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Biomedical subjects

T J Mathews

Publications and source records attributed to T J Mathews.

At least 37 records · Page 2Linked to original sources
PubMed2001

Smoking during pregnancy in the 1990s.

OBJECTIVES: This report presents trends and variations in smoking during pregnancy in the United States. Data are presented for various characteristics including mother's age, race, ethnic origin, place of birth and State of residence, live birth order, and birthweight. METHODS: Descriptive tabulations of data reported on the birth certificates are presented. RESULTS: The percentage of women who smoked during pregnancy declined every year from 1990 through 1999. In 1999, 12.3 percent of women giving birth reported smoking during pregnancy. For women 15 to 19 years of age, the rate of smoking during pregnancy declined between 1990 and 1994 but has increased since then and teenagers now have the highest rate of all age groups. Maternal smoking rates also declined for all race and ethnic groups in the 1990s, but important differences persist. American Indian, non-Hispanic white, and Hawaiian women had the highest rates of smoking during pregnancy in 1999 while, Chinese and Central and South American women had the lowest smoking rates.

Adolescent↗
PubMed2001

Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects.

CONTEXT: Daily consumption of 400 microg of folic acid before conception and during early pregnancy dramatically reduces the occurrence of neural tube defects (NTDs). Before food fortification, however, only an estimated 29% of US reproductive-aged women were taking a supplement containing 400 microg of folic acid daily. The US Food and Drug Administration authorized addition of folic acid to enriched grain products in March 1996, with compliance mandatory by January 1998. OBJECTIVE: To evaluate the impact of food fortification with folic acid on NTD birth prevalence. DESIGN, SETTING, AND POPULATION: National study of birth certificate data for live births to women in 45 US states and Washington, DC, between January 1990 and December 1999. MAIN OUTCOME MEASURE: Birth certificate reports of spina bifida and anencephaly before fortification (October 1995 through December 1996) compared with after mandatory fortification (October 1998 through December 1999). RESULTS: The birth prevalence of NTDs reported on birth certificates decreased from 37.8 per 100 000 live births before fortification to 30.5 per 100 000 live births conceived after mandatory folic acid fortification, representing a 19% decline (prevalence ratio [PR], 0.81; 95% confidence interval [CI], 0.75-0.87). During the same period, NTD birth prevalence declined from 53.4 per 100 000 to 46.5 per 100 000 (PR, 0.87; 95% CI, 0.64-1.18) for women who received only third-trimester or no prenatal care. CONCLUSIONS: A 19% reduction in NTD birth prevalence occurred following folic acid fortification of the US food supply. However, factors other than fortification may have contributed to this decline.

Folic Acid↗
PubMed2000

Infant mortality statistics from the 1998 period linked birth/infant death data set.

OBJECTIVES: This report presents 1998 period infant mortality statistics from the linked birth/infant death data set (linked file) by a variety of maternal and infant characteristics. METHODS: Descriptive tabulations of data are presented. RESULTS: In general, mortality rates were lowest for infants born to Cuban mothers (3.6 per 1,000), Central and South American (5.3), Asian or Pacific Islander (5.5), Mexican (5.6), and non-Hispanic white mothers (6.0), followed by Puerto Rican (7.8), American Indian (9.3), and black mothers (13.8). Infant mortality rates (IMRs) were higher for those infants whose mothers had no prenatal care, were teenagers, had 9-11 years of education, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. In 1998, 65 percent of all infant deaths occurred to the 7.6 percent of infants born at low birthweight. The three leading causes of infant death--Congenital anomalies, Disorders relating to short gestation and unspecified low birthweight (low birthweight), and Sudden infant death syndrome (SIDS)--taken together accounted for 46 percent of all infant deaths in the United States in 1998. Cause-specific mortality rates varied considerably by race and Hispanic origin. For infants of black mothers, the IMR for low birthweight was nearly four times that for white mothers. For infants of American Indian mothers, the SIDS rate was 3.8 times that for Asian or Pacific Islander (API) mothers. For infants of Hispanic mothers, the SIDS rate was 44 percent lower than that for non-Hispanic white mothers.

Birth Weight↗
PubMed2000

Variations in teenage birth rates, 1991-98: national and state trends.

OBJECTIVES: This report presents national birth rates for teenagers for 1991-98 and the percent change, 1991-98. State-specific teenage birth rates by age, race, and Hispanic origin for 1991 and 1998 and the percent change, 1991 to 1998, are also presented. METHODS: Tabular and graphical descriptions of the trends in teenage birth rates for the Nation and each State, by age group, race, and Hispanic origin of the mother, are discussed. RESULTS: Birth rates for teenagers 15-19 years declined nationally between 1991 and 1998 for all age and race and Hispanic origin populations, with the steepest declines recorded for black teenagers. State-specific rates fell significantly in all States for ages 15-19 years; declines ranged from 10 to 38 percent. In general, rates by State fell more for younger than for older teenagers, ranging by State from 10 to 46 percent for ages 15-17 years. Statistically significant reductions for older teenagers ranged from 3 to 39 percent. Reductions by State were largest for black teenagers 15-19 years, with rates falling 30 percent or more in 15 States. Among the factors accounting for these declines are decreased sexual activity, increases in condom use, and the adoption of the implant and injectable contraceptives.

Adolescent↗
PubMed2000

Births: final data for 1998.

OBJECTIVES: This report presents 1998 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant health characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown including teenage birth rates and total fertility rates, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.94 million births that occurred in 1998 are presented. RESULTS: Birth and fertility rates increased in 1998 by about 1 percent, the first increase since 1990. Birth rates for teenagers fell 2-5 percent. Rates for women in their twenties increased 1-2 percent each, whereas rates for women in their thirties rose 2-4 percent. All measures of childbearing by unmarried women increased in 1998; the number of births rose 3 percent, the birth rate increased about 1 percent while the percent of births that were to unmarried women rose to 32.8 percent. Smoking by pregnant women overall dropped again in 1998, but continued to increase among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate increased for the second year after declining for 7 consecutive years. The proportion of multiple births continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 13 percent in 1998, following a 14 percent rise from 1996 to 1997. Key measures of birth outcome--the percents of low birthweight and preterm births--increased. These changes are in large part the result of increases in multiple births.

Adolescent↗
PubMed1999

Declines in teenage birth rates, 1991-98: update of national and state trends.

OBJECTIVES: This report presents national birth rates for teenagers for 1991-98; the percent change, 1991-98; State-specific teenage birth rates for 1991 and 1997; and the percent change, 1991-97. METHODS: Tabular and graphical descriptions of the trends in teenage birth rates by age group, race, and Hispanic origin of the mother are discussed. RESULTS: Birth rates for teenagers 15-19 years declined nationally between 1991 and 1998 for all age, race, and Hispanic origin populations, with the steepest declines recorded for black women. State-specific rates by age fell in all States, with most declines statistically significant; overall declines ranged from 9 to 32 percent.

Adolescent↗
PubMed1999

Births and deaths: preliminary data for 1998.

OBJECTIVES: This report presents preliminary data for 1998 on births and deaths in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Natality data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include life expectancy, leading causes of death, and infant mortality. METHODS: Data in this report are based on more than a 99-percent sample of births and on more than an 85-percent sample of deaths in the United States for 1998. The records are weighted to independent control counts of births, infant deaths, and deaths 1 year and over received in State vital statistics offices in 1998. Comparisons are made with 1997 final data. RESULTS: The birth rate for teenagers continued to decline, dropping another 2 percent for 1997-98. The rate for young teens aged 15-17 years fell 5 percent, and the rate for teens aged 18-19 years declined 2 percent. Since 1991 rates have fallen 21 percent for teens aged 15-17 years and 13 percent for teens aged 18-19 years. Birth rates for women aged 20-29 years rose slightly. Among women in their thirties, birth rates rose 3 to 4 percent to the highest levels observed in three decades. The birth rate for women aged 40-44 years was the highest level reported since 1970. The birth rate for unmarried women was 44.3 per 1,000, 1 percent higher than 1997, but below the peak level reported for 1994 (46.9). The rate of prenatal care utilization continued to improve. The total cesarean rate increased to 21.2 percent. The low birthweight rate rose from 7.5 to 7.6 percent. In 1998 the age-adjusted death rate reached a record low, 2 percent below the rate for 1997. Human immunodeficiency virus infection (HIV infection) moved off the list of the 15 leading causes of death for the first time since 1987. Declines in age-adjusted rates occurred for Homicide and legal intervention (homicide) (14 percent) and Atherosclerosis (10 percent), while rates for Septicemia and Pneumonia and influenza increased 5 percent. Mortality also decreased for drug-induced deaths, deaths from injury by firearms, and alcohol-induced deaths. The infant mortality rate was unchanged. Life expectancy reached a record high of 76.7 in 1998.

Adolescent↗
PubMed1999

Births: final data for 1997.

OBJECTIVES: This report presents 1997 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant health characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown including teenage birth rates and total fertility rates, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.9 million births that occurred in 1997 are presented. RESULTS: Birth and fertility rates declined very slightly in 1997. Birth rates for teenagers fell 3 to 5 percent. Rates for women in their twenties changed very little, whereas rates for women in their thirties rose 2 percent. The number of births and the birth rate for unmarried women each declined slightly in 1997 while the percent of births that were to unmarried women was unchanged. Smoking by pregnant women overall dropped again in 1997, but continued to increase among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate increased slightly after declining for 7 consecutive years. The proportion of multiple birth continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 14 percent in 1997, following a 20 percent rise from 1995 to 1996. Key measures of birth outcome--the percents of low birthweight and preterm births--increased, with particularly large increases in the preterm rate. These changes are in large part the result of increases in multiple births.

Adolescent↗
PubMed1998

Declines in teenage birth rates, 1991-97: national and state patterns.

This report presents data on the numbers of teenage births and teenage birth rates for the United States for the period 1950-97 and State-specific birth rates for teenagers for 1991-96. After increasing sharply in the late 1980's, birth rates declined for American teenagers from 1991 through 1997. Rates fell overall by 16 percent for teenagers 15-17 years and by 11 percent for teenagers 18-19 years. Declines were reported for all race and ethnic origin groups, with the largest declines found for black teenagers, especially those aged 15-17 years. Particularly noteworthy has been the 21-percent decline in the rate of second births for teenagers who have had one child. Rates have fallen for first births as well, but the reductions are more modest, about 6 percent. Teenage mothers and their babies continue to be at greater risk of adverse health consequences compared with older mothers, including higher rates of preterm birth and low birthweight. While teenage birth rates vary considerably by State, rates fell in all States in the 1990's with nearly all declines statistically significant. Rates for black and non-Hispanic white teenagers dropped in most States from 1991 to 1996. Birth rate trends for Hispanic teenagers by State were not consistent. The proportion of second and higher order births among all teenage births declined substantially in most States. Data are from the National Center for Health Statistics' (NCHS) National Vital Statistics System.

Adolescent↗
PubMed1998

Smoking during pregnancy, 1990-96.

OBJECTIVE: This report presents trend data for smoking during pregnancy. Data are presented for various characteristics including age of mother, race and ethnic origin, place of birth of mother, and State of residence. METHODS: Descriptive tabulations were calculated using data reported on birth certificates between 1990 and 1996. RESULTS: The rate of smoking during pregnancy has declined each year between 1990 and 1996. In 1996 over 400,000 women reported smoking during their pregnancies (13.6 percent of all births). The rates of smoking during pregnancy for women 15-19 years of age declined between 1990 and 1994 but increased in the last two years, and now they have the highest rates of all age groups. Among race and ethnic groups, American Indian, non-Hispanic white, and Hawaiian women had the highest rates of smoking during pregnancy in 1996, while Chinese women had the lowest rates.

Adolescent↗
PubMed1998

Teenage births in the United States: state trends, 1991-96, an update.

OBJECTIVES: This report provides State-specific birth rates for teenagers for 1991 and 1996 and the percent change, 1991-96. METHODS: Tabular and graphical description of trends in teenage birth rates by age group for each State. RESULTS: Birth rates for teenagers 15-19 years declined significantly in all but three States between 1991 and 1996. Declines by State ranged from 6 to 29 percent.

Adolescent↗
PubMed1998

Report of final natality statistics, 1996.

OBJECTIVES: This report presents 1996 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant health characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown including teenage birth rates and total fertility rates, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.9 million births that occurred in 1996 are presented. RESULTS: Birth and fertility rates declined very slightly in 1996. Birth rates for teenagers fell 3 to 8 percent. Rates for women in their twenties increased slightly in 1996, the first increase since 1990, while rates for women in their thirties rose 2 to 3 percent. The number and percent of births to unmarried women increased slightly in 1996 while the birth rate for unmarried women declined modestly. Smoking by pregnant women overall dropped again in 1996, but increased among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate declined. The proportion of multiple births continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 19 percent. Key measures of birth outcome--the percents of low birthweight and preterm births--increased slightly, in large part the result of increases in multiple births.

Adolescent↗
PubMed1997

Triplet births: trends and outcomes, 1971-94.

OBJECTIVES: This report describes changes in the number and ratio of live births in triplet and other higher order multiple deliveries from 1971 to 1994 by maternal race, age, education, and marital status. The report also examines the birth outcomes of triplets compared with singletons, including overall gestation specific, and birthweight specific infant mortality rates. METHODS: Birth data are obtained from the U.S. certificates of live birth. Mortality data were obtained from the Linked Birth and Infant Death Data Sets for the 1983-91 birth cohorts. Most analyses are based on triplet and other higher-order multiple births (quadruplet and quintuplet and greater births) in the aggregate. (Triplet births comprise about 92 percent of all higher order multiple births.) Triplet and other higher order birth ratios for most variables are computed by combining data for years 1982-84 and 1992-94, and for infant mortality by combining birth cohorts for years 1987-91. FINDINGS: Between 1971 and 1994 the number and ratio of triplet births quadrupled, rising from 1,034 to 4,594, and from 29.1 to 116.2 per 100,000 live births. Most of the increase was among births to white mothers, particularly among married and more educated mothers. Only about one-third of the increase in triplet birthing among white mothers between 1989 and 1994 could be attributed to changes in the maternal age distribution. Massachusetts reported the highest triplet birth ratio (215.9), more than twice the U.S. ratio (105.5). Other States with comparatively high ratios were New Hampshire, New Jersey, and Iowa. Nine of 10 triplets were born preterm compared with 1 of 10 singletons. The average triplet weighed 1,698 grams at birth, one-half that of the average singleton (3,358 grams). Triplets were about 12 times more likely to die during the first year of life as singletons, but had a survival advantage over singletons at lower gestations and birthweights.

Adult↗
PubMed1996

Prenatal care in the United States, 1980-94.

OBJECTIVES: This report examines trends in timing of prenatal care in the United States from 1980 to 1994. Demographic characteristics examined include age, race, Hispanic origin, marital status, place of birth of mother, educational attainment of mother, and live-birth order. Social characteristics discussed include barriers to care and pregnancy wantedness. METHODS: The source of data for trends and demographic analysis is the certificate of live birth filed for each child born in the United States. Data for social characteristics are from the 1988 National Maternal and Infant Health Survey (NMIHS). Data from the NMIHS are based on 9,953 responses. RESULTS: Very few groups of women have yet to achieve the goal of 90 percent initiating prenatal care in the first trimester as set by Healthy People 2000. In 1994, 80 percent of all mothers initiated care in the first trimester. Cuban mothers were the only mothers to reach the objective of 90 percent with Japanese mothers close behind at 89 percent. Mothers with the lowest percent initiating early prenatal care were non-Hispanic black (68 percent), Puerto Rican (67 percent), and American Indian mother (65 percent). Mothers who have problems getting prenatal care due to financial, scheduling, transportation, or other problems have lower rates of initiating early care. Mothers who wanted to be pregnant when they did were more inclined to initiate early care than mothers who did not want to become pregnant or whose pregnancies were mistimed. CONCLUSIONS: Prenatal care use in the United States did not improve in the 1980's but has been improving since 1990. Variations in use by demographic characteristics persist. There are wide gaps between mothers with easier access to prenatal care and those who encounter barriers to care. Mothers who want to become pregnant also tend to seek help in understanding their pregnancy and its risks earlier than those who did not intend to get pregnant or cared to become pregnant at another time.

Adolescent↗
PubMed1994

Demographic influences on the number of children at school entry ages, with examples from three states.

"This paper analyzes the effects of changes in fertility, mortality, and net migration patterns on the growth of school entry-age populations in three states (Florida, South Carolina, and West Virginia) over the period 1950-1990. Fertility changes have had the largest influence on growth of these young populations, as common sense suggests. Changing migration patterns have been quite important, however, in explaining intertemporal and interspatial variations in growth rates."

Age Distribution↗
PubMed1988

Acute and acute-on-chronic mastoiditis (a five-year experience at Groote Schuur Hospital).

One hundred and thirty patients with acute-on-chronic mastoiditis were managed by the ENT Department of Groote Schuur Hospital between 1980 and 1984 inclusive. Seventy-four patients had cholesteatomas, of whom 78.4 per cent had intracranial extension and 44.6 per cent had intradural extension of the infection. In contrast, of the 56 patients without cholesteatomas, only 23.2 per cent had intracranial extension of the infection. These may be rare conditions in some privileged parts of the world but their lethal potential requires all ENT surgeons to be competent in their management.

Acute Disease↗