Night shift work undertaken by women and fertility treatment interact to increase prevalence of urogenital anomalies in children.

Objective: To investigate the role of maternal night shift work in occurrence of urogenital anomalies in offspring, considering a possible interaction with mode of conception.

Methods: A population-based cohort comprising births in South Australia (1986-2002) was produced via linkage of fertility clinic records, perinatal and birth defects data. This study concerned first births to women in paid employment (n=98 103).

Sperm donation perinatal outcomes in an Australian population cohort.

Aim: To compare perinatal outcomes for neonates conceived with donated sperm with those for neonates conceived spontaneously in an Australian population cohort.

Methods: 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.

Perinatal outcomes by mode of assisted conception and sub-fertility in an Australian data linkage cohort.

Background: Fertility treatment is associated with increased risk of major birth defects, which varies between in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), and is significantly reduced by embryo freezing. We therefore examined a range of additional perinatal outcomes for these exposures.

Methods: All patients in South Australia receiving assisted conception between Jan 1986-Dec 2002 were linked to the state-wide perinatal collection (all births/stillbirths ≥20 weeks gestation or 400 g birth weight, n = 306 995).

Reproductive technologies and the risk of birth defects.

Background: The extent to which birth defects after infertility treatment may be explained by underlying parental factors is uncertain.

Methods: We linked a census of treatment with assisted reproductive technology in South Australia to a registry of births and terminations with a gestation period of at least 20 weeks or a birth weight of at least 400 g and registries of birth defects (including cerebral palsy and terminations for defects at any gestational period). We compared risks of birth defects (diagnosed before a child's fifth birthday) among pregnancies in women who received treatment with assisted reproductive technology, spontaneous pregnancies (i.

A score for the prediction of cardiovascular events in the hypertensive aged.

Background: With few exceptions, tools used to estimate cardiovascular disease (CVD) risk in those without prior events are based mainly on data from middle-aged subjects. Given the ever increasing number of older people, many with hypertension, a risk score relevant to this group is warranted. Our aim was to develop a cardiovascular risk equation suitable for risk prediction in elderly, hypertensive populations.

Intergenerational associations of chronic disease and polycystic ovary syndrome.

Background: Polycystic ovary syndrome (PCOS) is a common female endocrine disorder of heterogeneous clinical presentation, high disease burden, and unknown aetiology. The disease and associated conditions cluster in families, suggesting that PCOS may be the reproductive consequence of underlying chronic disease susceptibility.

Objective: To determine whether parents of young women with PCOS were more likely to have a history of diabetes or cardiovascular disease in later adult life.

The risk of adverse pregnancy outcomes in women who are overweight or obese.

Background: The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes.

Methods: A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS).

Prediction of cardiovascular events in subjects in the second Australian National Blood Pressure study.

Estimating absolute risk rather than measurement of blood pressure alone is considered the best way to identify those who would most likely benefit from medical intervention. Risk calculators used to estimate risk in those without previous cardiovascular disease (CVD) events are based on the Framingham Heart Study, which had no person >74 years of age at baseline. This needs to be addressed, because age is the most important determinant of risk.

Patient satisfaction with point-of-care testing in general practice.

Background: Point-of-care testing is increasingly being used in general practice to assist GPs in their management of patients with chronic disease. However, patient satisfaction and acceptability of point-of-care testing in general practice has not been widely studied.

Aim: To determine if patients are more satisfied with point-of-care testing than with pathology laboratory testing for three chronic conditions.

Assessing agreement between point of care and pathology laboratory results for INR: experiences from the Point of Care Testing in General Practice Trial.

Aims: To assess the level of agreement between international normalised ratio (INR) results obtained from pathology laboratories and point of care testing (PoCT) devices used in a general practice setting.

Methods: INR pathology results were collected from multiple pathology laboratories and CoaguChek S PoCT devices over a 6 month period. Agreement was assessed using both clinically relevant agreement and the Bland Altman method.

Assessing agreement between point of care and laboratory results for lipid testing from a clinical perspective.

Objectives: Investigate agreement between lipid pathology results from point-of-care testing (PoCT) devices and laboratories.

Design And Methods: Agreement was assessed using the Bland-Altman method.

Results: : Mean difference (limits of agreement) were: -0.

The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria.

Background: 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 sampling 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.

Methods: 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).

Does point-of-care testing lead to the same or better adherence to medication? A randomised controlled trial: the PoCT in General Practice Trial.

Objective: To compare the clinical effectiveness of point-of-care testing (PoCT) with that of pathology laboratory testing, as measured by patients' adherence to medication.

Design: Multicentre, cluster randomised controlled trial using non-inferiority analysis. Medication adherence was assessed twice (in April 2006 and January 2007) by a self-administered questionnaire using the five-item Medication Adherence Report Scale (MARS-5).

Effectiveness of point-of-care testing for therapeutic control of chronic conditions: results from the PoCT in General Practice Trial.

Objective: To compare the clinical effectiveness of point-of-care testing (PoCT) and that of pathology laboratory testing, as measured by therapeutic control in chronic conditions.

Design: Multicentre, cluster randomised controlled trial using non-inferiority analysis.

Setting: 53 Australian general practices in urban, rural and remote areas across three Australian states, September 2005 to February 2007.

Gender, socioeconomic status, need or access? Differences in statin prescribing across urban, rural and remote Australia.

Objectives: To assess differences in statin prescribing across Australia by geographic area.

Design, Setting And Participants: A cross-sectional study using Pharmaceutical Benefits Scheme data on statin prescribing by rurality, gender and patient postcode for the period May to December 2002. Participants were the Australian population, stratified by gender, quintile of index of relative socioeconomic disadvantage and rural, remote and metropolitan areas classification.

Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial.

Context: Uncertainty exists about the benefit of dietary docosahexaenoic acid (DHA) on the neurodevelopment of preterm infants.

Objective: To determine the effect of meeting the estimated DHA requirement of preterm infants on neurodevelopment at 18 months' corrected age.

Design, Setting, And Participants: Randomized, double-blind controlled trial enrolling infants born at less than 33 weeks' gestation from April 2001 to October 2005 at 5 Australian tertiary hospitals, with follow-up to 18 months.

A pragmatic cluster randomised controlled trial to evaluate the safety, clinical effectiveness, cost effectiveness and satisfaction with point of care testing in a general practice setting - rationale, design and baseline characteristics.

Background: Point of care testing (PoCT) may be a useful adjunct in the management of chronic conditions in general practice (GP). The provision of pathology test results at the time of the consultation could lead to enhanced clinical management, better health outcomes, greater convenience and satisfaction for patients and general practitioners (GPs), and savings in costs and time. It could also result in inappropriate testing, increased consultations and poor health outcomes resulting from inaccurate results.

Borderline gestational diabetes mellitus and pregnancy outcomes.

Background: The impact of borderline gestational diabetes mellitus (BGDM), defined as a positive oral glucose challenge test (OGCT) and normal oral glucose tolerance test (OGTT), on maternal and infant health is unclear. We assessed maternal and infant health outcomes in women with BGDM and compared these to women who had a normal OGCT screen for gestational diabetes.

Methods: We compared demographic, obstetric and neonatal outcomes between women participating in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS) who had BGDM and who screened negative on OGCT.

Carbohydrate intake is the main determinant of growth in infants born <33 weeks' gestation when protein intake is adequate.

Objective: We investigated the relative contribution of macronutrients to postnatal growth in preterm infants born <33 wk of gestation.

Methods: An audit of daily parenteral and enteral intakes of protein, carbohydrate, fat, energy, and growth (daily weight, weekly length, and head circumference) from birth to discharge home in 138 infants at <33 wk of gestation admitted to an Australian tertiary hospital was done. A mixed-model analysis of variance with random effects (slope and intercept) for subject and controlling for time, sex, gestational age, and total energy was used to determine the relative contribution of macronutrients to growth.

Smaller aortic dimensions do not fully account for the greater pulse pressure in elderly female hypertensives.

This study examined the importance of aortic dimensions in determining pulse pressure in elderly hypertensives participating in the 2nd Australian National Blood Pressure Study, including a substantial number not previously receiving blood pressure lowering medication. Aortic dimensions were determined by ultrasound at the transverse arch and at the insertion of the aortic valve. Unadjusted data showed negative (P<0.

Costs and consequences of treatment for mild gestational diabetes mellitus - evaluation from the ACHOIS randomised trial.

Background: Recommended best practice is that economic evaluation of health care interventions should be integral with randomised clinical trials. We performed a cost-consequence analysis of treating women with mild gestational diabetes mellitus by dietary advice, blood glucose monitoring and insulin therapy as needed compared with routine pregnancy care, using patient-level data from a multi-centre randomised clinical trial.

Methods: Women with a singleton pregnancy who had mild gestational diabetes diagnosed by an oral glucose-tolerance test between 24 and 34 weeks' gestation and their infants were included.

Similar effects of treatment on central and brachial blood pressures in older hypertensive subjects in the Second Australian National Blood Pressure Trial.

The Second Australian National Blood Pressure Trial reported better prognosis for hypertensive subjects randomly assigned to an angiotensin-converting enzyme inhibitor (ACE-I) compared with a diuretic-based regimen despite no difference in brachial blood pressure control. A possible explanation is that there was a difference in central aortic pressures despite similar brachial pressure reductions. We examined this hypothesis in a subset of the Second Australian National Blood Pressure Trial cohort evaluated both before and after 4 years of treatment.

Mild gestational diabetes in pregnancy and the adipoinsular axis in babies born to mothers in the ACHOIS randomised controlled trial.

Background: Mild gestational diabetes is a common complication of pregnancy, affecting up to 9% of pregnant women. Treatment of mild GDM is known to reduce adverse perinatal outcomes such as macrosomia and associated birth injuries, such as shoulder dystocia, bone fractures and nerve palsies. This study aimed to compare the plasma glucose concentrations and serum insulin, leptin and adiponectin in cord blood of babies of women (a) without gestational diabetes mellitus (GDM), (b) with mild GDM under routine care, or (c) mild GDM with treatment.

Calcium supplementation in pregnancy and its impact on blood pressure in children and women: follow up of a randomised controlled trial.

Background: Follow up of participants in trials of antenatal calcium supplementation has reported an impact on blood pressure among mothers and children.

Aims: To determine whether blood pressure at 4-7 years follow up would be lower for calcium-supplemented mothers in the Australian Calcium Trial (ACT) and for their children.

Methods: This follow up targeted 414 of the original ACT participants with liveborn infants who lived in South Australia.