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Biomedical subjects

C Hoff

Publications and source records attributed to C Hoff.

At least 73 records · Page 4Linked to original sources

Trend associations of smoking with maternal, fetal, and neonatal morbidity.

Smoking habits, prenatal health, and pregnancy outcome were surveyed among 1700 nulliparous women. During pregnancy, increases in levels of hemoglobin and hematocrit and the frequency of women reporting bleeding and decreases in diastolic pressure and frequency of toxemia were observed with increased maternal smoking. A higher frequency of fetal bradycardia was detected among women smoking greater than or equal to one-half pack per day. With increased smoking there was an increased frequency of abnormal placentas. Mean birth weight and crown-heel length decreased with increased smoking, and neonates born to women smoking greater than or equal to one-half pack per day had a higher frequency of jaundice. The association between smoking and reduced birth weight and crown-heel length persisted after controlling for gestational age, maternal weight gain, prenatal visits, and other confounding variables.

Birth Weight↗

Earlier maturation of pregnant black and white adolescents.

A survey was made of the menarcheal age and anthropometry of 1,844 lower income, nulliparous female patients receiving prenatal care. No differences were observed between black and white patients in height and maximum pregnant weight. A significantly earlier mean menarcheal age was observed in adolescents (12 to 16 years) compared with adults (17 to 31 years). Younger adolescents (12 to 14 years) of both races were taller and heavier (prepregnancy) than National Center for Health Statistics standards and had a significantly greater weight-for-height. Menarcheal age and body habitus were consistent with other reports that younger pregnant adolescents tend to be earlier maturers than older pregnant adolescents and adults. Compared with their age-group cohorts (13 to 31 years) in the two-decades-old Collaborative Perinatal Study of the National Institute of Neurological Communicative Disorders and Stroke, these female patients were larger and had greater pregnancy weight gains. These anthropometric findings may reflect the two decades of improvements in social assistance and prenatal care for lower income women.

Adolescent↗

Contrasting effects of unmodified and time-release forms of niacin on lipoproteins in hyperlipidemic subjects: clues to mechanism of action of niacin.

To minimize the cutaneous flushing symptoms associated with niacin use, a time-release capsule form of niacin has been formulated. Thus study compares the effects of time-release niacin with those of unmodified niacin on lipoprotein lipids, including HDL2 and HDL3, apoproteins A-I and A-II, clinical chemistries, symptomatic side effects, and adherence to the medication regimen. Seventy-one primarily hypercholesterolemic subjects were randomized to either unmodified niacin or time-release niacin ad took medication for a six-month period. The two groups were closely matched on anthropomorphic and lipid variables. Adherence to the therapeutic regimen at a dose of 1.5 g/d in the first month of treatment was similar in the two groups. Thereafter, at a dose of 3.0 g/d, adherence was in excess of 90% among subjects taking unmodified niacin but only 64% among those taking time-release niacin, chiefly because of aggravated gastrointestinal symptoms; cutaneous flushing side effects, however, were slightly less common with time-release niacin. At these levels of adherence, LDL cholesterol (C) was reduced 21% by unmodified niacin and 13% by the time release form. Plasma total triglyceride was reduced more with unmodified niacin (27%) than with time-release niacin (8% maximum), and HDL-C and HDL2-C were increased significantly with unmodified niacin (26% and 36%) and were not significantly changed by time-release niacin. Increased to a similar degree on both regimens were HDL3-C (approximately 35%) and apoA-I (approximately 12%). ApoA-II was not affected by either drug regimen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Maternal sociomedical characteristics and birth weights of firstborns.

Pregnancy outcome and sociomedical characteristics were examined in a sample of 1844 black and white primiparous females who received prenatal care. White females were more frequently married and more likely to live with their husbands than with their parents. Black females were better educated and more interested in obtaining further education. White women smoked significantly more cigarettes. There were no differences in contraceptive use in black and white females. Number of prenatal visits was least frequent among adolescent black females. With the exception of a higher incidence of vaginal infection among black females, there were no significant differences in general health status. There were no differences in birth weights between the firstborns of black and white adolescents, but adult white females had significantly heavier firstborns than blacks. Nonetheless, no differences were found in prevalence of low birth weight-for-gestational neonates between black and white females. Infrequent prenatal visits, maternal diabetes and smoking were the only significant multivariate factors associated with the occurrence of a low birth weight-for-gestational age neonate among the total sample.

Adolescent↗

Chi-square trend analysis in antigen sharing studies.

Chi-square trend analysis is a useful technique for testing the statistical significance of dose-response associations between morbidity or mortality variables and degree of parental or maternofetal antigen sharing.

Abortion, Spontaneous↗

Blood pressure changes in normotensive women readmitted in the postpartum period with severe preeclampsia/eclampsia.

The purpose of this study was to determine whether women who had no clinical evidence of preeclampsia at delivery, but who were later readmitted with postpartum severe preeclampsia or eclampsia, differed in mean arterial pressure (MAP) and clinical presentation from women who either remained normotensive or had severe preeclampsia or eclampsia at the time of delivery. Control subjects did not require readmission and were matched (2:1) with study subjects in consecutive order for date of delivery and maternal age, race, and parity. Women in the study group had a significantly greater increase in MAP after delivery than control subjects, and analysis of variance for linear trends demonstrated highly significant differences between the study and control groups in the average intrapartum and postpartum MAPs. Compared to women in either control group, mothers who were readmitted were significantly more likely to demonstrate a > 10-mm Hg increase in MAP between the intrapartum and postpartum periods (delta MAP). Normotensive women with a delta MAP > 10 mm Hg had more than a threefold risk of readmission in the postpartum period with severe preeclampsia or eclampsia. Women who were readmitted reported a significantly greater frequency of headaches and nausea and vomiting than women with intrapartum preeclampsia. In summary, our findings indicate that MAP increase following delivery in normotensive women who were later readmitted with severe preeclampsia or eclampsia.

Analysis of Variance↗

Hospital readmission for postpartum endometritis.

This study identified risk factors associated with readmission for postpartum endometritis. The study group consisted of 109 mothers (Group I) who were discharged after delivery and readmitted with endometritis. Control groups consisted of women who had endometritis immediately after delivery but who did not require readmission (Group II, n = 109), and women who had no intrapartum or puerperal infection and also were not readmitted (Group III, n = 109). Subjects in Groups II and III were matched to an index study subject for date of delivery and maternal age, race, and parity; and women in Groups I and III were also matched for route of delivery. Groups were compared in terms of demographic characteristics, intrapartum course, and clinical presentation. The data were analyzed with the t-test, chi2, and multiple logistic regression analyses, and a P value < .05 was considered significant. Women in Groups I and III delivered vaginally more often than mothers in Group II. In addition, mothers in Groups I and III had similar postpartum courses, no evidence of infection on discharge after delivery, and a similar period from delivery until postpartum discharge. Although women in Group I were more likely to have spontaneous rupture of membranes, a shorter latent period, and have fewer bilateral tubal ligations than mothers in Group II, multivariate analysis identified route of delivery as the only significant maternal variable associated with postpartum endometritis requiring readmission. Women who were readmitted for endometritis usually delivered vaginally, and the occurrence of late-onset postpartum endometritis was unrelated to the length of stay following delivery.

Adult↗

Pneumonia as a complication of pregnancy.

OBJECTIVE: To identify risk factors for the development of antepartum pneumonia and to describe maternal and perinatal outcome in pregnant women with pneumonia. METHODS: The study group consisted of 59 women with antepartum pneumonia. Pneumonia was defined by the presence of lower respiratory tract symptoms, radiographic findings, no other source of infection, and at least two of the following: oral temperature > or =38 degrees C, white blood cell count > or =15,000/ml, auscultatory findings, and/or positive sputum cultures. For comparison, a control group (n = 118) of pregnant women was formed by selecting the first mother who delivered immediately before and after an index study subject. RESULTS: Mothers in the study group were significantly more likely than women in the control group to have either a history of asthma (P = 0.022) or an admission hematocrit < or =30% (P < 0.001). Women with pneumonia were also more likely to receive a tocolytic agent (P < 0.001) and/or beta-methasone to enhance fetal lung maturity (P < 0.001). In addition, study subjects delivered at an earlier mean gestational age (P = 0.002) and had infants who weighed significantly less (P = 0.003) than mothers in the control group. Multivariate analysis indicated that women with asthma or anemia had more than a five-fold increase in the risk of developing pneumonia during pregnancy (P = 0.013), and mothers with pneumonia were significantly more likely to deliver before 34 weeks gestation (P = 0.04). CONCLUSIONS: Pneumonia during pregnancy was associated with maternal anemia and asthma. In addition, preterm labor with tocolysis and/or beta-methasone was more common in women with pneumonia, and these women were more likely to deliver preterm and have low birthweight infants compared to women without pneumonia.

Anemia↗