Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Sleep deprivation, physical activity and low income are risk factors for inadequate weight gain during pregnancy: a cohort study(Wiley-Blackwell Pub. Asia, 2011) Abeysena, C.; Jayawardana, P.AIM: To determine the possible risk factors for inadequate gestational weight gain. METHODS: A population-based cohort study was carried out in Sri Lanka from May 2001 to April 2002. Pregnant women were recruited on or before 16 weeks' gestation and followed up until delivery; the sample size was 710. Trimester-specific exposure status and potential confounding factors were gathered on average at the 12th, 28th and 36th weeks of gestation. Maternal weight was measured at the first antenatal clinic visit and at delivery. Inadequate weight gain was defined as weight gain below the Institute of Medicine recommendations in 2009. Multiple logistic regression was applied and the results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: The risk factors for inadequate weight gain were low per-capita monthly income (OR 1.63, 95% CI 1.03, 2.58), multiparity (OR 1.96, 95% CI 1.34, 2.87), sleeping <8 h/day during the second, third, or both second and third trimesters (OR 1.60, 95% CI 1.05, 2.46), standing and walking ≥5 h/day during the second trimester (OR 1.50, 95% CI 1.04, 2.15), and the newborn being of the male sex (OR 1.50, 95% CI 1.04, 2.16), controlling for the effect of body mass index and gestational age. CONCLUSIONS: Risk factors for inadequate gestational weight gain were low income, being multiparous, sleep deprivation, physical activity in terms of standing and walking, and the male sex of baby.Item Effect of psychosocial stress and physical activity on low birth weight: a cohort study(Wiley-Blackwell Pub. Asia, 2010) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.AIM: To determine the effect of physical activity and psychosocial stress on low birthweight (LBW). METHODS: A prospective study was carried out in a district of Sri Lanka between May 2001 and April 2002. A total of 885 pregnant mothers were recruited at < or = 16 weeks of gestation and followed up until partus. Trimester-specific exposure statuses along with potential confounding factors were gathered on average at the 12th, 28th, and 36th weeks of gestation. Physical activities were assessed by inquiring about the duration of specific postures adopted per day by housewives during each trimester at home and both at home and during working hours for those who were engaged in paid employment. Psychosocial stress was assessed using the Modified Life Events Inventory and the General Health Questionnaire 30. LBW was defined as a birthweight of less than 2500 g. Multiple logistic regression analysis was applied for controlling confounders and the results were expressed as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Standing > 2.5 h/day (OR 2.26; 95%CI 1.10, 4.69) during the second trimester and sleeping 8 h or less/day (OR 2.84; 95%CI 1.49, 5.40) either during the second, third or both trimesters together, an increase in maternal age in years (OR 0.92; 95%CI 0.87, 0.98), and body mass index < 19.8 kg/m(2) (OR 2.2; 95%CI 1.17, 4.22) had a statistically significant association with LBW. Psychosocial stress was not associated with LBW.CONCLUSIONS: Standing > 2.5 h/day and sleeping < or = 8 h/day were risk factors for LBW, whereas psychosocial stress was notItem Maternal sleep deprivation is a risk factor for small for gestational age: a cohort study(Wiley-Blackwell, 2009) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.AIMS: To determine trimester-specific risk factors for small-for-gestational-age (SGA) infants. METHODS: A population-based prospective cohort study was conducted in Sri Lanka from May 2001 to April 2002. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. The sample size was 690. Trimester-specific exposure status and potential confounding factors were gathered on average at 12th, 28th and 36th weeks of gestation. SGA was assessed using customised birth centile charts. Multiple logistic regression was applied, and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: The risk factors for SGA less than 5th centile were shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters (OR 4.20, 95%CI 1.10-16.0), sleeping for less than or equal to 8 h during 2nd or 3rd or both trimesters (OR 2.23, 95%CI 1.08-4.59), walking for less than or equal to 2.5 h per day (OR 2.66, 95%CI 1.12-6.31) and alcohol consumption during the 3rd trimester (OR 14.5, 95%CI 2.23-94.7). Poor weekly gestational weight gain was significantly associated with both SGA < 10th and < 5th centiles. None of the other factors became significant for SGA < 10th centile. CONCLUSIONS: Risk factors for SGA less than 5th centile were sleep deprivation and shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters, less walking hours and alcohol consumption during 3rd trimester. Poor weekly gestational weight gain may be considered as a predictor of delivering an SGA infant.