Women of low socio-economic status (SES) give birth to lighter babies. It is unknown from which moment during pregnancy socio-economic differences in fetal weight can be observed, whether low SES equally affects different fetal-growth components, or what the effect of low SES is after taking into account mediating factors.

Methods: In 3545 pregnant women participating in the Generation R Study, we studied the association of maternal educational level (high, mid-high, mid-low and low) as a measure of SES with fetal weight, head circumference, abdominal circumference and femur length.

A comparison of parent-reported wheezing or shortness of breath among infants as assessed by questionnaire and physician-interview: The Generation R study.

Purpose: The prevalence of asthma symptoms among preschool children is difficult to determine with accuracy because no gold standard is available for diagnosis. The aim of this study was to compare parent-reported wheezing or shortness of breath among infants as assessed by questionnaire and physician-interview.

Methods: We studied 1,202 children participating in the Generation R study.

Parental fever attitude and management: influence of parental ethnicity and child's age.

Objective: The objective was to study parental fever management and attitude toward fever from the perspective of the child's ethnicity and age.

Patients And Setting: Children with fever presenting at the pediatric emergency department (PED) of the Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands, in the period from February 2002 to March 2004.

Design: Prospective observational.

Factors increasing the caries risk of second primary molars in 5-year-old Dutch children.

Background: Caries is still a prevalent condition in 5-year-old children. At present, knowledge regarding some aetiological factors, like deciduous molar hypomineralization (DMH), is limited.

Aim: To investigate aetiological factors both directly and indirectly associated with caries in second primary molars.

Glucocorticoid receptor gene polymorphisms do not affect growth in fetal and early postnatal life. The Generation R Study.

Background: Glucocorticoids have an important role in early growth and development. Glucocorticoid receptor gene polymorphisms have been identified that contribute to the variability in glucocorticoid sensitivity. We examined whether these glucocorticoid receptor gene polymorphisms are associated with growth in fetal and early postnatal life.

Employment status and the risk of pregnancy complications: the Generation R Study.

Objectives: This study explored the relationships of employment status, type of unemployment and number of weekly working hours, with a wide range of pregnancy outcomes.

Methods: Information on employment characteristics and pregnancy outcomes was available for 6111 pregnant women enrolled in a population-based cohort study in the Netherlands.

Results: After adjustment for confounders, there were no statistically significant differences in risks of pregnancy complications between employed and unemployed women.

Correlation of bacterial colonization status between mother and child: the Generation R Study.

Determinants of bacterial colonization in children have been described. In the Generation R Study, a population-based cohort study, we determined whether the colonization statuses of mothers and children are correlated. Such a correlation was observed for Staphylococcus aureus and Haemophilus influenzae.

Kidney growth curves in healthy children from the third trimester of pregnancy until the age of two years. The Generation R Study.

Information about growth of kidney structures in early life is limited. In a population-based prospective cohort study, from foetal life onwards, we constructed reference curves for kidney growth from the third trimester of pregnancy until early childhood, using data from 1,158 healthy children. Kidney size, defined as length, width, depth and volume, was measured in the third trimester of pregnancy and at the postnatal ages of 6 months and 24 months.

Challenges in the validation of triage systems at emergency departments.

Objectives: Triage systems, developed by consensus of experts and based on decision rules, are typically not validated. The objective is to discuss the challenges to evaluate the reliability and validity of triage systems.

Study Design And Setting: Theoretical-conceptual approach to validate triage systems.

Fetal growth from mid- to late pregnancy is associated with infant development: the Generation R Study.

Aim: The aim of this study was to investigate within a population-based cohort of 4384 infants (2182 males, 2202 females) whether fetal growth from early pregnancy onwards is related to infant development and whether this potential relationship is independent of postnatal growth.

Method: Ultrasound measurements were performed in early, mid-, and late pregnancy. Estimated fetal weight was calculated using head and abdominal circumference and femur length.

Explaining educational inequalities in birthweight: the Generation R Study.

Although low socio-economic status has consistently been associated with lower birthweight, little is known about the factors whereby socio-economic disadvantage influences birthweight. We therefore examined explanatory mechanisms that may underlie the association between the educational level of pregnant women, as an indicator of socio-economic status, and birthweight. The study was embedded within a population-based cohort study in the Netherlands.

Screening for child abuse at emergency departments: a systematic review.

Introduction: Child abuse is a serious problem worldwide and can be difficult to detect. Although children who experience the consequences of abuse will probably be treated at an emergency department, detection rates of child abuse at emergency departments remain low.

Objective: To identify effective interventions applied at emergency departments that significantly increase the detection rate of confirmed cases of child abuse.

The association of parent behaviors, chronic pain, and psychological problems with venipuncture distress in infants: the Generation R study.

Objective: To examine the association of parent behavior with infant distress during a potentially painful medical procedure. A second aim was to investigate the association of parent chronic pain and psychological problems with parent behavior and infant distress during the procedure.

Design: Population-based cohort study with both cross-sectional and prospective measurements.

Reliability and validity of triage systems in paediatric emergency care.

Background: Triage in paediatric emergency care is an important tool to prioritize seriously ill children. Triage can also be used to identify patients who do not need urgent care and who can safely wait. The aim of this review was to provide an overview of the literature on reliability and validity of current triage systems in paediatric emergency care

Methods: We performed a search in Pubmed and Cochrane on studies on reliability and validity of triage systems in children

Results: The Manchester Triage System (MTS), the Emergency Severity Index (ESI), the Paediatric Canadian Triage and Acuity Score (paedCTAS) and the Australasian Triage Scale (ATS) are common used triage systems and contain specific parts for children.

Role of Staphylococcus aureus nasal colonization in atopic dermatitis in infants: the Generation R Study.

Objective: To study the association between Staphylococcus aureus nasal colonization and atopic dermatitis (AD) in infancy.

Design: Population-based prospective cohort study of pregnant women and their children.

Setting: This project was embedded in the Generation R Study.

Sonographic assessment of abdominal fat distribution in infancy.

There is growing evidence that not only the total amount of fat, but also the distribution of body fat determines risks for metabolic and cardiovascular disease. Developmental studies on factors influencing body fat distribution have been hampered by a lack of appropriate techniques for measuring intraabdominal fat in early life. Sonography, which is an established method for assessing abdominal fat distribution in adults, has not yet been evaluated in infants.

Type 2 diabetes gene TCF7L2 polymorphism is not associated with fetal and postnatal growth in two birth cohort studies.

Background: An inverse association between birth weight and the risk of developing type 2 diabetes (T2D) in adulthood has been reported. This association may be explained by common genetic variants related to insulin secretion and resistance, since insulin is the most important growth factor in fetal life. The objective of this study was to examine whether T2D gene polymorphism TCF7L2 rs7903146 is associated with growth patterns from fetal life until infancy.

Paternal depressive symptoms during pregnancy are related to excessive infant crying.

Objective: Excessive infant crying, or infantile colic, is a common and often stress-inducing problem for parents that can ultimately result in child abuse. From previous research it is known that maternal depression is related to excessive crying, but so far little is known about the influence of paternal depression.

Methods: In a prospective, population-based study, we obtained information on both maternal and paternal depressive symptoms at 20 weeks of pregnancy by using the Brief Symptom Inventory.

Breastfeeding protects against infectious diseases during infancy in industrialized countries. A systematic review.

Firstly, this review was performed to assess the effect of breastfeeding on infections during infancy in industrialized countries. Secondly, the effect of duration and exclusiveness of breastfeeding were explored. Studies were identified using Medline, Cochrane Library, Science Citation Index and by a manual search from bibliographies of articles from August 1986 to January 2008.

Are starting and continuing breastfeeding related to educational background? The generation R study.

Objective: To assess the effect of a woman's educational level on starting and continuing breastfeeding and to assess the role of sociodemographic, lifestyle-related, psychosocial, and birth characteristics in this association.

Methods: We used the data of 2914 participants in a population-based prospective cohort study. Information on educational level, breastfeeding, sociodemographic (maternal age, single parenthood, parity, job status), lifestyle-related (BMI, smoking, alcohol use), psychosocial (whether the pregnancy was planned, stress), and birth (gestational age, birth weight, cesarean delivery, place and type of delivery) characteristics were obtained between pregnancy and 12 months postpartum.

Fetal and postnatal growth and blood pressure at the age of 2 years. The Generation R Study.

Objectives: To examine which fetal and postnatal growth characteristics are associated with blood pressure (BP) in children at the age of 2 years.

Methods: This study was embedded in the Generation R Study, a population-based prospective cohort study from early fetal life onwards. Fetal ultrasound examinations were carried out at the visits in one of the research centers in early, mid- and late pregnancy.

Maternal psychopathology influences infant heart rate variability: Generation R Study.

Objective: To assess the determinants of heart rate (HR) and heart rate variability (HRV) in children. The autonomic nervous system as measured by HR and HRV is considered a biological marker of psychopathology in children.

Methods: We examined the relationship of maternal psychopathology with infant HR and HRV.

Breast-feeding modifies the association of PPARgamma2 polymorphism Pro12Ala with growth in early life: the Generation R Study.

Objective: We examined whether the PPARgamma2 Ala12 allele influences growth in early life and whether this association is modified by breast-feeding.

Research Design And Methods: This study was embedded in the Generation R Study, a prospective cohort study from early fetal life onward. PPARgamma2 was genotyped in DNA obtained from cord blood samples in 3,432 children.