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Biomedical subjects

Jeanette H Magnus

Publications and source records attributed to Jeanette H Magnus.

6 recordsLinked to original sources

Psychosocial predictors of being an underweight infant differ by racial group: a prospective study of Louisiana WIC program participants.

OBJECTIVES: In order to prospectively identify psychosocial predictors of infants being underweight, we followed 3,302 low-income infants. These infants received well-baby care in health departments and were enrolled in the Women, Infants, and Children (WIC) Supplemental Food Program from the newborn period to 12 months of age. METHODS: We linked risk factor data collected from newborn medical history records to anthropometric data from a WIC database. The unadjusted relative risk of being underweight at 12 months of age, defined as weight for recumbent length below the 5th percentile, according to current Centers for Disease Control and Prevention growth charts, for each group was calculated for the study population and for black and white racial groups. Using logistic regression, we calculated odds ratios measuring the effect of the newborn risk factors on underweight status at 12 months of age. RESULTS: There were no psychosocial risk factors that were significantly associated with being underweight simultaneously in both racial groups. Among black infants, those whose mothers had an eighth grade education or lower were at greater risk of being underweight at 12 months of age (OR=3.7, CI=1.5-4.8), as were those whose mothers were married (OR=2.7, CI=1.5-4.8). Among white infants, those whose mothers initiated prenatal care in the third trimester were significantly more likely to have underweight infants at 12 months of age (OR=4.5, CI=1.6-12.4). CONCLUSIONS: Predictors of being underweight at 12 months of age in a low-income population differ by racial group. Further research of public health interventions targeting families of infants with the significant psychosocial risk factors is needed.

Adult↗

Birth weight and infant growth: optimal infant weight gain versus optimal infant weight.

OBJECTIVE: Infant growth assessment often focuses on "optimal" infant weights and lengths at specific ages, while de-emphasizing infant weight gain. Objective of this study was to examine infant growth patterns by measuring infant weight gain relative to birth weight. METHODS: We conducted this study based on data collected in a prospective cohort study including 3,302 births with follow up examinations of infants between the ages of 8 and 18 months. All infants were participants in the Louisiana State Women, Infant and Children Supplemental Food Program between 1999 and 2001. Growth was assessed by infant weight gain percentage (IWG%, defined as infant weight gain divided by birth weight) as well as by mean z-scores and percentiles for weight-for-age, length-for-age, and weight-for-length calculated based on growth charts published by the U.S. Centers for Disease Control (CDC). RESULTS: An inverse relationship was noted between birth weight category and IWG% (from 613.9% for infants with birth weights <1500 g to 151.3% for infants with birth weights of 4000 g or more). In contrast, low birth weight infants had lower weight-for-age, weight-for-length z-scores and percentiles compared to normal birth weight infants according to CDC growth charts. CONCLUSIONS: Although low birth weight infants had lower anthropometric measures compared to a national reference population, they had significant catch-up growth; High birth weight infants had significant slow-down growth. We suggest that growth assessments should compare infants' anthropometric data to their own previous growth measures as well as to a reference population. Further studies are needed to identify optimal ranges of infant weight gain.

Aid to Families with Dependent Children↗

Interferon-induced sarcoidosis.

Rheumatologists are increasingly asked to see patients with hepatitis C who exhibit a variety of clinical and serologic features that mimic systemic rheumatic disease. Treatment with interferons, now the standard of care, can precipitate a variety of inflammatory conditions, including sarcoidosis. We present a case of a 59-year-old former intravenous drug user who developed systemic sarcoidosis while receiving interferon alpha and ribavirin for the treatment of chronic hepatitis C. Because interferons are increasingly prescribed by specialists in a variety of disciplines, rheumatologists should be aware of their potential to induce sarcoidosis as well as various autoimmune diseases.

Antiviral Agents↗

A positive orientation toward early motherhood is associated with unintended pregnancy among New Orleans youth.

OBJECTIVE: Characterizing young women's willingness to enter motherhood is critical to understanding the high rates of unintended pregnancy among women under 20 years. Our objectives were to discuss a measure called Positive Orientation towards Early Motherhood (POEM), and investigate its association with self-reported unintended pregnancy experience. METHODS: We used data from 332 African-American women 13-19 years old recruited at public family planning and prenatal clinics in New Orleans. Using a series of ANOVAs and multinomial logistic regression, we assessed differences in POEM between four different outcome groups: women who were never pregnant and those who had only intended pregnancies, only unintended pregnancies and both unintended and intended pregnancies. RESULTS: The data suggested that young women perceive pregnancy as an opportunity to assert responsibility, become closer with their families and achieve greater intimacy with their boyfriends. Multiple regression analysis indicated that this positive orientation toward early motherhood independently raised the likelihood that young women experienced unintended pregnancies. In particular, the perception that a pregnancy makes a young woman feel more responsible was associated with an increased likelihood that a young woman had only unintended pregnancies compared to no pregnancies at all. Interestingly, this perception did not differentiate young women who had only intended pregnancies from those who were never pregnant. CONCLUSION: When interpreting reports of unintended pregnancy, more attention should be given to young women's orientation toward early motherhood. Doing so will inform policies that address both personal and structural factors that contribute to persistently high rates of unintended pregnancy among adolescents.

Adolescent↗

Relationship between bone mineral density and myocardial infarction in US adults.

Cardiovascular disease and osteoporosis have several common risk factors, and quite a few studies suggest a relationship between them. The objective of the present study was to explore the relationship between cardiovascular disease risk factors and bone mineral density in association with having had a previous myocardial infarction in a general population. This cross-sectional study was conducted using data for 5,050 women and men aged 50-79 years who participated in the Third National Health and Nutrition Examination Survey (NHANES III). Race/ethnic and gender-specific mean BMD values for young adults were used to determine race/ethnic and gender-specific T-scores to define osteoporosis and low BMD. Multiple logistic regression analysis revealed that subjects self-reporting a previous myocardial infarction had significantly higher odds (odds ratio 1.28, [95% confidence interval (CI), 1.01 to 1.63] p=0.04) of having low bone mineral density, when adjusting for cardiovascular disease and osteoporosis risk factors. Self-reported myocardial infarction was not significantly associated with low bone mineral density in women, (odds ratio 1.22, [95% CI, 0.80 to 1.86] p=0.37), but was significant in men, (odds ratio 1.39, [95% CI, 1.03 to 1.87] p=0.03). These findings demonstrate that male survivors of myocardial infarction have low bone mineral density. The pathophysiologic connection between the atherosclerotic and the osteoporotic processes needs further elucidation. It is also of importance to study the processes in both men and women.

Black or African American↗

Risk assessment and screening for low bone mineral density in a multi-ethnic population of women and men: does one approach fit all?

Screening for osteoporosis is currently recommended for all women aged 65 years and older in the USA. How to address screening of non-white women and all men is unclear. Osteoporosis risk assessment questionnaires have been designed and tested mostly among postmenopausal white women, and there is a lack of consensus on appropriate bone mineral density (BMD) cut-off values for defining osteoporosis in non-white persons. The objectives of the present study were to identify a set of risk factors from published population-based studies in white women and men and determine the ability of these risk factors to predict osteoporosis and low BMD in African-American (AA), Mexican-American (MA), and white women and men, and to assess the diagnostic accuracy of this set of risk factors for identifying osteoporosis separately in AA, MA, and white women and men by the use of data for 2,590 women and 2,391 men 50-79 years of age from the third National Health and Nutrition Examination Survey (NHANES III). We employed the World Health Organisation (WHO) definition of osteoporosis, using race/ethnic and gender-specific young adult mean values when calculating the T scores. Low body-mass index, low calcium intake, current cigarette smoking, and physical inactivity were independent risk factors identified from population-based studies. The presence of one or more risk factors was associated with having osteoporosis and low BMD in all groups. The strength of these associations was greater when two or more risk factors were present but varied with race/ethnicity, gender, and age. We conclude that this set of osteoporosis risk factors predicts osteoporosis in non-white women and men. Furthermore, as a risk assessment tool, this set of risk factors might be useful for reducing the number of unnecessary BMD tests performed in older women as well as identifying non-white men who do not require BMD testing.

Black or African American↗