Caring for babies of very low birth weight.
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Australia↗
Biomedical subjects
F J Stanley
Publications and source records attributed to F J Stanley.
An epidemiological study of cerebral palsy in Western Australia, 1956-1975. I: Changes in total incidence of cerebral palsy and associated factors.
Patterns in the incidence of cerebral palsy are described over a 20-year period in Western Australia. The incidence rose to a peak between 1966 and 1970, then fell again. This pattern was particularly marked in the spastic syndromes and was seen in both sexes, in each maternal age and parity group, in each IQ group, in both multiple and single births, and in infants born in metropolitan (but not rural) areas. Improvement was more marked in heavier than in lighter infants. Since 1968 the male rate has fallen more quickly than that for females. The risk of cerebral palsy with high maternal age declined, but it remained high in relation to high parities. There were marked reductions in the proportions of older and higher-parity mothers in Western Australia over the study period, and in the proportion of multiple births. There was also a shift toward heavier babies from 1968 to 1975. Social-class information was not available. The data indicate that factors in addition to changes in perinatal care were operating to improve neonatal outcome in terms of long-term handicap in Western Australia.
Adult↗
Infants of very low birthweight. I: Perinatal factors affecting survival.
The neonatal mortality of 692 liveborn infants with birthweights of 2000g or less born in south-east London was studied. They represented 98 per cent of all the liveborn infants of this birthweight born and admitted to hospitals in the study area. The over-all neonatal mortality rate was 303.5 per 1000 live births. The following factors were shown to have significant and independent associations with mortality: birthweight; a history of early bleeding in the mother; hour of birth; condition of the infant assessed after birth; temperature of the infant on admission to the special care unit; and the presence of respiratory disease. Implications for the organisation of neonatal care are discussed.
Birth Weight↗
Infants of very low birthweight. II: Perinatal factors in and conditions associated with respiratory distress syndrome.
The incidence and case fatality of certain neonatal conditions reported in 692 liveborn infants of birthweights 2000g or less born in South East London in 1970, 1971 and 1973 are presented. 210 (30.3 per cent) died in the neonatal period: respiratory disease and cerebral haemorrhage were the leading causes of death. 482 (69.7 per cent) survived. In these infants, jaundice, respiratory disease and biochemical disorders were the most frequently reported conditions. Because of the numerical importance of the respiratory distress syndrome, both as a single and as an associated diagnosis, a special study was made of predisposing factors. Gestational age, sex, condition of the infant assessed after birth, temperature of the infant on admission for care, and caesarean section were all shown to be independently associated with the incidence of respiratory distress. This confirms the views that the incidence could be reduced if particular attention were paid to the maintenance of body temperature, especially in those infants at risk by reason of the other factors identified.
Birth Weight↗
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↗
Teratogenic drugs in pregnancy.
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Abnormalities, Drug-Induced↗
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↗