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Biomedical subjects

C Savona-Ventura

Publications and source records attributed to C Savona-Ventura.

At least 19 recordsLinked to original sources
PubMed2004

Pregnancy in maltese drug-abusers: a socio-biological study.

The use of illicit drugs has increased disturbingly in the last decades, this increase being reflected by an increase in the number of female drug abusers who present in the pregnant state. A total of 47 cases of current or past heroine abuse (0.24% of total maternities) were delivered at the Karin Grech Maternity Unit of St. Luke's Teaching Hospital in Malta. The socio-biological characteristics of these women were assessed and compared to similar parameters in the remaining pregnant population. These women have been shown to be generally of a younger age <25 years and are generally unmarried. The women tend to seek antenatal care late in pregnancy. Their associated medical problems include Hepatitis C infection. There also appeared to be a statistically increased predisposition to pre-existing diabetes. There did not appear to be any statistically significant increased risks to the infant, though there may have been a greater predisposition to low birth weight and prematurity.

Adolescent↗
PubMed2003

Birth weight influence on the subsequent development of gestational diabetes mellitus.

Epidemiological observations have suggested a relationship between type 2 diabetes and a low or high birth weight. However, there are many confounding variables and problems with retrospective data collection. The study of women with gestational diabetes mellitus (GDM), who are likely to develop type 2 diabetes in the future, may help clarify these observations. Women diagnosed as suffering from GDM (n=162) were included in the study if their own birth weight data were available. The birth-weight distribution of the general population was obtained from published data for the same period. A family history of diabetes prevalence was assessed from medical records for the 162 GDM subjects, and by direct interview of 250 non-diabetic pregnant controls. The birth-weight distribution of women with GDM, when normalized to that of the general population, showed a statistically significant U-shape with a greater proportion of GDM women having low (1000-2000 g) or high (>4500 g) birth weight. Compared to non-diabetic pregnant controls, a statistically higher proportion of GDM women had a maternal family history of diabetes; the mean birth weight of these women was also statistically higher than that of GDM women with no family history of diabetes. No such differences were noted among women with a paternal family history. These data suggest that the intrauterine millieur Interieur, whether one of nutritional deprivation or one of nutritional plenty, results in changes in pancreatic development and peripheral response to insulin that may lead to adult-onset GDM and type 2 diabetes. Genetic predisposition, unless determined by mitrochondrial genetic material, does not apparently have any part in determining birth weight.

Birth Weight↗
PubMed2003

Lead and other metals in gestational hypertension.

OBJECTIVES: To identify any effects that lead, calcium, magnesium, and zinc may have on the development of gestational hypertension. METHODS: Third-trimester 110 normotensive and 33 gestational hypertension cases were assayed for various metal levels, using standard techniques, including atomic absorption spectrometry. RESULTS: Gestational hypertension cases showed significantly higher blood lead levels than normotensives. No differences were noticed regarding calcium (ionized and total), magnesium, and zinc levels. Blood lead was significantly related with blood pressure, even after correcting for the body mass indices and age. Blood pressure levels showed no relation to the other analyzed metals. However, the lead:ionized calcium ratio showed a stronger association with blood pressure, than lead alone. Blood lead showed a significant negative relationship with ionized calcium, but none with the other metals. CONCLUSIONS: Blood lead evidently influenced blood pressure increments and gestational hypertension development. This implies that all efforts should be made to reduce the population's exposure.

Adult↗
PubMed2003

Secular trends in sex ratios at birth in North America and Europe over the second half of the 20th century.

CONTEXT: A previous study showed that significantly more boys were born in southern latitudes in Europe than in northern latitudes and the converse pattern was observed in North America. OBJECTIVE: This study analyses secular trends in gender ratios for live births over the second half of the 20th century. DESIGN, SETTING, PARTICIPANTS: Analysis was carried out from a World Health Organisation dataset comprising live births over the above period. This included 127034732 North American and 157947117 European live births. MAIN OUTCOME MEASURES: Analysis of trends in gender ratios for countries in both continents. RESULTS: The findings show a highly significant overall decline in male births in both Europe and North America (p<0.0001), particularly in Mexico (p<0.0001). Interestingly, in Europe, male births declined in North European countries (latitude>40 degrees, p<0.0001) while rising in Mediterranean countries (latitude congruent with 35-40 degrees, p<0.0001). These trends produced an overall European male live birth deficit 238693 and a North American deficit of 954714 (total male live birth deficit 1193407). CONCLUSIONS: No reasonable explanation/s for the observed trends have been identified and the causes for these trends may well be multifactorial.

Birth Rate↗
PubMed2002

Long-term significance of gestational carbohydrate intolerance: a longitudinal study.

Severe forms of GDM have been conclusively associated with significantly increased risk of developing DM later on in life. The long-term significance of GIGT has not yet been definitely elucidated. The study was set up to compare the present carbohydrate metabolism status and anthropomorphic characteristics of women diagnosed as suffering from abnormal carbohydrate tolerance during pregnancy eight years previously with those recorded as having normal glucose tolerance. The prevalence of present abnormal glucose tolerance was significantly higher in women who had been noted to have carbohydrate intolerance during their pregnancy, the prevalence depending on the gestational severity (10.0% in normal glucose tolerance, 36.4% in borderline GIGT; 66.7% in GIGT). Women whose overweight or obese status persists or develops after their pregnancy were statistically more likely to develop abnormal glucose tolerance later on in life (11.9-12.5% in normal-overweight BMI, 38.2% in obese BMI). A maternal and sibling, but not paternal, family history of diabetes was also a statistically significant risk factor. GIGT appears to be a definite risk factor for the development of carbohydrate metabolism problems later on in life, this being related to the severity during pregnancy and the presence or development of obesity. It is proposed that women diagnosed to suffer from GIGT should be regularly monitored after the pregnancy, particularly if other risk factors such as obesity are also present.

Blood Glucose↗
PubMed2001

Domestic abuse in a central Mediterranean pregnant population.

The Mediterranean region is generally characterized by a patriarchal society that generally predisposes towards a higher prevalence of spouse abuse. The prevalence of domestic spouse abuse in a central Mediterranean closed island community was assessed to approximate 11.7% of the pregnant population. The abuse varied from psychological to physical abuse. There was a strong history of experience of domestic violence/abuse during childhood in both the victim and perpetrator suggesting that a "circle of abuse" may play a role in some cases. The socio-biological characteristics of the victim did not appear to statistically predispose towards a higher risk for domestic abuse, though single mothers were statistically more likely to report a history of domestic abuse. Abused women were more likely to smoke cigarettes during pregnancy than their counterparts. The perpetrator was statistically more likely to be unemployed, and smoke cigarettes and drink alcohol. There were no statistical correlation between a history of spouse abuse and educational level attained by both the victim and perpetrator. A history of domestic abuse appears to have an adverse effect on the pregnancy with a higher risk of premature birth and its attendant complications; although it is difficult to ascertain how much the reported poor obstetric outcome is a direct effect of violence itself or to other associated adverse social or biological co-factors. About a third of the women interviewed were unaware of the domestic violence services being offered in their community emphasizing the need of an information drive. The antenatal period, with the distribution of leaflets and antenatal classes, is an opportune time to promote the support services available in the community.

Adult↗
PubMed2001

Risk factors for gestational impaired glucose tolerance in the Maltese population: a cross-sectional study.

Screening criteria for impaired carbohydrate metabolism problems during pregnancy include the use of specified risk factors, which are generally considered to be inadequate. The value of these risk factors in a population characterised by a high prevalence of abnormal carbohydrate metabolism is investigated. The study identified biological characteristics such as a maternal age >35 years, previous early pregnancy loss, a maternal family history of DM/IGT, pre-prandial glucosuria and an operative delivery with resuscitation as significant risk factors for the development of G-IGT. There appeared to be no statistical association with a history of multiparity, previous perinatal loss, congenital anomalies or macrosomia and a parental and grandparent family history of DM/IGT. There appeared to be a statistical difference in fasting blood glucose values, but no difference in glycosated haemoglobin. The risk factors for the development of G-IGT are shown to have a high specificity and negative predictive value, but overall moderate to low sensitivity and positive predictive values when used in isolation. The prevalence of the various identified risk factors was very high, a feature which would require at least a third of the population to be screened with an oral glucose tolerance test. These features suggest that the historical and clinical risk criteria are not ideal screening tools to identify G-IGT and a routine early third-trimester oral glucose tolerance test remains the ideal screening tool to identify these cases.

Journal Article↗
PubMed2000

Declining male births with increasing geographical latitude in Europe.

OBJECTIVE: Demographic studies in various industrialised countries have shown a decline in male births in the latter half of the 20th century from the expected ratio of 0.515 (males/total). This study analyses trends in this ratio over the period 1890 to 1995 in Malta, and also analyses this ratio for Western European countries for the period 1990-1995. DESIGN: Births subdivided by sex were obtained from official Maltese publications. European countries were grouped according to geographical latitude by banding countries into three groups: Northern Mediterranean, Central European and Scandinavian. Births by sex for these countries were also analysed for the period 1990-1995. RESULTS: No decline in the ratio of male births to total births was noted in Malta over the period 1916-1995. However, the ratio was higher than expected (n = 151,766, ratio = 0.517 (95% confidence intervals (95% CI): 0.514, 0.519). Moreover, during the period 1890-1899 (n = 66,874), the ratio was 0.523 (95% CI: 0.519, 0.527), even higher than observed during the 20th century (chi 2 = 8.3, p = 0.004). Analysis of European births showed a much higher ratio of male births in the south of Europe than in the north (chi 2 = 87.2, p < 0.0001). CONCLUSIONS: The findings were unable to explain the higher incidence of male births in the south of Europe, but it is speculated that ambient temperatures may not only affect fertility, but also influence sex ratios at birth.

Birth Rate↗
PubMed1999

Declining mortality from congenital heart disease related to innovations in diagnosis and treatment: a population-based study.

The majority of live births with severe congenital cardiac malformations that do not undergo intervention of some form die prematurely. The population of Malta provides an ideal closed cohort from which to monitor trends. We have observed a significant declining specific mortality from congenital heart disease, and circumstantial evidence relates this decline to the introduction of new techniques used in the diagnosis and treatment of these malformations.

Cohort Studies↗
PubMed1999

Regional differences in birth prevalence of congenital heart disease in Malta.

AIM: Recent studies have shown a correlation between environmental pollutants and increased risk of selected congenital malformations. The South-East area of the Island of Malta is much more industrialised than the more rural North-West area. The aim of this study was to test the null hypothesis that there are no regional differences in Malta in the prevalence at birth of congenital cardiac malformations. METHODS: Live born infants with congenital cardiac malformations born between 1990 and 1994 were allocated to 10 areas, and thence to 2 regions of 5 areas each, so as to constitute North-West and South-East Malta. Official publications gave population totals and growth rates. Those infants with congenital cardiac malformations were then compared between the different regions using chi2 and the Mann-Whitney U test. RESULTS: The overall prevalence of congenital heart disease at birth was 8.8/1000 live births. The birth prevalence for the South-East region (10.1/1000 LB--95% CI 8.4-12.3/1000 live births) was significantly higher than for the North-West (7.4/1000 live births--95% CI 6.0-9.0/1000 live births)--p=0.03, Odds ratio 1.38 (95% CI 1.05-1.80). The Mann-Whitney U test showed a significant difference in the distribution amongst the 10 defined areas (p=0.016). The Central-East area had the highest prevalence of cardiac malformations in the entire Island--p=0.02, Odds ratio 1.70 (95% CI 1.10-2.61). Demography showed an efflux of individuals from the South-East of Malta. CONCLUSION: The higher prevalence of congenital heart disease noted at birth in South-East Malta is unlikely to be due to genetic factors, as these would have migrated North-West along with the population movement. An environmental factor, therefore, seems more likely to be responsible for the increased predisposition to congenital heart disease in the South-East of Malta.

Birth Rate↗
PubMed1994

Beta-thalassemia syndromes and pregnancy.

The literature relating to homozygous beta-thalassemia and the problems these patients have during their pregnancy is reviewed and another case report of a twin pregnancy in a homozygous beta-thalassemia individual is included. The majority of cases described refer to the intermedia clinical form of the hematological problem because patients with thalassemia major generally have poor sexual development. Although the reported cases had a greater frequency of delayed development, only one woman suffered from infertility and required ovulation induction agents. The thalassemia pregnant mother faces deleterious consequences resulting from chronic anemia and in nonsplenectomized patients there remains the risk of the onset of a hypersplenic crisis. The problems of splenectomized patients during pregnancy is also discussed. The chronic anemia of thalassemic patients predisposes to a poor fetal outcome with greater fetal loss, preterm labor, and intrauterine growth retardation.

Adult↗
PubMed1994

An outbreak of cerebrospinal fever in a 19th century British Mediterranean naval base.

Epidemic Meningococcal meningitis first made its definite appearance in Europe in the beginning of the nineteenth century. The first recorded epidemic in the Maltese Islands, which straddled the sea-routes of the Mediterranean, occurred in the late nineteenth century. This paper describes a manuscript report prepared at the request of the Lieutenant Governor regarding this epidemic in the light of the contemporary knowledge about the infection.

Adolescent↗