Lack of association between lactotransferrin polymorphism and dental caries.

OBJECTIVE: Dental caries is a complex, multifactorial disease and one of the most common illnesses worldwide. Its etiology is related to microbial, dietary and host factors. Recent evidence suggests a role of lactotransferrin (LTF) in caries. The purpose of this study was to determine the association between LTF gene polymorphism and dental caries. METHODS: In this case-control study, 637 unrelated children, aged 11-13 years, were enrolled. The subjects were divided into two groups, i.e. caries-free (decayed/missing/filled teeth = 0) and caries-affected children (decayed/missing/filled teeth ≥ 1). The LTF rs1126478 (140A/G in exon 2, Lys/Arg) genotypes were determined by PCR with restriction analysis using the EarI enzyme. RESULTS: Of 637 children, 155 (24.3%) were caries free. There were no statistically significant differences between caries levels and allele or genotype distributions in the total cohort. When the caries-affected group (n = 482) was stratified into low (decayed/missing/filled teeth = 1), moderate (2 ≤ decayed/missing/filled teeth ≤ 3) and high (decayed/missing/filled teeth ≥ 4) caries experience, allele and genotype frequencies were similar among all subgroups. CONCLUSIONS: The LTF 140A/G (exon 2, Lys/Arg) polymorphism was not associated with the susceptibility to or severity of dental caries in the Czech population.

Relationship between gingivitis severity, caries experience and orthodontic anomalies in 13-15 year-old adolescents in Brno, Czech Republic.

OBJECTIVES: The aim of the present cross-sectional study was to assess oral health in adolescents selected from the ELSPAC (European Longitudinal Study of Pregnancy and Childhood) Bmo group and complete thus the ELSPAC series of studies on child general health. MATERIAL AND METHODS: Randomly selected children from the ELSPAC group (n=780) were examined clinically for dental and periodontal status, dental plaque, dental calculus and orthodontic anomalies. The following clinical parameters were assessed: DMFT score and its components, gingival index (GI), plaque index (PI) and calculus index (CSI). GI, PI and CSI were recorded on selected teeth. The presence/absence of orthodontic anomalies and their severity were recorded. ANOVA test for quantitative and XZ2 test for qualitative parameters evaluation were used. RESULTS: Mean DMFT of the group was 2.82 (SE 0.36), share of caries-free children 25.4%. Mean GI index of the cohort was 0.204 (SE 0.011), grade 0 was found in 36.9% children, grade 1 in 43.0%, and grade 2 in 19.5%. Statistical significant associations (p < 0.05) were observed in GI and DMFT, GI and DT value, GI and severity of orthodontic anomaly; significant difference was found in GI of caries-free and treated children vs. treatment need and in PI value between children with gingivitis vs healthy ones. CONCLUSION: The results demonstrated a relatively high caries experience, low level of gingival inflammation and relation between GI and DMFT, particularly in D component, and between GI and orthodontic anomalies.

[Self-rated health status and its implications. Population study of pregnant women in Brno]. / Subjektivní hodnocení vlastního zdraví a jeho souvislosti. Populacní studie gravidních zen v Brne

OBJECTIVE: The subject of self-rated health status of women in fertile age has not yet been investigated in our country. As our study is longitudinal and the same questions-questionnaire items regarding self-rated health of the monitored women are repeated in each investigation phase, we are able to not only find out which factors are related but also verify how this relationship evolves with their ageing, life situation changes and growing up of their children. SETTING: Research Centre for Toxic Compounds in the Environment, Masaryk University, Brno. METHODS: Pregnant women from the Brno part of ELSPAC study rated their health status for the time period before becoming pregnant, for the first months of pregnancy and for the half of pregnancy. On the four-grade scale of self-reported health status the associations with their personal health-history (from prenatal questionnaires and prenatal and obstetrician health-care network) were investigated. RESULTS: The monitored women rated their pre-pregnancy health-status increasingly worse with increasing age and weight, increasing morbidity, increasing medicine consumption and with increasing number of injuries. Also their parents, siblings and children were more often ill and more often admitted in hospitals as in-patients. These women required more specialized care starting in their childhood, suffered more from infectious diseases, operations, injuries, stresses and break-ups of their original families. Their misunderstanding with parents was occurred with higher frequency, their upbringing was more strict, they suffered from school failures more often, they had problems with the police and premature pregnancies. According to the mothers education, especially the daughters of college educated women felt subjectively worse. Also women with basic level of education, problems at work, financial troubles, those who had many children and less adults in their household rated their health worse. They were also unemployed and dissatisfied with their housing situation. In partner relationships conflicts were present frequently including violence. They also suffered from depression, anxiety, neuroses, phobias and social isolation more often. They also attempted to become pregnant longer than other women and tolerated pregnancy worse. They noted more changes to themselves and experiences more stress. The worse their feelings were during the first months of pregnancy, the higher frequency of pregnancy difficulties, delivery pathologies and post-natal complications were present according to the health-status documentation. CONCLUSION: This paper brings a whole series of original findings of factors associated with self-rated health-status. The socio-economic position in the families of their own had a more substantial influence on the health-status of the monitored women compared to the position in the families where they grew up. The indicators - e.g. stress, social isolation, work, social support, education, income and household created gradients on the health-status scale which were overall highly significant.

[Child abuse in common family population--a longitudinal study]. / Týrání detí populaci bézných rodin--longitudinální studie.

BACKGROUND: Dunovský, Dytrych, Matejcek et al. have published their experience from their consulting and interventional activities, alongside with an analysis of the paediatric, psychological, psychiatric and social components of the child's development in the family and outside it, in a fundamental and still up-to-date paper (1, 2). In this elaborate they emphasized the necessity to map the occurrence, in our country, of pathological phenomena included in the CAN notion--a child that is abused and neglected. The background of the presented study lays in a retrospective investigation in an adult population. The subject of the study are men--the near future fathers of the investigated children, who have among other information specified within an extensive personal history if and how they were maltreated in their childhood. THE GOAL OF THE STUDY: A group of men maltreated in childhood is compared to a group which was not maltreated and the investigating team searched for indications as to how different were their natal families, their parents and their own selves and if any identifiable differences occurred later in their own families, relationships, conduct and health. METHODS: A comparative study was conducted in the group of fathers based on three consecutive questionnaire investigations, between those maltreated in childhood and those who were not maltreated (control). Fathers maltreated in childhood were identified based on the response variants (1-often, 2-sometimes, 3-never) to three questionnaire inquiries filled in before the birth of their children who are included in the ELSPAC (European Longitudinal Study of Pregnancy and Childhood) study. The data was provided by men whose wives with permanent residence in Brno gave birth from March 1st 1991 till June 30th 1992. RESULTS: According to three types of test it was found out that from the parents of the studied children 57.9% of the 3580 fathers and 48.3% of the 3848 mothers were physically or psychologically maltreated during childhood: boys were maltreated more often. Maltreated fathers as compared to control: a) were more often born prematurely (p < 0.05), in the childhood and adulthood they were ill more often (p < 0.01) and they were less resistant psychologically (p < 0.001); b) more often had parents with impaired health (p < 0.001) and worse partner relationships (p < 0.001); c) came from families which didn't differ according to the father's education or employment status. The mothers had secondary education more often (p < 0.01); d) had more often wives and children with worse health (p < 0.01); e) in their own families manifested more violence towards their own wives and children (p < 0.001), they maltreated them more often physically (p < 0.01) and psychologically (p < 0.01); f) manifested more often extra-family asocial behavior (p < 0.001); g) they felt less satisfied with their financial situation (p < 0.001), with their family life (p < 0.01) and life in general (p < 0.001). CONCLUSIONS: Men maltreated in childhood resembled their parents in the social and health aspect and in the partner relationships. Towards their children they acted similarly like their parents used to--violent behavior aimed at children and between partners transferred from one generation to the next.

Chronic morbidity in women, namely in pregnancy. (Comparative study between West, Central and East European centres).

18 chronic diseases were investigated in a population of 13,115 women living in six settings of West- (Avon UK, the Isle of Man), Central- (the Czech Republic and the Slovak Republic) and East-Europe (the Ukraine and Russia), that collaborate in the European Longitudinal Study of Pregnancy and Childhood (ELSPAC project). In prenatal questionnaires filled in after the first half of pregnancy, women reported 25,795 chronic diseases they ever suffered, out of them 11,188 having in present pregnancies. In the whole sample, lifelong prevalence was 11,2%, and prevalence in pregnancy 4,8% which means that 43,4% of all chronic diseases recurred in pregnancy. Up to mean age of 255 years in the whole sample, 39,6% women reported ever having indigestion, 29% back pains, 22,6% migraine, about 16% haemorrhoids, hay fever and eczema, about 10% varicose veins, anorexia nervosa, heavy depression and kidney diseases, over 5% rheumatism and 4% asthma. Less prevalent were infections of pelvic organs, febrile convulsions, joint inflammations, stomach ulcers, psoriasis and epilepsy. Lifetime prevalence of chronic diseases and their prevalence in pregnancy were the highest in the western zone and decreased eastwards, but recurrence grew in the opposite direction, being the highest in the eastern zone. The variation of each morbidity indicator is followed in all diseases between geographical zones as well as between individual study centres.

[Conduct disorders in seven-year-old children--results of ELSPAC study. 2. Risk factors]. / Poruchy chováiní u sedmiletých detí--výsledky studie ELSPAC 2. cást: Rizikové faktory.

BACKGROUND: Conduct disorders related to hyperactivity and significant attention deficit are caused by several types of risk factors-genetic, biological, environmental and psychosocial. A cohort of children was followed longitudinally in a prospective study during the pregnancy and childhood (ELSPAC). In the age of 7 years, marked behavioural divergences were described in 4,4% of children by their attending physicians. These children were also more often afflicted by other pathological symptoms (hyperactivity, sleep and psychomotor disorders). From the data collected from parents and physicians in the previous phases of investigation we selected possible risk factors which affect the prenatal and postnatal periods: prenatal exposure of children to smoking, alcohol, chemical substances, prenatal development complications, the level of education of parents, family dysfunction, alcoholism of both parents, conflicts with the police, mother's disturbed mental health. METHODS AND RESULTS: In the sample of 3752 children from the city of Brno, no behavioural divergence was found in 96.5% of cases. The presence of one or two of the four observed divergences occurred in 3.2% and 3 to 4 conduct disorder symptoms occurred in 0.3% children, significantly more often in boys. The children with conduct disorders compared to the children with no symptoms had significantly lower average birthweight, lower head circumference, their mothers had more often lower education, smoked and had psychological problems in childhood and as adults and the fathers had more often conflicts with the law. CONCLUSIONS: The ELSPAC study did not have the methodological possibility of studying the genetic-environmental interactions; nevertheless it contributes to the evidence supporting that some factors can negatively effect the foetal development and the unfavourable family environment can participate in the development of conduct disorders which can progress during lifetime.

[Conduct disorders in seven-year-old children--results of ELSPAC study. 3. Postnatal development]. / Poruchy chování u sedmiletých detí-- výsledky studie ELSPAC. 3. Vývoj v období po narození.

BACKGROUND: In the European Longitudinal Study of Pregnancy and Childhood (ELSPAC), the pediatric observation of the cohort of 6100 7-year-old children described 4.4% of them as having conduct disorders. METHODS AND RESULTS: The predominant markers such as strong negativism, aggressivity, attention deficit, non-adequate reactions, hyperactivity, disorders of psychomotoric development, school maturation delay, poorer school results and social adaptation described children behavioral problems. The first signs of conduct disorders were often discovered already at the 18th month and the 3rd year of children's age. The acceptance of standardized criteria of possible conduct disorders in the routine pediatric practice, and the special psychologic and/or psychiatric care for children with the confirmed diagnosis should be recommended as soon as in their toddler age. CONCLUSIONS: Possible causal associations between prenatal exposure to nicotine and conduct disorders in childhood are another strong reason for the primary prevention and smoking cessation in antenatal clinics.

[Conduct disorders in seven-year-old children--results of ELSPAC study 1. Co-morbidity]. / Poruchy chování u sedmiletých detí-- výsledky studie ELSPAC 1. Komorbidita.

BACKGROUND: The interest of experts in conduct disorders (CD) research is growing during the last two decades. The research areas include the diagnostics, ethiopathogenesis and treatment and also the comorbidity, especially with the hyperkinetic syndrome incidence (Attention Deficit Hyperactivity Disorder--ADHD). This paper intends to describe the conduct disorder occurrence and its other manifestations of divergence found during the investigation of children followed in the prospective longitudinal study ELSPAC in seven, respectively eight years of their age. METHODS AND RESULTS: Data of 6100 seven-year-old children characterizing their behaviour was collected from mothers and attending physicians. In the school year during which this investigation phase took place 2518 of the children reached eight years of age and their behaviour, temperament and school results were also evaluated by their teachers. The children were divided into three groups according to the presence or absence of the symptoms, which characterize conduct disorders (found by physicians): "stubborn negativistic behaviour", "inability to pay attention", "aggressiveness" and "inadequacy of reactions". The presence of two of these symptoms was found in 3%, presence of all four symptoms in additional 1.4% of children. Parents and teachers more often indicated various symptoms of hyperactivity in children with conduct disorders. CONCLUSIONS: In almost 5% of the ELSPAC cohort children in seven years of their age those symptoms were diagnosed, which match the Conduct Disorder criteria and Attention Deficit Hyperactivity Disorder (ADHD) criteria. In agreement with similar studies these frequent comorbidities were found: sleep disorders, psychomotor development disorders and laterality changes. The cognitive abilities evaluated by mothers and also teachers based on schoolwork results were more often worsened in children with conduct disorders. Various data indicating their worse social adaptability (which significantly disturbed the class) occurred more frequently in these children.

[Trends in respiratory morbidity of children in relation to their passive smoking exposure]. / Vývoj respiracní morbidity detí ve vztahu k jejich expozici pasivnímu kourení.

BACKGROUND: The exposure of children to passive smoking has shown significant associations to respiratory morbidity. The youngest children between 0 to 2 years of age are usually seriously affected. With increasing age of the child a decrease in respiratory illness incidence together with a decrease of the effects of passive smoking were observed. The aim of the study was to assess by repeated investigations the morbidity among children exposed to environmental tobacco smoke (at the age of 6, 18 months and 5 years) and the differences in morbidity in the groups with different exposure in children involved in the ELSPAC study (European Longitudinal Study of Pregnancy and Childhood). METHODS AND RESULTS: The data about health indicators and exposure were obtained from standardized questionnaire filled by mothers and physicians in the age of 6 and 18 month and in the 5th year of age. Results were assessed for 4 groups of children with different smoking habits of their mothers. The differences were statistically evaluated in the SPSS statistical program. The children of smoking mothers were more often exposed to environmental tobacco smoke; the children of middle and heavy smokers more than the children of light smokers. In the age of six months the children were slightly more often protected from passive smoking exposure than in the age of 18 months and 5 years: the differences were statistically significant (p < 0.01). The attendance in kindergarten represents an important protective factor: the children were exposed less during the week-days than during weekends (p < 0.001, resp. p < 0.01). The respiration symptomatology and morbidity were significantly increased in the earlier periods of life of those children, whose mothers smoked. In the age of 5 years the smoking household environment influences only the higher incidence of asthmatic symptomatology (wheeze breathing, apnoe) and more frequent allergies to household dust and pollen with symptoms of dyspnoe and wheezing (p < 0.05). CONCLUSION: The ELSPAC study has provided evidence of the significant influence of the mother's smoking on the child exposure to passive smoking. The consequences of such exposure are manifested especially as increased respiratory and allergic morbidity, more so in the first 18 months of life than at five years of age.

[Suicidal attempts within the set of young adult parents of children observed in ELSPAC study]. / Sebevrazedné pokusy v souboru mladých dospelých--výsledky studie ELSPAC.

BACKGROUND: Though effective medications for the treatment of mood disorders have been developed, panic anxiety, major depression and other psychiatric diseases, only small reduction in suicide rates has been achieved during last four decades. Further epidemiological, clinical and experimental studies are initiated to support both prevention and treatment of suicidal behaviour. METHODS AND RESULTS: In ELSPAC study, the data of 3148 men and 3637 women--parents of children aged 3 years--were analysed with the aim to detect possible determinants of psychiatric disorders. These data included both information about the parents' events and health after the child's delivery and about parents' history during their own childhood. According to their self-reported suicidal attempts during last 18 months, parents were divided into groups A (with positive history) and B (no attempt). Statistical significance was evaluated by the SPSS programme (Pearson's chi-square test, linear-by-linear associations, ANOVA). 23 persons (0,3%) overall self-reported the suicidal attempt during last 18 months: 18 men (0,6%) and 5 women (0,1%). Among them, 2 men and 4 women repeated the attempt. In the same cohort, the frequency of suicidal attempts dropped by 50% among women and rose by 125% among men compared to the previous observation. In the personal history, the information both about emotional and physical deprivation during childhood was more frequent among persons with suicidal attempts. On the other hand, partners' characteristics as possible sources of daily stress situations were not different between groups. Men with suicidal attempts were significantly more often heavy smokers (smoking more that 20 cigarettes daily) and alcohol abusers. Surprisingly, the level of satisfaction with family life was significantly higher in both sex groups with suicidal attempts. CONCLUSIONS: Although majority of respondents in all groups reported their health status as good, more detailed questions showed significantly higher frequency of different psychiatric disorders and moods in the groups of persons with suicidal attempts: irritation, exhaustion among men, anxiety, depression, dejection among women. Also subjective evaluation of parents' good health is not in correspondence with the relative high number of hospitalization (10% men and 40% women with suicidal attempts) and frequent using of psychoactive drugs. The psychic health of ELSPAC parents will be assessed in further prospective measurements.

[Factors associated with development of boy's aggressiveness]. / Faktory asociované s vývojem agresivity chlapcu.

BACKGROUND: There is no doubt about the aggressiveness increase in the population. All mass-media keep informing us about this problem. Based on the project ELSPAC data we considered participation in a brawl as an expression of aggressiveness and estimated its gravity depending on the place of treatment. From the information given in the questionnaire (wide variety of information about the respondent's family, upbringing, health and psychic condition) we searched for relationships between these injuries and their gravity. METHODS AND RESULTS: 894 men out of 4.5 thousand ELSPAC study participants in Brno and the Znojmo district gave information about their injuries from brawls and they also stated if they were treated with the injury on the hospital bed, as an outpatient or only at home. The vast majority of the injuries happened between their 16th-18th year of age. CONCLUSIONS: Dysfunctional family, ineffective upbringing, scholarity defects, low education, higher morbidity in the personal history together with the higher up-to-date accident rate of the respondent and his family members were assessed as factors associated with brawl injury occurence. The injury gravity was however less often associated with these factors than the injury occurence.

Characteristic differences between the growth of man and the other animals.

The method Dynamic Phenotype of Body Mass or of the body height was used for the interpretation of growth in children and adolescents from birth to the age of 18 years. Modelling of the body mass growth curve in boys by means of Dynamic Phenotype of Body Mass is expressed in the form of three individual curves which are compatible with the three I, C, P, components of Karlberg's body height growth curve. However the Dynamic Phenotype of Body Mass is based on the direct use of the measured biological values as input parameters of the simulated growth curve e.g. body mass in the origin of the growth curve (GO, kg), the genetic limit of body mass (GLi, kg) inherited from parents and the inherited physiological potency to produce the appropriate body mass increase (dG max, kg/d) in conditions of adequate nutrition and in convenient environment. The components I, C, P, of children and adolescents growth curve do exhibit principal difference in comparison with the growth curves of the other mammals. This difference is characterized by the long lasting (C) component with extremely slow body mass increase indicating the very low growth velocity of body mass growth. This long lasting (C) component of childhood postpones the puberty component (P) from the infancy component (I). This phenomenon makes the principal difference between the body mass growth in man and that of other mammals where immediately after the short episode of postnatal growth follows puberty, sexual and corporeal maturity. Some primates carry out the body mass growth similar to man. The method of Dynamic Phenotypes may be helpful for investigation of the brain's function ontogeny in relation to neural and humoral regulatory mechanisms of body mass growth during childhood and transition into puberty.

Influence of prenatal and postnatal exposure to passive smoking on infants' health during the first six months of their life.

On the Czech set of European Longitudinal Study of Pregnancy and Childhood (ELSPAC), we tried to verify whether it is possible to confirm the results of foreign studies which found out that the both prenatal and postnatal exposure of newborns to chemicals on cigarette smoke could influence the newborns' morbidity in the first six months of their life. Mothers, who served as sources of data about their smoking behaviour during the pregnancy and after the birth as well as information about the health status of the children after the birth (N=3,871) were divided into four groups: 1. women who never smoked (74.3%), 2. women who stopped smoking in pregnancy and started to smoke after delivery (18.3%), 3. women who smoked both during pregnancy and after delivery (7.2%), 4. women who smoked during pregnancy and stopped after delivery. Unfortunatelly, the last group was very small (only seven mothers) and did not allow assessment of exclusively prenatal exposition. Sucklings from Czech ELSPAC set exposed to chemicals in cigarette smoke either only after the birth or also during the prenatal period, showed significantly higher occurence of different symptoms of respiratory tract damages and their complications (like otitis media) when compared to children of non smoking mothers. Due to illnesses during the first six months after the birth, their parents had to look more often for the consultations of physician, including hospitalization. Our results, as well as results of foreign studies, confirm, that smoking of mothers during the pregnancy and after the birth represents significant risk for the first months of life. Illnesses of children in this early period can cause longitudinal consequences which emerge during the childhood as well as in adulthood. They also represent a strong stressogenic factor. Children's health consequences of exposure to cigarette smoke request very often intensive and expensive care within health system. Our results are the same as those of foreign studies and confirm that both prenatal and postnatal exposure to chemicals of cigarette smoke is significant risk factor which negatively influences the health status on the early periods life.

[Aspects of positive feelings of pregnancy]. / Aspekty pozitivního prozívání tehotenství.

OBJECTIVE: To analyze the relation of positive feeling in pregnancy with intentional conception, to analyze the relation between feeling the pregnancy by the women and her partner. TYPE OF STUDY: A questionnaire investigation in a representative cohort. SETTING: Ward for Preventive and Social Pediatrics, Medical Faculty, Masaryk University, Brno. METHODS: Frequency analysis, Chi-square, F-test. RESULTS: Positive feeling in pregnancy should not be simply associated with intentional pregnancy. In spite of the fact that planned pregnancies are mostly accepted positively, it does not necessarily mean that opposite is true in cases of unplanned gravidity. In the course of pregnancy the positive feeling is growing and the number of unhappy women decreases to a minimum. In women who positively accepted their pregnancy, we found out frequent support by their partner. It is of interest that the attitude of the partner in some cases proved to be more favorable than that of the woman herself. CONCLUSION: Results of this investigation revealed usefulness of differentiating between intentional conception and its emotional experience, since unplanned pregnancy does not necessarily follow to negative feeling from the position of the woman. On the contrary, partners of the pregnant women accepted pregnancy favorably in most cases.

[Birth weight and gestational age in relation to risk factors of social conditions and health status]. / Porodní hmotnost a délka tehotenství ve vztahu k rizikovým faktorum sociální a zdravotní povahy.

BACKGROUND: The participants of European Longitudinal Study of Pregnancy and Childhood (ELSPAC) are women permanently resident in Brno, whose expected term of delivery corresponded with the prelimited period. In midpregnancy, 3327 of them filled in two research questionnaires with data concerning their marital status, health, education, dwelling, their up-bringing and stress in childhood as the essential information for the study of birth weight and gestational age variations of expected newborns. METHODS AND RESULTS: Sharing the flat with the parental generation, heating with solid fuel or gas and more smokers at home meant the risk for antenatal development of foetus. A certain influence seemed to have the number of rooms, too. Education of the mother-to-be as well as that of her partner and partly of her mother, too, determined the birth weight. To a certain degree, partner's position in employment and his health status played also a role. An important factor predetermining the birth weight and gestational age was the marital status of the mother: in the best situation were children born in complete families and greatly handicapped were offsprings of single mothers not living with their partners. CONCLUSIONS: Small influence on the prenatal development had the medical history of mothers, character of the upbringing in their original families and presence stressogenic events occurring in their girlhood up to 18 years of age.

Pre- and postnatal parental smoking and wheeze in infancy: cross cultural differences. Avon Study of Parents and Children (ALSPAC) Study Team, European Longitudinal Study of Pregnancy and Childhood (ELSPAC) Co-ordinating Centre.

In longitudinal cohort studies, the relationships between prenatal and postnatal tobacco smoke exposure and infant wheezing illnesses were compared in two geographically defined populations in Avon, UK and Brno and Znojmo in the South Moravian Region of the Czech Republic. Pregnant females living in defined regions and with expected dates of delivery between defined dates were recruited. Females completed self-report questionnaires during pregnancy and when their infant was 6 months old. For this analysis, responses to questions about smoking during pregnancy, environmental tobacco smoke (ETS) exposure and reported wheezing illnesses of infants at 6 months after birth were used. Odds ratios for wheeze in relation to the smoking variables were calculated with adjustment for potential confounding effects. The prevalence of smoking during pregnancy was higher in Avon (17.5%) than the Czech Republic (7.1%). Exposure of infants to ETS during the first 6 months after birth was also reported to be higher in Avon (35.5%) than the Czech Republic (9.7%). The prevalence of reported wheezing by 6 months of age was 21.4% in Avon and 10.3% in Brno and Znojmo. In Avon, there was a significant relationship between infant wheeze and maternal smoking during pregnancy (odds ratio (95% confidence interval) 1.30 (1.09-1.56), p=0.004) but not with environmental exposure after birth (1.11 (0.98-1.25)). In contrast, in Brno and Znojmo in the Czech Republic, there was a significant relationship between infant wheeze and ETS exposure (1.66 (1.17-2.36), p=0.04) but not with maternal smoking during pregnancy (0.99 (0.64-1.55)). This study demonstrated an apparent difference in the associations between prenatal and postnatal tobacco smoke exposure and infant wheezing illnesses in two populations with different smoking prevalence. The relationships were independent of a number of potential confounding variables that have been associated with infant wheezing. Possible explanations of these observations include dose-related effects of prenatal and postnatal tobacco smoke exposure of infants.

Smoking and damages of reproduction: evidence of ELSPAC.

The international longitudinal prospective ELSPAC study also includes women from the Czech Republic: the results sum up data from 4530 women from City of Brno and District of Znojmo who had different exposure to active and passive smoking. Anamnestic data were collected by fulfilling the internationally unified questionnaires during pregnancy and at the 2nd month after delivery. Gynaecologists, obstetricians and pediatricians, using the unified procedures, were collecting objective data in the course of the pregnancy, delivery, monitoring health status of women and newborns. Significant differences were found between smoking and non-smoking women in the prevalence of alcohol and marihuana consumers both before and during pregnancy and after delivery. In personal health history, smoking women more often reported their self-perceived poor health, panic and loss of self-control during the delivery. In the current pregnancies, smoking women suffer more often with placenta praevia, placental abnormalities, fetal growth retardation and fetal malformations. On the other hand, the prevalence of preeclampsia was decreased among smokers. The children of mothers who were moderate/heavy smokers during pregnancy, had on average by 245 g lower birth weight, 1.22 cm shorter body length and by 0.66 cm smaller head circumference than those of non-smokers. These measures were on average also decreased in the groups of newborns whose mothers were light smokers or non-smokers heavy exposed to environmental tobacco smoke. On the contrary, the average gestational age was similar both in case of active smoking, passive smoking, and non-smoking women. In spite of the fact that most of smokers would give up smoking after getting pregnant, it is necessary to place the antismoking interventions and nutrition advisory service within the routine duty of physicians.

[Birth weight and gestational age in relation to the course of pregnancy]. / Porodní hmotnost a gestacní vek ve vztahu k prubehu gravidity.

BACKGROUND: In midpregnancy, more than 3000 women in Brno filled in the questionnaires for the ELSPAC study. They informed of their health, activities, stress and psychological state during this pregnancy. METHODS AND RESULTS: Out of medical documentation, the results from routine prenatal examinations were extracted and records concerning all disorders occurred during the gravidity. After delivery, information coming from both sources were linked to the birth weight (BW) and gestational age (GA) data of newborns and analysis of variance was performed. In statistically significant relations the differences were stated in BW (grams) and in GA (weeks) between the group means and sample means for boys, girls and all newborns together. BW, GA or both values were significantly lower after taking some medicaments, alcohol drinking, in offsprings of mothers who felt feeble around the quickening, who worked part time, who were in leading position in their employments, who experienced serious disease, who tempted a suicide, who worried that the foetus might be handicapped in any way and who did not take their future motherhood for a priority. Heavier were newborns of women who married during pregnancy and longer GA had children of those who took folic acid. The relation of neurotic symptoms to the outcome of pregnancy was not found and stressogenic events showed only a limited effect on it. A strong deficit in BW and GA followed after premature abruption of placenta, after eclampsia, placenta praevia, cervical cerclage, partus premature imminens, bleeding in the 2nd trimester, hypertension and hospitalization, namely when repeated. BW only was lower with IUGR, oligohydramnion, and higher BW followed after oedemas. GA only was affected in those whose mothers omitted the sonographic examination and who were obliged to have a special diet. CONCLUSIONS: When newborns BWs were divided into 8 classes by 500 g and some maternal characters followed across the scale, significant trends were found in maternal heights, in all their weight indicators including maternal BW as well as in the weight gain in pregnancy, in the highest means found during pregnancy of systolic and diastolic blood pressures and in the lowest haemoglobin levels.

[Characteristics of pregnancy, labor and low birth weight neonates. Part II]. / Charakteristiky gravidit, porodu a novorozencu s nízkou porodní hmotností. Cást II.

BACKGROUND: The study wants to find out the characteristics of pregnancies, deliveries and newborns with low birth weight (LBW) compared to the newborns with birth weight of 2500 g and more, in respect with the specific situation of the twins. METHODS AND RESULTS: The records from antenatal clinics and maternity hospitals about 5500 children born within strictly given time limit of 16 months during the years 1991-1992 to mothers with permanent habitation in Brno were evaluated. Children and their families are participating on still running prospective longitudinal study ELSPAC aimed to finding the determinants of the healthy development. The low birth weight occurred in 5.42% of children. There were altogether 48 pairs of twins, the low birth weight occurred in 52.6% of them. Compared to mothers who delivered the children with birth weight of 2500 g and more, the mothers of children with low birth weight entered the prenatal care later, with less consultations, had more complications both during their pregnancies and the deliveries and their children showed more often different kinds of neonatal morbidity. Mothers of the twins were cooperating with antenatal clinics better than other mothers of children with low birth weight. On the other hand, they were suffering from anaemia and hypertension more often than mothers of single children. Comparison of the somatic and functional signs has shown that the twins were less handicapped than the whole set of newborns with low birth weight. The twins with low birth weight formed 16.7% of the set. CONCLUSIONS: The study of the Brno newborn population shows the quantitative differences in the risks, which have influenced the courses and the results of the pregnancies ending by deliveries of children with low birth weight. Results are compared to those whith deliveries of children the birth weight of 2500 g and more.

[Maternal bonding and a healthy life style during pregnancy]. / Materské pouto a zdravý zivotní styl v tehotenství.

Maternal bonding in pregnancy appears to be an important factor, which may influence psychical and physical development of the child both before and after the birth. One of the significant determining factors of such influence is change in the general life style of the pregnant woman, which correspond with the strength of the maternal bonding. The study brings information on the basis of an empirical research, which was done, in ninetieths at a Research Institute of the Child Health in Brno. The investigated group comprised of 481 pregnant women who were all living in Brno. Results of our research bring the information about relations between the strength of maternal bonding and occupational position of the pregnant women, intensity of working activities and the way of spending their leisure time. Beside it, out research informs about some health risk activities in pregnancy and their relations to the formation of the emotional bonding towards unborn child.