24 research outputs found

    Spatial Geographic Mosaic in an Aquatic Predator-Prey Network

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    The geographic mosaic theory of coevolution predicts 1) spatial variation in predatory structures as well as prey defensive traits, and 2) trait matching in some areas and trait mismatching in others mediated by gene flow. We examined gene flow and documented spatial variation in crushing resistance in the freshwater snails Mexipyrgus churinceanus, Mexithauma quadripaludium, Nymphophilus minckleyi, and its relationship to the relative frequency of the crushing morphotype in the trophically polymorphic fish Herichthys minckleyi. Crushing resistance and the frequency of the crushing morphotype did show spatial variation among 11 naturally replicated communities in the Cuatro Ciénegas valley in Mexico where these species are all endemic. The variation in crushing resistance among populations was not explained by geographic proximity or by genetic similarity in any species. We detected clear phylogeographic patterns and limited gene flow for the snails but not for the fish. Gene flow among snail populations in Cuatro Ciénegas could explain the mosaic of local divergence in shell strength and be preventing the fixation of the crushing morphotype in Herichthys minckleyi. Finally, consistent with trait matching across the mosaic, the frequency of the fish morphotype was negatively correlated with shell crushing resistance likely reflecting the relative disadvantage of the crushing morphotype in communities where the snails exhibit relatively high crushing resistance

    Inadequate prenatal care and its association with adverse pregnancy outcomes: A comparison of indices

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    <p>Abstract</p> <p>Background</p> <p>The objectives of this study were to determine rates of prenatal care utilization in Winnipeg, Manitoba, Canada from 1991 to 2000; to compare two indices of prenatal care utilization in identifying the proportion of the population receiving inadequate prenatal care; to determine the association between inadequate prenatal care and adverse pregnancy outcomes (preterm birth, low birth weight [LBW], and small-for-gestational age [SGA]), using each of the indices; and, to assess whether or not, and to what extent, gestational age modifies this association.</p> <p>Methods</p> <p>We conducted a population-based study of women having a hospital-based singleton live birth from 1991 to 2000 (N = 80,989). Data sources consisted of a linked mother-baby database and a physician claims file maintained by Manitoba Health. Rates of inadequate prenatal care were calculated using two indices, the R-GINDEX and the APNCU. Logistic regression analysis was used to determine the association between inadequate prenatal care and adverse pregnancy outcomes. Stratified analysis was then used to determine whether the association between inadequate prenatal care and LBW or SGA differed by gestational age.</p> <p>Results</p> <p>Rates of inadequate/no prenatal care ranged from 8.3% using APNCU to 8.9% using R-GINDEX. The association between inadequate prenatal care and preterm birth and LBW varied depending on the index used, with adjusted odds ratios (AOR) ranging from 1.0 to 1.3. In contrast, both indices revealed the same strength of association of inadequate prenatal care with SGA (AOR 1.4). Both indices demonstrated heterogeneity (non-uniformity) across gestational age strata, indicating the presence of effect modification by gestational age.</p> <p>Conclusion</p> <p>Selection of a prenatal care utilization index requires careful consideration of its methodological underpinnings and limitations. The two indices compared in this study revealed different patterns of utilization of prenatal care, and should not be used interchangeably. Use of these indices to study the association between utilization of prenatal care and pregnancy outcomes affected by the duration of pregnancy should be approached cautiously.</p

    Impact of obesity on pregnancy outcome in different ethnic groups: calculating population attributable fractions.

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    OBJECTIVES: To quantify the proportion of adverse pregnancy outcome attributable to maternal obesity. DESIGN: Cross sectional analysis of routine obstetric dataset. SETTING: Guy's and St Thomas's NHS Foundation Trust (GSTFT). POPULATION: 23,668 women who had singleton deliveries at GSTFT between 2004 and 2008. METHODS: Logistic regression was used to estimate the association between BMI and outcome in different ethnic groups. Adjusted odds ratios, and the proportions of obese women, were used to calculate population attributable risk fractions (PAFs). MAIN OUTCOME MEASURES: (I) MATERNAL OUTCOMES: diabetes, type of delivery, post-partum haemorrhage, and preterm delivery. (ii) Perinatal outcomes: macrosomia, low birth weight, admission to neonatal intensive care/special care baby unit, and perinatal death. RESULTS: The prevalence of maternal obesity was 14%. Increasing BMI was independently associated with increasing risk of adverse obstetric and neonatal outcome. At the individual level, the effect of obesity on diabetes was highest in Asian women compared to white women (p for interaction = 0.03). Calculation of population attributable risk fractions demonstrated that one third of diabetes cases and one in six Caesarean sections could be avoided in this population if all obese women were of normal BMI. At the population level, the contribution of obesity to diabetes was highest for Black women (42%), and lowest for oriental women (8%). Seven percent of neonatal macrosomia in all the population, and 13% in Black mothers, were attributable to obesity. CONCLUSIONS: Preventing obesity prior to pregnancy will substantially reduce the burden of obstetric and neonatal morbidity in this population. This reduction will be higher in Black women

    The performance of various anthropometric assessment methods for predicting low birth weight in pregnant women Desempenho de diferentes métodos de avaliação antropométrica de gestantes na predição de baixo peso ao nascer

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    OBJECTIVES: to assess the performance of various anthropometric methods for the evaulation of the nutritional status of pregnant women as a means of predicting low birth weight (LBW). METHODS: a descriptive cross-cutting study carried out among 433 pregnant women (>20 years) attending a Public Maternity Hospital in Rio de Janeiro, Brazil. The adequacy of the weight gain at the end of the pregnancy was evaluated in accordance with the proposals of the Institute of Medicine and the Brazilian Ministry of Health. The sensitivity, specificity and accuracy of the adequacy of weight gain at the end of the pregnancy or nutritional state of mother as a predictor of low birth weight were calculated. RESULTS: the sensitivity of the various methods varied from 63.1% to 68.4% and the specificity from 71.2% to 75.1%. The adapted Institute of Medicine proposal drawn up by the Brazilian Ministry of Health, according to the classification of the pre-delivery nutritional status of the mother according to the World Health Organization cutoff points showed itself to be the most accurate (74.5%), this being the most adequate method for nutritional triage for reason of its association with low birth weight (OR=4.10; 95%CI=1.53-10.92). CONCLUSIONS: the best proposals for this population are those of the Institute of Medicine and the Brazilian Ministry of Health. Further studies aiming to ascertain the most appropriate methods of anthropometric evaluation for different populations should be encouraged.<br>OBJETIVOS: avaliar o desempenho de diferentes métodos antropométricos para avaliação nutricional de gestantes para predizer o baixo peso ao nascer (BPN). MÉTODOS: estudo descritivo do tipo transversal, realizado com 433 puérperas (>20 anos) atendidas numa Maternidade Pública do Rio de Janeiro, Brasil. A adequação do ganho de peso ao final da gestação foi avaliada segundo as propostas do Institute of Medicine e do Ministério da Saúde. Calculou-se a sensibilidade, a especificidade e a acurácia das variáveis adequação do ganho de peso gestacional total ou adequação do estado nutricional materno ao final da gestação na predição do BPN. RESULTADOS: a sensibilidade dos métodos variou de 63,1% a 68,4% e a especificidade de 71,2% a 75,1%. A adaptação da proposta do Institute of Medicine elaborada pelo Ministério da Saúde, segundo a classificação do estado nutricional pré-gestacional pelos pontos de corte da Organização Mundial da Saúde apresentou maior acurácia (74,5%), sendo este último o mais adequado para triagem nutricional pela sua associação com o BPN (OR=4,10; IC95%=1,53-10,92). CONCLUSÕES: os melhores para esta população foram as propostas do Institute of Medicine e do Ministério da Saúde. Estudos visando reconhecer os métodos de avaliação antropométrica mais adequados na gestação devem ser estimulados em diferentes populações
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