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P Y Robillard

Publications and source records attributed to P Y Robillard.

26 records · Page 2Linked to original sources

Paternity patterns and risk of preeclampsia in the last pregnancy in multiparae.

Few authors have published investigations regarding a possible association between preeclampsia and changing paternity. This study employs an epidemiological approach to explore the relationship between severe preeclampsia and changes in paternity patterns among multigravidae in a Caribbean community (Guadeloupe, French West Indies). Multiparae who were diagnosed with preeclampsia or eclampsia with fetal complications (transfer of their infants in the Neonatal Department) and controls were examined (134 mothers' interviews). Information concerning paternity for the index and previous pregnancies was collected from three groups: women with pregnancy-induced hypertension (PIH); women with chronic hypertension (CH); and a control group consisting of women without hypertension during pregnancy. In 21/34 (61.7%) of PIH mothers, the father of the current pregnancy was different than that of the former, compared to 4/40 (10%) among CH and 10/60 (16.6%) in the controls (P < 0.0001). Moreover, considering three and four consecutive pregnancies, there was a significant trend (P < 0.005 and P < 0.02) for an increase in PIH with having a different father in each successive pregnancy. Patterns of changing paternity were significantly correlated with pregnancy-induced hypertension in multiparae but not with chronic hypertension and controls.

Adult↗

Lipid intake during pregnancy in developing countries: possible effect of essential fatty acid deficiency on fetal growth.

There is a strong epidemiological association between poor nutritional status and low-birthweight (LBW) newborns. According to the World Health Organization (WHO), 95% of total LBW in the world are born in developing countries. Nevertheless, the nutritional etiology of intra uterine growth retardation (IUGR) is still controversial and not yet established largely because of contradictory nutritional studies in pregnancy. In 1981 Menon et al described an animal model of IUGR due to mild deficiency in essential fatty acids (EFA, linoleic and alpha linolenic acids), with a strong correlation between EFA intake during pregnancy and fetal growth. According to the WHO reports in the last decade, there was a dramatic deficiency of lipid intakes (less than 10% of total caloric amounts) in the majority of developing countries while the EFA requirements alone of normal nourished women are evaluated at 6% of total caloric amounts during pregnancy. A mild deficiency in dietary EFA may be a limiting factor in fetal growth processes in humans as it has been shown in animals. Such a mechanism could be easily verified. Research proposals are made in an attempt to test this hypothesis in developing countries with possible applications in further nutritional interventions in pregnancy.

Adult↗

Neonatal bacterial septicemia in a tropical area. Four-year experience in Guadeloupe (French West Indies).

During a four-year study (1987-1990) at the Neonatal Department, University Hospital Pointe-à-Pitre (French West Indies), blood culture was systematically performed on all admitted newborns. The incidence of septicemia was 48 of 1000 admissions and 8.9 of 1000 inborn live births. Among the 107 neonatal positive blood cultures, group B streptococcus accounted for 37% of blood culture isolates and was the most frequent cause of septicemia. The overall mortality rate was 8.4%. The incidence of neonatal bacterial septicemia was among the high rates reported in the literature. The incidence of neonatal bacterial septicemia is discussed as a public health problem in perinatology in Guadeloupe in spite of good medical care. A review of the literature on bacterial septicemia in tropical or developing countries compared to the Guadeloupean experience allows speculation that this problem might be underestimated in third world countries.

Escherichia coli Infections↗

Congenital heart disease diagnosed in Guadeloupe.

An epidemiologic survey of congenital heart disease was performed in Guadeloupe, French West Indies, during the 3-year period 1988-1990. This survey, the first on congenital heart disease from the Caribbean, found an overall rate of 6.08 congenital heart disease cases per 1,000 live births, a high rate of hypoplastic left heart disease, and a rate of coarctation of the aorta similar to rates reported in developed countries.

Female↗

Validity of postnatal assessments of gestational age in low birthweight infants from a Caribbean community.

The Dubowitz assessment of gestational maturity was compared with the best obstetric estimate of gestational age based on date of last menstrual period (LMP) or ultrasonography performed early in the pregnancy or both. This study involved 384 low birthweight infants admitted to the neonatal tertiary center in Guadeloupe, French West Indies, during the period 1986 through 1988. The Dubowitz assessment exceeded the best obstetric estimation by an average of nearly 5 days. This overestimation by the Dubowitz method was observed at every gestational age and was greatest at gestational ages of less than 35 weeks. The physical characteristics of the postnatal assessment were in closer agreement with the best obstetric estimate than the neurological characteristics. These findings concur with other investigations that indicate that the Dubowitz postnatal assessment of gestational age overestimates the gestational age interval from date of LMP in low birthweight and preterm infants.

Evaluation Studies as Topic↗

[Value of the measurement of arm circumference/head circumference in the evaluation of the nutritional status of infants and young children].

In 1970, Kanawati and McLaren proposed a nutritional criterion based on the arm circumference/head circumference (AC/HC) ratio, valid from 3 months to 4 years of age. For these authors, there were 4 situations: normal nutrition (ratio greater than 0.31), slight undernutrition: (0.31 greater than ratio greater than 0.28), medium undernutrition: (0.28 greater than ratio greater than 0.25) and severe undernutrition (ratio less than 0.25). A longitudinal study was undertaken on 45 children admitted in our unit for nutritional assistance (total parenteral nutrition and enteral nutrition). Weight, arm circumference and triceps skinfold were measured at regular intervals during their stay in hospital (total: 141 measurements). There was a strong correlation (p less than 0.001) between the values of AC/HC and weight for age, weight for height, triceps skinfold and arm circumference. There was no correlation between AC/HC, height for age and head circumference for age. Furthermore, this criterion seemed to be independent from the degree of hydratation in cases with dehydratation or oedemas (Kwashiorkor). AC/HC ratio is a simple and reliable criterion for nutritional follow-up. It is easily reproduced and independent from sex and age between ages 3 months and 4 years.

Anthropometry↗

Determinants of meconium-stained amniotic fluid in term pregnancies.

This study examines ethnic variations in meconium-stained amniotic fluid in term pregnancies, taking into account the role of gestational age, maternal sociodemographic characteristics, and medical risk factors. The study population included black and white singleton live births (N = 14,419) between 37 and 42 weeks' gestation, delivered vaginally at the Medical University of South Carolina from 1982 through 1990. Chi-square and logistic regression analysis were used to examine the association between the independent variables and meconium-stained amniotic fluid (MSAF). An increased risk of MSAF was found for advancing gestational age, indicators of fetal stress, fewer than five prenatal care visits, and > 15 hours labor. After controlling for demographic and clinical characteristics, the risk of MSAF in black patients was approximately 1.5 times that of white patients. The higher proportion of MSAF in blacks could not be explained with obvious risk factors.

Adolescent↗