Ponderal index of the newborn: effect of smoking on the index of the small-for-gestational-age infant.

The ponderal index (PI) is evaluated in the context of its distribution within a given population. Low PI (<10th percentile for gestational age) has been extensively studied but not much is known about the distribution and factors associated with a high (>90th percentile) PI among small-for-gestational-age (SGA) infants. This retrospective study of singleton live first births from 1990 to 2007 in a Midwestern city explores factors associated with a high PI, particularly among SGA infants.

Excess Hispanic fetal-infant mortality in a midwestern community.

Objective: We assessed excess fetal-infant mortality for Hispanic, non-Hispanic white, and non-Hispanic black populations in five contiguous counties of Missouri and Kansas.

Methods: We conducted a perinatal periods of risk (PPOR) assessment of fetal-infant mortality using electronic linked birth-death record files from 2001 through 2005. We generated an internal reference group in accordance with established PPOR protocol.

Pre-pregnancy overweight status between successive pregnancies and pregnancy outcomes.

Objective: The two objectives of this study were to (1) examine factors associated with changes in pre-pregnancy overweight to pre-pregnancy normal/underweight or obese Body Mass Index (BMI) in the subsequent pregnancy, and (2) assess select pregnancy and newborn outcomes associated with changes in pre-pregnancy BMI.

Methods: Birth certificates from 1995-2004 for residents of Kansas City, Missouri, were used to identify overweight nulliparous women who had a singleton birth and subsequently a second singleton birth. Maternal factors associated with changes in BMI between pregnancies were determined.

Risk factors for recurrent small-for-gestational-age birth.

The factors associated with recurrent small-for-gestational-age birth (R-SGA) have not been previously studied in a multiracial population. This is a retrospective cohort study of 5932 black and white women who had consecutive singleton first and second births in a Midwestern metropolis, from 1995 through 2004, to measure the risk and determine the factors associated with R-SGA. The rates for second-born small-for-gestational-age birth and R-SGA were 10.

Fetal mortality: timing of racial disparities.

Whether or not racial disparities exist in fetal mortality rate (FMR) statistics depends upon the methodology used to calculate the rates. While there appears to be consensus that there is a black-white disparity in late gestation (> or = 28 weeks), the issue is unclear for early gestation (20-27 weeks). To clarify this issue, we assessed disparities in FMR for singleton fetal deaths and live births between non-Hispanic blacks and non-Hispanic whites in three counties of Missouri using gestational age- and weight-specific analyses.

Clinical manifestation of small-for-gestational-age risk pregnancy from smoking is gestational age dependent.

To determine the gestational age period at which small-for-gestational-age (SGA) risk from pregnancy smoking manifests, we conducted a retrospective cohort study of 266,782 live births in Kansas City, Missouri, from 1990 to 2004. Information was obtained from birth records. Newborns were stratified by gestation (< 32, 32 to 36, and > or = 37 weeks) and maternal pregnancy smoking.

Changes in smoking behavior between first and second pregnancies.

Objective: To assess changes in maternal smoking behavior at the second pregnancy.

Methods: First and second birth certificates were matched for 5241 white and black mothers in Kansas City, Mo, who had singleton births between 1994 and 2003.

Results: The pregnancy-smoking quit rate was 24.

Cumulative and residual risks of small for gestational age neonates after changing pregnancy-smoking behaviors.

This retrospective cohort study examines the relationship between changing pregnancy-smoking behaviors, from the first to the second pregnancy, on second-pregnancy rates of small for gestational age (SGA) neonates. Electronic birth records provided data on 5107 pregnant women who had two singleton births in Kansas City, MO, from 1994 to 2003. Pregnancy-smoking behavior was classified by smoking status (nonsmoker [NS] or smoker [SMK]) during the first (previous)/second (current) pregnancy: NS/NS, NS/SMK, SMK/SMK, and SMK/NS.

The effect of health compromising behaviors on preterm births.

Objectives: The objective of our study was to determine whether there were combined effects of smoking, alcohol, and illicit drug use during pregnancy on the frequency of preterm births, and if so, the magnitude of the association after adjusting for confounding factors.

Methods: We conducted a retrospective cohort study of singleton live births in Kansas City, Missouri from 1990-2002. We defined health compromising behaviors as the use of cigarettes, alcohol, and illicit drugs.

Are fewer women smoking during pregnancy?

Objective: To determine whether pregnancy-smoking rates have changed in last decade.

Methods: Retrospective cohort study of 67,395 pregnancies in Kansas City over 2 epochs, 1993-1997 and 1998-2002, using computer files of birth certificates.

Results: Overall pregnancy-smoking rates decreased from 18.

Perinatal periods of risk: analysis of fetal-infant mortality rates in Kansas City, Missouri.

Objectives: The Perinatal Periods of Risk (PPOR) technique was used to analyze resident fetal and infant death data from Kansas City, Missouri, for the period 1998-2002. Results offer important information that can be used to develop community-based prevention strategies related to racial/ethnic disparities in infant mortality rates (IMR).

Methods: The PPOR approach for fetal and infant mortality can be mapped by birthweight at delivery and time of death into four strategic prevention areas: 1) Maternal Health/Prematurity (MHP), 2) Maternal Care (MC), 3) Newborn Care (NC), and 4) Infant Health (IH).

Sex differences in stroke recovery.

Introduction: This study examined differences between men and women in the ability to perform basic activities of daily living, instrumental activities of daily living, and higher physical functioning after stroke. The objective of the study was to determine whether sex differences in stroke recovery can be explained by depressive status beyond older age, stroke severity, prestroke physical functioning, and other medical comorbidities.

Methods: A total of 459 stroke patients were recruited from acute and subacute facilities in an urban midwestern community.