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At least 145 records · Page 8Linked to original sources
PubMed1997

Identification of neonatal deaths in a large managed care organisation.

The neonatal (< 28 days) mortality rate (NMR) is one of the most commonly employed maternal and child health epidemiological measures. It is also being employed in quality measures ("report cards') used to assess the performance of health care organisations. The objectives were to (1) develop methods for the rapid quantification of the neonatal mortality rate in a multi-hospital system, the Kaiser Permanente Medical Care Program's Northern California Region (KPMCP NCR), (2) develop methods for generating facility-specific rates and case lists, and (3) ascertain the capture rates of the information sources available to us. Potential neonatal deaths were identified in the KPMCP NCR for the 1990 and 1991 calendar years from 3 sources: (1) clerical searches of local facility records, (2) electronic searches of the KPMCP NCR hospitalisation database, and (3) linking KPMCP electronic birth records to death certificate tapes. The medical records of all infants identified through these methods were reviewed. The neonatal mortality rate was calculated in three ways: (1) including all livebirths, (2) excluding births weighing < 500 g, and (3) adjusting for prematurity by increasing the follow-up period in preterm babies (these babies were included as neonatal deaths if they died up to 40 weeks corrected age + 27.9 days). A total of 352 records out of 64 469 birth records in the KPMCP NCR were reviewed. If one includes babies < 500 g, the neonatal mortality rate was 3.72/1000 livebirths; if these babies are excluded, the rate was 3.05/1000. Adjusting for prematurity increased these rates to 3.91/1000 and 3.24/1000, respectively. Accurate quantification of the neonatal mortality rate in a multi-hospital system requires the use of multiple information sources. Use of a single source can lead to varying rates of over- or under-estimation. It is possible to employ our methodology for both research and operational purposes.

California↗
PubMed2005

Rates of voluntary paternity establishment for infants born to unmarried adolescents.

OBJECTIVE: To investigate factors associated with voluntary paternity establishment for infants born to teenagers. STUDY DESIGN: The medical records of 402 unmarried women aged 13-19 years and delivering between January 1 and July 31, 2000, were reviewed, including prenatal charts, delivery records, birth worksheets, affidavits of parentage and infant birth certificates. The primary outcome was voluntary paternity establishment, as defined by having the father's name on the infant's birth certificate. RESULTS: Separate documents from the medical records of teen mothers had different rates of identifying the father of the infant: 80% of prenatal records had the father's name, as did 76% of birth worksheets and 60% of birth certificates. Maternal age < 16 years was associated with lower rates of paternity establishment as compared with 18-19-year-old mothers (OR 2.9, 95% CI 1.2, 6.7). CONCLUSION: A significant proportion of birth certificates on children born to teenagers do not identify the father of the infant; however, the majority of mothers identified them, on either the prenatal record or birth worksheet. In order to develop effective programs that will affect rates of paternity establishment, we must understand barriers inherent in the process itself.

Adolescent↗
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↗
PubMedDate not supplied

Prenatal participation in WIC related to Medicaid costs for Missouri newborns: 1982 update.

This study replicates a 1980 evaluation of WIC prenatal participation in Missouri by using a file of 9,086 Missouri Medicaid records matched with the corresponding birth records. This file was divided into a WIC group containing 3,261 records and a non-WIC group of 5,825 records. The 1982 results generally confirm the 1980 results, with the 1982 findings showing slightly improved pregnancy outcomes for WIC participants and slightly reduced benefit-to-cost ratios compared with the 1980 findings. In 1982, WIC participation was found to be associated with an increase in mean birth weight of 31 grams and reductions in low birth weight rates (statistically significant) and in neonatal death rates (not statistically significant). The reduction in each rate was 23 percent. WIC participation was also associated with a reduction in Medicaid costs for newborns reported within 45 days of birth amounting to $76 per participant. For every dollar spent on WIC, about 49 cents in Medicaid costs were apparently saved. However, wide 95 percent confidence intervals ($.07, $.90) make it difficult to determine precisely what impact WIC has on Federal and State budget outlays.

Birth Weight↗
PubMed2004

Driver's licenses as a source of data on height and weight.

We investigated the feasibility of using driver's license records to obtain height and weight data of individuals. First, we linked Washington State driver's license records (DOL) to the state birth files to assess how well driver's licenses can be linked to a public health database. We were able to match 78.4% of mothers and 71.7% of fathers on birth records to driver's license records. Then we assessed the accuracy of DOL height and weight data by comparing them to heights and weights measured on control women enrolled in a cancer etiology study (CES). There is a close relation between CES and DOL heights, but not a close relation between weights. Our results suggest that driver's license files are a good source of information for women's heights, but are not as good for women's weights.

Automobile Driving↗
PubMed2005

The effect of the 1998 Master Settlement Agreement on prenatal smoking.

The Master Settlement Agreement (MSA) between the major tobacco companies and 46 states created an abrupt 20% increase in cigarette prices in November 1998. Earlier estimates of the elasticity of prenatal smoking implied that the price rise would reduce prenatal cigarette smoking by 7-20%. Using birth records on 9.8 million US births between January 1996 and February 2000, we examined the change in smoking during pregnancy and conditional smoking intensity in response to the MSA. Overall, adjusting for secular trends in smoking, prenatal smoking declined by less than half what was predicted in response to the MSA.

Adolescent↗
PubMed1997

Is there an association between preconception paternal x-ray exposure and birth outcome? The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

Diagnostic x-rays are performed commonly on men of reproductive age, yet little is known about the potential effects of these x-rays on the future unborn children of such men. This study examines the possibility that preconception diagnostic x-ray studies of fathers may adversely effect their newborns. The authors used prospectively collected data from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) for 7,678 birth records for women who gave birth in the County of Avon, England, in 1991-1992. Birth weight, gestational age, and fetal growth of infants whose fathers received diagnostic x-ray examinations likely to deliver significant gonadal doses within one year prior to conception were compared with infants whose fathers did not receive such x-rays. The mean birth weight of babies of exposed fathers was 3,358 g compared with a mean of 3,437 g in the unexposed group (p = 0.055). A similar difference was noted for intrauterine growth, 3,374 g exposed versus 3,437 g unexposed (p = 0.078). The downward trend in birth weight and fetal growth (birth weight adjusted for gestational age) persisted despite control for infants' sex and important parental variables such as age, height, race, education, occupational exposure, parity, and maternal smoking. Because medical x-rays are the largest controllable source of man-made ionizing radiation, more detailed study of the potential effect of paternal x-irradiation on progeny seems justified.

Adolescent↗
PubMed1999

Effects of short interpregnancy intervals on small-for-gestational age and preterm births.

We examined the effects of short interpregnancy intervals on small-for-gestational age and preterm births in a biracial population using North Carolina birth certificate data from 1988 to 1994. We defined small-for-gestational age birth as being below the 10th percentile on a race-, sex-, and parity-specific growth curve after a gestation of 37-42 weeks. We defined preterm birth as a gestation of less than 37 weeks. We analyzed birth records from all eligible singleton births to black or white women ages 15-45 years after an interpregnancy interval of 0-3 months (N = 11,451) and a random sample of singleton births after an interval of 4-24 months (N = 23,118). We defined interpregnancy interval exposure categories as 0-3, 4-12, and 13-24 months. The multivariate adjusted odds ratio for small-for-gestational age births after interpregnancy intervals of 0-3 months compared with 13-24-month intervals was 1.6 (95% confidence interval = 1.4-1.8). The odds ratio for preterm birth after interpregnancy intervals of 0-3 months was 1.2 (95% confidence interval = 1.1-1.3). Odds ratios did not vary substantially by race for either outcome.

Adolescent↗
PubMed2001

Maternal and perinatal outcomes in women with gestational diabetes mellitus as compared to nondiabetic controls.

OBJECTIVE: To determine maternal and fetal outcomes in pregnancies complicated by gestational diabetes mellitus as compared to nondiabetic pregnancies matched on the basis of age and parity and to study the association between different treatment regimens and fetal outcomes. STUDY DESIGN: The records of 128 consecutive pregnancies complicated with gestational diabetes mellitus and 138 nondiabetic controls matched on the basis of age and parity were studied. Patients with gestational diabetes mellitus were treated either with diet only or diet in combination with insulin. Data were collected from medical records of the patients and birth records of the newborns. RESULTS: Despite treatment, the gestational diabetes mellitus group had a significantly higher frequency of cesarean section, preterm delivery and admission to a neonatal unit (P < .05). Preterm delivery and admission to a neonatal unit were significantly higher in the gestational diabetics treated with diet plus insulin as compared to the diet-only group (P < .05). CONCLUSION: Pregnancies complicated by gestational diabetes mellitus are associated with a higher frequency of adverse maternal and fetal outcomes, and adverse outcomes seems to be more frequent in patients treated with diet plus insulin.

Adult↗
PubMed1985

Paternal-age and birth-order effect on the human secondary sex ratio.

Because of conflicting results in previous analyses of possible maternal and paternal effects on the variation in sex ratio at birth, records of United States live births in 1975 were sorted by offspring sex, live birth order (based on maternal parity), parental races, and, unlike prior studies, ungrouped parental ages. Linear regression and logistic analysis showed significant effects of birth order and paternal age on sex ratio in the white race data (1.67 million births; 10,219 different combinations of independent variables). Contrary to previous reported results, the paternal-age effect cannot be ascribed wholly to the high correlation between paternal age and birth order as maternal age, even more highly correlated with birth order, does not account for a significant additional reduction in sex-ratio variation over that accounted for by birth order alone.

Adolescent↗
PubMed2001

Feasibility of using different approaches for recruiting younger twins to establish a population based twin register in Sri Lanka.

Identifying twins for a population-based register can be achieved through birth records or community surveys. We studied the feasibility and effectiveness of different methods of identifying and recruiting twins to establish a population based register. To trace twins a population survey was carried out using an interviewer administered questionnaire. We also inspected the birth registration certificates at a divisional secretariat reported from a specified hospital between the years of 1985-1997 and compared it to the birth register of this same hospital. To recruit twins a random sample of 75 twin pairs (150 twins) identified at the Divisional Secretariat were contacted through the post and 25 twin pairs (50 twins) were personally visited. The prevalence of twins was 6.5 twins per 1000 people in the area surveyed. The twinning rate at the hospital was 18.92 twins per 1000 births. A discrepancy of 38 multiples births between the hospital labour room records and those registered at the DS was noted. The response from the postal invitation for recruitment was 59% and the response from the personal invitation was 68%. (Difference 9.4% 95% CI; 7.06-11.73). Community survey and systematic inspection of birth records either at the hospital or the birth registration office was an effective method to trace twins. Once traced, personal contact was more effective than the postal invitation for recruitment of younger twins. A cost-effective approach would be to use a postal coverage followed by personal contact for non-responders. The alternative method, community coverage, would have financial implications.

Birth Certificates↗
PubMed2000

Perinatal deaths in the Faroe Islands during 1986-95.

OBJECTIVE: To examine causes of perinatal mortality in the Faroe Islands, where it has been increased compared to other Nordic societies. METHOD: Cases were classified according to a fetal/obstetric, a fetal/neonatal, and a fetal/obstetric/neonatal classification (classifications C1, C2, and C3, respectively). SETTING: The Faroe Islands 1986-1995; as reference materials were used a) the preceding decade in the Faroes and b) a parallel period in Denmark. SUBJECTS: We examined all available information regarding each case from hospital records, midwife records, birth certificates, death certificates and autopsy records. RESULTS: The perinatal mortality was 10.3 per 1,000 total births (83/8,096) compared with 13.7 (102/7,458) in the preceding decade; the fall could be attributed to fewer cases with preeclampsia, antepartum bleedings (C1) and antepartum asphyxia (C2) and the number fell despite an increased occurrence of cases attributed to congenital malformations. Perinatal mortality in Denmark was 8.3 (4,574/550,971), where rates were lower of cases with congenital malformations and fetoplacental dysfunction, but where the rate was higher of cases related to preterm birth (C3). CONCLUSIONS: Although the perinatal mortality rate still is higher in the Faroes than Denmark, the rate had fallen in the Faroes from 1976-85 to 1986-1995. The fall was mainly due to fewer cases attributable to antepartum asphyxia, preeclampsia, antepartum bleedings, and hyaline membrane disease, a pattern compatible with a more efficient perinatal service in the Faroes in the latter period.

Birth Certificates↗
PubMed2002

Outcomes of infants born to mothers with inflammatory bowel disease: a population-based cohort study.

OBJECTIVE: Limited population-based data on inflammatory bowel disease (IBD) and pregnancy outcomes exist. The purpose of this study is to determine the association between maternal IBD status and adverse pregnancy outcomes. METHODS: Using computerized birth records of infants born to mothers with Crohn's disease (CD) or ulcerative colitis (UC) and mothers without diagnoses of IBD (no-IBD) in Washington State, we performed a cross-sectional retrospective study to determine gestational age, birth weight, and congenital malformations. RESULTS: Preterm delivery was seen in 15.2% of CD births, 10.4% of UC births, and 7.2% of no-IBD births. Low birth weight was found in 16.8% of CD births, 7.6% of UC births, and 5.3% of no-IBD births. Smallness for gestational age was present in 15.2% of CD births, 10.5% of UC births, and 6.9% of no-IBD births. Only CD births were at significantly increased risk of preterm delivery (p < 0.0025), low birth weight (p < 0.001), and smallness for gestational age (p < 0.001). Congenital malformations were more commonly recorded in UC births than in controls (7.9% vs 1.7%, p < 0.001), whereas 3.4% of CD births had malformations recorded. Using multivariable logistic regression, CD births were more likely to be preterm (odds ratio [OR] = 2.3, 95% CI = 1.4-3.8) and have low birth weights (OR = 3.6, CI = 2.2-5.9) and smallness for gestational age (OR = 2.3, CI = 1.3-3.9). UC births were more likely to have congenital malformations reported (OR = 3.8, CI = 1.5-9.8). CONCLUSIONS: Maternal IBD is associated with increased odds of preterm delivery, low birth weight, smallness for gestational age (CD), and reporting of congenital malformations (UC).

Adult↗
PubMed1999

Effect of cervical carcinoma in situ and its management on pregnancy outcome.

OBJECTIVE: To assess the effect of cervical carcinoma in situ (CIS) and its management on subsequent pregnancy outcome. METHODS: We used a population-based retrospective cohort design that included record linkage between cancer data and birth records. The Cancer Surveillance System records of women with CIS (n = 1851, 312 diagnosed during pregnancy) diagnosed between 1984 and 1992, were linked to birth certificates of their first subsequent deliveries after CIS diagnosis. The comparison group (n = 9201) was a random sample of women without CIS who gave birth during the same years. The outcome measures were preterm and low birth weight infants subsequent to CIS diagnosis and treatment. Treatments included no therapy, dilation and curettage or endocervical curettage, cryosurgery or laser vaporization, and conization. RESULTS: Women with CIS who were not treated with conization had a small increased risk of preterm delivery (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.0, 2.0) and no increased risk of low birth weight infant (OR 1.0, 95% CI 0.7, 1.6), compared with women without CIS, after adjusting for maternal smoking, race, parity, marital status, and history of induced pregnancy termination. Women with CIS who had conization were more likely to deliver premature infants (OR 1.6, 95% CI 1.2, 2.0) than women without CIS, after adjusting for the same confounding factors. The apparently increased risk of low birth weight (OR 1.8, 95% CI 1.4, 2.4) seemed to be a reflection of premature delivery. CONCLUSION: The risk of prematurity increased after conization for CIS and did not increase when women with CIS had other procedures.

Adult↗
PubMed2001

Twinning rates in Ghana.

The incidence of twin births in Accra and Kumasi, the two major cities in Ghana, was investigated. In Accra, data were collected from the Korle-Bu Teaching Hospital while data were collected and analyzed from the Komfo Anokye Teaching Hospital in Kumasi. Both hospitals are the leading teaching hospitals in Ghana. The data consisted mainly of single and twin births recorded in the hospitals over a period of 12 years in Accra (1988-1999) and 15 years in Kumasi (1985-1999). The study revealed an incidence of 33.4 twin births per thousand live births for Accra and 26.6 twin births per thousand live births for Kumasi. Though these values are not as high as those reported among the Yoruba tribe of southwest Nigeria, who are reported to have the highest twin birth rates in the world, the present values still rank among the highest recorded twin birth rates.

Birth Rate↗
PubMed1996

Testicular nonseminoma and seminoma in relation to perinatal characteristics.

BACKGROUND: Testicular cancer incidence peaks during the third decade of life, and an increasing trend in the occurrence of this disease has been seen in many countries. Few risk factors have been established for testicular cancer, but evidence suggests that causal factors operate early in life, perhaps even in utero. PURPOSE: We performed a case-control study to evaluate specific perinatal characteristics as risk factors for the two main histopathologic types of testicular cancer: seminomas and nonseminomas. METHODS: Two hundred thirty-two case patients with invasive testicular cancer and 904 individually matched control subjects (all singleton births), nested in a cohort of men born at 10 hospitals in Sweden from 1920 through 1978, were included in the study. Perinatal information about the study subjects and their parents was obtained from birth records. For the mothers, information was recorded concerning age at menarche, marital status, parity, age at delivery, maternal weight at delivery and at first visit to a maternal-care center, education and/or profession, and any medical problems encountered during pregnancy or after delivery. For the fathers, information was obtained concerning age at delivery and education and/or profession. For the study subjects, information was recorded about the following: gestational age, birth length and weight, placental weight, method of delivery (normal, cesarean section, or with forceps or vacuum extractor), medical problems during hospital stay, presence of jaundice, method of feeding at discharge, and duration of hospital stay after birth. Individuals diagnosed with testicular cancer were identified through the Swedish National Cancer Registry and the Uppsala Regional Cancer Registry. The data were analyzed by use of conditional logistic regression modeling. RESULTS: When testicular cancer was modeled as a single entity, significantly elevated risks were associated with neonatal jaundice (adjusted odds ratio [OR] = 2.30; 95% confidence interval [CI] = 1.07-4.94) and with either low (< 2500 g) or high (> or = 4000 g) birth weight (OR = 2.59; 95% CI = 1.05-6.38 and OR = 1.58; 95% CI = 1.10-2.29, respectively). When seminomas and nonseminomas were analyzed separately, high maternal socioeconomic status (OR = 2.54; 95% CI = 1.05-6.12), neonatal jaundice (OR = 3.96; 95% CI = 1.47-10.69), and low birth weight (OR = 7.62; 95% CI = 1.59-36.60) were associated with nonseminomas, whereas high placental weight (OR = 3.50; 95% CI = 0.97-12.62) suggested increased risk for seminomas. CONCLUSIONS AND IMPLICATIONS: Perinatal exposures appear to influence the risk of testicular cancer, and seminomas and nonseminomas may have somewhat different risk profiles. Future epidemiologic studies should consider the possibility of etiologic heterogeneity in the development of seminomas and nonseminomas.

Birth Weight↗
PubMed1995

Birth weight and blood pressure: cross sectional and longitudinal relations in childhood.

OBJECTIVE: To examine cross sectional and longitudinal relations between birth weight and blood pressure in childhood. DESIGN: Cross sectional study of primary school children aged 9-11 years, with analysis in relation to previous measurements at 5-7 years in a subgroup. SETTING: 20 primary schools in Guildford and Carlisle. SUBJECTS: 1511 children measured at 9-11 years (response rate 79%), including 549 who had been measured at 5-7 years. MAIN OUTCOME MEASURES: Blood pressure at 9-11 years, change in blood pressure between 5-7 and 9-11 years, birth weight (based on maternal recall), and placental weight (based on birth records). RESULTS: At 9-11 years birth weight was inversely related both to systolic blood pressure (regression coefficient -2.80 mm Hg/kg; 95% confidence interval -3.84 to -1.76) and to diastolic blood pressure (regression coefficient -1.42 mm Hg/kg; -2.14 to -0.70) once current height and body mass index were taken into account. Placental weight was inversely related to blood pressure after adjustment for current height and body mass index but placental ratio (placental weight to birth weight) was unrelated to blood pressure. Between 5-7 and 9-11 years systolic blood pressure rose more rapidly in children of lower birth weight (regression coefficient -1.71 mm Hg/kg; -3.35 to -0.07). This effect seemed to be stronger in girls. CONCLUSIONS: Birth weight rather than placental ratio is the early life factor most importantly related to blood pressure in childhood. The results support the possibility of "amplification" of the relation between birth weight and blood pressure, particularly in girls.

Aging↗
PubMed2000

Population evolution in 20th-century Easter Island: endogamy and admixture.

We studied the 20th-century evolution of the Rapanui population of Easter Island, the most geographically isolated in the world, to analyze the current process of admixture. Using parochial birth records, we determined origin of the birth parents based on their surnames. The origin of parents reveals two stages of population evolution: endogamy, due to the isolation of the island, but with a strong rejection of isonymous marriages; and admixture, beginning in 1965 with the opening of the island to the rest of the world. We used Lasker's coefficient (Lasker's Ri) and the Shannon-Weaver coefficient of diversity (H) to characterize both stages. The gene flow evaluated from admixture has increased significantly since 1965. Births from exogamous unions represented 3.5% of total births from 1937 to 1965. increased to 43.2% between 1966 and 1980, and constituted 50.8% of all births between 1981 and 1996.

Birth Rate↗