Timely MMR vaccination in infancy: influence of attitudes and medical advice on the willingness to vaccinate.

In light of the failure to eliminate measles by 2010, the closure of any gaps in immunisation coverage is of paramount importance to interrupt transmission and to protect vulnerable individuals. Not only vaccination-critical attitudes of parents but furthermore the medical advice by physician in charge influence the vaccine uptake. 3 groups of factors which potentially influence parental decisions on child vaccination were analysed by univariable and multivariable logistic regression for the timely uptake of the first and the second dose of measles vaccination: parents' attitudes towards immunization, the influence of medical and laypersons and the influence of the advice of a medical doctor.

Do trimester-specific cutoffs predict whether women ultimately stay within the Institute of Medicine/National Research Council guidelines for gestational weight gain? Findings of a retrospective cohort study.

Background: It is unknown how well the trimester-specific recommendations for gestational weight gain (GWG) given by the Institute of Medicine/National Research Council (IOM/NRC) identify women at risk of GWG outside IOM/NRC recommendations for total GWG.

Objective: We assessed the prognostic value of trimester-specific cutoffs for inadequate or excessive total GWG in term pregnancies.

Design: Data on prepregnancy weight and the temporal course of GWG were collected from medical records.

Gestational weight gain and body mass index in children: results from three german cohort studies.

Introduction: Previous studies suggested potential priming effects of gestational weight gain (GWG) on offspring's body composition in later life. However, consistency of these effects in normal weight, overweight and obese mothers is less clear.

Methods: We combined the individual data of three German cohorts and assessed associations of total and excessive GWG (as defined by criteria of the Institute of Medicine) with offspring's mean body mass index (BMI) standard deviation scores (SDS) and overweight at the age of 5-6 years (total: n = 6,254).

Different age-specific incidence and remission rates in pre-school and primary school suggest need for targeted obesity prevention in childhood.

Background: School entry marks a tremendous change in the children's life style, which might well be relevant for the emergence of overweight. Previous studies suggested a dramatic increase in the prevalence of overweight during this age.

Objective: To compare the age-specific balance between the incidence and remission of overweight between pre-school and primary school age children.

Gestational diabetes and cardiovascular risk factors in the offspring: results from a cross-sectional study.

Background: While the association of gestational diabetes mellitus and abnormal glucose tolerance is beyond doubt, its associations with other cardiovascular disease risk factors in the offspring are less clearly established. Some of these associations, in particular overweight in the offspring, might be confounded by maternal overweight.

Methods: Data on 12,542 children in the age of 3-17 years with full information about gestational diabetes mellitus and maternal BMI were available from the German nationwide KiGGS study.

Genetic markers of obesity risk: stronger associations with body composition in overweight compared to normal-weight children.

Background: Genetic factors are important determinants of overweight. We examined whether there are differential effect sizes depending on children's body composition.

Methods: We analysed data of n = 4,837 children recorded in the Avon Longitudinal Study of Parents and Children (ALSPAC), applying quantile regression with sex- and age-specific standard deviation scores (SDS) of body mass index (BMI) or with body fat mass index and fat-free mass index at 9 years as outcome variables and an "obesity-risk-allele score" based on eight genetic variants known to be associated with childhood BMI as the explanatory variable.

Breastfeeding and body composition in children: will there ever be conclusive empirical evidence for a protective effect against overweight?

An increased prevalence of childhood overweight has been observed worldwide over the past decades, which indicates the need for strategies to prevent obesity. There is some evidence that risk of obesity is primed by exposures early in life. Among other factors, breastfeeding has been hypothesized as a potential priming factor against overweight.

Is low birth weight in the causal pathway of the association between maternal smoking in pregnancy and higher BMI in the offspring?

A number of cross-sectional and prospective studies suggested a priming effect of maternal smoking in pregnancy on offspring's obesity. It has been hypothesized that this association might be explained by low birth weight and subsequent catch-up growth in the causal pathway. We therefore examined the role of birth weight in children exposed versus not exposed to cigarette smoking in utero on later body mass index (BMI).

Risk factors for obesity: further evidence for stronger effects on overweight children and adolescents compared to normal-weight subjects.

Background: We recently showed that in preschoolers risk factors for overweight show stronger associations with BMI in children with high BMI values. However, it is unclear whether these findings might also pertain to adolescents.

Methods: We extracted data on 3-10 year-old (n = 7,237) and 11-17 year-old (n = 5,986) children from a representative cross-sectional German health survey (KiGGS) conducted between 2003 and 2006 and calculated quantile regression models for each age group.

Associations between stress and migraine and tension-type headache: results from a school-based study in adolescents from grammar schools in Germany.

Introduction: Stress is considered the major contributor to migraine and tension-type headache in adolescents. Previous studies have focused on general stressors, whereas the aim of the present study was to investigate associations between individuals' stressful experiences and different types of headache.

Methods: Adolescents from 10th and 11th grades of grammar schools filled in questionnaires.

Physical activity and gestational weight gain: a meta-analysis of intervention trials.

Background: high gestational weight gain (GWG) has been found to be associated with a number of adverse perinatal and long-term outcomes.

Objectives: we aimed to perform a systematic review and meta-analysis to find out whether physical activity in pregnancy might help avoid high GWG.

Search Strategy: a literature search in relevant databases and an additional search by hand through bibliographies of various publications were performed.

Weight gain and dietary intake during pregnancy in industrialized countries--a systematic review of observational studies.

Background: Gestational weight gain (GWG) above the recently recommended ranges is likely to be related to adverse pregnancy outcomes and therefore a challenge in industrialized countries.

Aims: We conducted a systematic review on observational studies in order to gain more evidence on whether diets with lower caloric/protein content or other diets might be associated with lower GWG.

Methods: We searched in MEDLINE and EMBASE for observational studies written in English or German reporting associations between diet and GWG in singleton pregnancies of healthy women in industrialized countries.

Improvement in pregnancy-related outcomes in the offspring of diabetic mothers in Bavaria, Germany, during 1987-2007.

Aims: Reducing the risk of adverse outcomes in diabetic pregnancies to the level of risk in non-diabetic pregnancies is a major goal in diabetes care. So far there have not been any data to show whether progress is being made towards this goal.

Methods: We used population-based data on 2,292,053 deliveries between 1987 and 2007 in Bavaria, Germany, to assess temporal trends for stillbirths, early neonatal mortality, preterm delivery, macrosomia and malformations in consecutive 7 year intervals.

Associations of gestational weight loss with birth-related outcome: a retrospective cohort study.

Objective: Although the prevention of gestational weight loss (GWL) has become a priority for clinicians in the past few decades, recent work has suggested that GWL may be beneficial for obese mothers. We aimed to identify the potential beneficial or adverse associations of GWL with pregnancy outcome stratified by maternal body mass index (BMI) category.

Design: Retrospective cohort study.

Within-population average ranges compared with Institute of Medicine recommendations for gestational weight gain.

Objective: To compare the risk for pregnancy outcomes by gestational weight gain with the Institute of Medicine criteria and empirically established average ranges of gestational weight gain.

Methods: In a population-based data set comprising 678,560 singleton deliveries in Bavarian obstetric units from 2000 to 2007, we calculated the prevalence of adverse short-term pregnancy outcomes within the gestational weight-gain ranges recommended by the Institute of Medicine. We then compared these for gestational weight gain within data-based interquartile ranges (25th to 75th percentile) and interdecile ranges (10th to 90th percentile) of gestational weight gain by maternal weight category (underweight, normal weight, overweight, and obese).

Growth in utero and body mass index at age 5 years in children of smoking and non-smoking mothers.

Background: High birth weight is associated with overweight later in life, while tobacco exposure in utero is associated with low birth weight, but with later risk of overweight.

Aims: To examine whether body mass index (BMI) z-scores of children at age 5 are associated with measurements of mid-abdominal diameter (MAD) in utero comparing smoking and non-smoking mothers.

Study Design: Growth in utero was recorded as MAD in mm per days of gestational age (MAD for gestational age) at 17, 25, 33 and 37 weeks of gestation in 561 infants whose mothers participated in a population-based study in Scandinavia (1986-1988).

Associations of diet and lifestyle with headache in high-school students: results from a cross-sectional study.

Background: Diet and lifestyle are seen as factors which influence headache in adults. However, population-based studies on this issue in adolescents are rare.

Objective: Aim of the present study was to investigate associations between diet and lifestyle factors and different types of headache, ie, migraine and tension-type headache (TTH) in adolescents.

Quality of life in adolescents with headache: results from a population-based survey.

The aim of the investigation was to study the impact of headache on quality of life (QOL) in adolescents in a population-based sample (N = 1047, aged between 13 and 17 years). QOL was assessed using the KINDL-R (Revidierter Kinder Lebensqualitätsfragebogen) questionnaire with its six dimensions. In order to assess potential differences in the impact on QOL according to the type of headache, a stratified analysis was performed.

The association between use of electronic media and prevalence of headache in adolescents: results from a population-based cross-sectional study.

Background: Use of electronic media, i.e. mobile phones, computers, television, game consoles or listening to music, is very common, especially amongst adolescents.

Risk factors for childhood overweight: shift of the mean body mass index and shift of the upper percentiles: results from a cross-sectional study.

Background: The worldwide increasing prevalence of childhood overweight seems to be due to an increasing proportion of extremely high body mass index (BMI) values rather than to a shift of the entire BMI distribution. These findings might be attributed to incremental exposure to risk factors particularly affecting overweight children.

Objective: To assess the possible differences in associations of several risk factors by subgroups of children's BMI distribution.

Infant formula supplementation with long-chain polyunsaturated fatty acids has no effect on Bayley developmental scores at 18 months of age--IPD meta-analysis of 4 large clinical trials.

Objectives: To find out whether supplementation of formula milk by long-chain polyunsaturated fatty acids (LCPUFA) affects neurodevelopment at 18 months of age in term or preterm infants by an individual patient data (IPD) meta-analysis.

Materials And Methods: Data of 870 children from 4 large randomised clinical trials for formula milk with and without LCPUFAs allowed for assessing the effect of LCPUFA with adjustment for potential confounders and extensive subgroup analysis on prematurity, LCPUFA source, and dosage. Any additional clinical trials examining the effect of LCPUFA supplementation on Bayley Scales of Infant Development at 18 months were regarded as relevant.

Breastfeeding and childhood obesity: shift of the entire BMI distribution or only the upper parts?

A protective effect of breastfeeding on overweight (binary) has been reported by meta-analyses using logistic regression, whereas studies using linear regression and BMI (continuous) detected no significant association. To assess the relationship of these differences with different outcome classification, we compared results for linear, logistic, and quantile regression models in a cross-sectional data set of considerable size. Height, weight, and questionnaire data on 9,368 preschool children were collected during school-entry examinations in 1999 and 2002 in Bavaria, Southern Germany.

Surveillance for rare infectious diseases: is one passive data source enough for Haemophilus influenzae?

Background: The completeness of a compulsory reporting system of systemic Haemophilus influenzae infections in children in Germany is studied by means of cross-linking registry data from three sources and applying capture-recapture methods.

Methods: Cases were collected for the years 2001-05 by three national data sources: a passive administration registry (SurvNet@RKI), an active hospital surveillance system and an active laboratory surveillance system. The case definition required cultural detection of H.

Effectiveness of hexavalent vaccines against invasive Haemophilus influenzae type b disease: Germany's experience after 5 years of licensure.

Vaccine effectiveness (VE) was determined with a case-cohort approach using Cox regression. Cases with confirmed systemic Hib infections in children born from 1 August 2000 to 31 December 2004 were ascertained through two independent nationwide active surveillance systems. A representative cohort of 1303 children born in the same time frame was randomly sampled in a nationwide immunisation survey.

Immunisation status of children in Germany: temporal trends and regional differences.

Unlabelled: In Germany, a low coverage with hepatitis B and measles vaccines and a considerable delay in administration of all recommended vaccines were previously apparent. Whether there have been improvements and whether there are regional differences within Germany is not known. Using representative nationwide telephone interviews on 2,701 children born 1996-2003, we assessed vaccination coverage for the first dose or full primary series (2/3 doses, depending on vaccine used) at 24 months of age.