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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 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 Comparison of maternal anthropometry and a single symphysis fundal height measurement as a screening test for low birth weight babies(Sri Lanka College of Obstetricians and Gynaecologists, 1997) Gunasekera, P.C.; Wijesinghe, P.S.; Pathmeswaran, A.Objective To compare a single pre-delivery symphysis fundal height (SFH) measurement and maternal anthropometric measurements as screening methods for low birth weight (LBW). Material and methods SFH, weight, height and mid. upper arm circumference (MUAC) were measured in 525 consecutive pregnant women carrying singleton pregnancies admitted for delivery. Birthweight was recorded. Results 46 percent of the observed variation in birthweight of babies from singleton pregnancies is explained by the SFH. The predelivery height, weight, body mass index (BMl) and MUAC had less influence on birthweight. A SFH measurement of 34 cm or less detected 75 of 93 LBW babies. The sensitivity and specificity were 80.6 percent and 74.8 percent respectively. The negative predictive value at SFH of 34 cm or less was 94.7 percent. Conclusion A single pre-delivery SFH is a better screening test for LBW than pre-delivery maternal height, weight, BMI or MUAC and 95 percent of mothers with a SFH measurement of more than 34 cm delivered a baby weighing more than 2500g.Item Neonatal and post-neonatal mortality in the Galle district(Sri Lanka Medical Association, 1994) Fonseka, P.; Wijewardene, K.; de Silva, D.G.H.; Goonaratna, C.; Wijeyasiri, W.A.DESIGN: Descriptive study. SETTING: Galle district in Sri Lanka. SUBJECTS: 350 infant deaths of singleton births. MEASUREMENTS: Association between variables. RESULTS: Neonatal: post-neonatal death ratio was 3.2:1, and 62.3% (218) were early neonatal deaths. First day deaths comprised 28.6% (100); 67.8% (237) died at the Teaching Hospital. A high incidence (65.7%) of low birthweight (LBW) was noted. Mean birthweights of neonates and post-neonates were 1925 +/- 729 and 2520 +/- 620 gram respectively, and the difference between means was statistically significant (p < 0.001). LBW and related disorders were the major cause of death in 44% (154) of the total sample, and in 55.8% (149) of neonates. Infections were the commonest cause (55.8%) of death in post-neonates. Pediatric clinical assessment to differentiate small-for-dates (SFD) was not recorded in 90.3%. Statistically significant associations were found between the period of death (neonatal and post-neonatal) and the following variables: period of gestation (p < 0.001); birthweight (p < 0.001) and cause of death (p < 0.001). CONCLUSIONS: There was a high incidence of neonatal deaths and a high proportion of early neonatal deaths. About one-third of deaths occurred on the first day of life. Incidence of LBW was high. The major cause of death was LBW and related disorders in the total sample and in neonates. Assessment of SFD was not carried out in the vast majority of infants.