Biomedical subjects

D Hrubá

Publications and source records attributed to D Hrubá.

At least 19 recordsLinked to original sources

PubMed2004

Antismoking education in Czech medical and dental faculties.

Smoking education has been included in the curricula in all the medical faculties of the Czech Republic, although the scope of the education varies. At each of the faculties, a member of the staff has been appointed as co-ordinator of smoking education. These coordinators promote a sharing of experience and distribution of teaching materials. At the majority of faculties, obligatory workshops are held for all students to learn about smoking and smoking treatment within the framework of preventive medicine. In addition, selected students undertake selected studies on smoking and health as part of their research. At the Medical Faculty of Masaryk University, Brno, smoking education is included in the majority of theoretical and clinical subjects and its effectiveness is repeatedly assessed during the 6-year course study by testing the students' knowledge and smoking behaviour. The evaluation provides a basis for further modification and improvement of the education. Currently, a fundamental transformation of dental education is being undertaken in all medical faculties of the Czech Republic. These new curricula will benefit from the curriculum of the Medical Faculty, at Hradec Králové, where the changes that were made 5 years ago involve theoretical and practical education in the risks of smoking for oral health throughout the 5-year stomatology courses. Postgraduate medical education involves professional 2-day seminars for general practitioners on approaches to smoking cessation and smoking dependence treatment, and professional materials such as smoking cessation guidelines are published in medical and specialist journals.

Attitude to Health↗

PubMed2004

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.

Analysis of Variance↗

PubMed2004

[Signs of active infection with Chlamydia pneumoniae in patients with coronary heart disease].

BACKGROUND: Possible relationship between Chlamydia pneumoniae (CPN) infection and atherosclerosis has been documented in many seroepidemiological, histological and biological studies. The objectives of the present study were to find out whether serological signs of active CPN infection in patients with coronary heart disease (CHD) are associated with the presence of bacterial DNA in peripheral blood and to correlate with clinical symptoms and to study the dynamics of the markers of CPN infection within a six-month follow-up. METHODS AND RESULTS: Seventy-one patients with acute CHD were enrolled in the study. They underwent clinical and biochemical tests and were screened for the presence of genus- and type-specific IgG, IgA and IgM antibodies against CPN at admission and then in 3- and 6-month intervals. CPN DNA was detected in peripheral blood using nested PCR. Serological markers of active CPN infection were found in 36 patients (51.4%) while bacterial DNA was detected in two patients only. Laboratory signs of active CPN infection did not correlate with either clinical symptoms or levels of biochemical markers. In most of the patients, titers of anti-CPN antibodies were stable throughout the follow-up. Increase in antibody titers was observed in 23% of patients and was associated with more frequent signs of unstable angina pectoris (p=0.06) but not with higher risk of myocardial infarction within 6 months after the acute episode of CHD. CONCLUSIONS: In patients with CHD, serological markers of active infection persist for a long time. Nevertheless, their association with the course of CHD or relapse risk was not proved. Bacterial DNA was rarely detected in peripheral blood of the patients. None of the currently available laboratory tests proved adequately effective for detection of ongoing or chronic CPN infection. This project was sponsored by grant IGA MZ CR NI/6811-3 and research plan of Natl. Inst.Publ.Health

Antibodies, Bacterial↗

PubMed2003

Ascorbic acid and infertility treatment.

AIM OF THE STUDY: To assess the ascorbic acid (AA) in the follicular fluid in women treated by in vitro fertilization and embryonic transfer levels (IVF/ET) and to analyse the influence of vitamin C supplementation on the results of infertility treatment. TYPE OF THE STUDY: Prospective study in women treated by IVF/ET. METHODS: The influence of vitamin C supplementation on the outcome of infertility treatment in the assisted reproduction programme in 76 women (38 of them smokers, 38 non-smokers) was studied. Half the women (19 smokers and 19 non-smokers) were administered vitamin C in daily doses of 500 mg in so-called pellets allowing for gradual release over 8 to 12 hours. The control group consisted of the same number of smokers and non-smokers. In all the women, ascorbic acid levels were determined in two urine samples (prior to supplementation and at follicle retrieval) and in follicular fluid by means of a colorimetric method. Ovarian response to hormonal stimulation with gonadotropins (hMG, FSH) at a dosage of 150-225 IU per day combined with GnRH analogues in the short (buserelin) or long (triptorelin) protocols, and 5,000-10,000 IU of human chorionic gonadotropin was evaluated based on the number of follicles created and number of retrieved oocytes. Fertilisation was assessed, based on the number of successfully fertilised oocytes (fertilisation rate) and based on the number of cultivated embryos. The success of the infertility treatment was evaluated based on the number of pregnancies. RESULTS: Ascorbic acid levels in follicles were significantly higher (p < 0.001) in women with vitamin C supplementation than in the control group (8.98 +/- 5.09 vs. 5.04 +/- 2.85 mg/l). The administration of vitamin C during the period of hormonal stimulation showed a statistically insignificant impact in terms of the higher number of pregnancies (34.2% vs. 23.7%). Vitamin supplementation had a greater impact on the number of pregnancies in the non-smokers' group (57.9% vs. 31.6%). The pregnancy rate was significantly higher (p < 0.01) in non-smoking women than in smokers--44.7% vs. 13.2%, which appears to be a reason for asking women to cease smoking prior to infertility treatment.

Adult↗

PubMed2003

Serological markers of Chlamydia pneumoniae, cytomegalovirus and Helicobacter pylori infection in diabetic and non-diabetic patients with unstable angina pectoris.

The possible role of inflammation in coronary artery disease (CAD) is being recognised, while markers of inflammation (e.g., CRP) and infection with Chlamydia pneumoniae (C. pneumoniae), cytomegalovirus (CMV) and Helicobacter pylori (H. pylori) have been proposed as risk factors for CAD. However, these associations require further evaluation. It is a known fact that diabetic patients suffer from impaired immune response to some pathogens and a high incidence of atherosclerosis. In this case-control study we investigated serological markers of infection with C. pneumoniae, CMV, and H. pylori in a group of 140 patients with unstable angina pectoris (UA), 52 of them having type 2 diabetes mellitus, and in a matched control group. Anamnestic (IgG) and acute infection (IgA) antibodies against the above agents were tested using ELISA or indirect immunofluorescence tests. In patients with UA we found a significantly higher seroprevalence and titres of IgG antibodies against C. pneumoniae (p = 0.04) and increased titres of IgG antibodies against CMV (p = 0.007). No differences were found in IgA antibody response to these pathogens. Antibody response to H. pylori was similar in both groups tested. In diabetic patients with UA, the frequency of group-common IgG antibodies against C. pneumoniae was higher than in the non-diabetic UA patients. The other serological markers studied were comparable in the patients with or without diabetes mellitus. Our findings confirmed association of C. pneumoniae and CMV with cardiovascular heart disease. Moreover, diabetes mellitus may predispose the patients to C. pneumoniae infection. However, serological markers observed do not indicate that destabilisation of angina pectoris is associated with acute C. pneumoniae or CMV infection. No relationship was found between UA and H. pylori infection.

Adult↗

PubMed2003

[Chlamydia pneumoniae--etiology of ophthalmia neonatorum].

The authors observed mucous discharge in palpebral aperture, accompanied by a different degree of effusion of eyelids and chemosis of conjunctivae, particularly the tarsal ones, in 12 physiological newborns. Chlamydia pneumoniae proved to be the etiological agent in the newborn ophthalmia. The eye infection was not detected in the same period of time and in the same maternity hospital in the period of observation from September 1999 to March 2001. The detection of Chlamydia pneumoniae was performed in conjunctiva smears. The impression films on slides were examined by the method of indirect immunofluorescence with the use of specific monoclonal antibodies (medac, Germany). In the early stages the secretion included a sanguineous component, which was then changing into a mucoid or mucopurulent form. The character of conjunctival symptoms was changing in the course of inflammation. Effusion of the lower transitory fold (plica) was gradually accompanied by a picture of pseudofollicular changes on the tarsal conjunctiva. Clarithromycin in the form of syrup at daily doses of 15 mg/kg/day for the period of two weeks offered an efficient therapy of the affection. Control smears after 14 days were always negative and, at the same time, the pathological finding on the conjunctivae disappeared. The nasolacrimal obstruction was the only complication of this chlamydia infection, taking place in seven sucklings, i.e. in 58%. The passage through lacrimal drainage system reappeared in all the affected infants until they reached one year of age. The remaining question to be answered is the way the newborns encountered the infection. A nosocomial infection may be the case, but Chlamydia pneumoniae could also be present in the urogenital tract of mothers and transferred to the newborn via the birth canal similarly as is the case of Chlamydia trachomatis infection. The mode of infection deserves further investigation.

Chlamydia Infections↗

PubMed2003

Evaluation of the level of nicotine dependence among adolescent smokers.

The questionnaire containing ten items evaluated the degree of dependence in students-volunteers from Brno secondary and vocational schools (ages ranging from 15 to 17 years) and the anamnestic data were compared with the specific (urinary cotinine) and non-specific (CO in the air exhaled) biological tests of exposure to smoking. The sample of 147 students examined contained 42% non-smokers, 25% occasional smokers and almost 33% of those who smoked every day. Almost 10% children smoked more than 10 cigarettes a day, and more than 20% children stated that they smoked 60 and more cigarettes a week. In accordance with the pre-developed degrees of dependence, compiled by the scores of the individual responses, 59% of the respondents (including the non-smokers) were ranked among the non-dependent. The second most frequent group contained the "strongly dependent" (almost 17% of all persons, e.g. 30% of smokers), 3.4% of examined persons (6% of smokers) were ranked in the sub-group of persons with a very high degree of dependence. Highly positive correlations were found between the evaluation of the dependence degree according to the anamnestic data and the exposure bio-markers (urinary cotinine/creatinine and CO in the air exhaled): the values of correlation coefficients were 0.615 and 0.764, resp. Both bio-markers also correlated negatively with the time of the last exposure to both active and passive smoking. The individual items in the dependence questionnaire had positive correlations with the objective exposure indicators which had statistical significance. The strongest relationship was observed in the question about the first morning cigarette--the highest correlation coefficients, being followed by signs evaluating the smoking frequency and the usual number of cigarettes smoked per day and in a week. The lowest relationships concerned the occasions for smoking and the unpleasant symptoms associated with the withdrawal. The anamnestic questionnaire could explain 42.6% of urinary cotinine level variability (converted to the density measured by creatinine content) and 65.8% of variability of CO content in the air exhaled. It was demonstrated that regular adolescent smokers at the ages between 15 to 17 years inhaled the cigarette smoke and the young smokers' inner exposure to nicotine had been proved as well. In this age group, there are many individuals who have a strong or a very strong dependence on nicotine. As a result, it is necessary to promote smoking cessation and nicotine dependence treatment by recommending pharmaceuticals of substantial nicotine therapy.

Adolescent↗

PubMed2003

[Chlamydia pneumoniae--the etiologic agent of follicular conjunctivitis followed by keratoconjunctivitis sicca in adult patients].

The authors refer to 21 adult patients at the age of 22 to 87 years, who have suffered from a chronic form of follicular conjunctivitis, found to be caused by Chlamydia pneumoniae as the etiological agent. The observation was made in the period from July 1999 to December 2002. Chl. pneumoniae was detected by a direct demonstration of the conjunctiva smears and by means of serological examination. The print preparations on glass were examined by the method of indirect immunofluorescence by means of specific monoclonal antibodies (Medac, Germany). The serological examination included detection of genus-specific IgG, IgA, IgM antibodies, respectively (Medac, Germany) and species-specific anti-Ch. pneumoniae IgG, IgA abd IgM antibodies, respectively (FOCUS Technologies, U.S.A.). The clinical picture included various long-term subjective complaints (within the range of several months to ten years), particularly a pathological secretion or increased lacrimation, cutting, burning or feeling of a foreign body in the eye. The objective examination revealed chronic changes characterized by a mild edema of bulbar conjunctiva with increased meandering in vessels of irregular caliber and edema in the lower transition plica with follicular structure crossing into the tarsal conjunctiva. In the fornix there was an apparent sticking aqueous or mucinous secretion. The therapy was indicated by the positive smears alone in four patients or positive IgA and/or IgM of genus- or species-specific antibodies in 12 patients. The therapy in the remaining five patients was recommended by the combination of suspect-positive smears in combination with positive genus- or species specific antibody reaction. The therapy made use of systemic administration of a macrolide antibiotic, azithromycin, for the period of 12 to 14 days in a single course of treatment. The pretreatment was always followed by control smears after two weeks and by serological examinations after three and six months. The serological findings remained virtually unchanged during that period of time in all patients under observation. In two of them only the species-specific antibodies anti-Ch. pneumoniae IgA antibodies disappeared six months after the therapy. The clinical findings disappeared slowly, particularly the follicular changes occurred after more than six months after the therapy ended. The subjective complaints, accompanied by a transient hyperemia of conjunctives in particular, remained after the therapy in nine patients older than 45 years, who were found to suffer from kieratoconjnunctivitis sicca. The ocular symptomatology was not accompanied by symptoms of autoimmune disease. The general treatment by antibiotics and the results supportive treatment succeeded in 67% of patients who were completely free of subjective complaints and the pathological process in conjunctives was inhibited.

Adult↗

PubMed2003

[Infectious and inflammatory factors in the etiology and pathogenesis of atherosclerosis].

Although the metabolic syndrome together with insulin resistance and their consequences are probably basic factors in pathogenesis of atherosclerosis, inflammatory and infectious aspects of this process are unquestionable only in some of the patients. Endothelial dysfunction was identified both in the experiment and in patients after herpes virus simplex 1 infection, cytomegaloviral infection, Chlamydia pneumoniae infection, or Helicobacter pylori infection. However, it is not clear whether it is always caused by direct specific activity of a given pathogen or whether it is a result of inflammatory cytokines activity, heat shock protein activity, or CRP activity. In recent years secondary antibiotic prevention in patients after myocardial infarction has been discussed. Lower mortality rate from acute myocardial infarction and cerebral vascular accidents were found in several observations of patients vaccinated against influenza. In patients with non-stable angina pectoris we have found significantly more frequent occurrence of IgG antibodies against Chlamydia pneumoniae. This occurrence was more frequent in diabetics compared to non-diabetics. Endothelia exposed to cyto-megaloviral infection exprimed adhesive molecules on their surfaces. After an increase of the concentration of glucose in medium to 11.0 mmol/l and 16.5 mmol/l the expression of adhesive molecules after cyto-megaloviral infection increased. Relationship of infection, inflammation, and atherosclerosis has been a subject of intensive investigation in recent years. Discussion of possible consequences of these findings, especially from viewpoint of atherosclerosis prevention and its organ complications, is of the same intensity. Hypothesis about participation of infection and inflammation in pathogenesis of atherosclerosis seems to be very attractive. In spite of the fact that findings supporting this hypothesis cumulate final conclusion can't be made yet.

Arteriosclerosis↗

PubMed2001

Dietary guidelines in the Czech Republic III.: Challenge for the 3rd millennium.

In developed countries, dietary guidelines are more and more often used as a source of binding information not only in public health, food production, nutrition and agricultural policy, but in ecology and economy as well. In view of that, it is imperative to formulate such guidelines that would be supported by relevant population studies and correspond to the European model of WHO/CINDI guidelines. At the turn of the millennium, the Czech guidelines were updated in order that serving sizes of 5 basic food groups were brought closer to contemporary trends emphasizing lower protein intakes and at the same time, by setting limit ranges, they were able to meet specific need of people of different age group, sex, physiological status, physical activity, etc. The conversion of recommended servings to nutrients was compared with the results of the actual food basket of the Czech population and specific recommendations for amendments in proportions of individual food items in food groups and subgroups were given. On the basis of diet guidelines, conclusions describing tasks for the beginning of the third millennium were made. Besides them the most important are: production or health information systems with special emphasis to food intake and nutritional status report, policies to increase the access to vegetables and fruit for vulnerable groups, legislation to curb advertising high-fat energy-dense foods to children, policy to strengthen the operational targets of Innocenti Declaration and to increase the number of Baby Friendly Hospitals, legislation regarding food control systems based on international standards, sustainable campaigns to promote safe healthy diet, policies to ensure sustainable food production.

Czech Republic↗

PubMed2001

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.

Alcohol Drinking↗

PubMed2001

The outcome of infertility treatment by in-vitro fertilisation in smoking and non-smoking women.

The former and current smoking habits of 159 patients treated for infertility by means of IVF/ET technique were observed. The data were verified by a cotinine examination in urine. The basal levels of gonadotropines before treatment, the process and outcome of ovarian stimulation, oocyte fertilisation and incidence of pregnancy were observed. There were no differences between smokers and non-smokers in terms of their age and professional risks; smoking correlated with a lower level of education. The overall response of active smokers to hormonal stimulation was worse than that of non-smokers: a lower number of mature follicles (12.3 vs. 16.2) and a lower number of oocytes were gained (7.3 vs. 10.9). There was a correlation between the age of the smokers and the higher consumption of FSH needed for stimulation and lower levels of 17 beta-estradiole. The number of fertilised oocytes in smokers was significantly lower (p < 0.01; 68.2% vs. 47.8%). A negative correlation between the duration of exposure to cigarette smoke and fertilisation rate was shown (p < 0.05). There were fewer embryos in smokers as compared with non-smokers (3.3 vs. 4.7). A total of 35 women became pregnant (i.e. 22.1%), of which 28.8% were non-smokers, 12.5% were occasional smokers, and none were regular smokers. The OR value in non-smokers was 1.48, and in occasional smokers 0.57. In this study, the negative influence of smoking on the outcome of treatment by IVF/ET technique was proved. The phasing out of smoking should be an integral part of human infertility treatment.

Adult↗

PubMed2001

Is environmental cadmium a serious hazard to Czech population?

The main objective of the study was to asses whether the environmental cadmium exposure in the Czech Republic is high enough to be able to affect significantly the human reproduction. Cadmium levels were measured in the blood and follicular fluid of 220 women in in vitro fertilization (IVF) therapy, using atomic absorption spectrometry. The mean value of cadmium in venous blood was 0.85 ng x ml(-1) with significantly higher values among smokers (1.18 ng x ml(-1), SD = 1.6, 95%CI: 0.6-1.1) as compared to non-smokers (0.46 ng x ml(-1), SD = 0.4, 95%CI: 0.4-0.6) (p < 0.0001). In all, 1518 blood-free follicles were assessed to determine cadmium residues in follicular fluid. The mean cadmium value was 0.34 ng x ml(-1) (SD = 0.45, 95%CI: 0.28-0.41). No association was found between the cadmium levels in blood and follicular fluid, and similar cadmium levels were observed in the follicular fluid of women with different smoking habits. The calculated dietary cadmium intake was similar in all our patients and had no relation to either blood or follicular cadmium levels. The follicular cadmium levels were approximately 20 times lower as compared to those found in the group of Canadian women. Our study confirmed the previous findings on the low exposure of the Czech population to environmental cadmium.

Cadmium↗

PubMed2000

Dietary guidelines in the Czech Republic. I.: Theoretical background and development.

Setting dietary guidelines for the healthy population of the Czech Republic has respected the methodical steps suggested by authors as follows: consideration of dietary guidelines was preceded by the consensus on general goals and methods, e.g. health and well-being promotion at the population level. The guidelines cover a total diet, not only a part of it and have to be realistic, with respect to actual frequency of food in majority of population. The second step was the declaration of nutritional goals with respect to achieving the RDI. The third step was dividing the food into defined food groups according to the following criteria: the food contained in one food group had the same/similar nutritional characteristics with regard to achieving the adequate of decreased intake. Within the groups several sub-groups were set, associating foods with another specific nutrient content. The fourth step was the setting the serving sizes as an equivalent for each food group. These equivalents must reflect typical average consumed amount of food and always within the group the content of the main nutrient has to be same/similar. The fifth step was setting nutritional profile of each group and/or sub-group. This profile represented the content of energy, proteins, lipids, carbohydrates, vitamins and minerals. The sixth step was deciding the daily number of servings of each food group, which must allow the flexibility as much as possible--authors recommend the interval solution. The seventh step was decision about the form (textual and graphic), which presents the guidelines. The decision was preceded by the study focused on accepting suggested possibilities. The last, eighth step was working out the strategy of implementation in practise, which means the summarizing organizational, administrative and political arrangements with the aim to be positively accepted by the population who identify itself with the principles of the dietary guidelines. In the formulation of dietary guidelines in the Czech Republic, the authors accepted methods described above and each of the eight steps was supported by adequately focused population study.

Czech Republic↗

PubMed2000

Influence of maternal active and passive smoking during pregnancy on birthweight in newborns.

Many studies have documented a strong association of active smoking during pregnancy with fetal growth retardation. Increasing interest has also been focused on whether there is an association between exposure of pregnant women to environmental tobacco smoke (ETS) and low birthweight of their babies. In the intervention controlled study "Healthy Pregnancy--Healthy Child", mothers after delivery were interviewed by medical students who collected data about their smoking and nutrition. Students were also trained to stimulate non-smoking behaviour and to explain the risks related to smoking and exposure to ETS. Data from 1147 mothers after delivery were collected but only single births were included in the analysis of birthweight. In our study, 63.4% women never smoked and 32.2% women reported they had stopped smoking either before pregnancy or during the first trimester. Only 4.4% of mothers (n = 50) smoked during the whole pregnancy. Women with the history of smoking were exposed to ETS more often than mothers who never smoked (51.6% vs 17.4%; p < 0.001). The number of heavily exposed both at home and workplaces was more than twice higher among former smokers compared with never smokers (22.4% versus 9.4%, p < 0.01). The average birthweight of babies born to women who had stopped smoking was higher than that born to never smokers. The average birthweight of babies born to women who smoked during pregnancy was lower by 119 g and 171 g than that of the babies born to never smokers and former smokers, respectively. When pre-term neonates were excluded, differences in birthweight between babies born to never smokers and either formerly smoking or still smoking mothers were slightly lower. The greatest effect of ETS exposure on birthweight was recorded in never smoking mothers; an average reduction in birthweight was 88 g. A strong dose-effect was observed; in mothers heavily exposed to ETS both at home and at work, the babies' birthweight was lower by 189 g in comparison with the group of non-exposed, never smoking mothers and even by 70 g compared with mothers smoking during pregnancy.

Birth Weight↗

PubMed1999

[Pregnancy and fetal development in smoking and nonsmoking women].

In the second stage of the European longitudinal study of pregnancy and childhood (ELSPAC) detailed anamnestic data on the mother were assessed, and objective data on the health status during pregnancy, delivery and on the neonate were assembled. Numerous partial results of the ELSPAC study confirmed that smoking during pregnancy has an adverse effect on the course of pregnancy and foetal development. During pregnancy in smokers proteinuria as well as the diagnosis of suspect foetal retardation were significantly more frequent. During delivery placenta previa and placental abnormalities were recorded more often. The mean duration of gestational age was similar in smokers and non-smokers. The mean birth weight of newborns of women who smoked during pregnancy was on average by 107 g lower as compared with non-smokers. Significant differences were also found in the mean length and head circumference, always to the disadvantage of smokers. Smokers reported significantly more frequently greater fear and restlessness at the onset of labour pains and after return from the maternity home. They get frequently more excited without any reason and are more tense.

Birth Weight↗

PubMed1999

Occupational risks for human reproduction: ELSPAC Study. European Longitudinal Study of Pregnancy and Childhood.

Pregnant women living in Brno who were contacted for the first time at 18th week of their pregnancies during the period from February 1990 to January 1992 were involved into the ELSPAC group. Among others, the exposure to different occupational factors in the three periods was obtained by the self-reported questionnaire: 1. the last 9 months before pregnancy, 2. the first, and 3. second trimester periods. The women's health status during pregnancy, the history of delivery and the developmental and health status of newborns were described in details by obstetrics and pediatrics according to another internationally unified questionnaire. All data obtained from 3,897 pregnant women living in Brno were computered. Smoking women were significantly more often than non-smokers occupationally exposed to ergonomic stressors associated with the monotony work, and to chemical substances. In the whole group, the intrauterine growth retardation has been positively associated with shifting (OR 1.59, p < 0.05) and occupational exposure to permanent noise (OR 1.92, < 0.05). Newborns of such exposed women had in average lower parameters of head cimcumstances (p < 0.01). Non-physiologic, non-spontaneous deliveries have been more often observed among VDTs users (OR 1.20-1.28, p < 0.05). Women exposed to organic solvents during 2nd trimester of pregnancy delivered more often babies with some congenital malformations (OR 2.31, p < 0.05). On the other hand, the different occupational factors seemed to be protective for several markers of the women health status, as the prevalence of reproductive damages was significantly lower among exposed women than in the non-exposed group. After the standardization of the smoking habit, more significant associations have occurred in the group of smokers occupationally exposed to: shift work (low-birth-weight babies: OR 1.98, p < 0.05), chemicals (bleeding during pregnancy: OR 2.00, p < 0.05), sedentary work (placental abnormalities and congenital malformations: OR 1.59, p < 0.05). Non-smoking women using VDTs had more often babies with intrauterine growth retardation (OR 2.29, p < 0.05). Newborns with different malformations were more often born to non-smoking women occupationally exposed to chemicals (OR 2.33, p > 0.05).

Computer Terminals↗

PubMed1998

Cadmium and zinc concentrations in human placentas.

Cadmium and zinc levels in placentae of 688 women who delivered their children in two university hospitals in Brno and in the regional hospital in Znojmo during January-June 1992 were determined using AAS analytical method. Average value of zinc (54.6 micrograms/g) and cadmium (18.02 ng/g) concentrations found out in our file are in accord with those ones reported in literature. Individual differences in zinc contained in placentae occur uniformly. Very low concentrations prevail for cadmium; values exceeding 100 ng/g of dry basis are sporadic only. Zinc vs. cadmium concentrations values in placenta are mutually positively correlated [correlation coefficient (factor) r = +0.13, p < 0.001]. Cadmium content in placenta depends on mothers' age and it is significantly higher in older women. No changes in zinc contained in the placental tissue depending on mothers' age were found out. The mutual ratio of zinc vs. cadmium content in a placental tissue is significantly decreased in older mother (23.8 in older women, 41.2 in younger women, p < 0.01).

Adolescent↗