Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 4040620

Comparing perinatal mortality.

H A Hein·S S Lathrop·K R Papke
View original source ↗Export metadata ↓

Abstract

Comparisons of perinatal outcome data among regions or hospitals can be misleading if the risk status of the population served is not considered. Data are presented from two large perinatal centers (Medical Center Hospital in San Antonio, Texas, and University of Iowa Hospitals in Iowa City, Iowa), which report substantially different institutional neonatal and fetal mortality rates. However, examination of neonatal and fetal mortality by birth weight groupings demonstrates the difference between outcome in the two hospitals to be considerably less than the overall rates might imply. Additional data about the regionalized system of care in Iowa are presented to illustrate why mortality may rise in a referral center and yet be consistent with a salutary effect on perinatal outcome in the region.

Explore related subjects

Birth WeightEpidemiologic MethodsFemaleFetal DeathHumansInfant MortalityIowaPregnancyTexasJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

H A Hein, S S Lathrop, K R Papke. 1985. Comparing perinatal mortality.. https://pubmed.ncbi.nlm.nih.gov/4040620/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed1997

Does malnutrition in utero determine diabetes and coronary heart disease in adulthood? Results from the Leningrad siege study, a cross sectional study.

OBJECTIVE: To investigate the relation between decreased maternal food intake and risk factors for coronary heart disease in adult life. DESIGN: Cross sectional study. SUBJECTS: 169 subjects exposed to malnutrition in utero (intrauterine group) during the siege of Leningrad (now St Petersburg) in 1941-4; 192 subjects born in Leningrad just before rationing began, before the siege (infant group); and 188 subjects born concurrently with the first two groups but outside the area of the siege (unexposed group). SETTING: Ott Institute of Obstetrics and Gynaecology, St Petersburg. MAIN OUTCOME MEASURES: Development of risk factors for coronary heart disease and diabetes mellitus-obesity, blood pressure, glucose tolerance, insulin concentrations, lipids, albumin excretion rate, and clotting factors. RESULTS: There was no difference between the subjects exposed to starvation in utero and those starved during infant life in: (a) glucose tolerance (mean fasting glucose: intrauterine group 5.2 (95% confidence interval 5.1 to 5.3), infant group 5.3 (5.1 to 5.5), P = 0.94; mean 2 hour glucose: intrauterine group 6.1 (5.8 to 6.4), infant group 6.0 (5.7 to 6.3), P = 0.99); (b) insulin concentration; (c) blood pressure; (d) lipid concentration; or (e) coagulation factors. Concentrations of von Willebrand factor were raised in the intrauterine group (156.5 (79.1 to 309.5)) compared with the infant group (127.6 (63.9 to 254.8); P < 0.001), and female subjects in the intrauterine group had a stronger interaction between obesity and both systolic (P = 0.01) and diastolic (P = 0.04) blood pressure than in the infant group. Short adult stature was associated with raised concentrations of glucose and insulin 2 hours after a glucose load-independently of siege exposure. Subjects in the unexposed group had non-systematic differences in subscapular to triceps skinfold ratio, diastolic blood pressure, and clotting factors compared with the exposed groups. CONCLUSIONS: Intrauterine malnutrition was not associated with glucose intolerance, dyslipidaemia, hypertension, or cardiovascular disease in adulthood. Subjects exposed to malnutrition showed evidence of endothelial dysfunction and a stronger influence of obesity on blood pressure.

Birth Weight↗
PubMed1997

Birth weight of offspring and mortality in the Renfrew and Paisley study: prospective observational study.

OBJECTIVE: To investigate the association between birth weight of offspring and mortality among fathers and mothers in the west of Scotland. DESIGN: Prospective observational study. PARTICIPANTS: 794 married couples in Renfrew district of the west of Scotland. MAIN OUTCOME MEASURES: Mortality from all causes and from cardiovascular disease over 15 year follow up. RESULTS: Women who had heavier babies were taller, had higher body mass index and better lung function, and were less likely to be smokers than mothers of lighter babies. Fathers of heavier babies were taller and less likely to be smokers than fathers of lighter babies. Mortality was inversely related to offspring's birth weight for both mothers (relative rate for a 1 kg lower birth weight 1.82 (95% confidence interval 1.23 to 2.70)) and fathers (relative rate 1.35 (1.03 to 1.79)). For mortality from cardiovascular disease, inverse associations were seen for mothers (2.00 (1.18 to 3.33)) and fathers (1.52 (1.03 to 2.17)). Adjustment for blood pressure, plasma cholesterol, body mass index, height, social class, area based deprivation category, smoking, lung function, angina, bronchitis, and electrocardiographic evidence of ischaemia had little effect on these risk estimates, although levels of statistical significance were reduced. CONCLUSIONS: Birth weight of offspring was related inversely to mortality, from all causes and cardiovascular disease, in this cohort. The strength of this association was greater than would have been expected by the degree of concordance of birth weights across generations, but an extensive range of potential confounding factors could not account for the association. Mortality is therefore influenced by a factor related to birth weight that is transmissible across generations.

Birth Weight↗