- Email: [email protected]
Risk Profiles of Younger and Older Pregnant Women Who Consume Alcohol During Pregnancy
Abstracts / Annals of Epidemiology 24 (2014) 682e702
Methods: Cross sectional hospital-based study was conducted in 4 major hospitals in Tanzania from 2012 -2014. Parents/guardians of 175 children were assessed about their socio-demographic profile by questionnaires. Children were clinically examined for cleft types and oral health status. Analysis elicited frequency distributions, cross tabulations and Chi-square statistics were used to assess bivariate relationships (P < 0.05). Results: Majority were: boys (54.3%), below 5-years (86.3%; 37.7% below 1year), rural dwellers (80.6%) and with low-educated parents (89.1%). Most children had complete-unilateral cleft lip (52%), more on left side (37.1%). Complete-bilateral clefts were common (18%) than incomplete (4%). Hardsoft palate clefts were found in 37.1% and soft palate-only in 2.9%. Malocclusion, caries and poor oral hygiene were found in 48.6%, 28.4% and 42.3% of children, respectively. Significant association (p<0.05) was such that; bilateral clefts were more in children below than above 1-year, cleft of the soft palate-only was more in children above than below 5-years and a cleft of both palates was more in urban than rural dwellers. Conclusion: Complete-unilateral cleft lip was the commonest type, malocclusion were the commonest oral- health impacts, rural dwellers and low-level of parents’ education were significant risk indicators for lip/palateclefts in Tanzanian children.
P72. Longer Breastfeeding Duration Reduces the Positive Relationships among Gestational Weight Gain, Birthweight, and Childhood Growth Yeyi Zhu PhD, Ladia M. Hernandez PhD, Yongquan Dong MS, John H. Himes PhD, Steven Hirschfeld PhD, MD, Michele R. Forman PhD. University of Texas at Austin Purpose: The relationship between gestational weight gain (GWG) and childhood growth remains controversial; thus an examination whether early life nutrition mediates this relationship may improve our understanding. We aimed to investigate whether the relationships among GWG, birthweight, and childhood anthropometrics were mediated through infant feeding practices (i.e., breastfeeding duration and age at introduction of solid foods). Methods: In a cross-sectional multi-ethnic study of 1387 mothers and their children aged 0-5.9 years in the US (2011-2012), perinatal and socio-demographic factors were collected from the mother via an interviewer-administered questionnaire. Child anthropometrics included age- and sex-specific z-scores for: weight-for-age (WAZ), height/length-for-age (HAZ), weight-forheight/length (WHZ) and body mass index-for-age (BMIZ), and ulnar length, a linear marker for skeletal growth. Mediation analysis was used to calculate standardized coefficients of the paths among GWG, birthweight, infant feeding, and anthropometrics. Results: Maternal GWG had a consistent positive effect on all anthropometrics mediated via birthweight, whereas longer breastfeeding duration reduced the positive associations of GWG and birthweight with WAZ, WHZ, and BMIZ (Î2 ¼ -0.076, -0.062, and -0.124, respectively) in non-Hispanics. Longer breastfeeding duration and a later age at introduction of solid foods were both positively associated with ulnar length (Î2 ¼ 0.021 and 0.030, respectively) not HAZ, suggesting for the first time a distinct effect of infant feeding practices on limb growth. Conclusions: Findings suggest promoting breastfeeding among women with excessive GWG may mitigate offspring obesity. Future prospective research investigating ethnic-specific interrelationships among GWG, birthweight, infant feeding, and postnatal growth are warranted.
Public Health P73. Performance-Enhancing Dietary Supplements and Other Health Related Factors Associated with Adverse Medical Outcomes in Active Duty U.S. Army Soldiers Esther O. Dada MPH, Chiping Nieh PhD, Theresa Jackson PhD, MPH, Samar DeBakey MD, MPH, Bruce H. Jones MD, MPH. U.S. Army Institute of Public Health, U.S. Army Public Health Purpose: Amid safety concerns over dietary supplements containing dimethylamylamine (DMAA), this study examined associations between DMAA use and other potential risk factors with experiencing adverse medical outcomes (AMOs) among Active Duty U.S. Army Soldiers.
699
Methods: A case-control study was conducted among 712 Army Soldiers with clinician-identified AMO (cardiac dysrhythmia, seizure, heat injury, rhabdomyolysis, cerebral hemorrhage, acute/subacute necrosis of liver, acute kidney failure) and 1,077 controls, ascertained from Defense Medical Surveillance System. Participants completed questionnaire on DMAA use, physical activity/fitness, sleep, medication and substance use. Multivariate logistic regression was performed to examine associations between DMAA use and other potential risk factors and AMOs. Results: No statistically significant association was observed between selfreported DMAA use and selected AMOs after controlling for relevant factors (adjusted odds ratio [aOR] 95% confidence interval [CI] of 0.85 (0.59-1.23)). However, Soldiers with multiple AMOs were twice as likely to have reported using DMAA compared to those with one reported outcome (OR 2.28 (95% CI 1.01-4.95)). Soldiers with prior AMO were almost 18 times more likely to have a current AMO (aOR 17.86 (95% CI 9.60-33.22)). Soldiers who reported antidepressant use were about three times more likely to experience an AMO (aOR 2.75 (95% CI 1.96-3.87)). Conclusions: While this study did not find that simply using DMAA increased the likelihood of Service members experiencing an AMO, study did show that those with multiple AMOs were twice as likely to use DMAA. The strongest predictor of AMOs was prior AMO suggesting the importance of prevention strategies to reduce reoccurrence.
P74. Risk Profiles of Younger and Older Pregnant Women Who Consume Alcohol During Pregnancy Panagiota Kitsantas PhD, Kathleen Gaffney, Carol Wu. George Mason University Purpose: Recent studies indicate that older women are more likely to consume alcohol during pregnancy. However, little is known about alcohol consumption during pregnancy within the context of maternal age. This study identifies risk profiles of younger and older women who are at risk of consuming alcohol during pregnancy using classification and regression trees (CART) analysis. Methods: We used the 2002-2009 Pregnancy Risk Assessment Monitoring System (PRAMS) dataset (311,428 records U.S. women). Logistic regression and classification trees were constructed separately for age groups, 24, 2529, and 30 years. Results: Alcohol consumption by age group was: 3.7% for 24, 5.7% for 2529, and 10.1% for 30 years of age. Women 24 years were at greater risk of consuming alcohol if they also smoked (5.8%). Among nonsmokers, higher levels of education and being Hispanic were associated with a 35% increase in alcohol use. Distinct high-risk subgroups emerged for the 25-29 year old group. Specifically, 12.8% of non-obese women who reported having experienced abuse during pregnancy also reported drinking alcohol in the last trimester. About 16% of women 30 years with at least 16 years of education, white or Hispanic with normal or underweight BMI, drank alcohol during their last trimester. Conclusions: Given limited health care resources for prevention and treatment, the early identification of high-risk groups for prenatal alcohol use is critical. This study provides evidence that risk factors contributing to alcohol consumption during pregnancy may differ by maternal age.
P75. Status Epilepticus and Subsequent Epilepsy Angela M. Malek PhD, Dulaney A. Wilson PhD, Braxton B. Wannamaker MD, Gabriel U. Martz MD, Gigi Smith PhD, APRN, CPNP-PC, Anbesaw W. Selassie DrPH. Medical University of South Carolina Purpose: The incidence of status epilepticus (SE), characterized by continuous seizures lasting >5 minutes or repeated seizures without regaining consciousness, ranges from 6.8-41 per 100,000 persons (DeLorenzo 1995; Wu 2002). Few studies have investigated SE and subsequent epilepsy. We evaluated risk of subsequent epilepsy after SE and described associated comorbid conditions Methods: This retrospective cohort study included South Carolina hospitalizations and emergency department (ED) visits from 2000-2011. All individuals with SE were identified and classified based on a subsequent epilepsy diagnosis. Individuals with known epilepsy prior to the diagnosis of SE and persons with epilepsia partialis continua were excluded. Descriptive statistics were used to compare demographic and clinical characteristics. Cox
Methods: Cross sectional hospital-based study was conducted in 4 major hospitals in Tanzania from 2012 -2014. Parents/guardians of 175 children were assessed about their socio-demographic profile by questionnaires. Children were clinically examined for cleft types and oral health status. Analysis elicited frequency distributions, cross tabulations and Chi-square statistics were used to assess bivariate relationships (P < 0.05). Results: Majority were: boys (54.3%), below 5-years (86.3%; 37.7% below 1year), rural dwellers (80.6%) and with low-educated parents (89.1%). Most children had complete-unilateral cleft lip (52%), more on left side (37.1%). Complete-bilateral clefts were common (18%) than incomplete (4%). Hardsoft palate clefts were found in 37.1% and soft palate-only in 2.9%. Malocclusion, caries and poor oral hygiene were found in 48.6%, 28.4% and 42.3% of children, respectively. Significant association (p<0.05) was such that; bilateral clefts were more in children below than above 1-year, cleft of the soft palate-only was more in children above than below 5-years and a cleft of both palates was more in urban than rural dwellers. Conclusion: Complete-unilateral cleft lip was the commonest type, malocclusion were the commonest oral- health impacts, rural dwellers and low-level of parents’ education were significant risk indicators for lip/palateclefts in Tanzanian children.
P72. Longer Breastfeeding Duration Reduces the Positive Relationships among Gestational Weight Gain, Birthweight, and Childhood Growth Yeyi Zhu PhD, Ladia M. Hernandez PhD, Yongquan Dong MS, John H. Himes PhD, Steven Hirschfeld PhD, MD, Michele R. Forman PhD. University of Texas at Austin Purpose: The relationship between gestational weight gain (GWG) and childhood growth remains controversial; thus an examination whether early life nutrition mediates this relationship may improve our understanding. We aimed to investigate whether the relationships among GWG, birthweight, and childhood anthropometrics were mediated through infant feeding practices (i.e., breastfeeding duration and age at introduction of solid foods). Methods: In a cross-sectional multi-ethnic study of 1387 mothers and their children aged 0-5.9 years in the US (2011-2012), perinatal and socio-demographic factors were collected from the mother via an interviewer-administered questionnaire. Child anthropometrics included age- and sex-specific z-scores for: weight-for-age (WAZ), height/length-for-age (HAZ), weight-forheight/length (WHZ) and body mass index-for-age (BMIZ), and ulnar length, a linear marker for skeletal growth. Mediation analysis was used to calculate standardized coefficients of the paths among GWG, birthweight, infant feeding, and anthropometrics. Results: Maternal GWG had a consistent positive effect on all anthropometrics mediated via birthweight, whereas longer breastfeeding duration reduced the positive associations of GWG and birthweight with WAZ, WHZ, and BMIZ (Î2 ¼ -0.076, -0.062, and -0.124, respectively) in non-Hispanics. Longer breastfeeding duration and a later age at introduction of solid foods were both positively associated with ulnar length (Î2 ¼ 0.021 and 0.030, respectively) not HAZ, suggesting for the first time a distinct effect of infant feeding practices on limb growth. Conclusions: Findings suggest promoting breastfeeding among women with excessive GWG may mitigate offspring obesity. Future prospective research investigating ethnic-specific interrelationships among GWG, birthweight, infant feeding, and postnatal growth are warranted.
Public Health P73. Performance-Enhancing Dietary Supplements and Other Health Related Factors Associated with Adverse Medical Outcomes in Active Duty U.S. Army Soldiers Esther O. Dada MPH, Chiping Nieh PhD, Theresa Jackson PhD, MPH, Samar DeBakey MD, MPH, Bruce H. Jones MD, MPH. U.S. Army Institute of Public Health, U.S. Army Public Health Purpose: Amid safety concerns over dietary supplements containing dimethylamylamine (DMAA), this study examined associations between DMAA use and other potential risk factors with experiencing adverse medical outcomes (AMOs) among Active Duty U.S. Army Soldiers.
699
Methods: A case-control study was conducted among 712 Army Soldiers with clinician-identified AMO (cardiac dysrhythmia, seizure, heat injury, rhabdomyolysis, cerebral hemorrhage, acute/subacute necrosis of liver, acute kidney failure) and 1,077 controls, ascertained from Defense Medical Surveillance System. Participants completed questionnaire on DMAA use, physical activity/fitness, sleep, medication and substance use. Multivariate logistic regression was performed to examine associations between DMAA use and other potential risk factors and AMOs. Results: No statistically significant association was observed between selfreported DMAA use and selected AMOs after controlling for relevant factors (adjusted odds ratio [aOR] 95% confidence interval [CI] of 0.85 (0.59-1.23)). However, Soldiers with multiple AMOs were twice as likely to have reported using DMAA compared to those with one reported outcome (OR 2.28 (95% CI 1.01-4.95)). Soldiers with prior AMO were almost 18 times more likely to have a current AMO (aOR 17.86 (95% CI 9.60-33.22)). Soldiers who reported antidepressant use were about three times more likely to experience an AMO (aOR 2.75 (95% CI 1.96-3.87)). Conclusions: While this study did not find that simply using DMAA increased the likelihood of Service members experiencing an AMO, study did show that those with multiple AMOs were twice as likely to use DMAA. The strongest predictor of AMOs was prior AMO suggesting the importance of prevention strategies to reduce reoccurrence.
P74. Risk Profiles of Younger and Older Pregnant Women Who Consume Alcohol During Pregnancy Panagiota Kitsantas PhD, Kathleen Gaffney, Carol Wu. George Mason University Purpose: Recent studies indicate that older women are more likely to consume alcohol during pregnancy. However, little is known about alcohol consumption during pregnancy within the context of maternal age. This study identifies risk profiles of younger and older women who are at risk of consuming alcohol during pregnancy using classification and regression trees (CART) analysis. Methods: We used the 2002-2009 Pregnancy Risk Assessment Monitoring System (PRAMS) dataset (311,428 records U.S. women). Logistic regression and classification trees were constructed separately for age groups, 24, 2529, and 30 years. Results: Alcohol consumption by age group was: 3.7% for 24, 5.7% for 2529, and 10.1% for 30 years of age. Women 24 years were at greater risk of consuming alcohol if they also smoked (5.8%). Among nonsmokers, higher levels of education and being Hispanic were associated with a 35% increase in alcohol use. Distinct high-risk subgroups emerged for the 25-29 year old group. Specifically, 12.8% of non-obese women who reported having experienced abuse during pregnancy also reported drinking alcohol in the last trimester. About 16% of women 30 years with at least 16 years of education, white or Hispanic with normal or underweight BMI, drank alcohol during their last trimester. Conclusions: Given limited health care resources for prevention and treatment, the early identification of high-risk groups for prenatal alcohol use is critical. This study provides evidence that risk factors contributing to alcohol consumption during pregnancy may differ by maternal age.
P75. Status Epilepticus and Subsequent Epilepsy Angela M. Malek PhD, Dulaney A. Wilson PhD, Braxton B. Wannamaker MD, Gabriel U. Martz MD, Gigi Smith PhD, APRN, CPNP-PC, Anbesaw W. Selassie DrPH. Medical University of South Carolina Purpose: The incidence of status epilepticus (SE), characterized by continuous seizures lasting >5 minutes or repeated seizures without regaining consciousness, ranges from 6.8-41 per 100,000 persons (DeLorenzo 1995; Wu 2002). Few studies have investigated SE and subsequent epilepsy. We evaluated risk of subsequent epilepsy after SE and described associated comorbid conditions Methods: This retrospective cohort study included South Carolina hospitalizations and emergency department (ED) visits from 2000-2011. All individuals with SE were identified and classified based on a subsequent epilepsy diagnosis. Individuals with known epilepsy prior to the diagnosis of SE and persons with epilepsia partialis continua were excluded. Descriptive statistics were used to compare demographic and clinical characteristics. Cox