Vogazianos, Paris

Cigarette smoking during pregnancy has been causally associated with an increased risk of both intrauterine growth retardation and preterm delivery but most strongly with low birth weight. No such study to date had ever dealt with the Cypriot population. In interviews with their gynaecologists 65,530 pregnant women were asked between January 1990 and August 1996 to answer two questions, whether they had been smoking before and whether they had been smoking during pregnancy. Data from 59,014 births were considered to have valid birth weight data for this investigation. In 81.2% of the cases the mother explicitly declared that she had neither smoked before or during pregnancy whereas in 1.4% of the cases the mother said that she had smoked both before and during pregnancy and in 1.4% of the cases the mother said that she had smoked before but not during pregnancy. Finally, in 15.3% of the cases no answer to "smoking question" was given, whereas in 0.7% of the cases the answer that was given was deemed as not clear. The average birth weight of babies born to women who had stopped smoking was insignificantly different than that of those born to never smokers. The average birth weight of babies born to women who smoked during pregnancy was lower compared to babies born to non smokers' babies by 92 grams, 66 grams, and 109 grams for all babies, singleton boys and singleton girls respectively. The greatest effect to their mean birth weights was observed in babies whose mothers did not answer the question on smoking. Their babies had birth weights lower than non smokers' babies by 203 grams, 197 grams, and 201 grams for all babies, singleton boys and singleton girls respectively.

Many factors including maternal, pregnancy-specific, physiological, genetic, pathological, and environmental can influence foetal weight. Although they have been well studied in most EU countries, no such studies are specifically available on Cyprus. This study was based on the raw data, concerning births and birth-weights for the period of 1990-2002, which we managed to obtain from the database of the "Centre for Preventive Paediatrics", a non-governmental foundation on Cyprus. This first-ever study on the distribution of birth-weights in the Republic of Cyprus shows a downward trend in the birth-weights in the early 1990s (from the mean 3238 grams in 1991 to 3152 in 2002). The study also confirmed significant weight decrements for babies born prematurely, as a result of multifoetal pregnancies or to smoking mothers (mean decrement of 886 grams in the period of 1990-98 and 821 grams in the period of 1998-2002). Most importantly, this study shows a significant increase in the proportion of caesarean sections, which in 2002 reached almost four times the maximum number of caesarean sections recommended by the WHO (increase from 18 % in 1990 to 39 % in 2002). Furthermore, babies born by caesarean section were found to be significantly lighter than those born by natural delivery (by a mean of 147 grams for 1990-1996 and 212 grams for 1998-2002). An indirect result of this study also suggests that the overall proportion of Cypriot women who smoke, as reflected by the pregnant women, is much higher than previously thought. This study highlights the need for further investigations into these determinants of birth-weight in the Cypriot population.

This study was designed to examine whether atopy is associated with acute otitis media (AOM). Material and methods: The study was performed with the help of a questionnaire handed out to the parents of 262 children, all residents of Brno, who attended our department for adenoidectomy. The questionnaire was designed to establish any history of atopy and / or AOM in each child, as well as any family history of atopy. The information was compared to the existing data in our database of medical records. The children with one or more AOM events were used as the study group and the children with no AOM infections as a control group. The incidence of atopy in each of these two groups was then statistically analysed. The history of atopy in the family was also compared in each of these two groups. Results: No significant difference was found in the incidence of atopy when children with AOM and children without AOM episodes were compared. Furthermore, no significant difference was found in the family history of atopy, when children with AOM and children without AOM episodes were compared. Conclusion: Our data have shown no connection between AOM episodes and atopy incidence in children or their families, thus atopy or family history of atopy do not seem to play any role in the incidence of AOM.

Aim: We designed this study to assess the effect of breastfeeding and its duration on acute otitis media (AOM) in children of our geographical region. Our main aim was to determine the period of breastfeeding, necessary to achieve optimal preventive results against AOM. Methods: The children that, according to the questionnaire, had suffered AOM infections in the past were used as the study group with the rest of the children used as control. The duration of breastfeeding was divided into months and the odds ratios for the occurrence of AOM were calculated for the children breastfed for more than or equal to a certain period, compared to the children breastfed for less than that period. This was repeated for each month separately and the results plotted on a graph of the confidence interval (Cl) for the odds ratio values, against months of breastfeeding. Results: The results of our study show that breastfeeding for a period of up to 11 months can play a significant preventive role against AOM (odds ratio and lower 90% Cl >1). Breastfeeding for longer periods of time is also beneficial, with breastfeeding up to 18 months being associated with some preventive effect against the disease (odds ratio >1), but the reduction in the incidence of AOM is not statistically significant after the 11th month. Furthermore, there are marked differences in the importance of breastfeeding during the first 11 months, with a vital protective effect during the first 4 months of life which, however, drops by the 5th month and then rises again from the beginning of the 6th to the end of the 8th month. The protective effect then drops once more, although it remains positive and statistically significant until the 11th month of life and positive, but not statistically significant, until the 18th. Conclusion: Our study has revealed that for an optimal preventive effect to be achieved, the child should be breastfed for at least the first 11 months of its life. Continuing after this for up to the 18th month shows some preventive effect, which however is not statistically significant. Our results support the hypothesis that the importance of breastfeeding varies with the development of the child, its changing environment and to the new immunological challenges this brings.