human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Parental smoking during pregnancy is associated with lower birthweight and gestational age , as well as with the risks of low birthweight ( LBW ) and preterm birth . The present study aims to assess the association of  parental smoking during pregnancy with birth outcomes in urban and rural areas . Methods This was a secondary analysis of data collected in the Indonesia Family Life Survey , between 1993 and 2007 , the first national prospect i ve longitudinal cohort study in Indonesia . Retrospective data of parental smoking habits , socioeconomic status , pregnancy history and birth outcomes were collected from parents with children aged 0 to 5 years ( n = 3789 ) . We assessed the relationships between the amount of  parental smoking during pregnancy with birthweight ( LBW ) and with gestational age ( preterm birth ) . Results We found a significant reduction in birthweight to be associated with maternal smoking . Smoking ( except for paternal smoking ) was associated with a decrease in the gestational age and an increased risk of preterm birth . Different associations were found in urban area , infants born to smoking fathers and both smoking parents ( > 20 cigarettes/day for both cases ) had a significant reduction in birthweight and gestational age as well as an increased risk of LBW and preterm birth . Conclusions Residence was found to be an effect modifier of the relation between parental smoking during pregnancy , amount of parental smoking , and birth outcomes on their children . Smoking cessation/reduction and smoking intervention program should be advised and prioritized to the area that is more prone to the adverse birth outcomes Objective As part of a larger case – control study , the authors evaluated risk of  childhood leukemia  relative to parental self-reported smoking and alcohol consumption . Methods Children 0–14 years of age diagnosed with leukemia between 1990 and 1994 were ascertained through population -based sources at the time of diagnosis . For each participating case , an age , gender , and area-matched control was r and omly selected from provincial government health insurance rolls . Risk factor information was obtained through personal interviews with each child ’s parents . Conditional logistic regression models were used to examine risk of leukemia associated with parental smoking and drinking . Results Maternal alcohol consumption prior to conception ( OR = 1.37 , 95 % CI , 0.99–1.90 ) and during pregnancy ( OR = 1.39 , 95 % CI , 1.01–1.93 ) was associated with an excess risk of childhood leukemia , with a positive dose-response trend for increasing weekly consumption ( p < 0.05 ) . Similar results were observed for children diagnosed with acute lymphoblastic leukemia  ( ALL ) . Odds ratios for maternal cigarette smoking before and during pregnancy were consistently elevated above one , but not statistically significant . No relationship was observed with paternal drinking or smoking in the perinatal period . Conclusions Our study suggests that maternal alcohol drinking before or during pregnancy may contribute to an increased risk of childhood leukemia This study examined the association between  paternal age  and a wide range of structural birth defects . Data were drawn from The California Birth Defects Monitoring Program , a population -based active surveillance system for collecting information on infants and fetuses with defects born between 1989 and 2002 . The analysis included 46,114 cases with defects , plus a r and om sample of 36,838 non-malformed births . After adjustment for maternal age , risks of anomalies of the nervous system for 38 and 42 year-old fathers , as compared to 29 year-old fathers , were 1.05-fold [ 1.00 , 1.11 ] and 1.10-fold [ 1.02 , 1.18 ] higher , respectively . Similar results were observed for anomalies of the limbs , where 38 and 42 year-old fathers had a 1.06-fold [ 1.02 , 1.11 ] and 1.11-fold [ 1.05 , 1.18 ] higher risk , respectively . Risks of anomalies of the integument were 1.05-fold [ 1.00 , 1.09 ] and 1.10-fold [ 1.03 , 1.16 ] higher for 38 and 42 year olds , respectively . Young paternal age , i.e. , less than 29 years , was associated with an increased risk of amniotic b and s ( OR : 0.87 [ 0.78 , 0.97 ] ) , pyloric stenosis ( OR : 0.93 [ 0.90 , 0.96 ] ) and anomalies of the great veins ( OR : 0.93 [ 0.87 , 1.00 ] ) . In sum , both advanced and young paternal age was associated with select birth defects in California between 1989 and 2002 We conducted a matched case-control study to investigate risk factors for the two most common types of brain tumors in children , astrocytic glioma and primitive neuroectodermal tumor ( PNET ) . Since the study focused on gestational exposures , we restricted it to young children because these exposures would be expected to act early in life . Parents of 155 astrocytic glioma cases , 166 PNET cases , and controls identified by r and om digit dialing completed telephone interviews . Few associations occurred with the hypothesized risk factors , which were gestational exposure to alcohol , hair coloring products , farms , and substances containing N-nitroso compounds ( passive smoking , makeup , incense , new cars , pacifiers , baby bottles , beer ) . Of the products studied that contain N-nitroso compounds , only beer was associated with a significantly increased risk of either tumor type [ odds ratio ( OR ) for PNET = 4.0 ; 95 % confidence interval ( CI ) , 1.1 - 22.1 ; P = 0.04 ] . Elevated ORs for PNET were observed for farm residence of the mother during the pregnancy ( OR = 3.7 ; 95 % CI , 0.8 - 23.9 ; P = 0.06 ) and of the child for at least a year ( OR = 5.0 ; 95 % CI , 1.1 - 46.8 ; P = 0.04 ) . Significant associations with astrocytoma were observed for mother 's use of kerosene ( OR = 8.9 ; 95 % CI , 1.1 - 71.1 ; P = 0.04 ) and birth by Caesarean section ( OR = 1.8 ; 95 % CI , 1.1 - 3.2 ; P = 0.03 ) . History of miscarriage was associated with a lower risk of PNET ( OR = 0.5 ; 95 % CI , 0.3 - 0.9 ; P = 0.02 ) . ( ABSTRACT TRUNCATED AT 250 WORDS Maternal smoking during pregnancy is associated with  attention deficit hyperactivity disorder ( ADHD ) in offspring . It is assumed by many that this association is causal . Others suggest that observed associations are due to unmeasured genetic factors or other confounding factors . The authors compared risks of maternal smoking during pregnancy with those of paternal smoking during pregnancy . With a causal intrauterine effect , no independent association should be observed between paternal smoking and offspring ADHD . If the association is due to confounding factors , risks of offspring ADHD should be of similar magnitudes regardless of which parent smokes . This hypothesis was tested in 8,324 children from a well-characterized United Kingdom prospect i ve cohort study , the Avon Longitudinal Study of Parents and Children ( data from 1991–2000 ) . Associations between offspring ADHD and maternal  and paternal smoking during pregnancy were compared using regression analyses . Offspring ADHD symptoms were associated with exposure to both maternal and paternal smoking during pregnancy ( mothers : β = 0.25 , 95 % confidence interval : 0.18 , 0.32 ; fathers : β = 0.21 , 95 % confidence interval : 0.15 , 0.27 ) . When  paternal smoking  was examined in the absence of maternal smoking , associations remained and did not appear to be due to passive smoking exposure in utero . These findings suggest that associations between maternal smoking during pregnancy and child ADHD may be due to genetic or household-level confounding rather than to causal intrauterine effects OBJECTIVE : To explore associations of  maternal prenatal smoking and child psychological problems and determine the role of causal intrauterine mechanisms . PATIENTS AND METHODS :  Maternal smoking and child psychological problems were explored in 2 birth cohorts in Pelotas , Brazil ( n = 509 , r and om sub sample ) , and the Avon Longitudinal Study of Parents and Children ( ALSPAC ) in Britain ( n = 6735 ) . Four approaches for exploring causal mechanisms were applied : ( 1 ) cross- population comparisons between a high-income and a middle-income country ; ( 2 ) multiple adjustment for socioeconomic and parental psychological factors ; ( 3 ) maternal-paternal comparisons as a test of putative intrauterine effects ; and ( 4 ) search ing for specific effects on different behavioral subscales . RESULTS : Socioeconomic patterning of maternal prenatal smoking was stronger in the ALSPAC compared with the Pelotas cohort . Despite this difference in a key confounder , consistency in observed associations was found between these cohorts . In both cohorts , unadjusted maternal smoking was associated with greater offspring hyperactivity , conduct/externalizing problems , and peer problems but not with emotional/internalizing problems . After adjusting for confounders and paternal prenatal smoking , only the association with conduct/externalizing problems persisted in both cohorts ( conduct problems in the ALSPAC cohort , odds ratio [ OR ] : 1.24 [ 95 % confidence interval ( CI ) : 1.07–1.46 ] , P = .005 ; externalizing problems in the Pelotas cohort , OR : 1.82 [ 95 % CI : 1.19–2.78 ] , P = .005 ; ORs reflect ordinal odds ratios of maternal smokers having offspring with higher scores ) . Maternal smoking associations were stronger than paternal smoking associations , although statistical evidence that these associations differed was weak in 1 cohort . CONCLUSION : Evidence from 4 approaches suggests a possible intrauterine effect of maternal smoking on offspring conduct/externalizing problems Background : Overweight has its origins largely in early life . We aim ed to identify the most important parental , fetal , and infant risk factors of preschool overweight . Methods : In a prospect i ve cohort study , among 3,610 Caucasian preschool children , we assessed the associations of 34 putative parental , fetal , and infant factors with overweight risk . Results : Higher maternal BMI , paternal BMI , and birth weight were associated with higher risk of preschool overweight ( odds ratio ( OR ) : 1.23 , 95 % confidence interval ( CI ) : 1.10 , 1.39 ; OR : 1.35 , 95 % CI : 1.19 , 1.53 ; and OR : 2.71 , 95 % CI : 2.27 , 3.25 , respectively , per SD increase ) . The same model identified low household income ( OR : 1.74 , 95 % CI : 1.24 , 2.45 ) , being female ( OR : 1.55 , 95 % CI : 1.20 , 2.01 ) , and experiencing third-trimester accelerated growth ( OR : 1.73 , 95 % CI : 1.24 , 2.40 ) or postnatal accelerated growth ( OR : 6.39 , 95 % CI : 4.54 , 8.99 ) as risk factors for preschool overweight . Higher polyunsaturated fat intake at 14 mo was associated with a lower risk of preschool overweight ( OR : 0.77 , 95 % CI : 0.62 , 0.96 per SD ) . Conclusion : Parental anthropometrics and household income , fetal and infant accelerated growth , and infant dietary fat intake are the major risk factors for the development of preschool overweight . Further studies need to explore whether these risk factors could be potential targets for preventive interventions We investigated prospect ively documented parental age and bipolar disorder ( BD ) in a multi-ethnic birth cohort . The study was based on a nested case-control design from the Child Health and Development Study ( CHDS ) birth cohort from 1959 to 1966 . Potential cases with BD were ascertained by data base linkages between CHDS , Kaiser Permanente Medical Care Plan ( KPNC ) , and Alameda County Behavioral Health Care Services , and mailed question naires . Consensus diagnoses with the SCID for DSM-IV-TR were made . The total number of BD cases was 94 . Controls ( N=746 ) were selected from the birth cohort and matched on date of birth , sex , and KPNC membership or residence in Alameda County . For every 10-year increment of paternal age , there was no significant association with BD , adjusting for maternal age . There was also no significant association between maternal age , modeled in 10-year increments , and risk of BD after adjustment for paternal age and maternal race , although there was a suggestion for a protective relationship between increasing maternal age and BD with psychotic features . These findings suggest that if advanced paternal age is a risk factor for BD , the strength of the relationship is small Sporadic neurofibromatosis 1 ( NF1 ) occurs in the absence of a family history 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Parental smoking during pregnancy is associated with lower birthweight and gestational age , as well as with the risks of low birthweight ( LBW ) and preterm birth . The present study aims to assess the association of  parental smoking during pregnancy with birth outcomes in urban and rural areas . Methods This was a secondary analysis of data collected in the Indonesia Family Life Survey , between 1993 and 2007 , the first national prospect i ve longitudinal cohort study in Indonesia . Retrospective data of parental smoking habits , socioeconomic status , pregnancy history and birth outcomes were collected from parents with children aged 0 to 5 years ( n = 3789 ) . We assessed the relationships between the amount of  parental smoking during pregnancy with birthweight ( LBW ) and with gestational age ( preterm birth ) . Results We found a significant reduction in birthweight to be associated with maternal smoking . Smoking ( except for paternal smoking ) was associated with a decrease in the gestational age and an increased risk of preterm birth . Different associations were found in urban area , infants born to smoking fathers and both smoking parents ( > 20 cigarettes/day for both cases ) had a significant reduction in birthweight and gestational age as well as an increased risk of LBW and preterm birth . Conclusions Residence was found to be an effect modifier of the relation between parental smoking during pregnancy , amount of parental smoking , and birth outcomes on their children . Smoking cessation/reduction and smoking intervention program should be advised and prioritized to the area that is more prone to the adverse birth outcomes Objective As part of a larger case – control study , the authors evaluated risk of  childhood leukemia  relative to parental self-reported smoking and alcohol consumption . Methods Children 0–14 years of age diagnosed with leukemia between 1990 and 1994 were ascertained through population -based sources at the time of diagnosis . For each participating case , an age , gender , and area-matched control was r and omly selected from provincial government health insurance rolls . Risk factor information was obtained through personal interviews with each child ’s parents . Conditional logistic regression models were used to examine risk of leukemia associated with parental smoking and drinking . Results Maternal alcohol consumption prior to conception ( OR = 1.37 , 95 % CI , 0.99–1.90 ) and during pregnancy ( OR = 1.39 , 95 % CI , 1.01–1.93 ) was associated with an excess risk of childhood leukemia , with a positive dose-response trend for increasing weekly consumption ( p < 0.05 ) . Similar results were observed for children diagnosed with acute lymphoblastic leukemia  ( ALL ) . Odds ratios for maternal cigarette smoking before and during pregnancy were consistently elevated above one , but not statistically significant . No relationship was observed with paternal drinking or smoking in the perinatal period . Conclusions Our study suggests that maternal alcohol drinking before or during pregnancy may contribute to an increased risk of childhood leukemia This study examined the association between  paternal age  and a wide range of structural birth defects . Data were drawn from The California Birth Defects Monitoring Program , a population -based active surveillance system for collecting information on infants and fetuses with defects born between 1989 and 2002 . The analysis included 46,114 cases with defects , plus a r and om sample of 36,838 non-malformed births . After adjustment for maternal age , risks of anomalies of the nervous system for 38 and 42 year-old fathers , as compared to 29 year-old fathers , were 1.05-fold [ 1.00 , 1.11 ] and 1.10-fold [ 1.02 , 1.18 ] higher , respectively . Similar results were observed for anomalies of the limbs , where 38 and 42 year-old fathers had a 1.06-fold [ 1.02 , 1.11 ] and 1.11-fold [ 1.05 , 1.18 ] higher risk , respectively . Risks of anomalies of the integument were 1.05-fold [ 1.00 , 1.09 ] and 1.10-fold [ 1.03 , 1.16 ] higher for 38 and 42 year olds , respectively . Young paternal age , i.e. , less than 29 years , was associated with an increased risk of amniotic b and s ( OR : 0.87 [ 0.78 , 0.97 ] ) , pyloric stenosis ( OR : 0.93 [ 0.90 , 0.96 ] ) and anomalies of the great veins ( OR : 0.93 [ 0.87 , 1.00 ] ) . In sum , both advanced and young paternal age was associated with select birth defects in California between 1989 and 2002 We conducted a matched case-control study to investigate risk factors for the two most common types of brain tumors in children , astrocytic glioma and primitive neuroectodermal tumor ( PNET ) . Since the study focused on gestational exposures , we restricted it to young children because these exposures would be expected to act early in life . Parents of 155 astrocytic glioma cases , 166 PNET cases , and controls identified by r and om digit dialing completed telephone interviews . Few associations occurred with the hypothesized risk factors , which were gestational exposure to alcohol , hair coloring products , farms , and substances containing N-nitroso compounds ( passive smoking , makeup , incense , new cars , pacifiers , baby bottles , beer ) . Of the products studied that contain N-nitroso compounds , only beer was associated with a significantly increased risk of either tumor type [ odds ratio ( OR ) for PNET = 4.0 ; 95 % confidence interval ( CI ) , 1.1 - 22.1 ; P = 0.04 ] . Elevated ORs for PNET were observed for farm residence of the mother during the pregnancy ( OR = 3.7 ; 95 % CI , 0.8 - 23.9 ; P = 0.06 ) and of the child for at least a year ( OR = 5.0 ; 95 % CI , 1.1 - 46.8 ; P = 0.04 ) . Significant associations with astrocytoma were observed for mother 's use of kerosene ( OR = 8.9 ; 95 % CI , 1.1 - 71.1 ; P = 0.04 ) and birth by Caesarean section ( OR = 1.8 ; 95 % CI , 1.1 - 3.2 ; P = 0.03 ) . History of miscarriage was associated with a lower risk of PNET ( OR = 0.5 ; 95 % CI , 0.3 - 0.9 ; P = 0.02 ) . ( ABSTRACT TRUNCATED AT 250 WORDS Maternal smoking during pregnancy is associated with  attention deficit hyperactivity disorder ( ADHD ) in offspring . It is assumed by many that this association is causal . Others suggest that observed associations are due to unmeasured genetic factors or other confounding factors . The authors compared risks of maternal smoking during pregnancy with those of paternal smoking during pregnancy . With a causal intrauterine effect , no independent association should be observed between paternal smoking and offspring ADHD . If the association is due to confounding factors , risks of offspring ADHD should be of similar magnitudes regardless of which parent smokes . This hypothesis was tested in 8,324 children from a well-characterized United Kingdom prospect i ve cohort study , the Avon Longitudinal Study of Parents and Children ( data from 1991–2000 ) . Associations between offspring ADHD and maternal  and paternal smoking during pregnancy were compared using regression analyses . Offspring ADHD symptoms were associated with exposure to both maternal and paternal smoking during pregnancy ( mothers : β = 0.25 , 95 % confidence interval : 0.18 , 0.32 ; fathers : β = 0.21 , 95 % confidence interval : 0.15 , 0.27 ) . When  paternal smoking  was examined in the absence of maternal smoking , associations remained and did not appear to be due to passive smoking exposure in utero . These findings suggest that associations between maternal smoking during pregnancy and child ADHD may be due to genetic or household-level confounding rather than to causal intrauterine effects OBJECTIVE : To explore associations of  maternal prenatal smoking and child psychological problems and determine the role of causal intrauterine mechanisms . PATIENTS AND METHODS :  Maternal smoking and child psychological problems were explored in 2 birth cohorts in Pelotas , Brazil ( n = 509 , r and om sub sample ) , and the Avon Longitudinal Study of Parents and Children ( ALSPAC ) in Britain ( n = 6735 ) . Four approaches for exploring causal mechanisms were applied : ( 1 ) cross- population comparisons between a high-income and a middle-income country ; ( 2 ) multiple adjustment for socioeconomic and parental psychological factors ; ( 3 ) maternal-paternal comparisons as a test of putative intrauterine effects ; and ( 4 ) search ing for specific effects on different behavioral subscales . RESULTS : Socioeconomic patterning of maternal prenatal smoking was stronger in the ALSPAC compared with the Pelotas cohort . Despite this difference in a key confounder , consistency in observed associations was found between these cohorts . In both cohorts , unadjusted maternal smoking was associated with greater offspring hyperactivity , conduct/externalizing problems , and peer problems but not with emotional/internalizing problems . After adjusting for confounders and paternal prenatal smoking , only the association with conduct/externalizing problems persisted in both cohorts ( conduct problems in the ALSPAC cohort , odds ratio [ OR ] : 1.24 [ 95 % confidence interval ( CI ) : 1.07–1.46 ] , P = .005 ; externalizing problems in the Pelotas cohort , OR : 1.82 [ 95 % CI : 1.19–2.78 ] , P = .005 ; ORs reflect ordinal odds ratios of maternal smokers having offspring with higher scores ) . Maternal smoking associations were stronger than paternal smoking associations , although statistical evidence that these associations differed was weak in 1 cohort . CONCLUSION : Evidence from 4 approaches suggests a possible intrauterine effect of maternal smoking on offspring conduct/externalizing problems Background : Overweight has its origins largely in early life . We aim ed to identify the most important parental , fetal , and infant risk factors of preschool overweight . Methods : In a prospect i ve cohort study , among 3,610 Caucasian preschool children , we assessed the associations of 34 putative parental , fetal , and infant factors with overweight risk . Results : Higher maternal BMI , paternal BMI , and birth weight were associated with higher risk of preschool overweight ( odds ratio ( OR ) : 1.23 , 95 % confidence interval ( CI ) : 1.10 , 1.39 ; OR : 1.35 , 95 % CI : 1.19 , 1.53 ; and OR : 2.71 , 95 % CI : 2.27 , 3.25 , respectively , per SD increase ) . The same model identified low household income ( OR : 1.74 , 95 % CI : 1.24 , 2.45 ) , being female ( OR : 1.55 , 95 % CI : 1.20 , 2.01 ) , and experiencing third-trimester accelerated growth ( OR : 1.73 , 95 % CI : 1.24 , 2.40 ) or postnatal accelerated growth ( OR : 6.39 , 95 % CI : 4.54 , 8.99 ) as risk factors for preschool overweight . Higher polyunsaturated fat intake at 14 mo was associated with a lower risk of preschool overweight ( OR : 0.77 , 95 % CI : 0.62 , 0.96 per SD ) . Conclusion : Parental anthropometrics and household income , fetal and infant accelerated growth , and infant dietary fat intake are the major risk factors for the development of preschool overweight . Further studies need to explore whether these risk factors could be potential targets for preventive interventions We investigated prospect ively documented parental age and bipolar disorder ( BD ) in a multi-ethnic birth cohort . The study was based on a nested case-control design from the Child Health and Development Study ( CHDS ) birth cohort from 1959 to 1966 . Potential cases with BD were ascertained by data base linkages between CHDS , Kaiser Permanente Medical Care Plan ( KPNC ) , and Alameda County Behavioral Health Care Services , and mailed question naires . Consensus diagnoses with the SCID for DSM-IV-TR were made . The total number of BD cases was 94 . Controls ( N=746 ) were selected from the birth cohort and matched on date of birth , sex , and KPNC membership or residence in Alameda County . For every 10-year increment of paternal age , there was no significant association with BD , adjusting for maternal age . There was also no significant association between maternal age , modeled in 10-year increments , and risk of BD after adjustment for paternal age and maternal race , although there was a suggestion for a protective relationship between increasing maternal age and BD with psychotic features . These findings suggest that if advanced paternal age is a risk factor for BD , the strength of the relationship is small Sporadic neurofibromatosis 1 ( NF1 ) occurs in the absence of a family history 
    Output:
    