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Biomedical subjects

M Dauncey

Publications and source records attributed to M Dauncey.

7 recordsLinked to original sources
PubMed1987

Antecedents and outcome of very early neonatal seizures in infants born at or after term.

Recent experimentally derived evidence has confirmed earlier suggestions that seizures which occur within 48 h of birth in babies born at or later than 37 completed weeks gestation are particularly likely to reflect intrapartum asphyxia. We have compared 54 cases of such seizures with 41,090 controls in a geographically defined population. Nulliparity, hydramnios, post-term pregnancy, oxytocin augmentation of labour, abnormalities of fetal heart rate and/or meconium-stained amniotic fluid, prolonged second stage of labour, emergency caesarean section, assisted vaginal delivery, low Apgar score and resuscitation at delivery and subsequent ventilatory support were all statistically significantly more common among cases than among controls. Five of the 54 babies who developed seizures died within 28 days of birth and 11 of the 49 survivors had an impairment diagnosed by 3 years of age which was usually associated with some degree of cerebral palsy. Comparison of the frequency of antecedent perinatal risk factors in the seizure babies who died, those who survived with disabilities and normal survivors failed to reveal any clear pattern.

Cerebral Palsy↗
PubMed1986

Perinatal outcomes and related factors: social class differences within and between geographical areas.

This paper makes use of the opportunity provided by comparable obstetric data bases to examine area and social class variations in perinatal outcome and associated factors in areas smaller than those usually reported. Analyses are based on singleton births to primiparous residents in the catchment areas of the Aberdeen Maternity and Neonatal Database (n = 4948) and the Cardiff Births Survey (n = 11893) between 1976 and 1981. The factors considered relate to the obstetric population (height, age, and smoking), obstetric practice (induction and assisted delivery), and perinatal outcome (curtailed gestation, low birthweight, and perinatal death). Our analysis confirms the existence of both area and social class differences and suggests that, except in the case of teenage pregnancy and smoking, the association observed between those factors and area and social class are largely independent of each other.

Female↗
PubMed1985

Debendox revisited.

Two further studies re-examine the findings by Golding et al. (1983) in Oxford that mothers of children born with oral clefts had been more frequently prescribed Debendox (Bendectin) than had the mothers of matched controls. In Cardiff, 86 283 total births between 1965 and 1979 included 139 infants with oral clefts. Detailed information was obtained about 93 of these infants and matched controls. The relative risk of the birth of an infant with an oral cleft to women prescribed Debendox within 69 days of the first day of their last menstrual period was 0.64 (95% confidence limits 0.12-3.34). No increased effect was found amongst women who smoked. In Aberdeen, 17 640 livebirths between 1976 and 1979 included 31 children with oral clefts. Compared with the non-exposed group the risk of a birth of an infant with an oral cleft to a woman prescribed Debendox in early pregnancy was 0.37 (95% confidence limits 0.09-1.47). These results do not confirm the previous findings in Oxford of a possible association between exposure to Debendox in early pregnancy and the occurrence of oral clefts in the child.

Abnormalities, Drug-Induced↗
PubMed1984

Employment in pregnancy: prevalence, maternal characteristics, perinatal outcome.

Data from the Cardiff Births Survey was used to examine the relation between the nature of employment and perinatal outcome. The proportion of all expectant mothers who work during pregnancy increased from 38.7% in 1965/69 to 43.9% in 1975/79 (p less than 0.001). The percentage of working primiparas, however, remained unchanged at approximately 80%, whereas the percentage of working multiparas rose from 15.1% to 22.1%. The non-employed primiparas were more likely than the employed primiparas to be at the extremes of maternal age, to have a history of medical problems and previous abortions, and to attend less often for antenatal care. Perinatal outcome (measured in terms of perinatal mortality, birthweight, and length of gestation) was significantly better among the employed mothers. Non-employed mothers in social classes I and II seemed to be a particularly high risk group. Exclusion of mothers with an adverse obstetric or medical history considerably reduced the differences in perinatal outcome between the two groups. The findings suggest that healthy women without an adverse obstetric or medical history can safely continue in employment during pregnancy.

Birth Weight↗
PubMed1984

Planned and unplanned deliveries at home: implications of a changing ratio.

The observation that perinatal mortality among babies delivered at home has tended to increase beyond that among babies delivered in consultant obstetric units has caused alarm and prompted recommendations that delivery at home should be further phased out. With data derived from the Cardiff Births Survey the possibility was investigated that this trend might reflect a changing ratio of planned to unplanned domiciliary births. At the beginning of the 1970s deliveries at home that were planned to be so outnumbered those that were not by nearly five to one. By 1979 unplanned deliveries at home outnumbered planned deliveries. The characteristics of the mothers, the health care they received, and the outcome of delivery differed strikingly between planned and unplanned deliveries at home. It is concluded, firstly, that every year the maternity services must try to meet the various needs of about 2000 women in England and Wales who give birth at home without planning to do so; and, secondly, that the heterogeneity of births at home and in hospital will continue to obstruct the search for unbiased estimates of the risks attributable to delivery in specialist obstetric units, general practitioner units, and at home.

Adult↗
PubMed1984

Obstetric analgesia, anaesthesia and the Apgar score.

This study examines the changing pattern of maternal analgesia administration during the decade 1970-1979. In addition, the relationship between analgesia, anaesthesia and the infant's Apgar score was documented. Approximately 40000 deliveries to South Glamorgan residents were included in the study. Over the two quinquennia 1970-1974 and 1975-1979 the administration of epidural block increased from 5.6% to 17.5%. The Apgar score of babies in the epidural block group was significantly better in the latter period. Respiratory depression following Caesarean section remains a problem. The group delivered by elective Caesarean section contained a substantial proportion of infants with a low Apgar score; 30% had an Apgar score less than 8 and 10% had a score of less than 4. Likely causative factors include undue sensitivity of the infants' respiratory centre and aortocaval compression during surgery.

Analgesia↗