Background—: Accumulating evidence demonstrates that both maternal prepregnancy body mass index (mppBMI) and gestational weight gain (GWG) are associated with adult offspring adiposity. However, whether these maternal attributes are related to other cardiometabolic risk factors in adulthood has not been comprehensively studied. Methods and Results—: We used a birth cohort of 1400 young adults born in Jerusalem who had extensive archival data and clinical information at 32 years of age to prospectively examine the associations of mppBMI and GWG with adiposity and related cardiometabolic outcomes. Greater mppBMI, independently of GWG and confounders, was significantly associated with higher offspring BMI, waist circumference, systolic and diastolic blood pressures, insulin, and triglycerides and with lower high-density lipoprotein cholesterol. For example, the effect sizes were translated to nearly 5 kg/m ² higher mean BMI, 8.4 cm higher waist circumference, 0.13 mmol/L (11.4 mg/dL) higher triglycerides, and 0.10 mmol/L (3.8 mg/dL) lower high-density lipoprotein cholesterol among offspring of mothers within the upper mppBMI quartile (mppBMI >26.4 kg/m ² ) compared with the lower quartile (mppBMI 14 kg) and lower (GWG <9 kg) quartiles of GWG were compared. Further adjustment for offspring adiposity attenuated the observed associations to the null. Conclusions—: Maternal size both before and during pregnancy is associated with cardiometabolic risk factors in young adult offspring. The associations appear to be driven mainly by offspring adiposity. Future studies that explore mechanisms underlying the intergenerational cycle of obesity are warranted to identify potentially novel targets for cardiometabolic risk-reduction interventions.

Background: TBI may be defined by different methods. Some may be most useful for immediate clinical purposes, however less optimal for epidemiologic research. Other methods, such as the Abbreviated Injury Score (AIS), may prove more beneficial for this task, if the cut-off-points for their categories are defined correctly. Objective: To reveal the optimal cut-off-points for AIS in definition of severity of TBI in order to ensure uniformity between future studies of TBI. Results: Mortality of patients with TBI AIS 3, 4 was 1.9% and 2.9% respectively, comparing with 31.1% among TBI AIS 5+. Predictive discrimination ability of the model with cut-off-points of 5+ for TBI AIS (in comparison with other cut-off-points) was better. Patients with missing Glasgow Coma Scale (GCS) in the ED had an in-hospital mortality rate of 11.5%. In this group, 25% had critical TBI according to AIS. Normal GCS didn’t indicate an absence of head injury, as, among patients with GCS 15 in the ED, 26% had serious/critical TBI injury. Moreover, 7% of patients with multiple injury and GCS 3–8 had another reason than head injury for unconsciousness. Conclusions: This study recommends the adoption of an AIS cut-off ≥ 5 as a valid definition of severe TBI in epidemiological studies, while AIS 3–4 may be defined as ‘moderate’ TBI and AIS 1–2 as ‘mild’.

Background: The chest cage is a common target for traumatic damage. Although relatively rare, it is considered to be a serious condition with significant reported mortalities. As most flail injuries are accompanied by severe extrathoracic injuries, it is often difficult to pinpoint a single injury responsible for the patient’s death. Aim: To investigate the factors related to mortality when flail injury is diagnosed. Methods: Data from the Israel National Trauma Registry between 1998 and 2003 included 11 966 chest injuries (262 flail chest injuries) out of a total of 118 211 trauma hospitalisations. Mortality figures were analysed to determine which factors, singly or in combination, influenced flail chest mortality. Results: Road crashes accounted for most flail injuries (76%). The total mortality was 54 (20.6%) of 262 patients with flail chest injuries. 13 (20.4%) of the deaths occurred soon after admission to the emergency room and 37 (68.5%) within the first 24 h. Mortality in moderate to severe injuries (injury severity score (ISS) 9–24) was 3.6% and that in critical injuries 28.5% (ISS >24). Mortality increased with age: 17% in those aged 65 years. Age remained a risk for inpatient death when adjusted for severity. Mortality in isolated unilateral flail injury was not more than 6%. Total mortality for traumatic brain injury (TBI) and flail was 34%. Flail, TBI and other major injuries increased the mortality to 61.1%. Conclusions: Advanced age is associated with higher mortality. Isolated unilateral bony cage instability infrequently leads to death in patients who make it to the emergency department but rather its combination with additional extrathoracic trauma.