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Parent and sibling influences on adolescent alcohol use and misuse: evidence from a U.S. adoption cohort.

OBJECTIVE: Although adolescent alcohol use has been consistently associated with parental drinking behavior, sibling drinking behavior and family functioning, the extent to which these associations owe to genetic or shared environmental influences has not been previously investigated. Using an adoption study design, we sought to determine whether the familial correlates of adolescent alcohol involvement were due to common genetic or common environmental effects. METHOD: The sample consisted of 653 adopted families ascertained through adoption agencies in four U.S. states. Each family consisted of a target adopted adolescent, an adoptive mother and an adoptive father. In addition, 68 birth adolescents (i.e., biological offspring of the adoptive parents) and 187 second adopted adolescents from these families participated in the study. All participants completed a mail survey that included assessment of drinking behavior and family functioning. RESULTS: The relationship between parental problem drinking and adolescent alcohol involvement was moderate and significant among birth offspring (corrected multiple correlation, Rc = .30), but small and non-significant among adoptive offspring (Rc = .00). The relationship between adolescent alcohol involvement and family functioning was substantial for birth offspring (Rc = .39), but only modest for adoptive offspring (Rc = .16). The nonbiological sibling correlation for involvement with alcohol was significant (r = .24) and moderated by sibling pair demographic similarity, such that same-sex, similar-age siblings were substantially more similar (r = .45) than opposite-sex, dissimilar-aged siblings (r = .01). CONCLUSIONS: These findings suggest that adolescent alcohol use is affected minimally by the environmental consequences of parent problem drinking and family functioning, but substantially by sibling environmental effects.

Adolescent↗

Law No. 99 amending Law No. 49 of 7 April 1947 on working conditions, as amended, 26 December 1987.

This Law includes substantive provisions dealing with occupational health aspects of work by minors and women in Japan. Section 65 lays down, in particular, that an employer must not employ a woman for six weeks (or 10 weeks, in the case of a multiple pregnancy) before childbirth, if she requests leave during this period. An employer must not, except as indicated, employ a woman within a period of eight weeks following childbirth. A woman nursing an infant under one year of age is entitled to two nursing breaks a day, each for a period of at least 30 minutes. Under Section 68, an employer may not require a woman to work if she suffers from dysmenorrhea and requests leave for that reason.

Asia↗

Maternal atopy and the number of offspring: is there an association?

We investigated the association between maternal atopy and the number of offspring. In a population- and pregnancy-based survey (part of the European Studies on Infertility and Subfecundity), we obtained information on the number of offspring, adverse pregnancy outcomes, age at pregnancy, and waiting time to pregnancy. The German portion of these surveys also included information on physician-diagnosis of asthma, atopic eczema, or hay fever. The odds ratio (OR) adjusted for age showed that the number of children was reduced among women with atopy (OR = 0.75, 95% CI: 0.57-0.98 in the pregnancy-based sample; OR = 0.79, 95% CI: 0.63-0.99 in the population-based sample). We did not identify other signs of reduced reproductive ability in atopic women. The results provide support for two assumptions: (i) either a lower number of offspring in atopic mothers combined with an increased risk of atopy in offspring of atopic mothers may explain the protective effect of a higher number of siblings on atopy in offspring; or (ii) successive pregnancies may decrease the atopic response of the mother and thus the risk of developing atopy in subsequent offspring.

Adult↗

Offspring risk and sibling risk for multilocus traits.

The recurrence risk of a trait in a relative of type R is the probability that an individual who is in relationship of type R to an affected proband has the trait. It is intuitively clear that closer relationships lead to higher recurrence risks. However, no exact analysis of this phenomenon has been presented for multilocus traits. We prove a theorem that shows how recurrence risks are influenced by the degree of closeness of the relationship R. For example, our theorem implies that sibling risk is always higher than offspring risk. The loci influencing the trait are assumed to be autosomal and unlinked, but arbitrary epistasis between the loci is allowed. We give a detailed proof of the theorem by using stochastic matrices. A shorter proof based on the additive and dominance genetic variances is also sketched. Additionally, we also give some empirical results and discuss generalizations of the theorem.

Chromosome Mapping↗

A population-based study of inflicted traumatic brain injury in young children.

CONTEXT: Physical abuse is a leading cause of serious head injury and death in children aged 2 years or younger. The incidence of inflicted traumatic brain injury (TBI) in US children is unknown. OBJECTIVE: To determine the incidence of serious or fatal inflicted TBI in a defined US population of approximately 230 000 children aged 2 years or younger. DESIGN, SETTING, AND SUBJECTS: All North Carolina children aged 2 years or younger who were admitted to a pediatric intensive care unit or who died with a TBI in 2000 and 2001 were identified prospectively. Injuries were considered inflicted if accompanied by a confession or a medical and social service agency determination of abuse. MAIN OUTCOME MEASURE: Incidence of inflicted TBI. Multivariate logistic regression models were used to compare children with inflicted injuries with those with noninflicted injuries and with the general state population aged 2 years or younger. RESULTS: A total of 152 cases of serious or fatal TBI were identified, with 80 (53%) incurring inflicted TBI. The incidence of inflicted traumatic brain injury in the first 2 years of life was 17.0 (95% confidence interval [CI], 13.3-20.7) per 100 000 person-years. Infants had a higher incidence than children in the second year of life (29.7 [95% CI, 22.9-36.7] vs 3.8 [95% CI, 1.3-6.4] per 100 000 person-years). Boys had a higher incidence than girls (21.0 [95% CI, 15.1-26.6] vs 13.0 [95% CI, 8.4-17.7] per 100 000 person-years). Relative to the general population, children who incurred an increased risk of inflicted injury were born to young mothers (< or =21 years), non-European American, or products of multiple births. CONCLUSIONS: In this population of North Carolina children, the incidence of inflicted TBI varied by characteristics of the injured children and their mothers. These data may be helpful for informing preventive interventions.

Age Factors↗

Twinning and heteropaternity in chimpanzees (Pan troglodytes).

Unlike monozygotic (MZ) twins, dizygotic (DZ) twins develop from separate ova. The resulting twins can have different sires if the fertilizing sperm comes from different males. Routine paternity testing of a pair of same-sexed chimpanzee twins born to a female housed with two males indicated that the twins were sired by two different males. DNA typing of 22 short-tandem repeat (STR) loci demonstrated that these twins were not MZ twins but heteropaternal DZ twins. Reproductive data from 1926-2002 at five domestic chimpanzee colonies, including 52 twins and two triplets in 1,865 maternities, were used to estimate total twinning rates and the MZ and DZ components. The average chimpanzee MZ twinning rate (0.43%) equaled the average human MZ rate (0.48%). However, the chimpanzee DZ twinning rate (2.36%) was over twice the human average, and higher than all but the fertility-enhanced human populations of Nigeria. Similarly high twinning rates among African chimpanzees indicated that these estimates were not artifacts of captivity. Log-linear analyses of maternal and paternal effects on recurrent twinning indicated that females who twinned previously had recurrence risks five times greater than average, while evidence for a paternal twinning effect was weak. Chimpanzee twinning rates appear to be elevated relative to corresponding estimated human rates, making twinning and possibly heteropaternity more important features of chimpanzee reproductive biology than previously recognized.

Animals↗

Increased risk of birth defects among children from multiple births.

BACKGROUND: Multiple births are increasing, and may be associated with birth defects. METHODS: To explore this relationship, data from the Virginia birth defects registry (VaCARES) was analyzed. RESULTS: During 1989-1998, a total of 44505 children from singleton births and 2258 children from multiple births were born with birth defects in Virginia. The risk of birth defects was significantly increased in children from multiple births as compared to singleton births (birth defect rate per 10000 live births: singleton 482.3, twin 922.0, triplet 1300.0, and quadruplet or higher 2222.2). Increased risk was observed for 39 of 86 diagnoses. The five diagnoses with the highest risk ratio per 10000 live births (RR) were: neurofibromatosis (RR, 12.80), retrolental fibroplasia (RR, 9.96), microphthalmos (RR, 5.24), pulmonary valve anomalies (RR, 5.00), and patent ductus arteriosus (RR, 4.68). A significantly reduced risk ratio for congenital hip dislocation was found in these children (RR, 0.54). In most multiple births, only one child was born with birth defects (81% in twin births, 71% in triplet births, and 56% in quadruplet and higher births). The diagnosis of birth defects might be concordant or discordant for children in which all siblings had birth defects. The children from multiple births who had birth defects were generally preterm and had significantly lower birth weight. A higher fatality and mortality rate and longer hospital stay were also observed. CONCLUSIONS: Overall, children from multiple births have an increased risk of birth defects.

Congenital Abnormalities↗

The influence of IVF, multiple gestation and miscarriage on the acceptance of genetic amniocentesis.

OBJECTIVES: To determine the effect of in vitro fertilization (IVF), multiple gestation, and history of unkaryotyped miscarriage on the acceptance of genetic amniocentesis. METHODS: We studied women expected to be at least 35 years of age at the estimated date of delivery without family history of chromosomal abnormalities or fetal structural anomalies. The influence of IVF, multiple gestation, and history of miscarriage on the acceptance rate of genetic amniocentesis was evaluated. Chi-square test and logistic regression were used for analysis. RESULTS: In singleton pregnancies, the acceptance rate of genetic amniocentesis was 70.7% (58/82) in the IVF group compared to 77.9% (1837/2356) (P = 0.14) in the women who conceived spontaneously. The corresponding values in multiple gestation pregnancies were 71.1% (37/52) and 62.9% (34/54) respectively (P = 0.41). There was no difference in the acceptance rate of amniocentesis between singletons (70.7%) and multiple gestations (71.1%) after IVF (P = 0.96), while in women who conceived spontaneously, the acceptance rate of 78% in singletons was significantly higher than the acceptance rate of 63% in multiple gestations (P = 0.008). Adjusting for confounding variables, women with multiple gestations were about 40% less likely to accept genetic amniocentesis (OR = 0.63, 95% CI = 0.39-1.00, P = 0.05), while women with a history of miscarriage were about 17% less likely to accept genetic amniocentesis (OR = 0.83, 95% CI = 0.68-1.00, P = 0.05). Adjusting for multiple gestation and previous miscarriage, IVF was not independently associated with acceptance of genetic amniocentesis (OR = 0.84, 95% CI = 0.54-1.29, P = 0.42). CONCLUSIONS: There is no difference in the acceptance rate of genetic amniocentesis among women with IVF pregnancies compared with those who conceive spontaneously, after adjusting for multiple gestation and previous miscarriage. Unlike women who conceive spontaneously, the decision to accept amniocentesis appears not to be influenced by the presence of multiple gestation in women with IVF pregnancies.

Abortion, Spontaneous↗

The analysis of the influence of birth order and other factors in multiple birth data.

We compare three methods which can be used to analyse the influence of birth order and other factors on health outcomes in multiple birth data. We consider marginal models based on generalized estimating equations (GEE) and two kinds of conditional models; conditional logistic regression (CLR) and mixed effects models (MEM). Although the models may be written similarly, there are differences in both the interpretation and the numerical values assigned to the parameters. Our main conclusion is that GEE and MEM are preferable to CLR since they provide more flexibility in dealing with missing values and covariates. The choice between GEE and MEM is less obvious and depends on the data, the parameter of interest and statistical power.

Birth Order↗

The epidemiology of cardiovascular defects, part I: a study based on data from three large registries of congenital malformations.

To analyze complex and noncomplex cardiac malformations regarding prevalence and in relation to demographic variables, we pooled data on infants (age 1 year or younger) with congenital cardiovascular defects from three large birth defect registries in California, Sweden, and France. Altogether, 12,932 infants had one or more congenital heart defects out of 4.4 million live births and stillbirths. The registries in Sweden and France obtained data through reporting from various sources; in California, medical records were reviewed. As expected, definitions and ascertained conditions differed among each of the registries. The total rates for severe defects were similar (1.43 per 1,000), but differed for specific defects. Clear differences in epidemiological characteristics existed for specific defects; for example, severe cardiac defects sex ratios were significantly high for hypoplastic left heart syndrome, d-transposition of great vessels, double outlet right ventricle, total anoralous pulmonary venous return, tetralogy of Fallot, and significantly low for pulmonary atresia without ventricular septal defect and endocardial cushion defect. Few defects were similar for several epidemiological characteristics, but, for example, the combination of ventricular and atrial septal defects appeared equivalent with endocardial cushion defect under some circumstances, yet behaved differently with regard to associated noncardiovascular defects.

Age Factors↗

The risk of birth defects in multiple births: a population-based study.

OBJECTIVES: To determine if multiple births have higher risks of birth defects compared to singletons and to identify types of birth defects that occur more frequently in multiple births, controlling for seven sociodemographic and health-related variables. METHODS: A retrospective cohort study was conducted of all resident live births in Florida during 1996-2000 using data from a population-based surveillance system. Birth defects were defined as in the 9th edition of the International Classification of Diseases-Clinical Modification (ICD-9-CM) code for the 42 reportable categories in the Centers for Disease Control and Prevention (CDC) Birth Defects Registry list and eight major birth defects classifications. Relative risks (RR) before and after adjusting for control variables and 95% confidence intervals (95% CI) were calculated. The control variables included mother's race, age, previous adverse pregnancy experience, education, Medicaid participation during pregnancy, infant's sex and number of siblings. RESULTS: This study included 972,694 live births (27,727 multiple births and 944,967 singletons). Birth defects prevalence per 10,000 live births was 358.50 for multiple births and 250.54 for singletons. After adjusting for control variables, multiple births had a 46% increased risk of birth defects compared to singletons. Higher risks were found in 23 of 40 birth defects for multiple births. Five highest adjusted relative risks for birth defects among multiple births were: anencephalus, biliary atresia, hydrocephalus without spina bifida, pulmonary valve atresia and stenosis, and bladder exstrophy. Increased risks were also found in 6 out of 8 major birth defects classifications. CONCLUSIONS: Multiple births have increased risks of birth defects compared to singletons.

Adult↗

Prenatal and birth complications in autism.

OBJECTIVES: Prenatal and birth history as potential sources of risk factors in relation to the onset of autism were examined. METHODS: A cohort of 164 families of autistic children referred to The Autism Center at New Jersey Medical School-UMDNJ, Newark, New Jersey, over a two-year period was studied. Intake prenatal and birth history information was obtained from each family and reviewed by a clinician. RESULTS: Prevalence rates in this cohort for vaginal bleeding, prolonged labor and prematurity were higher than comparable rates reported nationally and in New Jersey. Clustering of multiple prenatal risk factors was observed. This clustering was associated with the age of the mother, but uncorrelated with birth order. CONCLUSIONS: These findings support the general hypothesis that systemic problems at the prenatal stage may form a distinct dimension of risk associated with autism.

Adolescent↗