Biomedical subjects
Publications and source records attributed to I Borlee.
Twenty-five cases of congenital rubella syndrome were recorded in 1,458,126 live births in 19 EUROCAT birth defects registries from 1980 to 1986. During the study period, the incidence declined steadily from 3.50 to 0.41 per 100,000 births. Rubella infection occurred in 12 multiparous women indicating failure in immunization programme.
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In the province of Hainaut (Belgium), a study was undertaken in order to assess a pediatric pathology department, organized at the regional level. The study concerned 182 perinatal deaths, occurring among the 16,071 births in 9 maternity hospitals, in 1982 and 1983. The frequency of autopsies was 51%, both for stillbirths and for early neonatal deaths. It was 76% in the group of deaths related to congenital malformations and 48% in the group of deaths of unknown cause. The lack of an autopsy was explained in 20% of cases by the parents' refusal, in 8% of cases by the state of maceration of the fetus and by the obviousness of the diagnosis in 24%. In 46% of cases, no etiology was found and it appeared that the degree of physician interest was an important factor in the frequency of autopsies. Dissection alone revealed the cause of death in 13 of the 94 autopsies. In children presenting with congenital malformations, the performance of a complete pathologic study almost always led to genetic counseling for the parents. This counseling was almost never given when autopsy was not performed.
A survey of children admitted with meningococcal disease to 53 paediatric units in Belgium between 1975 and 1979 was made in order to assess the case mortality rate (CMR) and to identify risk factors associated with death. A total of 309 cases (226 bacteriologically confirmed and 83 unconfirmed) was recorded. The overall CMR was 6.1 per cent. It was 4.4 for bacteriologically confirmed cases and 10.8 for unconfirmed cases. The CMR was higher for septicaemia without meningitis (22.2 per cent) than for meningitis with or without signs of septicaemia (3.4 per cent). The risk of death was not related to the sex or nationality of the patients. Age was a major determinant of the CMR, independently of the clinical picture. The highest risk of death was in children under one year of age. Poor socio-economic conditions were a significant risk factor. Failure to recognise the severity of the disease by some poorly educated mothers, and the admission of the patient to a hospital lacking adequate facilities for managing severely affected children, were the two significant causes of delay of adequate treatment.
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This study indicates that tobacco smoking by the mother is associated with a significant reduction of the newborn's size. This effect cannot be explained by either an association of the smoking habit with malformation, premature birth, exaggerated consumption of coffee matrimonial status or paternal smoking, or by a combination of malformation, prematurity and any one of the other factors. The effect is also unrelated to the continuation or discontinuation of smoking during pregnancy. Paternal smoking seems to be associated with a reduced weight in children born to nonsmoking mothers.
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