Maternal educational level and risk of gestational hypertension: the Generation R Study.

We examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug use), pre-existing diabetes, anthropometrics (that is height and body mass index (BMI)) and blood pressure at enrolment. This was studied in 3262 Dutch pregnant women participating in the Generation R Study, a population-based cohort study. Level of maternal education was established by questionnaire at enrolment, and categorized into high, mid-high, mid-low and low. Diagnosis of gestational hypertension was retrieved from medical records using standard criteria. Odds ratios (OR) of gestational hypertension for educational levels were calculated, adjusted for potential confounders and additionally adjusted for potential mediators. Adjusted for age and gravidity, women with mid-low (OR: 1.52; 95% CI: 1.02, 2.27) and low education (OR: 1.30; 95% CI: 0.80, 2.12) had a higher risk of gestational hypertension than women with high education. Additional adjustment for substance use, pre-existing diabetes, anthropometrics and blood pressure at enrolment attenuated these ORs to 1.09 (95% CI: 0.70, 1.69) and 0.89 (95% CI: 0.50, 1.58), respectively. These attenuations were largely due to the effects of BMI and blood pressure at enrolment. Women with relatively low educational levels have a higher risk of gestational hypertension, which is largely due to higher BMI and blood pressure levels from early pregnancy. The higher risk of gestational hypertension in these women is probably caused by pre-existing hypertensive tendencies that manifested themselves during pregnancy

The Generation R Study: design and cohort update 2010

The Generation R Study is a population-based prospective cohort study from fetal life until young adulthood. The study is designed to identify early environmental and genetic causes of normal and abnormal growth, development and health during fetal life, childhood and adulthood. The study focuses on four primary areas of research: (1) growth and physical development; (2) behavioural and cognitive development; (3) diseases in childhood; and (4) health and healthcare for pregnant women and children. In total, 9,778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. General follow-up rates until the age of 4 years exceed 75%. Data collection in mothers, fathers and preschool children included questionnaires, detailed physical and ultrasound examinations, behavioural observations, and biological samples. A genome wide association screen is available in the participating children. Regular detailed hands on assessment are performed from the age of 5 years onwards. Eventually, results forthcoming from the Generation R Study have to contribute to the development of strategies for optimizing health and healthcare for pregnant women and children

Diagnosis of pharyngeal disorders in dogs: a retrospective study of 67 cases

OBJECTIVES: To assess the frequency distribution of pharyngeal disorders and to compare clinical signs in diseases of the different pharyngeal areas. To review the investigation methods. METHODS: Medical records of 67 dogs presenting with abnormalities of the pharyngeal area were retrospectively reviewed and classified according to the anatomic area involved, i.e. the nasopharyngeal, oropharyngeal and laryngopharyngeal areas. Clinical signs, endoscopic findings and results of additional sampling were reviewed. RESULTS: Nasopharyngeal disorders were most frequently encountered (49 per cent), with choanal masses being the most frequent diagnosis (24 of 33), followed by laryngopharyngeal disorders (37.5 per cent) and oropharyngeal disorders (10.5 per cent). A rare condition, stenosis of the intrapharyngeal opening, was classified separately (3 per cent). An overall good correlation between matched cytology and histopathology samples was found. In all categories of diseases, clinical signs related to both the upper respiratory and digestive tracts were reported. CLINICAL SIGNIFICANCE: Pharyngeal disorders are more frequently localised in the nasopharyngeal area and include essentially choanal masses. The use of a flexible endoscope for retrograde rhinoscopy is essential for adequate investigation of the proximal nasopharyngeal area. Clinical signs do not allow differentiation of the pharyngeal disorder within the different pharyngeal areas