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At least 19 recordsLinked to original sources
PubMed1989

Obstetric outcomes at the birth place in Menlo Park: the first seven years.

During its first seven years of operation, the Birth Place, a free-standing birth center in California, registered 898 women, of whom 690 (77%) were admitted in labor and 150 (17%) were referred for hospital birth prior to onset of labor. Using carefully delineated screening criteria, the center had an overall 18% intrapartum transport rate to the hospital, primarily for prolonged or arrested labor, a 3% cesarean section rate, no maternal mortality, and one neonatal death resulting from Cornelia de Lange syndrome, a congenital mental retardation-malformation syndrome of unknown etiology, which in this case was incompatible with life. Deliveries at the Birth Place were associated with low cost, a high level of maternal satisfaction, a low cesarean section rate, low neonatal mortality, and no maternal mortality.

Ambulatory Care Facilities↗
PubMed1991

Birth places: a geographical perspective on planned home birth in New Zealand.

In New Zealand until the 1920s, most births occurred at home or in small maternity hospitals under the care of a midwife. Births subsequently came under the control of the medical profession and the prevalent medical ideology continues to support hospitalised birth in the interests of safety for mother and child. Despite resistance from the medical profession, recent (1990) legislation has reinstated the autonomy of midwives and this has come at a time when the demand for home births is increasing. This paper locates these changes within the geographical context of home as a primary place within human experience. It is argued that the medical profession has been an agent of an essentially patriarchal society in engendering particular experiences of time and place for women in labour. Narrative data indicate that the choice of home as a birth place is related to three dimensions of experience unavailable in a hospital context: control, continuity and the familiarity of home.

Adult↗
PubMed2005

Syrian women's preferences for birth attendant and birth place.

BACKGROUND: Women's preferences for type of maternity caregiver and birth place have gained importance and have been documented in studies reported from the developed world. The purpose of our study was to identify Syrian women's preferences for birth attendant and place of delivery. METHODS: Interviews with 500 women living in Damascus and its suburbs were conducted using a pretested structured questionnaire. Women were asked about their preferences for the birth attendant and place of delivery, and an open-ended question asked them to give an explanation for their preferences. We analyzed preferences and their determinants, and also agreement between actual and preferred place of delivery and birth attendant. RESULTS: Only a small minority of women (5-10%) had no preference. Most (65.8%) preferred to give birth at the hospital, and 60.4 percent preferred to be attended by doctors compared with midwives (21.2%). More than 85 percent of women preferred the obstetrician to be a female. The actual place of delivery and type of birth attendant did not match the preferred place of delivery and type of birth attendant. Women's reasons for preferences were a perception of safety and competence, and communication style of caregiver. CONCLUSIONS: Most women preferred to be delivered by female doctors at a hospital in this population sample in Syria. The findings suggest that proper understanding of women's preferences is needed, and steps should be taken to enable women to make good choices. Policies about maternity education and services should take into account women's preferences.

Adult↗
PubMed1999

Geographical variation in rate of schizophrenia in rural Ireland by place at birth vs place at onset.

This study examined geographical variation in rate of occurrence of schizophrenia by place at birth vs place at onset, among a rural Irish catchment area population of unusual stability and socioeconomic homogeneity. Within a catchment area of 21,520 persons, all cases of schizophrenia were sought using current inpatient and outpatient records and key informants active in the community. Suspected cases were interviewed personally and diagnosed using DSM-III-R criteria. Place at birth and place at onset of psychosis were specified among the 32 District Electoral Divisions constituting the study region. For the 72 cases ascertained, an unremarkable overall prevalence rate/morbid risk obscured substantial and significant geographical variations therein between District Electoral Divisions. Particularly after controlling for high-density families, men demonstrated prominent geographical variation both by place at birth and by place at onset, with most men remaining unmarried and becoming ill at their place of birth; conversely, women demonstrated prominent variation by place at birth but more limited variation by place at onset, despite more frequent transitions from the parental home to the marital home before onset. Even when cases changed their location before the onset of psychosis, geographical variation in rate of occurrence of schizophrenia remained associated more strongly with factors related to the place of their birth.

Adult↗
PubMed1996

Alzheimer's disease: preliminary study of spatial distribution at birth place.

Alzheimer's disease (AD) is a neurodegenerative disorder which is characterized by a progressive loss of memory and the alteration of cognitive functions. At least three chromosomal segments have been associated with early-onset AD in genetic linkage studies. These results argue for a certain degree of heterogeneity in the genetic origin of some forms of AD, although environmental risk factors cannot be ruled out in late-onset AD. In this preliminary study, we analyzed the geographical distribution of the birth places of a sample of 235 AD cases born in a defined region of Quebec (Canada), between 1895 and 1935. We wished to test the hypothesis that risk factors acting at, or around birth place and time play a role in the etiology of AD. The field of study was divided into rural and urban areas. A reference population of live births was used to compute a measure of odds ratio (OR). The OR results showed a statistically significant excess of AD cases in the rural area as compared to the reference population. When stratified for sex, the OR results showed a global excess of female AD cases in both the rural and the urban areas. For men, only the urban area presented a statistically significant deficit. We also analyzed the structures of the genealogical kinships of the rural and urban sub-groups. Although AD cases from the rural sub-group were more closely related to each other than those from the urban one, removal of the kin pairs from the OR analysis seemed to have little effect on the rural/urban distribution of cases. Therefore, the OR results would not appear to be due primarily to a difference in the kinship structures of the two sub-groups. This could mean that some risk factors for AD afflict women more strongly than men, the effect being different depending on the urban or rural origin. However, potential biases such as a higher rate of report for women, differential migration between birth places or a differential mortality ratio between sexes could produce spurious results in the direction of what we have observed in this preliminary study.

Aged↗
PubMed1998

Geographical distribution of birth places of children with cancer in the UK.

Using birth addresses, we examined the geographical variation in risk for all types of childhood cancers in the UK, on a scale corresponding to the 10-km squares of the National Grid. The effects of socioeconomic and environmental factors, including natural background radiation, were investigated and their relative importance assessed using Poisson regression. Data came from a national collection of all fatal cancers between 1953 and 1980 in children aged 0-15 years and consisted of 9363 children of known place of birth from 12 complete annual cohorts born in the period 1953-64. For solid cancers, as well as for leukaemias and lymphomas, there was marked variation of cumulative mortality according to place of birth. High mortalities were associated with areas characterized as having high social class, higher incomes and good housing conditions, but also with high population densities (births per hectare). Each of these contrasting social indicators operated independently of the other, indicating complex determining mechanisms. Mortalities increased with increased radon exposure, and the relationship operated independently of the socioeconomic factors. At this scale of analysis, we found no increased mortality in industrialized areas. A population-mixing infective hypothesis, which postulates high rates of leukaemia when highly exposed urban populations are introduced to isolated rural areas, was supported by observations of high mortalities in 'growth areas' and New Towns, but was not readily reconcilable with the high rates seen in the high-density areas. If these correlations do indeed represent an infective mechanism, then the outcomes are not limited to malignancies of the immune system alone.

Adolescent↗
PubMed1990

A multifactorial study of birth place options: improving health care delivery in Saudi Arabia.

Although consumer demands may dictate a review of the highly mechanized and sophisticated technology of obstetric care provided in some parts of the western world, problems in Saudi Arabia revolve around under-utilization of health care facilities for maternity care and the consequences of this circumstance. A multifactorial analysis was performed to study the association of certain social correlates with options for birth settings in a rural region of the Kingdom. Age and educational level of the mother were found to be highly significant (P less than 0.005) variables influencing the choice for place of delivery, whereas economic status (P greater than 0.1) and housing conditions (NS) tailed to make an equally impressive contribution. Within the constraints of available health care manpower at the local level, suggestions are made for the best strategy to successfully educate mothers for safer options in birth.

Developing Countries↗
PubMed2003

Spatial clustering of amyotrophic lateral sclerosis in Finland at place of birth and place of death.

Previous evidence for spatial clustering of amyotrophic lateral sclerosis is inconclusive. Studies that have identified apparent clusters have often been based on a small number of cases, which means the results may have occurred by chance processes. Also, most studies have used the geographic location at the time of death as the basis for cluster detection, rather than exploring clusters at other points in the life cycle. In this study, the authors examine 1,000 cases of amyotrophic lateral sclerosis distributed throughout Finland who died between June 1985 and December 1995. Using a spatial-scan statistic, the authors examine whether there are significant clusters of the disease at both time of birth and time of death. Two significant, neighboring clusters were identified in southeast and south-central Finland at the time of death. A single significant cluster was identified in southeast Finland at the time of birth, closely matching one of the clusters identified at the time of death. These results are based on a large sample of cases, and they provide convincing evidence of spatial clustering of this condition. The results demonstrate also that, if the cluster analysis is conducted at different stages of the cases' life cycle, different conclusions about where potential risk factors may exist might result.

Adult↗
PubMedDate not supplied

Recent changes in birth attendant, place of birth, and the use of obstetric interventions, United States, 1989-1997.

Although more than nine out of every ten births are attended by physicians, the percent of births attended by midwives increased during the 1989 to 1997 period and accounted for 7% of all births in 1997. About 99% of births in 1997 were in hospitals, basically unchanged from 1989, but the percent of out-of-hospital births that occurred in residences increased over the period, while those in freestanding birthing centers declined. The percent of mothers receiving electronic fetal monitoring, ultrasound, and induction and stimulation of labor increased. The most dramatic increase was a doubling of the use of induction. In 1997, approximately 18% of all births were induced. Midwives as well as physicians increased the use of these obstetric procedures over the 1989 to 1997 period, and the use of many procedures by CNMs was as high, or nearly as high, as use by physicians. The rate of cesarean births dropped by 9%, from about 23% in 1989 to about 21% in 1997, while the rate of vaginal birth after a previous cesarean increased by 50%. The proportion of births assisted by forceps consistently declined during the period, while the use of vacuum extraction consistently increased. The number of episiotomies performed in the United States declined each year during the 1990-1996 period.

Birthing Centers↗
PubMed2000

Strontium isotope composition of skeletal material can determine the birth place and geographic mobility of humans and animals.

The Sr isotope composition measured in skeletal elements (e.g., bone, teeth, or antlers) can be used to infer the geographic region that an animal or human inhabited, because different regions tend to have distinct Sr isotope compositions, and natural variations in the relative abundance of Sr isotopes are not changed as Sr is processed through the food chain. Therefore, an organism that ingests Sr from one region can have a Sr isotope composition that is different than that of an organism that ingests Sr from another region. The Sr isotope composition of skeletal elements is a reflection of the concentration-weighted average of dietary Sr that was ingested while that skeletal element was produced. Because different skeletal elements grow and exchange Sr at different stages during the life times of organisms, Sr isotope analysis of different skeletal elements can be used to infer changes in geographic location at different stages in an organism's life. The Sr isotope composition measured in human teeth will reflect the average Sr isotope composition that was ingested as a child, due to the immobile nature of Sr and Ca in teeth after formation, whereas the Sr isotope composition of bone will reflect the average isotopic composition over the last ten years of life, due to continuous biological processing of Sr and Ca in bone. Inferring the average isotopic composition of dietary Sr is best done by analyzing skeletal fragments from control groups, which might be animals that have the same feeding habits as the animal in question, or, in the case of humans, analysis of close family relatives. In cases where it is not possible to construct a Sr isotope database from control groups, it becomes necessary to estimate the isotopic composition of dietary Sr based on geologic principles. We present three case studies from our research that illustrate a range of approaches: (1) results from a criminal case where a deer was illegally harvested and the location of the deer was important to establish, (2) a pilot study of commingled human remains from a burial in Vietnam, associated with the Vietnam Conflict, and (3) a study of 13th and 14th century migration of peo ple from an archeological site in the Southwest United States.

Adult↗
PubMed2002

[Genetic demography of Ukrainian urban populations in the 1990's: ethnicity and birth places of migrants to the Poltava population].

Analysis of the birthplace and ethnicity of males and females contracting marriages in the city of Poltava in 1960, 1985, and 1995 revealed a trend towards return of Ukrainians from various regions of the former Soviet Union to their places of origin. In the migration flow, Russians were gradually substituted by Ukrainians, and the total proportion of Slavs increased. The isolation by distance (b) decreased from 0.00122 to 0.00075 in the period from 1960 to 1985 and then increased to 0.00098 by 1995. Positive association was found between the parent-offspring distance and marriage distance (the correlation coefficient r = 0.65-0.75).

Adult↗
PubMed1984

[Perinatal and neonatal mortality and morbidity in central Switzerland in 1982. An analysis of all newborns in a geographically circumscribed region].

In assessment of the perinatal situation in Central Switzerland, all 5616 infants born in the geographically surrounding areas of the Children's Hospital Lucerne have been statistically evaluated, according to birth place, birth weight, gestational age, perinatal condition, and postnatal development. 76 infants (1.4%) were born at home, 417 births (7.5%) took place before the completed 37th gestational week. Only 5.8% of our newborns had weights below the 10th percentile according to the Winterthur percentile curves used in Switzerland. The perinatal mortality was 12.9%, the neonatal mortality 7.1%. 2/3 of the deaths concern either extremely premature babies or infants with severe congenital malformations. The recorded malformations coincide with the known incidence, with the exception of trisomy 21, which marked an incidence of 1:1400. 8% of all live-born babies (499) needed special neonatal care. Among the preterm infants, every 2nd, and among the full-term babies every 12th had to be transferred to the neonatal care unit. Most of the transferrals were due to simple disturbances of adaptation (6% of all live-borns), whereas 1% required intensive care because of severe disorders. In 50 babies (1% of all live-borns), the neonatal diagnosis allows to anticipate a reduction of the quality of life.

Birth Weight↗