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  • 1
    ISSN: 1432-1076
    Keywords: Congenital adrenal hyperplasia ; Growth ; Delayed treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The growth pattern is reported of 16 patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency in whom therapy was started after the age of 3 years. Treatment was initiated at a mean chronological age (CA) of 4.7 years (range 3.0–7.2) and at a mean bone age (BA) of 10.4 years (range 10.2–13.2). It consisted of hydrocortisone (mean dosage 26 mg/m2) or prednisone (8.7 mg/m2) in all, and of fluorohydrocortisone (0.05–0.1 mg daily) in five patients. At the last examination the mean duration of therapy was 5.2 years, the mean CA 10.0 years, and the mean BA 12.6 years. In 13 of the 16 patients a “catch-down growth” pattern was observed, which was characterised by a decrease in height (expressed, as SDS) for CA, a deceleration of bone maturation and increase of height (SDS) for BA, and an improvement in predicted height (Bayley-Pinneau).
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1076
    Keywords: HIV infections ; Infant newborn ; Pregnancy ; Parity ; Caesarean section
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abstract In a national prospective study of risk factors for mother-tochild transmission of human immunodeficiency virus (HIV), 316 children of HIV-positive mothers were followed up for at least 6 months. Infection status was determined in 254 of them and 46 were found to be infected giving a transmission rate of 18.1%. Univariate analysis of potential risk factors for mother-to-child transmission showed an association between primiparity and increased transmission rate: odds ratio 2.2, 95% confidence interval (CI) 1.1–4.6,P〈0.05. Analysis by logistic regression confirmed this association (adjusted odds ratio 2.4) and showed, in addition, a negative association between transmission rate and elective Caesarean section (adjusted odds ratio 0.36, 95% CI 0.13–0.97,P〈0.05). The effect of primiparity was less pronounced in combination with elective Caesarean section (odds ratio 1.7) than with other delivery modes (odds ratio 2.5, difference not significant. HIV-infected children were less likely to experience the birth of a younger sibling during the observation period than their uninfected counterparts (2 of 46 vs 27 of 208,P〈0.05 by logrank test). Conclusions Primiparous women appear to transmit HIV to their children at a higher rate. This could be explained by increased intrapartum transmission because of longer and more complicated labour in primiparas and/or by a self-selection of women with lower risk of transmission among those deciding to have additional children.
    Type of Medium: Electronic Resource
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