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Biomedical subjects

F J Stanley

Publications and source records attributed to F J Stanley.

At least 91 records · Page 5Linked to original sources
PubMed1988

The cerebral palsies in Western Australia: trends, 1968 to 1981.

Data were analyzed from all cases of cerebral palsy in a population-based register in Western Australia. The number of cases of cerebral palsy diagnosed by age 5 years varied little among cohorts of infants born between 1960 and 1982. Trends toward more intensive perinatal care, increasing frequency of cesarean section, and the increased use of electronic fetal monitoring to detect fetal distress were associated with decreases in perinatal mortality but not in cerebral palsy. The increase in survival of low birth weight infants has resulted in an increased number of children with cerebral palsy, but this has had a minimal impact on total cerebral palsy rates. These descriptive trends raise doubts about the relationship between cerebral palsy and perinatal events, the effects of obstetric and neonatal interventions in reducing cerebral palsy, and the use of cerebral palsy data as an index of perinatal care practices.

Birth Weight↗
PubMed1988

Intrapartum asphyxia: a rare cause of cerebral palsy.

Data on all children with spastic cerebral palsy (N = 183) and on a matched group of control children (N = 549) born in Western Australia between 1975 and 1980 were compared to investigate the relationship between birth asphyxia and spastic cerebral palsy. Information on perinatal events for both the children with cerebral palsy and the control subjects was collected by means of epidemiologic methods to reduce bias. An association between clinically observed perinatal signs of birth asphyxia and spastic cerebral palsy was found (relative risk 2.84; 95% confidence interval 1.85 to 4.37). The population-attributable risk proportion was 14.1%. The likelihood of birth asphyxia's causing perinatal brain damage was assessed by two independent observers using defined criteria. It was estimated that in only about 8% (15/183) of all the children with spastic cerebral palsy was intrapartum asphyxia the possible cause of their brain damage. The contribution of intrapartum events and obstetric mismanagement to overall cerebral palsy rates is probably less than was previously thought.

Apgar Score↗
PubMed1988

Hidden handicap in school-age children who received neonatal intensive care.

A group of 347 children who had been classed as 'at risk' in the neonatal period were examined by means of academic attainment tests and teacher ratings at the end of their first year in primary school. Matched classroom controls were also examined to estimate the prevalence of reading, spelling and mathematics difficulties. Preterm birth and low birthweight appeared to be significant antecedents of poorer outcome in all three subjects. The attributable risk of low birthweight to academic handicap was estimated to be 29 per cent. There was no additional effect of time to spontaneous respiration (short and long) on academic outcome for the preterm low-birthweight group. In contrast, poor outcome for the low-birthweight children who had not been preterm was associated with longer time to spontaneous respiration. Graduates of neonatal intensive care with normal birthweights performed comparably with their low-risk controls. These results are discussed in relation to other longitudinal studies of the outcome for 'at-risk' infants.

Child↗
PubMed1988

Stillbirths in Western Australia 1980-1983: influence of race, residence and place of birth.

All stillbirths in Western Australia from 1980-83 weighing 1,000 g and over were identified from perinatal death certificates, and their causes and demographic correlates described. The stillbirth rate was 4.91 per 1,000 total births; nearly 65% were antepartum, 25% intrapartum and in 10% the time of death was unknown. The cause of death of most stillbirths was unknown (52%) or associated with lethal congenital malformations (13%), antepartum haemorrhage (12%) or maternal hypertension (8%). Whilst Aboriginal women had much higher stillbirth rates (10.80) than non-Aboriginal women (4.57), their patterns of time and causes of death were similar. Both antepartum and intrapartum stillbirth rates were much higher at low birth-weights and low gestational ages in both racial groups. Women living in rural areas who delivered in the metropolitan area had much higher antepartum (11.02) and intrapartum (3.31) stillbirth rates than either rural women delivering in rural areas (1.89 and 1.34) or metropolitan women delivering in the metropolitan area (2.72, 0.98). This reflects the transfer of rural high risk pregnant women or those with fetal death in utero, for delivery in metropolitan specialist hospitals.

Age Factors↗
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↗
PubMed1986

Birth-weight patterns in aboriginal and non-aboriginal singleton adolescent births in Western Australia, 1979-83.

Births to Aborigines and teenagers are known to be at a higher risk of low birth-weight (LBW) than those to non-Aboriginal and older women. Data on singleton birth-weight and gestational age by maternal age and race were analysed from the West Australian Midwives Notification of Birth system for 1979-1983. The main aim of the analysis was to describe the patterns of preterm birth (PTB) and intrauterine growth retardation (IUGR) in these births. Aboriginal teenage fertility was much higher than that for non-Aborigines and seemed to be rising. Many more young teenagers giving birth were Aboriginal than Caucasian. Contrary to expectation, the majority of the LBW births in both racial groups were due to PTB not IUGR. There was an increasing trend to PTB with decreasing maternal age in both Aborigines and non-Aborigines. These data should be considered preliminary due to the difficulties of estimating gestational age and in categorizing IUGR. They may have implications in terms of further research into the aetiological pathways and prevention of LBW in Australia.

Adolescent↗
PubMed1986

The decline in congenital rubella syndrome in Western Australia: an impact of the school girl vaccination program?

Rubella vaccination became available in 1970 in Australia. In Western Australia (WA), a school girl vaccination program was well established by 1971. Mothers under 26 years of age in 1983 would have been eligible for this program and they constitute 40 per cent of WA births. Data on Congenital Rubella Syndrome (CRS) cases were obtained for years of birth 1968-83 inclusive to ascertain if there had been an impact of the program on the CRS rate. Epidemics of rubella occurred in 1970-71, 1974, and 1979-80. The CRS rate has fallen steadily; it did not rise during the 1979-80 epidemic and was less than one in each year after 1977. All CRS cases born since 1974 were to mothers too old to have been eligible for the program. The data suggest that the vaccination program is effective, but this cannot be proven until data become available on pregnancy terminations.

Adolescent↗
PubMed1986

Prevalence of and risk factors for cerebral palsy in a total population cohort of low-birthweight (less than 2000g) infants.

This paper reports a total population-based cohort study of over 500 surviving children born in 1974, 1975 and 1976, who were identified as having been a low birthweight (less than 200g). The prevalence of cerebral palsy (CP) diagnosed by age six years was compared for groups who had various antenatal and perinatal attributes. For children who had weighed less than 2000g the CP prevalence was 3.6 per cent for those less than 1500g and 4.3 per cent for those between 1500g and 1999g. The main factors predicting CP in the low-birthweight infants were measures of neonatal asphyxia, but the majority of children with CP had no extra adverse perinatal risk-factors compared to non-CP survivors, were not asphyxiated and had not received high-level neonatal intensive care. The CP rates were not significantly different between any other available antenatal, perinatal or sociodemographic risk-factor groups. It is suggested, therefore, that CP is not a good index of the impact of neonatal intensive care, and that research should now concentrate on elucidating the genetic, developmental and antenatal risk-factors for the various CP syndromes.

Asphyxia↗
PubMed1985

Changing patterns of perinatal and infant mortality in Western Australia: implications for prevention.

Perinatal and infant mortality rates have fallen dramatically in the developed world this century. A review of perinatal and infant mortality in Western Australia from 1970 to 1981 was undertaken, to examine trends in birthweight-specific and cause-specific rates. The predominant causes of death are now congenital malformation, stillbirth of unknown cause, preterm birth and cot death. Perinatal and infant mortality rates are unlikely to be reduced substantially until the reasons for these four causes of death are elucidated.

Australia↗
PubMed1985

Congenital rubella syndrome in Western Australia.

The birth prevalence of congenital rubella syndrome (CRS) in Western Australia has been around 20 per 10 000 live births with peaks up to 100 per 10 000 in rubella epidemic years. The rate appears to be falling but it is still too soon to know whether the rubella vaccination programme in Western Australia has made a significant impact. The cohorts of young women who would have received the schoolgirl vaccination programme are only now entering the child bearing age groups. Observed falls may be due also to delayed diagnosis particularly of cases of deafness only. The proportion of nonimmune young women who would have been eligible for the programme in one maternity hospital has fallen. This study needs to be repeated to ascertain whether further epidemics of rubella have resulted in peaks of CRS or whether the vaccination programme has started to have an effect.

Australia↗
PubMed1985

Methodology of a cerebral palsy register. The Western Australian experience.

Population-based disease registers serve a variety of purposes and have proven their value in stimulating and facilitating epidemiological research and health planning. The methods used to establish and maintain the Western Australian Cerebral Palsy Register are described. Efforts to reduce diagnostic variation by regular interobserver study meetings with clinicians have been highly productive in addition to promoting awareness of the requirements of the register. The existence of perinatal data sets as denominators are essential to monitor trends, which in turn generate hypotheses that can be readily investigated with the case population and basic variables already identified. The costs of setting up and running an ongoing register are thus offset by its output and potential uses. These, as well as its limitations, are discussed.

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↗