1. Author:Frandes Vlad Coordinators:Pascanu Ionela Pop Raluca Co-authors:Andrei Ioana Otvos-Moldovan Andrada Tanase Elena

2. Factors interacting with child development Breastfeeding period Gestational age Birth weight

3. Benefits: The main source of nutrition[2,4,5] Immune function and protection for diseases[3,4,5] Prevent the obesity [1] baby Physical and mental development[4,5] Uterine shrinkage Decrease the risk of: Breast cancer Osteoporosis mother[5] Depression Protection for metabolic syndrome

4. The preterm babies have a higher risk of: Lung function abnormalities[ 8,9 ] Cognitive deficit[ 8,9 ] Metabolic disorders[ 7 ] Cardiovascular or renal diseases[ 8,9 ] Higher blood pressure[ 9 ] Infectious diseases[ 6,8,9 ] infant mortality and morbidity[ 6 ]

5. The purpose of the study is the evaluation of various factors considered having an influence on normal development 5

6. Type of study: cross-sectional Target population: children 6-14 years of age Sample: Randomized-1168 children from 8 schools in Mures County wich were included in function of their ages The study was approved by Ethics Comitee of UMF Tg-Mures A signed consent was obtained from the legal representant of each subject 6

7. Variables analyzed: 1. Age 2. Sex 3. Environment 4. Age at menarche 5. Tanner stage 6. Gestational age 7. Breastfeeding period 8. Birth weight 9. Medical history

8. Method: Questionnaire for medical and perinatal history Clinical evaluation of pubertal status For statistical analysis M.O Excel

9. Results 1 Figure nr. 1-Sex and environment ratio 9

10. Results 2 Figure nr. 2 –Age repartition 10

11. Results 3 Figure nr.3-The onset of puberty 11

12. Results 4 Figure nr. 4-Breastfeeding period 12

13. Results 5 Figure nr. 5-Birth weight 13

14. Results 5 Figure nr. 6-Gestational age 14

15. Results 6 Figure nr. 7-Medical history 15

16.  Epidemiological evaluation of factors influencing growth should be an important public health issue  Breastfeeding according to WHO recommendation is still a problem in Romania – higher percentage than previously reported.  The secular trend in pubertal development shows earlier onset, but not for Romania, apparently.  Low birth weight had about the same incidence in Romania 10 years ago.

17. 1.There is an improvement in the percentage of children breastfed according to WHO recommendations. 2.The incidence of low birth weight is about the same as the last evaluation available from the WHO. 3.The age of onset of puberty has not lowered in our country, compared to the global tendency.

18. [1]Janet M. Wojcicki, Ph.D., M.P.H., and Melvin B. Heyman, M.D., M.P.H:”Let's Move — Childhood Obesity Prevention from Pregnancy and Infancy Onward “-N Engl J Med 2010 [2] Caroline J. Chantry, M.D., FABM,Anne Eglash, M.D., FABM,Miriam Labbok, M.D., MPH, FABM: “ABM Statements-Position on Breastfeeding”-BREASTFEEDING MEDICINE Volume 3, Number 4, 2008 [3] 1. Black, R.E. et al., ‘Maternal and Child Undernutrition: Global and regional exposures and health consequences’, The Lancet, vol. 371, no. 9608, 2008, pp. 243-260 [4] http://www.childinfo.org [5] http://www.babycenter.com/0_how-breastfeeding-benefits-you-and-your- baby_8910.bc?showAll=truehttp://www.babycenter.com/0_how-breastfeeding-benefits-you-and-your- baby_8910.bc?showAll=true [6] Pamela J. Surkan, M.S., Olof Stephansson, M.D., Ph.D., Paul W. Dickman, Ph.D., and Sven Cnattingius, M.D., Ph.D:” Previous Preterm and Small-for-Gestational-Age Births and the Subsequent Risk of Stillbirth”-N Engl J Med 2004 [7] Paul L. Hofman, M.B., Ch.B., Fiona Regan, M.B., B.S., Wendy E. Jackson, M.B., Ch.B:” Premature Birth and Later Insulin Resistance”-N Engl J Med 2004; [8] Mark A. Sperling, M.D.:” Prematurity — A Window of Opportunity?”-N Engl J Med 2004 [9] Julie R. Ingelfinger, M.D.:”Prematurity and the Legacy of Intrauterine Stress”-N Engl J Med 2007

19. Thank you! 19