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PubMed1987

[The stability of long-term birth expectations, 1982-1985].

Changes in expected number of births in the Netherlands are examined using data from the 1982 Netherlands Fertility Survey and a follow-up survey conducted in 1985. "On the 'yes', 'no', 'don't know' level, the answers of four out of every five respondents were identical in 1982 and 1985. On the level of an exact number of additional children this was three out of five. The expectation not to have any (more) children turned out to be stable for 87% of the respondents; the expectation to have one or more (additional) children for 84%. On an aggregate level there were minimal changes in the average expected number of additional children." (SUMMARY IN ENG)

Aspirations, Psychological↗
PubMed1991

[Determination of birth term by early ultrasonic examination--wrong, wrong and wrong again?].

The article is a critical review of principal weaknesses in the current use of ultrasonography for determination of gestational age and discusses the fact that the method in its practical use disregards any biological variation in biparietal diameter. It is concluded that second trimester determination of gestational age by ultrasonography has an accuracy no greater than +/- 1.5 weeks. This is comparable to the accuracy of the clinical assessment of maturation in the newborn baby. Ultrasonography as the main indicator of gestational age should be used only when the pregnant woman's own menstrual history is obviously incorrect.

Diagnostic Errors↗
PubMed1993

Prenatal weight gain, term birth weight, and fetal growth retardation among high-risk multiparous black and white women.

OBJECTIVE: To examine the association of prenatal weight gain below, within, and above the Institute of Medicine guidelines with birth weight and fetal growth restriction (FGR) among low-income, high-risk black and white women. METHODS: Eight hundred three black and 365 white women were grouped by pregravid body mass index (BMI): low (below 19.8), normal (19.8-26), high (above 26-29), and very high (above 29). The impact of maternal weight gain on birth weight and race-specific FGR was determined while controlling for sociodemographic and reproductive variables and for time between last weight observation and delivery. RESULTS: One-third of both black and white women failed to achieve the Institute of Medicine minimum recommended gain for pregravid BMI. More women with low BMI gained less than the recommended weight as compared with those having normal, high, or very high BMI. Nonobese black women (BMI 29 or below) delivered fewer infants with FGR as weight gain increased from below the recommended range (17.9% FGR) to within (10.3% FGR) or above (3.8% FGR) the range; corresponding data for nonobese white women were 20.9, 19.1, and 10.5% FGR, respectively. Obese black women (BMI above 29) also delivered fewer infants with FGR (4.2%) when they exceeded the minimum gain (6 kg) than did white women (11.8%). When analysis of covariance was used to adjust mean birth weight, black women in each pregravid BMI category delivered increasingly larger infants (P < or = .01 for each category) as they met or exceeded the guidelines; among white women this trend was attenuated. CONCLUSION: These observations support the Institute of Medicine suggestion that black women strive for prenatal weight gain at the upper end of the recommended range for pregravid BMI.

Adult↗
PubMed1988

Some biological and social factors of risk associated with the birth of pre-term infants.

The main purpose of the present study was to evaluate the effects of factors associated with spontaneous pre-term births so that the high risk woman could be identified before or at early stages of pregnancy. For this purpose, we have compared the measurements of 21 anthropometric traits and mean fluctuating asymmetry over 8 bilateral anthropometric traits, as well as age, occupation, education, previous obstetric history, complications during pregnancy, medicines received during and after pregnancy and some others in women who delivered babies of short (26-36 wk, n = 113 ind.) and normal gestational age (n = 103). Diseases and mean fluctuating asymmetry of eight morphological traits in the newborn infants themselves were also studied. Both univariate and multivariate analyses were carried out and these were in agreement, showing a highly significant increase in the morbidity rate (especially of respiratory diseases) among pre-term infants and in complications during pregnancy in their mothers. Among other variables associated with the current pre-term birth were previous spontaneous pre-term births, suggesting their special risk value. The estimate of the sib correlation in gestational age on the liability scale was about 0.63. Spearman and Pearson correlations in gestational age for siblings were 0.34 and 0.31, respectively.

Female↗
PubMed2003

Mouse placental prostaglandins are associated with uterine activation and the timing of birth.

We explored a potential mechanism linking placental prostaglandins (PGs) with a fall in plasma progesterone and increased expression of uterine activation proteins in the mouse. PG endoperoxide H synthase 2 (PGHS-2) mRNA expression increased in placenta in late gestation in association with an 8-fold increase in PGF(2alpha) concentration, reaching a peak on Gestational Day (GD) 18. This peak coincided with the final descent in plasma progesterone and birth on GD 19.3 +/- 0.2. Implantation of a progesterone-releasing pellet in intact pregnant dams on GD 16 delayed birth at term until GD 20.9 +/- 0.4 and inhibited the GD 18 increase in placental PGF(2alpha) levels in conjunction with a delayed fall in plasma progesterone that reached its lowest level 1 day after term birth. The mRNA levels of uterine activation proteins, connexin-43 (CX-43), oxytocin receptor, PGF(2alpha) receptor (FP), and PGHS-2, and the concentration of uterine PGF(2alpha) all increased at normal term birth. At progesterone-delayed term birth on GD 19.3, even though tissue PGF(2alpha) concentrations were at the same high levels observed at normal term birth, CX-43 and FP mRNA levels were lower than those at normal term birth, thereby possibly contributing to the delay of birth. These data are consistent with the hypotheses that fetal placental PGs affect the timing of birth by hastening luteolysis, that uterine activation initiates labor, and that birth may be delayed by blocking or decreasing the expression of two of the uterine activation proteins.

Animals↗
PubMed2000

Term breech birth in New South Wales, 1990-1997.

Data on 636,708 women delivering a singleton infant of gestational age > or =37 weeks in NSW from 1 January 1990 to 31 December 1997 were used to examine trends in breech births at term and the mode of delivery. From 1990 to 1997, although the crude rate of breech births at term remained stable at 3.4%, the adjusted odds ratio for breech birth compared with cephalic birth decreased over time. Among live breech births, the crude rate of vaginal breech birth declined from 29.4% to 19.7%, with an attendant increase in elective Caesarean sections from 49.1% to 58.4%. Most of this increase was at 38 and 39 weeks gestation. There was no change in the perinatal mortality rate among breech births during the study period. Despite increasing maternal age, the adjusted odds of a breech birth at term decreased over time. This could be due to offsetting factors, such as increased use of external cephalic version. If the decrease in vaginal breech birth continues, it may lead to the skills for this procedure being lost.

Adult↗
PubMed1988

Educational readiness of survivors of neonatal encephalopathy associated with birth asphyxia at term.

Standardized individual psychoeducational school-readiness tests were completed by 127 nondisabled survivors of moderate (lethargy, hypotonia, and suppressed primitive reflexes) or mild (hyperalertness, hyperexcitibility) neonatal encephalopathy associated with term birth asphyxia. Application of the readiness test battery to the children with moderate or mild encephalopathy and a peer population, revealed that children with moderate encephalopathy had significantly lower scores for many tests than those in the other groups. Children with mild encephalopathy performed well. We found no significant differences due to social variables. For the moderate group, we found an increased number of types of anticonvulsants and abnormal findings on the neurologic examination at neonatal intensive care unit (NICU) discharge to be predictors of low achievement on school-readiness tests. Also for the nondisabled moderate group, multiple regression analysis of the independent variables with the 5.5-year scores added variables suggestive of intrauterine growth retardation to the prediction of lower scores on many school-readiness tests. We conclude that clinical categorizing of moderate neonatal encephalopathy associated with birth asphyxia in term infants selects a group of children with an increased percentage of school-readiness delay, and could be a useful indicator for clinicians and educators in defining those neonates who may need special preschool evaluation and benefit from a modified early school program.

Asphyxia Neonatorum↗