Search PubMed⌕ Search

Biomedical subjects

C Bower

Publications and source records attributed to C Bower.

102 records · Page 6Linked to original sources
PubMed1989

Screening for congenital dislocation of the hip by child-health nurses in Western Australia.

The child-health nurse screening programme for the presence of congenital dislocation of the hip in Western Australia was evaluated by the use of data that were collected as a routine from the Congenital Malformations Registry, the records of child-health nurses and the Hospital Morbidity System. The programme performed well operationally, with a sensitivity of 68.5%, a specificity of 98.8%, and a positive predictive value of 15.1%. Of the children who were born in the study period (1981-1983), 450 children were diagnosed with congenital dislocation of the hip, and 46 (10.2%) of these children required 104 hospital admissions for the treatment of their dislocation. Of the children whose hips were found to be dislocated in screening (those who were screened as "true-positive" cases), 10.1% were hospitalized, whereas 16.1% of those children who were missed by screening (who screened as "false negative") required hospitalization (95% confidence interval [CI] for the difference in proportions, -7.8% to 19.9%). A comparison of the measures of hospitalization was made between the children who were found to be "true positive" on screening and the children whose dislocation was diagnosed in the hospitals of their birth--a group that generally is considered to show the best outcome. A somewhat-higher proportion of children who were screened as "true positive" required an open surgical procedure (5.0% of children compared with 2.8% of children; 95% CI for the difference, -2.1% to 6.5%). The differences in the other measures of hospitalization between the two groups were small.

Child↗
PubMed1987

Congenital dislocation of the hip in Western Australia. A comparison of neonatally and postneonatally diagnosed cases.

Speculation that neonatally diagnosed congenital dislocation of the hip (CDH) may have a different etiology from cases diagnosed in the postneonatal period has not been examined in Australia because insufficient data have been available. A population-based study of CDH in children up to the age of two years who were born in Western Australia (WA) in 1981, 1982, or 1983 is the subject of this report. Study material comprised cases of CDH from the WA Congenital Malformations Register and denominator data (all births in WA for 1981-1983) from the Health Department of WA. From this material, rates of CDH were calculated for each of the study variables of interest. The rate of CDH was low for babies born to aboriginal mothers, and it is postulated that this may have a cultural basis, possibly in infant carrying postures. Overall, the prevalence of CDH for 1981-1983 was 6.4 cases per 1000 births, with 4.2/1000 diagnosed in the neonatal period and 2.2/1000 in the postneonatal period. Epidemiologic differences were noted between infants diagnosed in the neonatal period and those diagnosed postneonatally; rates of neonatally diagnosed CDH were higher in first births, breech presentation, and postmature infants than were rates of postneonatally diagnosed cases. Bilateral dislocation was more common (45.3%) in neonatally diagnosed cases than in postneonatally diagnosed cases (23.3%). These findings tended to support the idea that the time of diagnosis may define two distinct entities in CDH.

Adult↗
PubMed1984

Neural tube defects in Western Australia 1966-81 and a review of Australian data 1942-81.

Cases of neural tube defects born in Western Australia during the years 1966-81 were identified from hospital records and death certificates. The overall rate for the 16 year period was 1.81 cases of neural tube defects per 1000 births. The rate rose and then fell over the 16 years. The initial lower rate may have been due to underascertainment, but the recent dramatic fall is statistically significant and has been observed in other Australian states and other parts of the world. This fall was not accounted for by termination of affected pregnancies before 20 weeks' gestation nor by demographic changes in birth order, father's occupation, or parental country of birth. The birth prevalence of neural tube defects determined in previous Australian studies is reviewed in relation to the recent decline in these disorders.

Australia↗
PubMed1983

Western Australian Congenital Malformations Register.

The Western Australian Congenital Malformations Register, the first of its kind in Australia, was established in 1980, and records malformations occurring in children born on, or after, January 1, 1980. Multiple sources of notification are used, and diagnoses are validated and updated on an ongoing basis. Analysis of data from the first two years of operation showed a malformation rate of 4.3% in 1980 and of 3.8% in 1981. The labour-intensive nature of the Register ensures that the records are as complete and accurate as possible, and, therefore, form a reliable population-based data set for incidence, prevalence, and investigative studies of congenital malformations in Western Australia.

Australia↗
PubMedDate not supplied

Maternal hair zinc and neural tube defects: no evidence of an association from a case-control study in Western Australia.

In a case-control study of isolated neural tube defects in Western Australia, zinc was estimated by flame spectrophotometry in post-partum hair specimens from 54 mothers of infants with neural tube defects, and from 128 mothers of normal infants. The distribution of the estimates of zinc was divided into quartiles. Using the lowest quartile as the reference group, the crude odds ratios (and their 95% confidence intervals) for quartiles two through four were 1.07 (0.44, 2.59), 1.02 (0.41, 2.56), and 0.70 (0.28, 1.73). Adjustment for several potential confounding variables (parental country of birth, social class, previous pregnancy outcome, interval between previous and index pregnancy, pregnancy order, and interval from birth to interview) made little difference to the odds ratios. This study provides no evidence of an association between post-partum, maternal hair zinc and offspring with neural tube defects.

Case-Control Studies↗
PubMedDate not supplied

Planned homebirths in Western Australia 1981-1987: a descriptive study.

Descriptive data on all 995 singleton planned homebirths in Western Australia from 1981 to 1987, including transfers to hospital, were collected from homebirth records and other sources. Data on singleton Caucasian births in Western Australia for the same years are also presented. The proportion of homebirths rose from 3.5 per 1000 to 7.9 per 1000 singleton births over the study period. Women who had planned homebirths were predominantly Caucasian, similar in parity and marital status but taller and slightly older. They were not all at low risk as some had had complications in previous pregnancies. Transfers to hospital (antenatal, intrapartum or postpartum) occurred in 24.6% of planned homebirths, about 20% in each year transferring before delivery. The main reason for transfer was failure to progress in labour. Postpartum haemorrhage occurred in 8.5% of women, 1.9% of infants were of low birthweight and 3.2% were born before term. The perinatal mortality proportion was 10.1 per 1000 total births. Based on the results of this study homebirth practice in Western Australia appears to be characterised by appropriate diagnosis and referral of complications. As randomised controlled trials of planned home and hospital births are not possible, data such as these are important in evaluating homebirth practice and assisting in the formulation of policy.

Adult↗