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Juhl M.,University of Southern Denmark | Kogevinas M.,University of Southern Denmark | Kogevinas M.,Center for Research in Environmental Epidemiology | Kogevinas M.,Municipal Institute of Medical Research | And 5 more authors.

BACKGROUND:: Exercise in pregnancy is recommended in many countries, and swimming is considered by many to be an ideal activity for pregnant women. Disinfection by-products in swimming pool water may, however, be associated with adverse effects on various reproductive outcomes. We examined the association between swimming in pregnancy and preterm and postterm birth, fetal growth measures, small-for-gestational-age, and congenital malformations. METHODS:: We used self-reported exercise data (swimming, bicycling, or no exercise) that were prospectively collected twice during pregnancy for 74,486 singleton pregnancies. Recruitment to The Danish National Birth Cohort took place 1996-2002. Using Cox, linear and logistic regression analyses, depending on the outcome, we compared swimmers with physically inactive pregnant women; to separate a possible swimming effect from an effect of exercise, bicyclists were included as an additional comparison group. RESULTS:: Risk estimates were similar for swimmers and bicyclists, including those who swam throughout pregnancy and those who swam more than 1.5 hours per week. Compared with nonexercisers, women who swam in early/mid-pregnancy had a slightly reduced risk of giving birth preterm (hazard ratio = 0.80 [95% confidence interval = 0.72-0.88]) or giving birth to a child with congenital malformations (odds ratio = 0.89 [0.80-0.98]). CONCLUSIONS:: These data do not indicate that swimming in pool water is associated with adverse reproductive outcomes. Copyright © 2010 by Lippincott Williams & Wilkins. Source

Dolk H.,University of Ulster | Armstrong B.,London School of Hygiene and Tropical Medicine | Lachowycz K.,London School of Hygiene and Tropical Medicine | Vrijheid M.,London School of Hygiene and Tropical Medicine | And 5 more authors.
Occupational and Environmental Medicine

Objectives To investigate whether there is an association between risk of congenital anomaly and annual ward level exposure to air pollution in England during the 1990s. Methods A geographical study was conducted across four regions of England using population-based congenital anomaly registers, 1991-1999. Exposure was measured as 1996 annual mean background sulphur dioxide (SO 2), nitrogen dioxide (NO2) and particulate matter (PM 10) concentrations at census ward level (n=1474). Poisson regression, controlling for maternal age, area socioeconomic deprivation and hospital catchment area, was used to estimate relative risk for an increase in pollution from the 10th to the 90th centile. Results For non-chromosomal anomalies combined, relative risks were 0.99 (95% CI 0.93 to 1.05) for SO2, 0.97 (95% CI 0.84 to 1.11) for NO2 and 0.89 (95% CI 0.75to 1.07) for PM10. For chromosomal anomalies, relative risks were 1.06 (95% CI 0.98 to 1.15) for SO2, 1.11 (95% CI 0.95 to 1.30) for NO2 and 1.18 (95% CI 0.97 to 1.42) for PM10. Raised risks were found for tetralogy of Fallot and SO2 (RR=1.38, 95% CI 1.07 to 1.79), NO 2 (RR=1.44, 95% CI 0.71 to 2.93) and PM10 (RR=1.48, 95% CI 0.57 to 3.84), which is of interest in light of previously reported associations between this cardiac anomaly and other air pollutants. Conclusions While air pollution in the 1990s did not lead to sustained geographical differences in the overall congenital anomaly rate in England, further research regarding specific anomalies is indicated. Source

Koutra K.,University of Crete | Chatzi L.,University of Crete | Bagkeris M.,University of Crete | Vassilaki M.,University of Crete | And 4 more authors.
Social Psychiatry and Psychiatric Epidemiology

Purpose: A growing body of evidence links poor maternal mental health with negative outcomes on early child development. We examined the effect of antenatal and postnatal maternal mental health on infant neurodevelopment at age 18 months in a population-based mother-child cohort (Rhea Study) in Crete, Greece. Methods: Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of women during pregnancy and at 8 weeks postpartum (n = 223). An additional sample of 247 mothers also completed the EPDS scale at 8 weeks postpartum (n = 470). Neurodevelopment at 18 months was assessed with the use of Bayley Scales of Infant and Toddler Development (3rd edition). Results: Multivariable linear regression models adjusted for confounders revealed that antenatal depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive development independently of postnatal depression. High trait anxiety and extraversion were associated with decrease and increase, respectively, in social-emotional development. Also, high trait anxiety and neuroticism had a positive effect on infants' expressive communication. Finally, postpartum depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive and fine motor development independently of antenatal depression. Conclusions: These findings suggest that antenatal and postnatal maternal psychological well-being has important consequences on early child neurodevelopment. © 2012 Springer-Verlag Berlin Heidelberg. Source

Koutra K.,University of Crete | Vassilaki M.,University of Crete | Georgiou V.,University of Crete | Koutis A.,University of Crete | And 5 more authors.
Social Psychiatry and Psychiatric Epidemiology

Purpose: Antenatal maternal mental health has been identified as an important determinant of postpartum depression (PPD). We investigated the occurrence of depression both antenatally and postnatally and examined whether maternal trait anxiety and depression during pregnancy were associated with PPD at 8 weeks postpartum in a prospective mother-child cohort (Rhea Study) in Crete, Greece. Methods: 438 women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Trait subscale of the State-Trait Anxiety Inventory (STAI-Trait) questionnaires assessing antenatal depression and anxiety, respectively, during the third trimester of pregnancy as well as the EPDS at 8 weeks postpartum. Results: The prevalence of women with probable depression (EPDS score ≥13) was 16.7 % at 28-32 weeks of pregnancy and 13.0 % at 8 weeks postpartum. A per 5 unit increase in the STAI-Trait subscale increased the odds for PPD by 70 % (OR = 1.70, 95 % CI 1.41, 2.05), whereas a per unit increase in EPDS during pregnancy increased the odds for PPD by 27 % (OR = 1.27, 95 % CI 1.19, 1.36). Conclusions: Our findings suggest that antenatal maternal psychological well-being has a significant effect on PPD, which might have important implications for early detection during pregnancy of women at risk for postpartum depression. © 2013 Springer-Verlag Berlin Heidelberg. Source

de Nazelle A.,Center for Research in Environmental Epidemiology | de Nazelle A.,Municipal Institute of Medical Research | de Nazelle A.,CIBER ISCIII | Morton B.J.,University of North Carolina at Chapel Hill | And 2 more authors.
Transportation Research Part D: Transport and Environment

This paper examines how conversion of automobile trips of less than 3. miles to other transportation modes reduces emissions. Short trips contribute disproportionately to emissions because of cold starts. An analysis is conducted of short-trip behavior across the US using the 1995 Nationwide Personal Transportation Survey. The data is used to develop likely scenarios of mode conversions for short trips, which are then applied to estimate emission savings using MOBILE6 cold start and running emission factors for volatile organic compounds, nitrogen oxides, carbon monoxide, and carbon dioxide. The results suggest that reducing short auto trips would modestly reduce mobile source air pollution, but emission reductions are high compared to most federally-funded surface transportation interventions aimed at improving air quality. Enhanced the community pedestrian environment to encourage short trip mode conversion also produces co-benefits such as increased physical activity and subsequent reductions in chronic diseases. © 2010 Elsevier Ltd. Source

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