Diet during pregnancy and the risk of cerebral palsy.

The role of maternal diet in the development of the fetal brain has not been adequately explored. Marine n-3 fatty acids have, however, been proposed to be important for brain development. The present case-control study aimed to investigate the relationship between dietary intake during pregnancy and the occurrence of cerebral palsy (CP) in the offspring. Children with CP (n 109), born between 1984 and 1988 to mothers residing in the Greater Athens area, were identified at any time in 1991 or 1992 through institutions delivering care and rehabilitation. Successful nutritional interviews were conducted with ninety-one of these children. Controls were chosen among the neighbours of the CP cases or were healthy siblings of children with neurological diseases other than CP, seen by the same neurologists as the children with CP. A total of 278 control children were chosen, and 246 of them were included in the nutritional study. Guardians of all children were interviewed in person on the basis of a questionnaire covering obstetric, perinatal socioeconomic and environmental variables. A validated semiquantitative food-frequency questionnaire of 111 food items was used to estimate maternal dietary intake during pregnancy. Statistical analysis was done by modelling the data through logistic regression. Food groups controlling for energy intake were alternatively and simultaneously introduced in a core model containing non-nutritional confounding variables. Consumption of cereals (mostly bread) and fish intake were inversely associated with CP (P < 0.05 and P < 0.09 respectively) whereas consumption of meat was associated with increased risk (P < 0.02). A protective effect of fish consumption and a detrimental effect of meat intake have been suggested on the basis of earlier work and appear to be biologically plausible. If corroborated by other studies, these results could contribute to our understanding of the nutritional influences on fetal brain development.

Unintentional childhood poisoning in athens: a mirror of consumerism?

OBJECTIVE: To estimate the incidence of unintentional childhood injuries resulting from accidental poisonings in the Greater Athens area and to ascertain what fraction of this incidence could be linked to specified conditions, amenable to preventive interventions. METHODS: Prospective study over 12 months of 670 children hospitalized 224 hours for accidental poisoning. Site: Two pediatric hospitals and three smaller units in Greater Athens admitting children < or = 15 years old. Information was recorded in a semistructured questionnaire and the data were analyzed through simple stratification by one or more variables. Results Accidental poisoning requiring hospitalization > or = 24 hours was 50% higher among boys than among girls, peaked towards the end of the second year, and declined sharply after the fourth year of life with an estimated incidence of 500 cases per 100,000 among children > or = 5 years old. Cigarettes were the most common agent among infants, whereas medicinal products dominated all other childhood periods. Detergents, petroleum products, and pesticides each contributed about 10% of all poisonings with detergents peaking during the second year of life, petroleum products during the third year, and pesticides remaining constant, in proportional terms, throughout childhood. During the working hours of the day the incidence of poisonings was 80% higher than during the late afternoon and evening hours or the weekends, the times when both parents are usually at home; the excess was statistically significant. The presence of both parents at home in the afternoon hours was associated with an almost 50% reduction of hospitalized poisoning. The accessibility of products with poisoning potential was of major importance. Some specific conditions that led to the incident included storage of potentially poisoning products in the refrigerator, storage of such products in containers of innocuous products, without proper labeling, and parental errors in medication. CONCLUSIONS: Unintentional childhood poisoning further reflects an interaction between inappropriate storage of consumer products and suboptimal supervision during the housekeeping hours of the day.

Risk factors for cerebral palsy: a case-control study in Greece.

The purpose of this study was to investigate the relation between a series of maternal, antenatal, perinatal, socioeconomic and environmental variables and the occurrence of cerebral palsy (CP) in a setting different from those in which previous analytic epidemiologic studies had been undertaken. The study was of case-control design and included 103 children with cerebral palsy born between 1984 and 1988 and residents of the Greater Athens area at any time during 1991 and 1992. Controls were chosen among the neighbors of the index case or were healthy siblings of children with neurological diseases other than CP seen by the same neurologists as the children with CP; a total of 254 control children were eventually included. Statistical analysis was done by modeling the data through unconditional logistic regression. Statistically significant (p < 0.05) risk factors of potential causal importance were: twin membership (OR = 10.2), gestational age (OR = 0.5 per 4 weeks), birth weight conditional on gestational age (OR = 0.9 per 100 g), congenital malformations (OR = 7.5), unhealthy placenta (OR = 6.6), placenta previa (6 cases, no controls), abnormal amniotic fluid (OR = 3.6), head circumference more than 36 cm (OR = 9.0), general anesthesia during labor (OR = 4.3), forceps delivery (OR = 6.8), and birth trauma (OR = 11.5). Among children with no identifiable prenatal risk factors there was no excess prevalence of one or more perinatal risk factors in CP cases compared to controls, which implies that the latter factors impart their effect through interactions with co-existing prenatal or other risk factors.