Malnutrition, pregnancy, and infant mortality: a biometric model

No association between infant growth and adherence to the dietary approaches to stop hypertension (DASH) diet in lactating women

OBJECTIVE

Breastmilk is considered an optimal food for infant development especially during the first 6 months of life. However, little evidence exists regarding maternal dietary intake and infant growth. We evaluated how adherence to the DASH diet in lactating women is associated with the infant weight, height and head circumference at birth, 2 and 4 months of age.

STUDY DESIGN

A cross-sectional study.

METHODS

The present study was conducted with 292 lactating mothers and their infants. A validated and reliable 168-item food frequency questionnaire (FFQ) was used to assess mothers' dietary intakes. To evaluate adherence to the DASH diet among lactating mothers, we scored food items based on the Fung method.

RESULT

Lactating mothers in the highest tertile of adherence to the DASH diet consumed significantly lower amounts of fat, cholesterol, salt, red and process meats and higher amounts of vitamin C, B1, B9, whole grains, low-fat dairy, fruits, vegetables and dietary fiber compared to lactating mothers in the lowest tertile (P < 0.05). No significant association was found between mothers' adherence to the DASH dietary pattern and any of the infant growth indices (P > 0.05).

CONCLUSION

Lactating mothers' adherence to the DASH diet was not associated with growth indices among exclusively breastfed infants.

Assessment of physiological disturbances during pre- and early postnatal development based on microscopic analysis of human deciduous teeth from the Late Epipaleolithic site of Shubayqa 1 (Jordan)

OBJECTIVES

To study pre- and early postnatal tooth formation and to analyze the effects of physiological disturbances on enamel and dentin formation in deciduous teeth of infants from the Late Epipaleolithic (Natufian) site Shubayqa 1.

MATERIALS AND METHODS

Ten deciduous teeth from six infants (ages at death between 21 and 239 days) were analyzed by light and scanning electron microscopy.

RESULTS

Marked prism cross-striations and an abnormal wavy course of the prisms were recorded in pre- and postnatal enamel of all analyzed teeth. Single or multiple accentuated incremental lines were observed in prenatal enamel of nine teeth and in postnatal enamel of eight teeth. Accentuated Andresen lines and broader zones exhibiting an enhanced calcospheritic pattern were recorded in the pre- and postnatally formed dentin of nine teeth.

DISCUSSION

The structural abnormalities in the pre- and postnatally formed enamel of the infants are considered indicative of chronic stress that negatively affected the activity of secretory ameloblasts. The structural aberrations in pre- and postnatal dentin denote that odontoblasts were also affected by this stress. The presence of single or multiple accentuated incremental lines in pre- and postnatal enamel is interpreted as reflecting (short-term) impacts of higher intensity superimposed on the chronic stress. Our findings suggest compromised maternal health affecting the late fetus and compromised health in newborns. Although limited by the small number of analyzed individuals, the present study contributes to the knowledge of maternal and early infant health conditions in Late Epipaleolithic populations.

The Jewish advantage and household security: life expectancy among 19th Century Sephardim of Gibraltar

Using the historical population of Gibraltar to examine the pattern of mortality of Jews and Roman Catholics revealed that: (1) the Jews exhibited a significantly better health status as measured by life expectancy at birth (47.66 and 47.56 for Jewish males and females vs. 38.10 and 40.89 for Catholics males and females, respectively), (2) most of the disparity is found in the very young age categories and (3) the significantly lower rates of deaths could be attributed to the diarrheal and nutritional complex. Stage two of the research involved the linkage of deaths over a 7-year period relative to their household context as of 1878. Being Jewish, having a servant, having access to a water well in the tenement and residing in a tenement only with other Jews, were all factors that contributed to a higher life expectancy. Our explanation for the enhanced survivorship among the Jews is grounded in economics as well as in an established welfare system, in religious precepts and in secular knowledge of health. One of the more notable and hitherto unobserved findings is that Roman Catholics residing in the same tenements with Jews enjoyed a distinct health advantage. This suggests that a positive amplification effect arose from their co-residence with the Jews.

Children of the Golden Minster: St. Oswald’s Priory and the Impact of Industrialisation on Child Health

This study explores the disease experience of children buried within the cemetery of St. Oswald’s Priory, Gloucester from AD1153 to 1857. Evidence for ages-at-death, infant mortality, and the prevalence of stress indicators, trauma, and pathology were compared between the early and postmedieval periods. The skeletal remains of these children provide evidence for child health spanning the economic expansion of Gloucester at St. Oswald’s, from a mostly rural parish to a graveyard catering for families from the poorer northern part of the town and the workhouse. Results showed that the children from the postmedieval period in Gloucester suffered higher rates of dental caries (38%) and congenital conditions (17.3%) than their counterparts from the early and later medieval period. This paper serves to highlight the value of nonadult skeletal material in the interpretation of past human health in transitional societies and illustrates the wide variety of pathological conditions that can be observed in nonadult skeletons.

Is sibling rivalry fatal?: siblings and mortality clustering

Evidence drawn from nineteenth-century Belgian population registers shows that the presence of similarly aged siblings competing for resources within a household increases the probability of death for children younger than five, even when controlling for the preceding birth interval and multiple births. Furthermore, in this period of Belgian history, such mortality tended to cluster in certain families. The findings suggest the importance of segmenting the mortality of siblings younger than five by age group, of considering the presence of siblings as a time-varying covariate, and of factoring mortality clustering into analyses.

SEX DIFFERENCES IN INFANT MORTALITY IN SPITALFIELDS, LONDON, 1750–1839

This study examines sex differences in infant mortality in Spitalfields, London, and the estimated contribution of endogenous and exogenous factors to neonatal and infant mortality using the biometric model from 1750 to 1839. There was a marked decline in the risk of death during infancy and the neonatal period for both sexes during the study period. There was significant excess male infant mortality compared with that of females in the 1750–59 cohort, estimated from baptism and burial registers, but not in later cohorts. Similarly, males had higher neonatal mortality rates than females in 1750–59 but not in later cohorts. Biometric analyses suggest that the observed decrease in neonatal mortality in both sexes was caused by a reduction in both endogenous and exogenous causes of death. The contribution of maternal health and breast-feeding practices to the observed patterns of mortality is discussed in the light of available evidence.

Brief and precarious lives: Infant mortality in contrasting sites from medieval and post-medieval England (AD 850–1859)

This study compares the infant mortality profiles of 128 infants from two urban and two rural cemetery sites in medieval England. The aim of this paper is to assess the impact of urbanization and industrialization in terms of endogenous or exogenous causes of death. In order to undertake this analysis, two different methods of estimating gestational age from long bone lengths were used: a traditional regression method and a Bayesian method. The regression method tended to produce more marked peaks at 38 weeks, while the Bayesian method produced a broader range of ages and were more comparable with the expected "natural" mortality profiles.At all the sites, neonatal mortality (28-40 weeks) outweighed post-neonatal mortality (41-48 weeks) with rural Raunds Furnells in Northamptonshire, showing the highest number of neonatal deaths and post-medieval Spitalfields, London, showing a greater proportion of deaths due to exogenous or environmental factors. Of the four sites under study, Wharram Percy in Yorkshire showed the most convincing "natural" infant mortality profile, suggesting the inclusion of all births at the site (i.e., stillbirths and unbaptised infants).

Secondary sex ratio variation during stressful times: the impact of the French revolutionary wars on a German parish (1787-1802)

The observation that declines in the human secondary sex ratio (SSR) may be linked to stressful periconceptional periods has received considerable attention (Catalano [2003] Hum Reprod 18:1972-1975; Catalano et al. [2005] Int J Epidemiol 34:944-948, [2005] Hum Reprod 20:1221-1227, [2005] Paediatr Perinat Epidemiol 19:413-420). For the purpose of testing the external validity of this phenomenon, birth records from four German village genealogies (N = 1,048) were analyzed to study the impact of the French Revolutionary Wars (1787-1802) on the proportion of male births. All births were subdivided into three cohorts (prewar, 1787-1792; war, 1792-1797; and postwar, 1797-1802). Differences in SSR between cohorts achieved statistical significance (chi2= 7.695; df = 2; P = 0.021). In addition, changes in SSR before, during, and after the wars were monitored by risk analysis. Using the SSR of the prewar period as a control, the results of the war cohort failed to achieve statistical significance (regression coefficient, -0.257; ExpB= 0.773; P = 0.118), while the odds reduction of 32.3% in the postwar period proved to be statistically significant (regression coefficient, -0.390; ExpB= 0.677; P = 0.006). It is hypothesized that the experience of postwar economic hardship (attributable to lowered food availability paired with dietary changes) represents the most likely proximate cause. The study also finds evidence of a parental sex ratio manipulation strategy meant to offset the female-biased SSR after the wars. It is argued that from an evolutionary perspective both the decline in SSR in response to stress as well as parental manipulation of the tertiary sex ratio convey reproductive advantages.

Economic change and infant mortality in England, 1580-1837

Adaptation of the results from a recent family-reconstitution study of twenty-six parishes in pre-transition England reveals that long-term trends in post-neonatal mortality follow trends in a real-wage index, and that trends in neonatal mortality correlate with other economic factors. Thus, the hypothesis that infant mortality and economic performance in pre-transition England were related is consistent with the family-reconstitution data.