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Biomedical subjects

R Bertollini

Publications and source records attributed to R Bertollini.

26 records · Page 2Linked to original sources
PubMed1986

A joint international study on the epidemiology of hypospadias.

A descriptive epidemiological study of hypospadias has been made utilizing data from seven malformation surveillance systems round the world: Denmark, Hungary, Italy, Mexico, South America, Spain, and Sweden. The joint material represents 8,122 boys with hypospadias, 7,419 of which were "isolated", that is, with no other known malformation except those obviously related to hypospadias (undescended testis, hydrocele, scrotum anomalies). The main study was based on the infants with isolated hypospadias, but an analysis of multimalformed infants with hypospadias was also made. The registered birth prevalence of isolated hypospadias varied much among the seven programs. For the years 1980-1981, the lowest recorded birth prevalence was 0.26 (Mexico) and the highest, 2.11 (Hungary). An analysis of ascertainment was made for three programs: Denmark, Hungary, and Sweden. While some uncorrect registration of infants as hypospadiac were detected, a strong underascertainment of varying degree was seen. In Hungary and Sweden, where the highest birth prevalences were recorded, there was a 30-40% underascertainment of cases later operated on; in Denmark underascertainment was still larger. When correction was made for underascertainment, the Danish and Swedish birth prevalences of isolated hypospadias were very similar. No information on ascertainment was available for the other systems, but it seems very unlikely that the low birth prevalences recorded in Mexico and South America can be solely explained by underascertainment. Therefore, it appears that true differences in the prevalence at birth of hypospadias do exist. There are no indications that the different birth prevalences depend on inclusion or exclusion of mild (distal) forms of hypospadias. There is an apparent inverse correlation between fertility in a population (estimated from mean parity in control women) and the birth prevalence of isolated hypospadias. Within each program geographical variations in birth prevalence could be seen, but the interprogram variation was larger than the intraprogram one. There is an effect of maternal age and parity on the intensity ratio of isolated hypospadias. This effect varies among programs. The variability for mothers under 20, parity 1, seems to be inversely related to the proportion of delivered women belonging to that age class. With increasing maternal age, especially within parity 1, an increased hypospadias intensity ratio is seen. Infants with isolated hypospadias show a lower birth weight and to some extent also a shorter gestational length than do controls.(ABSTRACT TRUNCATED AT 400 WORDS)

Abnormalities, Multiple↗
PubMed1985

Maternal epilepsy and birth defects: a case-control study in the Italian Multicentric Registry of Birth Defects (IPIMC).

A case control study on the association between maternal epilepsy, anticonvulsants use during pregnancy and birth defects was carried out in the Italian Multicentric Registry of Birth Defects (IPIMC). In the period 1980-1983, 7,607 malformed babies out of 439,717 total births (still + live) were registered. Fourty-one malformed babies with maternal epilepsy were identified (5.39 X 1,000). The overall relative risk of having a malformed baby among pregnant epileptic women was 1.87. Spina Bifida, Congenital Heart Defects, Clefts, Diaphragmatic Hernia and Trisomy 18 were more frequent than expected among babies with maternal epilepsy. The different therapeutic regimens were also tested to identify the possible independent teratogenic effect of anticonvulsants. A statistically significant association between Spina Bifida and Valproic Acid (odds ratio 22.7; Fisher p value = 0.0364) was observed: no other anticonvulsant tested showed any association with any type of malformation.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Cesarean section rates by type of maternity unit and level of obstetric care: an area-based study in central Italy.

BACKGROUND: The rate of cesarean section in the Lazio region of Italy is one of the highest in the Western world, 26.5%. In order to evaluate the effects of nonmedical factors on cesarean section, we examined its relationship to the characteristics of maternity units in the region. METHODS: We collected data from the birth certificates of 91,557 infants born to women residing in Lazio in 1988-1989 and classified all maternity units in the region by method of financing (public, semiprivate with arrangements with the national health service, and completely private) and level of obstetric care (unclassified and levels I,II, and III). The rates of cesarean section were examined for primiparous and multiparous women, taking into account birthweight, gestational age, fetal presentation, maternal age, and day of delivery. RESULTS: The adjusted odds ratio for cesarean section (with public units of level I taken as reference) was 1.06 (primiparous) and 1.22 (multiparous) for semiprivate maternity units and 1.59 (primiparous) and 1.52 (multiparous) for private units; it increased to 1.59 (primiparous) and 1.61 (multiparous) for unclassified semiprivate units and to 2.06 (primiparous) and 1.87 (multiparous) for unclassified private units. CONCLUSIONS: The rate of cesarean section was associated in the Lazio region with private payment for hospital care and with inadequate level of obstetric care. The latter factor is of particular concern and should be investigated elsewhere.

Adult↗
PubMedDate not supplied

Declining trends of male proportion at birth in Europe.

Declining trends in male proportion at birth observed in several Western countries might reflect widespread exposure to pollutants capable of interfering with human reproduction. In this study, the authors describe male live birth proportion trends in 23 European countries from 1950 to 1996 (total of 305 million live births). Overall, there was a significant linearly decreasing trend of 10 fewer males per 100,000 births each year, resulting in a loss of 73,462 boys during a 47-yr period. The proportion of male births during the first 3 yr of the study period was higher than in the last 3 yr in 18 countries (i.e., 78%). Decreasing trends, which varied in slope and shape, were observed in 11 countries; no significant trend was found in 8 countries, and male birth proportion increased in 4 countries. The results of this study confirmed that the proportion of male births is declining in Europe, and differences exist by region and country. Social and cultural aggregations of countries with decreasing trends suggest that sociodemographic characteristics might be more likely to explain trends than environmental exposures to chemicals. Investigators should evaluate this hypothesis to assess the usefulness of male birth proportion as a sentinel event.

Birth Certificates↗