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Biomedical subjects

J Golding

Publications and source records attributed to J Golding.

At least 145 records · Page 8Linked to original sources
PubMed1991

Comparison of prevalence of depression in mothers of twins and mothers of singletons.

OBJECTIVE: To determine whether the apparent additional and exceptional stresses associated with bearing and parenting twins affect the emotional wellbeing of mothers. SETTING: Great Britain, 1970-5. DESIGN: Cohort study of 13,135 children born between 4 April and 11 April 1970. Mothers of all children, both singletons and twins, were interviewed by health visitors (providing demographic data) and completed a self report measure of emotional well-being (the Rutter malaise inventory) when the child was 5 years of age. The malaise scores of mothers of twins were compared with those of all mothers of singletons and then with those of mothers categorised by the age spacing of their children (only one child, widely spaced, or closely spaced), taking account of maternal age, social class, and whether the study child had a disability, by using logistic regression. SUBJECTS: 139 mothers of twins--122 pairs of twins and 17 twins whose cotwin had died--and 12,573 controls, who were mothers of singletons. RESULTS: A significantly higher proportion of mothers of twins at 5 years had malaise scores indicative of depression than mothers of singletons at the same age. Mothers who had borne twins, one of whom had subsequently died, had the highest malaise scores and were three times more likely than mothers of singletons to experience depression. Both mothers of twin pairs and mothers of singletons closely spaced in age were at significantly higher risk of experiencing depression than mothers of children widely spaced in age or mothers of only one child (p less than 0.0001). Odds ratios indicated that the risk of depression in mothers of twins was higher than that in mothers of closely spaced singletons. CONCLUSION: Mothers of twins are more likely to experience depression. This suggests a relation between the additional and exceptional stresses that twins present and the mother's emotional wellbeing.

Adult↗
PubMed1991

Maternal mortality in Jamaica: health care provision and causes of death.

Details of 62 maternal deaths occurring in 1986/1987 were compared with a control population. The incidence was 11.5 per 10,000 livebirths. The major cause of maternal mortality was hypertension followed by hemorrhage and infection. There were trends with advanced maternal age and high parity. The risk of maternal death varied with hospital facilities available, being lowest in areas with access to a specialist hospital and highest in areas where there were no obstetricians available.

Adolescent↗
PubMed1991

Delayed antenatal care: does it effect pregnancy outcome?

Information on 13,127 mothers who were certain of the date of their last menstrual period (LMP) and who delivered in one week of April 1970, was analysed to assess whether delayed attendance for antenatal care (defined as not attending prior to 28 weeks of gestation) was associated with adverse outcome of pregnancy. Background factors that had been found to be predictive of delayed attendance were as follows: region of residence, region of birth of the child's father, marital status and contraceptive use in the 18 months prior to conception for primigravidae and the same four variables together with parity, maternal age and interpregnancy interval for multigravidae. Both before and after these factors had been taken into account, there was no evidence of any association between delay in attendance for care and severe pre-eclampsia, perinatal mortality, pre-term delivery and birthweight, although after adjustment for the background factors the length of gestation in delayed attenders was, on average, 2 days longer.

Adult↗
PubMed1991

Antenatal care received and its association with preterm birth in Greece.

A total population sample of singleton births to mothers with certain dates of last menstrual period (LMP) was identified from the Greek National Perinatal Survey of April 1983. Two groups of mothers were considered separately, 3116 primigravidae and 6524 multigravidae, with preterm birth rates of 5.9% and 8.4% respectively. Of all the antenatal care factors tested, primigravidae showed significant associations (unadjusted) with haematocrit level and with drugs taken during pregnancy. The logistic regression analysis which followed showed that the only factor independently associated with preterm delivery for that group of mothers was drugs taken during this period: women taking no drugs (including vitamins and iron) had the highest risk of preterm delivery. In contrast, multigravidae showed significant unadjusted associations with a great variety of parameters of antenatal care. Nevertheless, in the logistic regression analysis only three proved to have independent significant associations: drugs taken during pregnancy (reduced risk among mothers taking vitamins and iron), hospital admission during pregnancy (mainly for cervical cerclage) and the pattern of antenatal care during the first two trimesters (those attending the recommended number of times having least risk).

Cross-Sectional Studies↗
PubMed1991

Hospice home care.

This has turned out to be a remarkable adventure into the human condition. It has been most rewarding to see that it is quite possible to overcome the most difficult clinical situations by knowledge, patience and the sort of natural sympathy which should be part of the personality of every physician. Once these facts have been experienced, what at first must appear to be a repulsive subject becomes a happy and, in many ways, beautiful illustration of how a natural process should proceed with dignity.

Critical Illness↗
PubMed1990

Incidence of anencephaly in Jamaica.

Information was collected on 2,197 stillbirths and neonatal deaths on the island of Jamaica during the 12 month period September 1986 to August 1987 as part of the population based nationwide Jamaican Perinatal Morbidity and Mortality Survey. There were 14 cases of anencephalus giving an incidence of 0.26 per 1,000 total births. One of these cases was associated with the amniotic band syndrome; excluding this, the incidence would be even lower (0.24 per 1,000). There was no apparent association with social class, maternal age, or parity. The rate found in Jamaica is considerably lower than found in any other national population study.

Anencephaly↗
PubMed1990

Previous obstetric history and subsequent preterm delivery in Greece.

A total population sample of 6524 multigravid women who were certain of the date of their last menstrual period was obtained from the population-based Greek National Perinatal Survey of April 1983. The sample was used to determine the associations between features of the maternal obstetric history and preterm delivery. There were significant associations between preterm delivery and previous fetal losses, whether early (miscarriages and/or induced abortions) or late (stillbirths). For mothers who had experienced miscarriage(s), induced abortion(s) or stillbirth(s) the odds ratios were 1.40, 1.36 and 1.15, respectively, compared with mothers without any fetal loss. The odds ratio increased substantially with the increasing number of losses and reached 5.60 for the small group of mothers who had had prior miscarriage, termination and stillbirths. The results changed very little when the socioeconomic characteristics of the family were taken into account.

Cross-Sectional Studies↗
PubMed1990

Low birth-weight and pre-term delivery in South-east Asia. The WHO International Collaborative Study of Hypertensive Disorders of Pregnancy.

Population-based data from 10 centres in Burma, Thailand, China and Vietnam, have been analysed to assess those social and environmental factors which may be associated with pre-term delivery and low birth-weight. The philosophy behind the study was that if the same association was found in different countries, then the association may be causal; if associations differed in the various countries, then causality was unlikely. The major findings were as follows: a strong association between low birth-weight and pre-term delivery and the unmarried state (RR 1.64, 1.39), a consistent reduced risk of pre-term delivery when the father was in a managerial post (RR 0.77), an excess risk of pre-term delivery if the mother was a housewife (RR 1.16), lifting heavy objects at the time of quickening (RR 1.63) or frequently bending and stooping at the time of quickening (1.15). Strong associations were found with both paternal and maternal education levels but these were strongest for the mother's education level. The association was far stronger for pre-term delivery than for low birth-weight and it is assumed that the low birth-weight effect is secondary to pre-term delivery. The only variation with maternal age concerned an excess of low birth-weight among teenage mothers, but not of pre-term delivery, and an excess of low birth-weight but not pre-term delivery among mothers with small head circumferences or small arm circumferences. We conclude that the aetiology of growth retardation and pre-term delivery are probably different in South-east Asia, and point out the need to elucidate further the strong variation with education level.

Asia, Southeastern↗
PubMed1990

Factors associated with childhood cancer in a national cohort study.

Information on 16,193 infants delivered in Great Britain in one week of April, 1970 was collected by midwives at the birth and during the first 7 days of life. Using multiple sources, 33 children developing cancer by 1980 were identified from this cohort, giving an incidence of 2.04 per 1,000 total births by the age of 10. Comparisons of these 33 children were made with 99 controls, three for each index case, matched on maternal age, parity and social class. Statistically significant associations were initially found with maternal X-rays and smoking during pregnancy, and the use of analgesics such as pethidine during labour, confirming the findings of retrospective case-control studies. Unexpected statistically significant associations were found with delivery of the child outside term, and drug administration in the first week of life. The latter was found in the absence of an association with neonatal abnormalities in the child and relates mostly to the administration of prophylactic drugs such as vitamin K. Logistic regression involving the whole cohort showed independent statistical associations with maternal smoking (OR 2.5), and drugs to the infant (OR 2.6). After adjusting for these factors no other statistically significant associations were found.

Adult↗
PubMed1990

Birthweight specific perinatal mortality in Greece.

Data from the Greek Perinatal Study in April 1983 revealed an excessively high perinatal mortality rate of 21.6 per 1,000 total births among singletons despite a low birthweight rate of only 4.5%. Comparison of perinatal mortality rates with Danish mortality rates in 1983, revealed the Greek rates to be three times higher than those in Denmark. When divided by time of death, the Greek stillbirth rates were two times higher and the early neonatal mortality rates were four times higher than the corresponding Danish rates. Subdivision of the Greek perinatal deaths using the Wigglesworth classification showed that the biggest group (40%) consisted of deaths associated with intrapartum asphyxia. The incidence of such deaths was 10 times higher than that found in Denmark. We conclude that in reducing the excessively high perinatal mortality rate in Greece special attention should be made to improve intrapartum and resuscitation techniques.

Birth Weight↗
PubMed1990

Regional variations in wheezing illness in British children: effect of migration during early childhood.

STUDY OBJECTIVE: The aim was to examine the regional distribution of wheezing illness among British children, and the age at which geographical differences may be determined. DESIGN: Cross sectional analyses and study of interregional migrants were used. SUBJECTS: The subjects were national cohorts of British children born in 1958 and 1970. MEASUREMENTS AND MAIN RESULTS: The regional distribution of wheezing illness showed significant heterogeneity at age 5 (1970 cohort) and 7 (1958 cohort). In both cohorts, children in Scotland had a low prevalence of wheeze, which could not be attributed to underreporting of mild cases. There was a less consistent tendency for high prevalence in Wales, and in the South Western and Midlands regions of England. In the 1958 cohort, the regional differentials diminished progressively with age and were negligible at age 23. There was a poor correlation between the regional distribution of childhood asthma and the common geographical pattern shown by eczema in infancy and hay fever at age 23. Analysis of interregional migrants suggested that the regional variation in each cohort at age 5-7 was primarily related to the region of current residence, and not to the region of birth. CONCLUSIONS: Genetic constitution, perinatal exposures, or early childhood experiences are unlikely to account for the regional variation in wheezing illness. Although local patterns of symptom reporting or disease labelling may be acquired by parents who move to a new region, environmental factors operating at a regional level probably determine the prevalence of asthma in primary school children. These influences do not appear to have long lasting effects upon the tendency to wheeze in adolescence and early adulthood.

Adolescent↗
PubMed1990

A cluster of central nervous system defects in Jamaica.

1. Information was collected on all stillbirths and neonatal deaths on the island of Jamaica during the 12-month period between September 1986 and August 1987. 2. There were 33 such deaths with anencephaly, spina bifida and hydrocephalus out of an estimated 54,400 total births. 3. There was a statistically significant cluster in respect to time of conception in one small rural area of the island. 4. There were no obvious differences between parents involved in the cluster and the rest of the population, but particular Jamaican fruit and vegetables have been shown to be teratogenic in animals. It is postulated that the cluster may have been associated with an unripe crop.

Anencephaly↗
PubMed1990

Maternal attitudes to antenatal care: changes over time.

A survey to assess the effect of changes introduced to antenatal care services provided by a Bristol teaching hospital was carried out immediately before and three years after the changes were implemented (1983 and 1986). Some 751 women resident in a neighbouring health district who gave birth during March and April 1983, were compared with 794 of their counterparts who gave birth during March and April 1986. Aspects studied included the number of antenatal hospital appointments (increased), the number of different doctors seen during the visits (unchanged), and time spent waiting to be seen at the hospital (decreased) significantly. More women had alpha-feto protein tests for spina bifida and ultrasound scans, but many less were anxious about having the test.

Attitude to Health↗
PubMed1990

Children of the nineties. A longitudinal study of pregnancy and childhood based on the population of Avon (ALSPAC).

A survey to assess factors, especially those in the environment, which influence child health and development is shortly to be started within the South West region. This study will start during pregnancy and involve both the mother and her partner as well as the child. Data will be collected on environmental exposures, and psychosocial aspects of the family home. Biological samples will also be kept and stored as a means of identifying pollutants inter alia, and to assess their influence on the fetus/infant. The children will be followed up to the age of 7 when they will receive a full educational, psychological and medical examination. Follow up of the outcome of pregnancy and the development of the child will help identify ways in which the environment influences child health and development.

Child Development↗
PubMed1990

Cognitive and behavioral sequelae of mild head injury in children.

Data from a longitudinal study of 13,000 British children were used to assess the sequelae of mild head injury 1 to 5 years after injury. One hundred fourteen children with parental reports of mild head injury treated with ambulatory care or admission to hospital for one night were compared with 601 children with limb fractures, 605 with lacerations, 136 with burns, and 1726 children without injury. Scores at age 10 were adjusted for intelligence, aggressive and hyperactive behavior at age 5, sex, socioeconomic status, and six other social factors. Children with head injuries were statistically indistinguishable from uninjured children on all outcomes except teacher's report of hyperactivity. After control of hyperactivity at age 5 and the social and personal factors, the head-injured children's mean hyperactivity score was four tenths of a standard deviation above that of the uninjured children. Children with lacerations and burns scored as badly or worse on measures of intelligence, mathematics, reading, and aggression as the children with head injuries. The small magnitude of the hyperactivity association coupled with the overall negative results suggests that mild head injury in school-aged children does not have an adverse effect on global measures of cognition, achievement, and behavior 1 to 5 years after injury.

Achievement↗
PubMed1989

Zinc supplementation during pregnancy: a double blind randomised controlled trial.

OBJECTIVE: To see whether zinc supplementation during pregnancy improves maternal and fetal outcome. DESIGN: Prospective study started at booking and continued till discharge of mother and baby from the maternity hospital. Mothers were randomly assigned to receive zinc supplementation or placebo in a double blind trial. SETTING: Mothers booking at one hospital. PATIENTS: Women booking before 20 weeks of gestation who agreed to take part in the study. 494 Mothers were followed up till the end of pregnancy. There was no difference between the groups given zinc and placebo in their social or medical backgrounds. INTERVENTIONS: Mothers in the active treatment group received one capsule of 20 mg elemental zinc daily and those in the placebo treated group a capsule identical in appearance and taste with the active capsule but which contained inert substances. MAIN OUTCOME MEASURE: Various adverse outcomes were tested, including maternal bleeding, hypertension, complications of labour and delivery, gestational age, Apgar scores, and neonatal abnormalities. The main outcome measure was birth weight. RESULTS: There were no differences whatsoever between mothers given a zinc supplement and those given a placebo. CONCLUSION: Zinc supplementation in pregnancy in the United Kingdom does not seem to offer any benefits to the mother or her fetus.

Adult↗