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At least 1,153 records · Page 64Linked to original sources
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↗
PubMedDate not supplied

[Occurrence and economic importance of congenital hernia in German Fleckvich calves].

The frequency of congenital hernia was investigated in German Fleckvieh calves being driven up for sale on livestock markets for breeding and fattening calves in Miesbach and Traunstein. Data were collected on 77 livestock auctions in the years 1996 and 1997. Altogether 53,105 calves were examined and 1.8% of these calves showed a congenital umbilical hernia. The incidence of umbilical hernia was significantly influenced by the sex of the calf, the occurrence of multiple births, the market place/market date, the sire and the sire line. Red Holstein blood proportion, lactation number, duration of pregnancy and 305 day milk performance were not of significant importance. Herd milk level did not influence the incidence of congenital umbilical hernia, however, herdmate averages for calves differed significantly in their incidence. The average difference of the market price between male calves affected by congenital umbilical hernia and not affected male calves amounted to 75 DM, in female calves, however, only to 38 DM. The risk, that a congenital umbilical hernia is not closing within an age of 15 months, depends on the width of the hernial opening in the newborn calf. An opening of 4 cm and more has only a healing chance of 50% and less. However, negative effects on fattening and carcass traits could be not found. The genetic influence on congenital umbilical hernia was obvious. The analyses indicated that the incidence of congenital umbilical hernia observed could not be explained by one autosomal recessive gene locus, but it seemed much more likely that more than one gene locus is involved or a mixed multifactorial monogenic mode of inheritance may be the underlying genetic mechanism. Breeders should be aware of the implications of congenital hernias and thus, congenital hernia should get more attention in the selection process of young sires.

Animals↗
PubMed1995

[Twins in the Greco-Roman world: medical theories and iconographpy].

The phenomenon of multiple births aroused very ambivalent feelings in the ancient classical world. This article endeavours to define how this ambivalence was expressed, on the one hand in ancient medical theories, through associations with concepts of monstrosity and excess, on the other hand in art, through a selection of mythological themes and iconographic conventions.

Art↗
PubMed2002

Infant mortality statistics from the 1999 period linked birth/infant death data set.

OBJECTIVES: This report presents 1999 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 Chinese and Japanese mothers (2.9 and 3.4 per 1,000, respectively). Infants of Cuban, Central and South American, Mexican, and non-Hispanic white mothers had low rates, while rates were higher for infants of Puerto Rican and highest for non-Hispanic black mothers (13.9). Filipino mothers also had low rates. Rates were high for infants of Hawaiian and American Indian mothers. Infant mortality rates 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. The three leading causes of infant death--Congenital malformations, low birthweight, and Sudden infant death syndrome (SIDS)--taken together accounted for 45 percent all infant deaths in the United States in 1999. Cause-specific mortality rates varied considerably by race and Hispanic origin. For infants of black mothers, the infant mortality rate for low birthweight was four times that for white mothers. For infants of American Indian mothers, the SIDS rate was 2.4 times that for non-Hispanic white mothers. SIDS rates for infants of Hispanic and Asian or Pacific Islander mothers, were 40-50 percent lower than those for non-Hispanic white mothers.

Birth Certificates↗
PubMed2003

Evaluation of the subfertile man.

Infertility affects 15 percent of couples, and 50 percent of male infertility is potentially correctable. Evaluation of the subfertile man requires a complete medical history, physical examination, and laboratory studies. The main purpose of the male evaluation is to identify and treat correctable causes of subfertility. In addition, many men seek an explanation for their condition, which can be discovered during their evaluation. Furthermore, the male fertility evaluation can uncover significant medical and genetic pathology that could affect the patient's health or that of his offspring. Although pregnancies can be achieved without any evaluation other than a semen analysis, this test alone is insufficient to adequately evaluate the male patient. Treatment of correctable male-factor pathology is cost effective, does not increase the risk of multiple births, and can spare the woman invasive procedures and potential complications associated with assisted reproductive technologies. Appropriate evaluation and treatment of the subfertile man are critical in delivering suitable care to the infertile couple.

Critical Pathways↗
PubMedDate not supplied

[A neuropsychological study of triplets with a history of prematurity].

INTRODUCTION AND AIMS: Prematurity has often been associated with a general intellectual deficit and with different structural brain disorders which can be revealed by volumetric measurements performed by magnetic resonance imaging (MRI). In turn, perinatal asphyxia, even when it is not accompanied by neurological disorders, is related to a deficit in specific neuropsychological functions. CASE REPORT: This study describes the case of three 13 year old female triplets, with a history of extreme prematurity and perinatal asphyxia, the long term effects of which are evaluated in terms of cognitive performance. We studied their performance in the neuropsychological functions of intelligence, memory, and visual perceptual, visual constructive, visual spatial and frontal functions. In two of the subjects, structural MRI and volumetric analysis of the hippocampuses were performed. In all the subjects, intelligence was found to be above average, the most notable result being the superior score in case 1. Verbal learning and the long term retention of verbal material were altered in case 3, where there was also a smaller hippocampal volume. CONCLUSIONS: In the context of a multiple birth, we have seen that extreme prematurity, accompanied by non severe perinatal asphyxia without hypoxic ischemic encephalopathy, can exert very diverse effects on neurocognitive development. It can be normal, and even superior, or show a deficit in some skill. In our case, the functions that were most liable to suffer these antecedents are long term memory and verbal learning. This disorder is accompanied by bilateral involvement of the hippocampus, which can be observed using MRI.

Adolescent↗
PubMed1992

The grand multipara--an obstetric problem?

At the Medical Central Department of Obstetrics and Gynecology in Sibenik over 1970-1991 period there were 26,116 deliveries (multiple births excluded), of which 254 (0.97%) occurred in grand multiparas (five and more deliveries). The authors have found that the number of grand multiparas decreased by 38.3% (P < 0.001) over the past eleven years. Control subjects were 7920 multiparas (two to four deliveries, 20-34 years of age, from the same period). In 84.3% of the cases grand multiparas were delivered of their fifth or sixth infant, and 68.5% were > or = 35 years of age. Spontaneous abortion occurred in 16.9%, and 14.2% had no antenatal visit. EPH gestosis (8.3%), glucose intolerance (9.9%), preterm delivery (8.3%) and meconium-stained amniotic fluid (15.0%) were more common in the grand multiparas, whereas cervical cerclage (5.4%) and 7-to-12-hour duration of labour (12.8%) were more common in the control group. No significant differences were found in weight gain, prolonged pregnancy, caesarean delivery, assisted breech and vacuum extraction between two groups. There was also no difference in the incidence of neonatal morbidity and congenital abnormalities between the grand multiparas and controls. Late fetal and early neonatal deaths in the grand multiparous and control group occurred in 1.18% and 1.57, respectively, resulting in a 2.75% overall perinatal death rate for both groups (P > 0.05). No case of maternal death or uterine rupture occurred in either group. The authors conclude that pregnancy and delivery in grand multiparas are at higher risk due to poorer antenatal care and advancing maternal age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Unexpected high mortality rates found in a review of district statistics: what action is appropriate?

The regular review of statistical and other data is now a routine public health activity in district health authorities. The interpretation of findings indicative of high or otherwise unexpected rates of mortality or disease may be complicated by small numbers, and also by questions concerning the reliability with which the available data describe the problems. Judgement about whether to undertake further investigation of these problems is subject to uncertainty about the likely effectiveness and efficiency of the investigation, and of any remedial action that would be expected to follow. Examples of these problems are explored in relation to the finding of a high rate of infant and late neonatal mortality in a district population, and a high rate of female suicide. The late neonatal death rate showed a rising trend over a period of four years and was significantly elevated above national and regional rates. The perinatal death rate was not correspondingly low, nor had there been an excess of multiple births over the period. A review of neonatal death certificates did not demonstrate any identifiable problems relating to either the cause or place of death, and the high rate subsequently reverted to the expected level without further intervention. In the case of female suicide, analyses including deaths by misadventure and open verdicts were carried out to allow for possible differences between men and women in the certification of suicide. However, this did not alter the conclusions, and further investigation of the circumstances of death is planned to assess the potential for preventive action in the locality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Value of subcutaneous and intravenous pulsatile gonadotropin releasing hormone in polycystic ovary disease.

Nine patients with clomiphene-resistant polycystic ovary disease (PCOD) were treated with pulsatile gonadotropin releasing hormone (GnRH). The patients were started on subcutaneous (SC) GnRH. If they failed to ovulate on SC therapy, intravenous (IV) therapy was administered. Nine patients were treated for a total of 22 cycles; 13 were SC and 9, IV. There were nine ovulatory cycles (41%); four were SC (31%) and five, IV (56%). Two conceptions occurred, both among the IV cycles. One conception was a singleton; the infant was delivered uneventfully at term. The second conception was quadruplets, with the delivery of four healthy infants at 36 weeks. These data suggest that ovulation and conception in clomiphene-resistant PCOD patients using pulsatile GnRH are more likely to occur after IV than SC administration. However, the overall pregnancy rate was not greater than with gonadotropin treatment, and the risk of multiple births after IV administration is potentially high.

Adolescent↗
PubMedDate not supplied

Peripartum cardiomyopathy.

We report a case of peripartum cardiomyopathy (PPCM) with a literature review. Although PPCM is an uncommon form of cardiomyopathy, it sometimes occurs in women of childbearing age and thus should be considered in a woman who develops heart failure in the peripartum period. The diagnosis is based on a compatible clinical picture and exclusion of other potential causes. Risk factors include being black, over 30 years old, and multiparous, as well as having preeclampsia or hypertension or a multiple birth. The cause is unknown but may be multifactorial. Treatment is similar to that for other dilated cardiomyopathies; steroids and immunosuppressive agents may be useful in some circumstances. Outcome is variable with a long-term survival rate of about 50%. Patients who survive usually have few symptoms.

Adult↗
PubMed1991

[A survey on polio paralysis in Shandong Province Department of Program Immunization, Cooperation Group on the Survey of Polio Paralysis].

The survey was conducted in four counties where Polio consistently occurred during 1986-1988. According to the survey, there were 251 polio cases from 1974 to 1989, of which only 138 cases were reported. The paralytic rate by polio in the population under 15 years old was 0.486%. The survey also showed that polio was still a severe disease which paralysed children in the country. The number of polio cases accounted for 48% of all paralytic persons. Legs were the chiefly affected limbs, being about 90%. From analysis of vaccine history of polio cases, we found that the difference between two groups was highly significant. 90% of polio cases had no vaccine history or no full vaccine history. The reason for this was mainly due to lack of related knowledge. In addition, we also analysed multiple birth factor, which seemed to be not significant.

Adolescent↗
PubMed1990

[The amniotic band syndrome--report of two cases].

The amniotic band syndrome (ABS) includes intrauterine amputations, syndactyly, fetal disruption, fetal compression deformities and constriction rings associated with disruption of the amniotic membrane. The defects caused by ABS varied from simple digital band constrictions, limb defects to major visceral and craniofacial defects; fetal death may also occur. Because the ABS is a sporadic disorder that may mimic recurrent disorders, such as achondroplasia, anencephaly, Apert's syndrome, etc, it is very important to do appropriate genetic counseling and accurate diagnosis for every infant born with multiple birth defects. We report two severely damaged cases with typical features. This article also reviews the clinical features of ABS, its etiology, pathogenesis, and the status of prenatal and neonatal diagnosis are also discussed.

Adult↗
PubMed1990

International differences in the use of obstetric interventions.

This study investigated current levels and trends between 1975 and 1986 in the rates of cesarean section in 21 countries and of operative vaginal delivery in 14 countries. Sharp differences in national obstetric practice were found, with cesarean rates ranging from a high of 32 (Brazil) to 7 (Czechoslovakia) per 100 hospital deliveries, and operative vaginal rates from 16 (Canada) to 2 (Czechoslovakia) per 100 hospital deliveries. For most countries, rates of cesarean section have risen as operative vaginal rates have fallen, but some important exceptions exist. A comparison of cesarean section rates for two complications of labor and delivery that can be objectively diagnosed, multiple births and breech delivery, demonstrates that cesarean section rates for these complications rose sharply in almost every country from 1980 to 1985. A comparison of 1985 national rates of intervention and measures of birth outcome found no significant relationship between the two. While such ecological comparisons are imperfect at best, this does indicate that low levels of early infant mortality can be achieved in some populations despite a low rate of cesarean deliveries.

Australia↗
PubMed1990

Defining quality of care indicators for neonatal intensive care units independent of maternal risk factors.

Observed and birthweight-specific neonatal mortality rates have been used for assessing quality of neonatal care, but these are crude and affected by risk characteristics of the population served. Even when neonatal mortality rate is corrected for four risk factors, race, sex, birthweight, and multiple births, (California Data Research Facility, Santa Barbara, CA) it is possible that the corrected neonatal mortality rate is not comparable among institutions because of population differences not corrected for, eg, prenatal care. To analyze whether our high neonatal mortality rate is primarily dependent on population risk or quality of neonatal care, we used contemporaneous data collection by senior physicians and a microcomputer database system to construct indices of quality of care that are based on diagnoses graded according to disease severity. For the 1987/1988 academic year, we found: neonatal intensive care unit nosocomial infection rate, 20%; severe intraventricular hemorrhage per 100 very low birthweight infants (1500 g), 20%; bronchopulmonary dysplasia per 100 cases of severe respiratory distress syndrome, 27%; necrotizing enterocolitis per 100 neonatal intensive care unit discharges, 5%; air leak per 100 cases of severe respiratory distress syndrome, 21%; and neonatal mortality rate per very low birthweight delivery rate, 0.4. We propose that microcomputer, hospital-based analyses will improve comparisons of neonatal intensive care unit quality of care if appropriate indices can be sufficiently well-defined and shared.

Black or African American↗
PubMed1989

[Diagnosis and surgical management of varicosities].

The diagnosis of varicose veins is based on historical details pertaining to risk factors such as familial preponderance, advanced age, overweight, multiple births, professional activities carried out mainly in the standing or sitting position, use of oral contraceptives, diuretics or drugs which lower venous tone. Swelling of the legs on prolonged recumbancy, during pregnancy, fractures or cast treatment may be associated with thrombosis (Table 1). In addition to inspection and palpation in the standing and lying positions, the status of the pulses and the joints are of importance. The diagnostic measures must clarify the stage of the chronic venous insufficiency and provide adequate information on the various forms of venous functional disturbances (Table 2). Classification of varicose veins is carried out according to etiology--primary or secondary--or according to anatomical and functional derangement: with varicosities of the great saphenous vein and the lesser saphenous vein, in addition to valve incompetence at the proximal confluence of the saphenous-femoral junction, there may be segmental or global valve incompetence frequently in combination with a perforating vein incompetence. Varicosities of the great saphenous vein are classified with respect to whether the venous valves involved are those only in the region of the proximal confluence or from the inguinal region to above or below the knee or to the ankle, respectively, in four degrees of severity (Figure 1). For varicosities of the lesser saphenous vein, three degrees of severity are differentiated, the confluence incompetence, incompetence of the venous valves from the knee to the middle of the lower leg or from the knee to the ankle.4+ as the postthrombotic syndrome. Chronic venous insufficiency is characterized by venous hypertension and subdivided into three degrees of severity: grade I in the presence of corona phlebectatica paraplantaris and stasis edema; grade II in the presence of hyperpigmentation, melanodermitis, atrophy blanche, stasis induration and hypodermitis; grade III in the presence of hyperpigmentation, melanodermitis, atrophy blanche, stasis induration and hypodermitis; grade III in the presence of healed or florid ulceration. The two most important diagnostic measures are Doppler ultrasonography and ascending pressure phlebography which complement each other (Table 3)...

Dissection↗
PubMed1989

Grand multiparity--a nationwide survey.

Grand multiparity has been considered to be an obstetric hazard to both the mother and the fetus. In order to evaluate this statement we analyzed the information of a nationwide survey. The delivery records of all women (22,814) attending 30 obstetric wards in Israel between November 1983 and January 1984 were analyzed and the medical and obstetric complications associated with grand multiparity were investigated. Diabetes, hypertension, malpresentations, multiple births, large-for-gestational-age deliveries and perinatal deaths were found to be significantly more common in 1,542 multiparae who had seven or more deliveries. The association between parity and age partially accounted for this observation.

Adolescent↗
PubMed1989

[Acute retinopathy of prematurity: shift of the manifestation risk to extremely premature infants by neonatal intensive care medicine].

A total of 381 surviving prematures (birthweight less than or equal to 2500 g) at the heidelberg University Children's Hospital were examined ophthalmologically between January 1986 and June 1988. Of the 762 eyes, 112 (14.7%) showed acute retinopathy of prematurity (ROP). In our study, a correlation between birthweight, gestational age and retinopathy of prematurity was confirmed. In addition, the results concerning severity, differences between the right and left eye, and the incidence in twins and multiple births were demonstrated. Data were compared with the data in 29 papers dealing with the prevalence of acute ROP since 1968: 12,468 preterm infants were investigated in all papers; 2,087 of these infants (16.7%) showed ROP. In the literature, 8.4% of the premature babies with a birthweight of 1501 to 2500 g were found to have ROP. In our group with the same birthweight, only one baby (birthweight 1510 g) had retinopathy (0.6%). The fact that the average ROP prevalence has not changed significantly indicates that the risk of having retinopathy of prematurity has switched over to the more immature preterms, whose prognosis of survival has improved in the last few years as a result of the improvement in neonatal care.

Female↗
PubMed1987

Sexual and reproductive risk factors for invasive squamous cell cervical cancer.

A case-control study of 418 women with invasive squamous cell cervical cancer and 704 population controls enabled evaluation of risk factors for this relatively rare cancer. Consistent with an infectious etiology was a pronounced effect of multiple sexual partners, with those reporting 10 or more partners being at a significant threefold excess risk. Early first intercourse also was associated with some residual effect on risk, although the relationship was not linear, nor the explanation readily apparent. Those with multiple births were at significantly elevated risks, even after adjustment for sexual parameters. Menstrual and hygiene factors, including use of tampons, vaginal deodorants, and douching products, were not consistently related to risk. Histories of specific infections involving the genital tract were poor predictors of risk, since few women provided positive responses, but those with nonspecific diseases were at a significant twofold excess risk.

Adult↗