Predicting date of birth: the best time to date a pregnancy?

Objective: To compare the estimated date of birth calculations from last menstrual period (LMP) and ultrasounds at varying gestations (<70, 70-106, 110-140, 141-196 and 200-276) against the actual date of birth (DOB). Methods: This cohort study in a single local health district, Australia included 18,708 women with spontaneous labor who gave birth to a single live born infant without major anomalies between 2007 and 2011. Data were sourced from a computerized population birth database. The outcome of interest was duration of pregnancy expressed as total days, and the difference between actual DOB and estimated date of birth by dating method. Results: Only 5% of births occurred on the estimated date of birth regardless of the timing of the estimate. Approximately 66% of births occurred +/-7 days of the estimated date of birth, and there was little difference between ultrasound gestational week bands. The 110-140 weeks of gestation ultrasound performed as well if not better than ultrasounds conducted at other gestations. Maternal factors such as ethnicity and smoking status during pregnancy influenced duration of pregnancy; however, their explanatory power was too low to support incorporating these characteristics in dating estimations. Conclusion: An early dating scan (10 weeks or earlier) is unnecessary if LMP is reliable.Australian National Health and Medical Research Council (NHMRC) Centre for Research Excellence Grant (#APP1001066), Sydney Medical School Summer Research Scholarship, NHMRC Senior Research Fellowship (#APP1021025)

Food Resource Management Education With SNAP Participation Improves Food Security

Objective: To determine the influence of Supplemental Nutrition Assistance Program (SNAP) and participant demographics on nutrition education outcomes. Methods: At program enrollment (pre) and 1 month later (post), a statewide convenience sample of adults, who participated in the Plan, Shop, Save, and Cook program, completed a 7-item questionnaire to evaluate change in resource management skills (RMS) and running out of food before the end of the month. Results: Percent of participants (n = 3,744) who reported behavioral improvements in RMS ranged from 38.8%in comparing prices to 54% in reading labels. Female gender and Hispanic ethnicity were positively related to pre–post RMS change (P = .001). Participants who received SNAP food assistance and made greater pre–post improvement in RMS reported the greatest decrease in running out of food (P = .001). Conclusions and Implications: Both food assistance and education on nutrition and resource management are needed to reduce food insecurity in SNAP-eligible audiences

Food Resource Management Education With SNAP Participation Improves Food Security

Objective: To determine the influence of Supplemental Nutrition Assistance Program (SNAP) and participant demographics on nutrition education outcomes. Methods: At program enrollment (pre) and 1 month later (post), a statewide convenience sample of adults, who participated in the Plan, Shop, Save, and Cook program, completed a 7-item questionnaire to evaluate change in resource management skills (RMS) and running out of food before the end of the month. Results: Percent of participants (n = 3,744) who reported behavioral improvements in RMS ranged from 38.8%in comparing prices to 54% in reading labels. Female gender and Hispanic ethnicity were positively related to pre–post RMS change (P = .001). Participants who received SNAP food assistance and made greater pre–post improvement in RMS reported the greatest decrease in running out of food (P = .001). Conclusions and Implications: Both food assistance and education on nutrition and resource management are needed to reduce food insecurity in SNAP-eligible audiences

Rate of spontaneous onset of labour before planned repeat caesarean section at term

In an auditory lexical decision experiment, 5,541 spoken content words and pseudo-words were presented to 20 native speakers of Dutch. The words vary in phonological makeup and in number of syllables and stress pattern, and are further representative of the native Dutch vocabulary in that most are morphologically complex, comprising two stems or one stem plus derivational and inflectional suffixes, with inflections representing both regular and irregular paradigms; the pseudo-words were matched in these respects to the real words. The BALDEY data file includes response times and accuracy rates, with for each item morphological information plus phonological and acoustic information derived from automatic phonemic segmentation of the stimuli. Two initial analyses illustrate how this data set can be used. First, we discuss several measures of the point at which a word has no further neighbors, and compare the degree to which each measure predicts our lexical decision response outcomes. Second, we investigate how well four different measures of frequency of occurrence (from written corpora, spoken corpora, subtitles and frequency ratings by 70 participants) predict the same outcomes. These analyses motivate general conclusions about the auditory lexical decision task. The (publicly available) BALDEY database lends itself to many further analyses

Rate of spontaneous onset of labour before planned repeat caesarean section at term

BACKGROUND: Guidelines recommend that, in the absence of compelling medical indications (low risk) elective caesarean section should occur after 38 completed weeks gestation. However, implementation of these guidelines will mean some women go into labour before the planned date resulting in an intrapartum caesarean section. The aim of this study was to determine the rate at which low-risk women planned for repeat caesarean section go into spontaneous labour before 39 weeks. METHODS: We conducted a population-based cohort study of women who were planned to have an elective repeat caesarean section (ERCS) at 39-41 weeks gestation in New South Wales Australia, 2007-2010. Labour, delivery and health outcome information was obtained from linked birth and hospital records for the entire population. Women with no pre-existing medical or pregnancy complications were categorized as ‘low risk’. The rate of spontaneous labour before 39 weeks was determined and variation in the rate for subgroups of women was examined using univariate and multivariate analysis. RESULTS: Of 32,934 women who had ERCS as the reported indication for caesarean section, 17,314 (52.6%) were categorised as ‘low-risk’. Of these women, 1,473 (8.5% or 1 in 12) had spontaneous labour or prelabour rupture of the membranes before 39 weeks resulting in an intrapartum caesarean section. However the risk of labour <39 weeks varied depending on previous delivery history: 25% (1 in 4) for those with spontaneous preterm labour in a prior pregnancy; 15% (1 in 7) for women with a prior planned preterm birth (by labour induction or prelabour caesarean) and 6% (1 in 17) among those who had only previously had a planned caesarean section at term. Smoking in pregnancy was also associated with spontaneous labour. Women with spontaneous labour prior to a planned CS in the index pregnancy were at increased risk of out-of-hours delivery, and maternal and neonatal morbidity. CONCLUSIONS: These findings allow clinicians to more accurately determine the likelihood that a planned caesarean section may become an intrapartum caesarean section, and to advise their patients accordingly

Preconceptional factors associated with very low birthweight delivery in East and West Berlin: a case control study

BACKGROUND: Very low birthweight, i.e. a birthweight < 1500 g, is among the strongest determinants of infant mortality and childhood morbidity. To develop primary prevention approaches to VLBW birth and its sequelae, information is needed on the causes of preterm birth, their personal and social antecedents, and on conditions associated with very low birthweight. Despite the growing body of evidence linking sociodemographic variables with preterm delivery, little is known as to how this may be extrapolated to the risk of very low birthweight. METHODS: In 1992, two years after the German unification, we started to recruit two cohorts of very low birthweight infants and controls in East and West Berlin for a long-term neurodevelopmental study. The present analysis was undertaken to compare potential preconceptional risk factors for very low birthweight delivery in a case-control design including 166 mothers (82 East vs. 84 West Berlin) with very low birthweight delivery and 341 control mothers (166 East vs. 175 West). RESULTS: Multivariate logistic regression analysis was used to assess the effects of various dichotomous parental covariates and their interaction with living in East or West Berlin. After backward variable selection, short maternal school education, maternal unemployment, single-room apartment, smoking, previous preterm delivery, and fetal loss emerged as significant main effect variables, together with living in West Berlin as positive effect modificator for single-mother status. CONCLUSION: Very low birthweight has been differentially associated with obstetrical history and indicators of maternal socioeconomic status in East and West Berlin. The ranking of these risk factors is under the influence of the political framework