Biomedical subjects
B Borman
Publications and source records attributed to B Borman.
Risk factors for low birthweight in New Zealand, 1981-83.
This paper describes the patterns of risk factors for low birthweight in a cohort of New Zealand births. The trend of low birthweight with maternal age and parity was U-shaped. Maori mothers had the highest (79.38/1000 livebirths) and Pacific Island mothers the lowest (39.88/1000), rates of low birthweight infants. There was an indication that the risk for Pacific Island mothers was modified by the mother's place of birth. Compared to nonMaori nonPacific Island New Zealand born women, the risk was high for Pacific Island New Zealand born women (RR = 1.27, 95% CI 1.04-1.56), but low for nonNew Zealand born Pacific Island mothers (RR = 0.70, 95% CI 0.61-0.79). The risk for Maori mothers increased if the father was also of Maori ethnic origin. The risk of a low birthweight infant increased (p less than 0.001) with social class, and the rate was high among exnuptial births (75.25/1000 live births). The rates of low birthweight for nonMaori and Pacific Island births in the South Island were similar to those in the North Island, but among Maori births the rate in the South Island (RR = 0.64, 95% CI 0.51-0.82) was lower than in the North Island.
Fallacies of international and national comparisons of disease occurrence in the epidemiology of neural tube defects.
Despite extensive research, little progress has been made in elucidating the etiologies of anencephalus and spina bifida. International and national distributions of disease occurrence have often been used as a basis for generating etiological hypotheses (e.g., potato blight, tea consumption, and zinc deficiency hypotheses). However, few of the epidemiological studies of neural tube defects (NTDs) have been conducted with scientific rigor in design, and most are of dubious validity, often with low precision in the estimates. This paper shows that the accepted geographic patterns of NTDs may be attributable to variations in the validity of studies used to describe these patterns. The nonuniformity in the duration and diligence of case ascertainment, the lack of a standardized nomenclature and classification, and the definition of the denominator remain principal problems in evaluating the epidemiology of NTDs. For example, the distinction between incidence and prevalence is not always made, and there is no consistency in the placement of the gestational boundary between late fetal deaths and spontaneous abortions. Findings are compared from studies conducted at different times, without due regard to the effect of secular trends, and using studies that have varying levels of case ascertainment. In etiological research, it is important to perform studies that are accurate and precise, but the literature used to define the spatial distribution of NTDs has often been accepted without due regard to the effect of these factors.
Maori and nonMaori postneonatal mortality rates by domicile.
The urbanisation of Maori with the possible loss of family and cultural ties may in part account for the higher Maori postneonatal mortality rate compared with nonMaori. To examine this hypothesis rural and urban postneonatal mortality rates by region and ethnic group were compared. In the North Island regions there was no significant difference between the urban and rural rates of either ethnic group. In the South Island the rate for Maori in the rural areas (7.51/1000 live births) was lower (RR = 0.45, 95%CI = 0.17-1.17) than in the urban areas (16.83/1000).
Caesarean section: a national study.
Although the use of caesarean section (CS) continues to be debated, the demographic characteristics of the affected population have received little attention. This paper shows that in New Zealand during 1983-84, a CS was performed on 9.6% of delivered women between the ages of 15-44. The rate increased with maternal age (p less than 0.01), and was highest for 'single' women (11.3/100) and Pacific Island women aged 35-44 (21/100). There was a significantly (p less than 0.05) high rate in the Auckland and South Otago hospital board districts, but a low rate (p less than 0.05) in the Ashburton, Nelson, Canterbury, Southland, Taumaranui, Waiapu, Wairarapa, Wanganui, and Wellington board districts. The rate was also high (p less than 0.01) in the principal teaching hospitals. Long labour (15.2%), malposition and malpresentation of the fetus (14.7%) were the leading reasons for performing a CS. The paucity of national data on a number of other highly relevant birth and maternal factors hinders the further definition of the epidemiological patterns of CS in New Zealand.
A national study of sudden infant death syndrome in New Zealand.
Although the sudden infant death syndrome is a major component of New Zealand's high postneonatal mortality rate, little is known about its national epidemiological patterns. In this paper, based on all cases born during 1981-83, the rate of sudden infant death syndrome was 4.2/1000 livebirths. The rate declined with maternal age, birthweight, and length of gestation, but increased with parity and Registrar-General's social class. Exnuptial and male births were also at high risk, as were births to Maori and New Zealand born mothers. There was a significant seasonal pattern and a distinct north-south gradient. The rate of sudden infant death syndrome in the south of the South Island was almost twice that in the north of the North Island. These patterns are, however, similar to those of the other preventable causes of postneonatal mortality. Future research into New Zealand's postneonatal mortality needs to consider all the possible preventable causes of mortality during this period of an infant's life, rather than concentrating on only one group of at-risk infants.
Using a national register for the epidemiological study of congenital heart defects.
Data validity is a fundamental problem in epidemiology. An objective of birth defect registers is the collection of high quality data, often from a number of sources, for use in epidemiological research. This paper examines the use of data from a national register in New Zealand in the study of congenital heart defects. The prevalence rates of congenital heart defects are shown to depend on the definition of the terms employed, the methods and completeness of the case ascertainment, the correctness of the diagnoses, the nature and size of the population under study, and the duration of followup. Recommendations are made for increasing the utility of this register in the study of this major group of malformations.
Sports injuries in New Zealand.
A study of 5108 patients admitted to public hospitals with sports injuries was undertaken for the years 1981-82. Winter sports caused 80% of the injuries, with 58.1% of the cases having been involved in either rugby union or league. Almost 40% of all the injuries were to the head, and fractures were the most common type of injury. Sports-specific injury patterns were found.
Demographic characteristics of asthma admissions to hospitals.
The age, sex, race, domicile and geographic distribution of patients admitted to hospital for asthma in New Zealand in 1981 were studied. The 0-14 year age group had a higher admission rate than the older age group. Males were admitted more frequently than females in the youngest and eldest age groups, but the converse was found in the 15-64 year age group. The Polynesian admission rates were more than double those of Europeans in all age groups. The effect of urban or rural domicile on asthma admission rates is age dependent. Urban dwellers under 25 years of age have higher admission rates than those with rural domiciles, however, in those over 45 there is a higher admission rate from rural areas than from urban areas. There was a highly significant difference in the admission rates between hospital boards (p = 0.003). For hospital boards serving populations of 50,000 or more there was a 9 fold difference between the highest (Hawkes Bay) and lowest (Nelson) admission rates. The geographical distribution of asthma admission rates show distinct areas with high (south of the North Island) and low (Auckland and Waikato) rates. The national admission rates almost doubled between 1976 and 1981 and the spatial pattern of admission rates was similar in these two years (r = 0.627 p less than 0.001). This indicates that the increase in admissions occurred uniformly throughout the country.
Lung cancer in New Zealand women.
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Pedal cycle accidents.
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National data tests a cancer risk hypothesis.
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The epidemiological study of birth defects.
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Medical geography and the aetiology of the rare connective tissue diseases in New Zealand.
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Diabetes mellitus morbidity in New Zealand: a geographic perspective.
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