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At least 1,747 records · Page 97Linked to original sources
PubMed1999

Effect of prenatal care on infant mortality rates according to birth-death certificate files.

Infant mortality has decreased nationwide; however, our national rates still log behind those of other industrialized countries, especially the rates for minority groups. This study evaluates the effect of prenatal care and risk factors on infant mortality rates in Chicago. Using linked infant birth and death certificates of Chicago residents for 1989-1995, a total of 5838 deaths occurring during the first year of life were identified. Birth certificate variables, especially prenatal care, were reviewed. Variables were compared by stratified analysis. Pearson chi 2 analysis and odd ratios (ORs) were computed. Infant mortality rate (IMR) in Chicago decreased from 17 in 1989 to 12.6 in 1995 (P < .0001). Some factors increased IMR several fold: prematurity (OR 17.43), no prenatal care (OR 4.07), inadequate weight gain (OR 2.95), African-American ethnicity (OR 2.55), and inadequate prenatal care (OR 2.03). Compared with no care, prenatal care was associated with lower IMR; however, early care was associated with higher IMR and ORs than later care. These results demonstrate prenatal care is associated with lower IMR; however, compared with late prenatal care, early care does not improve IMR. Further studies should evaluate whether improving the quality of care improves IMRs.

Adolescent↗
PubMed1999

Lamotrigine for adults and children: new indication. A noteworthy improvement in the assessment file.

(1) The indications for lamotrigine have been extended as monotherapy for adults, and in combination for children over 2 years of age. (2) In adults, two comparative trials have established that the efficacy of lamotrigine monotherapy is not significantly different from that of carbamazepine. (3) In children, lengthy non comparative trials suggest a positive effect of lamotrigine when it is added to ongoing inadequately effective treatment, especially for patients with absences, atonic seizures and tonic-clonic seizures. In contrast, lamotrigine can increase the frequency of myoclonic seizures in some cases. (4) In patients with the Lennox-Gastaut syndrome, the addiction of lamotrigine to an ongoing inadequately effective treatment proved more effective than a placebo in two methodologically sound trials. (5) Potentially severe cutaneous adverse effects calls for special precautions during the introduction of lamotrigine, taking account of aggravating factors such as combination with valproate sodium and too rapid a dose increment in the first two months of treatment.

Adult↗