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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 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.Item Envenoming due to snake bite during pregnancy(Oxford University Press, 2002) Seneviratne, S.L.; de Silva, C.E.; Fonseka, M.M.D.; Pathmeswaran, A.; Gunatilake, S.B.; de Silva, H.J.No Abstract AvailableItem Effect of mebendazole therapy in pregnancy on birth outcome(Lancet Publishing Group, 1999) de Silva, N.R.; Sirisena, J.; Gunasekera, D.P.S.; Ismail, M.M.; de Silva, H.J.BACKGROUND: In areas endemic for hookworm, routine antenatal mebendazole therapy could greatly reduce the prevalence of anaemia in pregnancy. At present, however, this is not a widely accepted control strategy because of a lack of data on the safety of the drug. We assessed the effect of mebendazole therapy during pregnancy on birth outcome. METHODS: A cross-sectional study was done in Sri Lanka, where prescription of mebendazole to women in the second trimester of pregnancy is recommended. Two hospitals were chosen for the study, and women who gave birth there between May, 1996, and March, 1997, were recruited. We compared the rates of major congenital defects, stillbirth, perinatal death, and low birthweight (less or equal 1500 g) among babies of mothers who had taken mebendazole during pregnancy with those whose mothers had not taken an anthelmintic (controls). FINDINGS: The rate of major congenital defects was not significantly higher in the mebendazole group than in the control group (97 [1.8 percent] of 5275 vs 26 [1.5 percent] of 1737; odds ratio 1.24 [95 percent CI 0.8-1.91], p equal 0.39). Among 407 women who had taken mebendazole in the first trimester (contrary to medical advice), 10 (2.5 percent) had major congenital defects (odds ratio vs controls 1.66 [0.81-3.56], p equal 0.23). The proportions of stillbirths and perinatal deaths were significantly lower in the mebendazole group (1.9 vs 3.3 percent, 0.55 [95 percent CI 0.4-0.77]), as was the proportion of low-birthweight babies (1.1 vs 2.3 percent 0.47 [95 percent CI 0.32-0.71]). INTERPRETATION: Mebendazole therapy during pregnancy is not associated with a significant increase in major congenital defects, but our results indicate that it should be avoided during the first trimester. This therapy could offer beneficial effects to pregnant women in developing countries, where intestinal helminthiases are endemic.Item Adolescent pregnancy; weight and zinc supplementation effects(Wiley-Blackwell, 1993) Cherry, F.F.; Sandstead, H.H.; Wickremasinghe, A.R.No Abstract AvailableItem Adolescent pregnancy: zinc supplementation and iron effects(Wiley-Blackwell, 1993) Cherry, F.F.; Sandstead, H.H.; Wickremasinghe, A.R.No Abstract AvailableItem Adolescent pregnancy: maternal weight effects on fetal heaviness: possible route to improved outcomes(Human Sciences Press, 1991) Cherry, F.F.; Rojas, P.; Sandstead, H.H.; Johnson, L.K.; Wickremasinghe, A.R.; Ebomoyi, E.W.In a previous report of a zinc supplementation trial in pregnant adolescents zinc effect varied according to maternal weight (wt) status--normal (90-110% of expected wt), light or heavy, prompting this analysis of effects of wt status and gestational wt gain on fetal heaviness relative to length and gestational age (GA) and other pregnancy outcomes. One-third of adolescents shifted in or out of normal wt by delivery, creating seven outcome groups--light-light, light to normal, normal to light, normal-normal, normal to heavy, heavy to normal, and heavy-heavy. These wt class change groups varied significantly as to intrauterine growth (SGA, low AGA, high AGA, and LGA); by weekly grams gain per cm height (ht), birth wt, infant wt/length ratio, and occurrence of low birth wt (LBW). Infants with above average intrauterine growth had an advantage in: absolute size, length of hospital stay, rates of LBW, fetal demise, rates of low Apgar score, and "other" complications. This association between intrauterine growth and maternal wt class change suggests that promotion of wt gain might lower rates of LBW. Birthwt varied by quartiles of weekly wt change (gm) per cm ht in women grouped by their percent of expected wt: in the lowest quartile (Q1) only one group in seven reached average Bwt (3025 grams); with Q4 gain all groups did. Thus, the parameter wt gain/wk/cm ht deserves study as a tool for monitoring wt status and gain to identify those pregnant adolescents in greatest need for nutritional counseling and to set wt gain goals.