WorldWideScience

Sample records for common major birth

  1. Residential proximity to major roads and placenta/birth weight ratio.

    Science.gov (United States)

    Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Tsuda, Toshihide; Doi, Hiroyuki; Kawachi, Ichiro

    2012-01-01

    Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight. We examined whether proximity to major roads (as a marker of exposure to air pollution) is associated with increased placenta/birth weight ratio (as a biomarker of the placental transport function). Data on parental characteristics and birth outcomes were extracted from the database maintained by a major hospital in Shizuoka Prefecture, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,189). Using geocoded residential information, each birth was classified according to proximity to major roads. We examined the association between proximity to major roads and the placenta/birth weight ratio, using multiple linear regression. Proximity to major roads was associated with higher placenta/birth weight ratio. After adjusting for potential confounders, living within 200 m of a major road increased the ratio by 0.48% (95% CI = 0.15 to 0. 80). In addition, proximity to major roads was associated with lower placenta weight and birth weight. These observed associations were stronger among participants living closer to major roads. Exposure to traffic-related air pollution is associated with higher placenta/birth weight ratio. Impaired placental oxygen and nutrient transport function might be a mechanism for explaining the observed association between air pollution and low birth weight as well as preterm birth. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Assisted reproductive technology and major birth defects in Western Australia.

    Science.gov (United States)

    Hansen, Michele; Kurinczuk, Jennifer J; de Klerk, Nicholas; Burton, Peter; Bower, Carol

    2012-10-01

    To estimate the prevalence of major birth defects diagnosed by 6 years of age in all births and terminations of pregnancy for fetal anomaly conceived by assisted reproductive technology (when this included intracytoplasmic sperm injection and in vitro fertilization [IVF]) and the remainder of nonassisted reproductive technology-conceived children born in Western Australia from 1994 to 2002. This retrospective cohort study used data linkage between three population-based registers (Reproductive Technology Register, Western Australian Register of Developmental Anomalies, and Midwives' Notification of Birth System) to identify all assisted reproductive technology (n=2,911) and nonassisted reproductive technology (n=210,997) births with and without birth defects diagnosed by age 6 and all terminations of pregnancy for fetal anomaly. A major birth defect was diagnosed in 8.7% of assisted reproductive technology and 5.4% of nonassisted reproductive technology singletons (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.30-1.79), as well as 7.1% of assisted reproductive technology twins and 5.9% of nonassisted reproductive technology twins of unlike sex (OR 1.08, 95% CI 0.77-1.51). The prevalence of birth defects in assisted reproductive technology singletons and twins decreased markedly over the study period. This change was evident across all three clinics contributing data over the whole study and was particularly marked for children conceived as a result of IVF. There has been a decrease in the prevalence of birth defects over time in children born as a result of assisted reproductive technology in Western Australia; however, the prevalence of major birth defects in assisted reproductive technology singletons remains increased compared with nonassisted reproductive technology singletons. II.

  3. First Trimester Influenza Vaccination and Risks for Major Structural Birth Defects in Offspring.

    Science.gov (United States)

    Kharbanda, Elyse Olshen; Vazquez-Benitez, Gabriela; Romitti, Paul A; Naleway, Allison L; Cheetham, T Craig; Lipkind, Heather S; Klein, Nicola P; Lee, Grace; Jackson, Michael L; Hambidge, Simon J; McCarthy, Natalie; DeStefano, Frank; Nordin, James D

    2017-08-01

    To examine risks for major structural birth defects in infants after first trimester inactivated influenza vaccine (IIV) exposures. In this observational study, we used electronic health data from 7 Vaccine Safety Datalink sites to examine risks for selected major structural defects in infants after maternal IIV exposure. Vaccine exposures for women with continuous insurance enrollment through pregnancy who delivered singleton live births between 2004 and 2013 were identified from standardized files. Infants with continuous insurance enrollment were followed to 1 year of age. We excluded mother-infant pairs with other exposures that potentially increased their background risk for birth defects. Selected cardiac, orofacial or respiratory, neurologic, ophthalmologic or otologic, gastrointestinal, genitourinary and muscular or limb defects were identified from diagnostic codes in infant medical records using validated algorithms. Propensity score adjusted generalized estimating equations were used to estimate prevalence ratios (PRs). We identified 52 856 infants with maternal first trimester IIV exposure and 373 088 infants whose mothers were unexposed to IIV during first trimester. Prevalence (per 100 live births) for selected major structural birth defects was 1.6 among first trimester IIV exposed versus 1.5 among unexposed mothers. The adjusted PR was 1.02 (95% CI 0.94-1.10). Organ system-specific PRs were similar to the overall PR. First trimester maternal IIV exposure was not associated with an increased risk for selected major structural birth defects in this large cohort of singleton live births. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Placenta previa and risk of major congenital malformations among singleton births in Finland.

    Science.gov (United States)

    Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

    2015-06-01

    Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

  5. Staying home to give birth: why women in the United States choose home birth.

    Science.gov (United States)

    Boucher, Debora; Bennett, Catherine; McFarlin, Barbara; Freeze, Rixa

    2009-01-01

    Approximately 1% of American women give birth at home and face substantial obstacles when they make this choice. This study describes the reasons that women in the United States choose home birth. A qualitative descriptive secondary analysis was conducted in a previously collected dataset obtained via an online survey. The sample consisted of 160 women who were US residents and planned a home birth at least once. Content analysis was used to study the responses from women to one essay question: "Why did you choose home birth?" Women who participated in the study were mostly married (91%) and white (87%). The majority (62%) had a college education. Our analysis revealed 508 separate statements about why these women chose home birth. Responses were coded and categorized into 26 common themes. The most common reasons given for wanting to birth at home were: 1) safety (n = 38); 2) avoidance of unnecessary medical interventions common in hospital births (n = 38); 3) previous negative hospital experience (n = 37); 4) more control (n = 35); and 5) comfortable, familiar environment (n = 30). Another dominant theme was women's trust in the birth process (n = 25). Women equated medical intervention with reduced safety and trusted their bodies' inherent ability to give birth without interference.

  6. Season of birth, clinical manifestations and Dexamethasone Suppression Test in unipolar major depression

    Directory of Open Access Journals (Sweden)

    Kaprinis George S

    2007-08-01

    Full Text Available Abstract Background Reports in the literature suggest that the season of birth might constitute a risk factor for the development of a major psychiatric disorder, possibly because of the effect environmental factors have during the second trimester of gestation. The aim of the current paper was to study the possible relationship of the season of birth and current clinical symptoms in unipolar major depression. Methods The study sample included 45 DSM-IV major depressive patients and 90 matched controls. The SCAN v. 2.0, Hamilton Depression Rating Scale (HDRS and Hamilton Anxiety Scale (HAS were used to assess symptomatology, and the 1 mg Dexamethasone Suppression Test (DST was used to subcategorize patients. Results Depressed patients as a whole did not show differences in birth season from controls. However, those patients born during the spring manifested higher HDRS while those born during the summer manifested the lowest HAS scores. DST non-suppressors were almost exclusively (90% likely to be born during autumn and winter. No effect from the season of birth was found concerning the current severity of suicidal ideation or attempts. Discussion The current study is the first in this area of research using modern and rigid diagnostic methodology and a biological marker (DST to categorize patients. Its disadvantages are the lack of data concerning DST in controls and a relatively small size of patient sample. The results confirm the effect of seasonality of birth on patients suffering from specific types of depression.

  7. Advances in the Prevention of infection-Related Preterm Birth

    DEFF Research Database (Denmark)

    Lamont, R. F.

    2015-01-01

    Infection-related preterm birth (PTB) is more common at early gestational ages and is associated with major neonatal mortality and morbidity. Abnormal genital tract microflora in early pregnancy predicts late miscarriage and early PTB. Accordingly, it is logical to consider antibiotics as an inte......Infection-related preterm birth (PTB) is more common at early gestational ages and is associated with major neonatal mortality and morbidity. Abnormal genital tract microflora in early pregnancy predicts late miscarriage and early PTB. Accordingly, it is logical to consider antibiotics...

  8. LPRS by State, County, Country of Birth and Major Class of Admission 2015

    Data.gov (United States)

    Department of Homeland Security — These tables offer county-level data for the top 200 counties of residence of new LPRs by major class of admission and by country of birth. OIS assigns county of...

  9. Racial/ethnic variations in the prevalence of selected major birth defects, metropolitan Atlanta, 1994-2005.

    Science.gov (United States)

    Kucik, James E; Alverson, Clinton J; Gilboa, Suzanne M; Correa, Adolfo

    2012-01-01

    Birth defects are the leading cause of infant mortality and are responsible for substantial child and adult morbidity. Documenting the variation in prevalence of birth defects among racial/ethnic subpopulations is critical for assessing possible variations in diagnosis, case ascertainment, or risk factors among such groups. We used data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth defects registry with active case ascertainment. We estimated the racial/ethnic variation in prevalence of 46 selected major birth defects among live births, stillbirths, and pregnancy terminations at >20 weeks gestation among mothers residing in the five central counties of metropolitan Atlanta between 1994 and 2005, adjusting for infant sex, maternal age, gravidity, and socioeconomic status (SES). We also explored SES as a potential effect measure modifier. Compared with births to non-Hispanic white women, births to non-Hispanic black women had a significantly higher prevalence of five birth defects and a significantly lower prevalence of 10 birth defects, while births to Hispanic women had a significantly higher prevalence of four birth defects and a significantly lower prevalence of six birth defects. The racial/ethnic disparities in the prevalence of some defects varied by SES, but no clear pattern emerged. Racial/ethnic disparities were suggested in 57% of included birth defects. Disparities in the prevalence of birth defects may result from different underlying genetic susceptibilities; exposure to risk factors; or variability in case diagnosis, ascertainment, or reporting among the subpopulations examined. Policies that improve early diagnosis of birth defects could reduce associated morbidity and mortality.

  10. Population trends and live birth rates associated with common ART treatment strategies.

    Science.gov (United States)

    Chambers, Georgina M; Wand, Handan; Macaldowie, Alan; Chapman, Michael G; Farquhar, Cynthia M; Bowman, Mark; Molloy, David; Ledger, William

    2016-11-01

    Have ART live birth rates improved in Australia over the last 12 years? There were striking improvements in per-cycle live birth rates observed for frozen/thaw embryo transfers, blastocyst transfer and single embryo transfer (SET), while live birth rates following ICSI were lower than IVF for non-male factor infertility in most years. ART and associated techniques have become the predominant treatment of infertility over the past 30 years in most developed countries. However, there are differences in ART laboratory and clinical practices, and success rates worldwide. Australia has one of the highest ART utilization rates and lowest multiple birth rates in the world, thus providing a unique setting to investigate the contribution of common ART strategies in an unrestricted population of patients to ART success rates. A retrospective cohort study of 585 065 ART treatment cycles performed in Australia between 2002 and 2013 using the Australian and New Zealand Assisted Reproduction Database (ANZARD). An unrestricted population of all women who underwent autologous ART treatment between 2002 and 2013. Visual descriptive analysis was used to assess the trends in ART procedures by the calendar years. Adjusted odds ratios (aORs) of a live birth for four common ART techniques were calculated after controlling for important confounders including female age, infertility diagnosis, stage of the embryo (blastocyst versus cleavage stage), type of embryo (fresh versus thawed), fertilization method (IVF versus ICSI) and number of embryos transferred (SET versus multiple embryos). The overall live birth rate per embryo transfer increased from 19.2% in 2002 to 23.3% in 2013 (21.9-24.3% for fresh embryo transfers and 14.6-23.3% for frozen/thaw embryo transfers). This occurred concurrently with an increase in SET from 29.7% to 78.9%, and an increase in the average age of women undergoing treatment from 35.0 to 35.9 years. Individuals who had a frozen/thaw embryo transfer cycle in 2002

  11. Associations between maternal periconceptional exposure to secondhand tobacco smoke and major birth defects.

    Science.gov (United States)

    Hoyt, Adrienne T; Canfield, Mark A; Romitti, Paul A; Botto, Lorenzo D; Anderka, Marlene T; Krikov, Sergey V; Tarpey, Morgan K; Feldkamp, Marcia L

    2016-11-01

    While associations between secondhand smoke and a few birth defects (namely, oral clefts and neural tube defects) have been noted in the scientific literature, to our knowledge, there is no single or comprehensive source of population-based information on its associations with a range of birth defects among nonsmoking mothers. We utilized data from the National Birth Defects Prevention Study, a large population-based multisite case-control study, to examine associations between maternal reports of periconceptional exposure to secondhand smoke in the household or workplace/school and major birth defects. The multisite National Birth Defects Prevention Study is the largest case-control study of birth defects to date in the United States. We selected cases from birth defect groups having >100 total cases, as well as all nonmalformed controls (10,200), from delivery years 1997 through 2009; 44 birth defects were examined. After excluding cases and controls from multiple births and whose mothers reported active smoking or pregestational diabetes, we analyzed data on periconceptional secondhand smoke exposure-encompassing the period 1 month prior to conception through the first trimester. For the birth defect craniosynostosis, we additionally examined the effect of exposure in the second and third trimesters as well due to the potential sensitivity to teratogens for this defect throughout pregnancy. Covariates included in all final models of birth defects with ≥5 exposed mothers were study site, previous live births, time between estimated date of delivery and interview date, maternal age at estimated date of delivery, race/ethnicity, education, body mass index, nativity, household income divided by number of people supported by this income, periconceptional alcohol consumption, and folic acid supplementation. For each birth defect examined, we used logistic regression analyses to estimate both crude and adjusted odds ratios and 95% confidence intervals for both

  12. Gestational age at birth and risk of intellectual disability without a common genetic cause.

    Science.gov (United States)

    Heuvelman, Hein; Abel, Kathryn; Wicks, Susanne; Gardner, Renee; Johnstone, Edward; Lee, Brian; Magnusson, Cecilia; Dalman, Christina; Rai, Dheeraj

    2017-12-06

    Preterm birth is linked to intellectual disability and there is evidence to suggest post-term birth may also incur risk. However, these associations have not yet been investigated in the absence of common genetic causes of intellectual disability, where risk associated with late delivery may be preventable. We therefore aimed to examine risk of intellectual disability without a common genetic cause across the entire range of gestation, using a matched-sibling design to account for unmeasured confounding by shared familial factors. We conducted a population-based retrospective study using data from the Stockholm Youth Cohort (n = 499,621) and examined associations in a nested cohort of matched outcome-discordant siblings (n = 8034). Risk of intellectual disability was greatest among those born extremely early (adjusted OR 24 weeks  = 14.54 [95% CI 11.46-18.44]), lessening with advancing gestational age toward term (aOR 32 weeks  = 3.59 [3.22-4.01]; aOR 37 weeks  = 1.50 [1.38-1.63]); aOR 38 weeks  = 1.26 [1.16-1.37]; aOR 39 weeks = 1.10 [1.04-1.17]) and increasing with advancing gestational age post-term (aOR 42 weeks  = 1.16 [1.08-1.25]; aOR 43 weeks  = 1.41 [1.21-1.64]; aOR 44 weeks  = 1.71 [1.34-2.18]; aOR 45 weeks  = 2.07 [1.47-2.92]). Associations persisted in a cohort of matched siblings suggesting they were robust against confounding by shared familial traits. Risk of intellectual disability was greatest among children showing evidence of fetal growth restriction, especially when birth occurred before or after term. Birth at non-optimal gestational duration may be linked causally with greater risk of intellectual disability. The mechanisms underlying these associations need to be elucidated as they are relevant to clinical practice concerning elective delivery around term and mitigation of risk in post-term children.

  13. How do Major, Violent and Nonviolent Opposition Campaigns, Impact Predicted Life Expectancy at birth?

    Directory of Open Access Journals (Sweden)

    Judith Stoddard

    2013-08-01

    Full Text Available This study compared the effects of major violent and nonviolent opposition campaigns for regime change, on predicted life expectancy at birth. The study measured life expectancy five and ten years after the campaign ended, so that deaths which occurred during the campaign would not be included in the metric, and thus enabling the study of changes made in the state on the social determinants affecting longevity, after the campaign was over. Life expectancy is one of the best reported World Development Indicators and is considered to be a good indication of the overall health and general living conditions of the state and therefore is an ideal indicator to reflect the changes made in the state following a major campaign. The results of this analysis showed that states have a hard time recovering from a major opposition campaign and initially drop behind the growth trend in the world average for predicted life expectancy at birth. But, the type of campaign that was waged and whether it was successful, greatly affects the state’s ability to recover. Encouragingly by a decade after the campaign ends, states that experienced a nonviolent campaign that was successful had caught up to the world average and inched ahead of it. This shows that on this important development indicator, new governments that were ushered into power by nonviolent social movements, had made positive changes in the state that enabled it to surpass world averages.

  14. Beating Birth Defects

    Centers for Disease Control (CDC) Podcasts

    Each year in the U.S., one in 33 babies is affected by a major birth defect. Women can greatly improve their chances of giving birth to a healthy baby by avoiding some of the risk factors for birth defects before and during pregnancy. In this podcast, Dr. Stuart Shapira discusses ways to improve the chances of giving birth to a healthy baby.

  15. Facts about Birth Defects

    Science.gov (United States)

    ... label> Information For… Media Policy Makers Facts about Birth Defects Language: English (US) Español (Spanish) Recommend on ... having a baby born without a birth defect. Birth Defects Are Common Every 4 ½ minutes, a ...

  16. Outcomes of independent midwifery attended births in birth centres and home births: a retrospective cohort study in Japan.

    Science.gov (United States)

    Kataoka, Yaeko; Eto, Hiromi; Iida, Mariko

    2013-08-01

    the objective of this study was to describe and compare perinatal and neonatal outcomes of women who received care from independent midwives practicing home births and at birth centres in Tokyo. a retrospective cohort study. birth centres and homes serviced by independent midwives in Tokyo. of the 43 eligible independent midwives 19 (44%) (10 assisted birth at birth centres, nine assisted home birth) participated in the study. A total of 5477 women received care during their pregnancy and gave birth assisted by these midwives between 2001 and 2006. researchers conducted a retrospective chart review of women's individual data. Collected data included demographic characteristics, process of pregnancy and perinatal and neonatal outcomes. We also collected data about independent midwives and their practice. of the 5477 women, 83.9% gave birth at birth centres and 16.1% gave birth at home. The average age was 31.7 years old and the majority (70.6%) were multiparas. All women had vaginal spontaneous deliveries, with no vacuum, forceps or caesarean section interventions. No maternal fatalities were reported, nor were breech or multiple births. The average duration of the first and second stages of labour was 14.9 hours for primiparas and 6.2 hours for multiparas. Most women (97.1%) gave birth within 24 hours of membrane rupture. Maternal position during labour varied and family attended birth was common. The average blood loss was 371.3mL, while blood loss over 500mL was 22.6% and over 1000mL was 3.6%. Nearly 60% of women had intact perinea. There were few preterm births (0.6%) and post mature births (1.3%). Infant's average birth weight was 3126g and 0.5% were low-birthweight-infants, while 3.3% had macrosomia. Among primiparas, the birth centre group had more women experiencing an excess of 500mL blood loss compared to the home birth group (27.2% versus 17.6% respectively; RR 1.54; 95%CI 1.10 to 2.16). Multiparas delivering at birth centres were more likely to have a

  17. Training traditional birth attendants to use misoprostol and an absorbent delivery mat in home births.

    Science.gov (United States)

    Prata, Ndola; Quaiyum, Md Abdul; Passano, Paige; Bell, Suzanne; Bohl, Daniel D; Hossain, Shahed; Azmi, Ashrafi Jahan; Begum, Mohsina

    2012-12-01

    A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in operations research among 77,337 home births in rural Bangladesh. The purpose of this study was to evaluate TBAs' knowledge acquisition, knowledge retention, and changes in attitudes and practices related to PPH management in home births after undergoing training on the use of misoprostol and the blood collection delivery mat. We conclude that the training was highly effective and that the two interventions were safely and correctly used by TBAs at home births. Data on TBA practices indicate adherence to protocol, and 18 months after the interventions were implemented, TBA knowledge retention remained high. This program strengthens the case for community-based use of misoprostol and warrants consideration of this intervention as a potential model for scale-up in settings where complete coverage of skilled birth attendants (SBAs) remains a distant goal. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. The Consequences of Chorioamnionitis: Preterm Birth and Effects on Development

    Directory of Open Access Journals (Sweden)

    Robert Galinsky

    2013-01-01

    Full Text Available Preterm birth is a major cause of perinatal mortality and long-term morbidity. Chorioamnionitis is a common cause of preterm birth. Clinical chorioamnionitis, characterised by maternal fever, leukocytosis, tachycardia, uterine tenderness, and preterm rupture of membranes, is less common than subclinical/histologic chorioamnionitis, which is asymptomatic and defined by inflammation of the chorion, amnion, and placenta. Chorioamnionitis is often associated with a fetal inflammatory response. The fetal inflammatory response syndrome (FIRS is defined by increased systemic inflammatory cytokine concentrations, funisitis, and fetal vasculitis. Clinical and epidemiological studies have demonstrated that FIRS leads to poor cardiorespiratory, neurological, and renal outcomes. These observations are further supported by experimental studies that have improved our understanding of the mechanisms responsible for these outcomes. This paper outlines clinical and experimental studies that have improved our current understanding of the mechanisms responsible for chorioamnionitis-induced preterm birth and explores the cellular and physiological mechanisms underlying poor cardiorespiratory, neural, retinal, and renal outcomes observed in preterm infants exposed to chorioamnionitis.

  19. Linkage of Maternity Hospital Episode Statistics data to birth registration and notification records for births in England 2005-2014: Quality assurance of linkage of routine data for singleton and multiple births.

    Science.gov (United States)

    Harper, Gillian

    2018-03-01

    To quality assure a Trusted Third Party linked data set to prepare it for analysis. Birth registration and notification records from the Office for National Statistics for all births in England 2005-2014 linked to Maternity Hospital Episode Statistics (HES) delivery records by NHS Digital using mothers' identifiers. All 6 676 912 births that occurred in England from 1 January 2005 to 31 December 2014. Every link between a registered birth and an HES delivery record for the study period was categorised as either the same baby or a different baby to the same mother, or as a wrong link, by comparing common baby data items and valid values in key fields with stepwise deterministic rules. Rates of preserved and discarded links were calculated and which features were more common in each group were assessed. Ninety-eight per cent of births originally linked to HES were left with one preserved link. The majority of discarded links were due to duplicate HES delivery records. Of the 4854 discarded links categorised as wrong links, clerical checks found 85% were false-positives links, 13% were quality assurance false negatives and 2% were undeterminable. Births linked using a less reliable stage of the linkage algorithm, births at home and in the London region, and with birth weight or gestational age values missing in HES were more likely to have all links discarded. Linkage error, data quality issues, and false negatives in the quality assurance procedure were uncovered. The procedure could be improved by allowing for transposition in date fields, and more discrimination between missing and differing values. The availability of identifiers in the datasets supported clerical checking. Other research using Trusted Third Party linkage should not assume the linked dataset is error-free or optimised for their analysis, and allow sufficient resources for this. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved

  20. Where There Are (Few) Skilled Birth Attendants

    Science.gov (United States)

    Prata, Ndola; Rowen, Tami; Bell, Suzanne; Walsh, Julia; Potts, Malcolm

    2011-01-01

    Recent efforts to reduce maternal mortality in developing countries have focused primarily on two long-term aims: training and deploying skilled birth attendants and upgrading emergency obstetric care facilities. Given the future population-level benefits, strengthening of health systems makes excellent strategic sense but it does not address the immediate safe-delivery needs of the estimated 45 million women who are likely to deliver at home, without a skilled birth attendant. There are currently 28 countries from four major regions in which fewer than half of all births are attended by skilled birth attendants. Sixty-nine percent of maternal deaths in these four regions can be attributed to these 28 countries, despite the fact that these countries only constitute 34% of the total population in these regions. Trends documenting the change in the proportion of births accompanied by a skilled attendant in these 28 countries over the last 15-20 years offer no indication that adequate change is imminent. To rapidly reduce maternal mortality in regions where births in the home without skilled birth attendants are common, governments and community-based organizations could implement a cost-effective, complementary strategy involving health workers who are likely to be present when births in the home take place. Training community-based birth attendants in primary and secondary prevention technologies (e.g. misoprostol, family planning, measurement of blood loss, and postpartum care) will increase the chance that women in the lowest economic quintiles will also benefit from global safe motherhood efforts. PMID:21608417

  1. Quality assessment of home births in Denmark.

    Science.gov (United States)

    Jensen, Sabrina; Colmorn, Lotte B; Schroll, Anne-Mette; Krebs, Lone

    2017-05-01

    The safety of home births has been widely debated. Observational studies examining maternal and neonatal outcomes of home births have become more frequent, and the quality of these studies has improved. The aim of the present study was to describe neonatal outcomes of home births compared with hospital births and to discuss which data are needed to evaluate the safety of home births. This was a register-based cohort study. Data on all births in Denmark (2003-2013) were collected from the Danish Medical Birth Registry (DMBR). The cohort included healthy women with uncomplicated pregnancies and no medical interventions during delivery. A total of 6,395 home births and 266,604 hospital births were eligible for analysis. Comparative analyses were performed separately in nulliparous and multiparous women. The outcome measures were neonatal mortality and morbidity. Frequencies of admission to a neonatal intensive care unit and treatment with continuous positive airway pressure were significantly lower in infants born at home than in infants born at a hospital. A slightly, but significantly increased rate of early neonatal death was found among infants delivered by nulliparous at home. This study indicates that home births in Denmark are characterized by a high level of safety owing to low rates of perinatal mortality and morbidity. Missing registration on intrapartum transfers and planned versus unplanned home births in the DMBR are, however, major limitations to the validity and utility of the reported results. Registration of these items of information is necessary to make reasonable assessments of home births in the future. none. not relevant. Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

  2. Linkage of Maternity Hospital Episode Statistics data to birth registration and notification records for births in England 2005–2014: Quality assurance of linkage of routine data for singleton and multiple births

    Science.gov (United States)

    2018-01-01

    Objectives To quality assure a Trusted Third Party linked data set to prepare it for analysis. Setting Birth registration and notification records from the Office for National Statistics for all births in England 2005–2014 linked to Maternity Hospital Episode Statistics (HES) delivery records by NHS Digital using mothers’ identifiers. Participants All 6 676 912 births that occurred in England from 1 January 2005 to 31 December 2014. Primary and secondary outcome measures Every link between a registered birth and an HES delivery record for the study period was categorised as either the same baby or a different baby to the same mother, or as a wrong link, by comparing common baby data items and valid values in key fields with stepwise deterministic rules. Rates of preserved and discarded links were calculated and which features were more common in each group were assessed. Results Ninety-eight per cent of births originally linked to HES were left with one preserved link. The majority of discarded links were due to duplicate HES delivery records. Of the 4854 discarded links categorised as wrong links, clerical checks found 85% were false-positives links, 13% were quality assurance false negatives and 2% were undeterminable. Births linked using a less reliable stage of the linkage algorithm, births at home and in the London region, and with birth weight or gestational age values missing in HES were more likely to have all links discarded. Conclusions Linkage error, data quality issues, and false negatives in the quality assurance procedure were uncovered. The procedure could be improved by allowing for transposition in date fields, and more discrimination between missing and differing values. The availability of identifiers in the datasets supported clerical checking. Other research using Trusted Third Party linkage should not assume the linked dataset is error-free or optimised for their analysis, and allow sufficient resources for this. PMID:29500200

  3. Birth outcomes of planned home births in Missouri: a population-based study.

    Science.gov (United States)

    Chang, Jen Jen; Macones, George A

    2011-08-01

    We evaluated the birth outcomes of planned home births. We conducted a retrospective cohort study using Missouri vital records from 1989 to 2005 to compare the risk of newborn seizure and intrapartum fetal death in planned home births attended by physicians/certified nurse midwives (CNMs) or non-CNMs with hospitals/birthing center births. The study sample included singleton pregnancies between 36 and 44 weeks of gestation without major congenital anomalies or breech presentation ( N = 859,873). The adjusted odds ratio (aOR) of newborn seizures in planned home births attended by non-CNMs was 5.11 (95% confidence interval [CI]: 2.52, 10.37) compared with deliveries by physicians/CNMs in hospitals/birthing centers. For intrapartum fetal death, aORs were 11.24 (95% CI: 1.43, 88.29), and 20.33 (95% CI: 4.98, 83.07) in planned home births attended by non-CNMs and by physicians/CNMs, respectively, compared with births in hospitals/birthing centers. Planned home births are associated with increased likelihood of adverse birth outcomes. © Thieme Medical Publishers.

  4. Mortality and major morbidity of very low birth weight infants in Germany 2008-2012: A report based on administrative data

    Directory of Open Access Journals (Sweden)

    Elke eJeschke

    2016-03-01

    Full Text Available Background: Expectant parents of very preterm infants, physicians and policy makers require estimates for chances of survival and survival without morbidity. Such estimates should derive from a large, reliable and contemporary data base of easily available items known at birth.Objective: To determine short-term outcome and risk factors in very low birth weight preterm infants based on administrative dataMethods: Anonymized routine data sets transmitted from hospital administrations to statutory health insurance companies were used to assess survival and survival free of major morbidities in a large cohort of preterm infants in Germany.Results: After exclusion of infants with lethal malformations, there were 13,147 infants with a birth weight below 1,500 g admitted to neonatal care 2008-2012, of whom 1,432 infants (10.9% died within 180 d. Estimated 180 d survival probabilities were 0.632 [95% confidence interval 0.583-0.677] for infants with 250-499 g birth weight, 0.817 [0.799-0.834] for 500-749 g, 0.931 [0.920-0.940] for 750-999 g, 0.973 [0.967-0.979] for 1,000-1,249 g and 0.985 [0.981-0.988] for 1,250-1,499 g. Estimated probabilities for survival without major morbidity (surgically treated intraventricular hemorrhage, necrotizing enterocolitis, intestinal perforation, or retinopathy were 0.433 [0.384-0.481] (250-499 g, 0.622 [0.600-0.643] (500-749 g, 0.836 [0.821-0.849] (750-999 g, 0.938 [0.928-0.946] (1,000-1,249 g, and 0.969 [0.964-0.974] (1,250-1,499 g, respectively. Prediction of survival and survival without major morbidities was moderately improved by adding sex, small-for-gestational-age, and severe or moderate congenital malformation, increasing ROC areas under the curve from 0.839 [0.827-0.850] to 0.862 [0.852-0.874] (survival and from 0.827 [0.822-0.842] to 0.852 [0.846-0.863] (survival without major morbidities, respectively. Conclusion: The present analysis encourages attempts to use administrative data to investigate the

  5. Spontaneous preterm birth : prevention, management and outcome

    NARCIS (Netherlands)

    Vermeulen, Gustaaf Michiel

    1999-01-01

    Preterm birth (birth before 37 completed weeks of pregnancy) is a major cause of perinatal morbidity and mortality. Strategies to prevent and adequately treat preterm labour, in order to postpone birth and to identify risk factors for neonatal damage due to preterm birth, have to be developed by

  6. Successful water birth in a woman with vaginismus.

    Science.gov (United States)

    Moraloğlu, O; Engin-Ustün, Y; Ozakşit, G; Mollamahmutoğlu, L

    2011-01-01

    Vaginismus is a common sexual dysfunction. The case of a successful water birth in a woman with vaginismus is presented. Water birth should be considered as an alternative method of birth in women with vaginismus.

  7. Evidence of Bos javanicus x Bos indicus hybridization and major QTLs for birth weight in Indonesian Peranakan Ongole cattle.

    Science.gov (United States)

    Hartati, Hartati; Utsunomiya, Yuri Tani; Sonstegard, Tad Stewart; Garcia, José Fernando; Jakaria, Jakaria; Muladno, Muladno

    2015-07-04

    Peranakan Ongole (PO) is a major Indonesian Bos indicus breed that derives from animals imported from India in the late 19(th) century. Early imports were followed by hybridization with the Bos javanicus subspecies of cattle. Here, we used genomic data to partition the ancestry components of PO cattle and map loci implicated in birth weight. We found that B. javanicus contributes about 6-7% to the average breed composition of PO cattle. Only two nearly fixed B. javanicus haplotypes were identified, suggesting that most of the B. javanicus variants are segregating under drift or by the action of balancing selection. The zebu component of the PO genome was estimated to derive from at least two distinct ancestral pools. Additionally, well-known loci underlying body size in other beef cattle breeds, such as the PLAG1 region on chromosome 14, were found to also affect birth weight in PO cattle. This study is the first attempt to characterize PO at the genome level, and contributes evidence of successful, stabilized B. indicus x B. javanicus hybridization. Additionally, previously described loci implicated in body size in worldwide beef cattle breeds also affect birth weight in PO cattle.

  8. Neonatal jaundice and birth asphyxia as major causes of cerebral ...

    African Journals Online (AJOL)

    Background: Cerebral Palsy is permanent sequela of severe nonprogressive insult to the immature brain of children. In Nigeria, kernicterus from neonatal jaundice and hypoxic ischaemic encephalopathy form severe birth asphyxia have been identified as among the leading causes of this scourge. Poor management of ...

  9. Evaluation of factors affecting birth weight and preterm birth in southern Turkey

    International Nuclear Information System (INIS)

    Araz, N. C.

    2013-01-01

    Objective: To identify factors affecting birth weight and pre-term birth, and to find associations with electromagnetic devices such as television, computer and mobile phones. Methods: The study was conducted in Turkey at Gazintep University, Faculty of Medicine Outpatient Clinic at the Paediatric Ward. It comprised 500 patients who presented at the clinic from May to December 2009. All participants were administered a questionnaire regarding their pregnancy history. SPSS 13 was used for statistical analysis. Results: In the study, 90 (19%) patients had pre-term birth , and 64 (12.9%) had low birth weight rate Birth weight was positively correlated with maternal age and baseline maternal weight (r= 0.115, p= 0.010; r= 0.168, p=0.000, respectively). Pre-term birth and birth weight less than 2500g were more common in mothers with a history of disease during pregnancy (p=0.046 and p=0.008, respectively). The habit of watching television and using mobile phones and computer by mothers did not demonstrate any relationship with birth weight. Mothers who used mobile phones or computers during pregnancy had more deliveries before 37 weeks (p=0.018, p=0.034; respectively). Similarly, pregnancy duration was shorter in mothers who used either mobile phone or computers during pregnancy (p=0.005, p=0.048, respectively). Conclusion: Mobile phones and computers may have an effect on pre-term birth. (author)

  10. Neonatal jaundice and birth asphyxia as major causes of cerebral ...

    African Journals Online (AJOL)

    McRoy

    Background: Cerebral Palsy is permanent sequela of severe non- progressive insult to the immature brain of children. In Nigeria, kernicterus from neonatal jaundice and hypoxic ischaemic encephalopathy form severe birth asphyxia have been identified as among the leading causes of this scourge. Poor management of ...

  11. Prediction of Spontaneous Preterm Birth

    NARCIS (Netherlands)

    Dijkstra, Karolien

    2002-01-01

    Preterm birth is a leading cause of neonatal morbidity and mortality. It is a major goal in obstetrics to lower the incidence of spontaneous preterm birth (SPB) and related neonatal morbidity and mortality. One of the principal objectives is to discover early markers that would allow us to identify

  12. Residential proximity to major roads and term low birth weight: the roles of air pollution, heat, noise, and road-adjacent trees.

    Science.gov (United States)

    Dadvand, Payam; Ostro, Bart; Figueras, Francesc; Foraster, Maria; Basagaña, Xavier; Valentín, Antònia; Martinez, David; Beelen, Rob; Cirach, Marta; Hoek, Gerard; Jerrett, Michael; Brunekreef, Bert; Nieuwenhuijsen, Mark J

    2014-07-01

    Maternal residential proximity to roads has been associated with adverse pregnancy outcomes. However, there is no study investigating mediators or buffering effects of road-adjacent trees on this association. We investigated the association between mothers' residential proximity to major roads and term low birth weight (LBW), while exploring possible mediating roles of air pollution (PM(2.5), PM(2.5-10), PM(10), PM(2.5) absorbance, nitrogen dioxide, and nitrogen oxides), heat, and noise and buffering effect of road-adjacent trees on this association. This cohort study was based on 6438 singleton term births in Barcelona, Spain (2001-2005). Road proximity was measured as both continuous distance to and living within 200 m from a major road. We assessed individual exposures to air pollution, noise, and heat using, respectively, temporally adjusted land-use regression models, annual averages of 24-hour noise levels across 50 m and 250 m, and average of satellite-derived land-surface temperature in a 50-m buffer around each residential address. We used vegetation continuous fields to abstract tree coverage in a 200-m buffer around major roads. Living within 200 m of major roads was associated with a 46% increase in term LBW risk; an interquartile range increase in heat exposure with an 18% increase; and third-trimester exposure to PM(2.5), PM(2.5-10), and PM10 with 24%, 25%, and 26% increases, respectively. Air pollution and heat exposures together explained about one-third of the association between residential proximity to major roads and term LBW. Our observations on the buffering of this association by road-adjacent trees were not consistent between our 2 measures of proximity to major roads. An increased risk of term LBW associated with proximity to major roads was partly mediated by air pollution and heat exposures.

  13. Birthing Healthy Babies (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Birth defects are common, costly, and critical. If you're pregnant or planning to get pregnant, you can take steps to improve your chances of giving birth to a healthy child. This podcast discusses ways to prevent birth defects.

  14. Home births and postnatal practices in Madagali, north-eastern Nigeria.

    Science.gov (United States)

    Bukar, M; Jauro, Y S

    2013-01-01

    Home births are common in resource poor countries and postnatal practices vary from one community to the other. To determine the proportion of home births, reasons for home delivery, and evaluate postnatal practices in Madagali, north-eastern Nigeria. This was a cross-sectional descriptive study of 400 women of reproductive age, who had put to birth in the past 1 year. The study was carried out over a period of 8 weeks from April to June 2010. The multistage method of sampling was used to select respondents. In the first stage, four of the five health districts were chosen randomly, namely, Gulak, Madagali, Sukur, and Duhu. The questionnaires were evenly distributed among the four health districts. In the second stage, from each district, two villages were chosen by simple random sample. In the third stage, two wards were selected in each village by simple random sampling. Of the 400 respondents interviewed, 289 (72.2%) were aged between 20 and 39 years, and most, 374 (93.5%) were married. Only 14 (3.5%) had tertiary education. Most respondents, 224 (56.0%) were farmers and grandmultiparae, 187 (46.7%). A total of 196 (49.0%) women delivered at home, whereas 204 (51.0%) delivered at the hospital. Of the 196 respondents who delivered at home, the bedroom 142 (72.4%), was the preferred place of birth. The most common reason for home birth was short duration of labor in 71 (36.3%) cases. Delivery was conducted by untrained persons in 50, (25.4%), whereas 99 (50.8%) and 31 (15.5%) deliveries were supervised by Traditional Birth Attendants (TBAs) and Midwives/Nurses, respectively. Postpartum, the majority, 235 (58.7%) respondents used sanitary pads to stanch lochia, whereas 140 (35%) used rags. A significant number of births take place in the home and supervised by unskilled persons. Against the backdrop of poor education and low socio-economic status of respondents, perineal hygiene can be adjudged satisfactory. There is the need to increase on the number of hospital

  15. Birth order and risk taking in athletics: a meta-analysis and study of major league baseball.

    Science.gov (United States)

    Sulloway, Frank J; Zweigenhaft, Richard L

    2010-11-01

    According to expectations derived from evolutionary theory, younger siblings are more likely than older siblings to participate in high-risk activities. The authors test this hypothesis by conducting a meta-analysis of 24 previous studies involving birth order and participation in dangerous sports. The odds of laterborns engaging in such activities were 1.48 times greater than for firstborns (N = 8,340). The authors also analyze performance data on 700 brothers who played major league baseball. Consistent with their greater expected propensity for risk taking, younger brothers were 10.6 times more likely to attempt the high-risk activity of base stealing and 3.2 times more likely to steal bases successfully (odds ratios). In addition, younger brothers were significantly superior to older brothers in overall batting success, including two measures associated with risk taking. As expected, significant heterogeneity among various performance measures for major league baseball players indicated that older and younger brothers excelled in different aspects of the game.

  16. Home birth or short-stay hospital birth in a low risk population in The Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Kerssens, J.J.; Keirse, M.J.N.C.

    1998-01-01

    In the Netherlands women with low risk pregnancies can choose whether they want to give birth at home or in hospital, under the care of their own primary caregiver. The majority of these women prefer to give birth at home, but over the last few decades an increasing number of low risk women have

  17. Parental mental illness and fatal birth defects in a national birth cohort

    DEFF Research Database (Denmark)

    Webb, Roger; Pickles, A.R.; King-Hele, Sarah

    2007-01-01

    BACKGROUND: Few large studies describe links between maternal mental illness and risk of major birth defect in offspring. Evidence is sparser still for how effects vary between maternal diagnoses and no previous study has assessed risk with paternal illnesses.MethodA population-based birth cohort...... genetic effects directly linked with maternal illness, lifestyle factors (diet, smoking, alcohol and drugs), poor antenatal care, psychotropic medication toxicity, and gene-environment interactions. Further research is needed to elucidate the causal mechanisms...

  18. Analysis using life tables of the major causes of death and the differences between country of birth groups in New South Wales, Australia.

    Science.gov (United States)

    Weerasinghe, D P; Parr, N J; Yusuf, F

    2009-05-01

    This study used life table methods to evaluate the potential effects of reduction in major disease mortality on life expectancy in New South Wales (NSW), and the differences in cause-specific mortality between country of birth groups. The total and partial elimination of major causes of death were examined to identify the high-risk groups for community-level health planning. Life tables were used to combine the mortality rates of the NSW population at different ages into a single statistical model. Using abridged, multiple decrement and cause-elimination life tables with the mortality data for NSW in 2000-2002, broader disease groups were examined. Multiple decrement tables were generated by country of birth. The effect of the partial elimination of ischaemic heart disease (IHD) was also studied. This study found that Pacific-born men and women who reach their 30th birthday and eventually die from IHD are expected to live, on average, 10.8 and 5.8 years less, respectively, than average men and women in NSW. If IHD is eliminated as a cause of death, 7.5 years for males and 6.7 years for females would be added to life expectancy at birth. Life expectancy at birth is likely to be further increased by reducing deaths caused by diseases of the cardiovascular system, particularly among people aged over 65 years, by reducing malignant neoplasm deaths among those aged below 65 years, and by reducing deaths due to accidents, injury and poisoning, mainly among men aged 15-29 years. Further gains in life expectancy could be achieved with community-level educational programmes on lifestyle management and disease prevention.

  19. Quality assessment of home births in Denmark

    DEFF Research Database (Denmark)

    Jensen, Sabrina; Colmorn, Lotte B.; Schroll, Anne-Mette

    2017-01-01

    by nulliparous at home. CONCLUSIONS: This study indicates that home births in Denmark are characterized by a high level of safety owing to low rates of perinatal mortality and morbidity. Missing registration on intrapartum transfers and planned versus unplanned home births in the DMBR are, however, major......INTRODUCTION: The safety of home births has been widely debated. Observational studies examining maternal and neonatal outcomes of home births have become more frequent, and the quality of these studies has improved. The aim of the present study was to describe neonatal outcomes of home births...... compared with hospital births and to discuss which data are needed to evaluate the safety of home births. METHODS: This was a register-based cohort study. Data on all births in Denmark (2003-2013) were collected from the Danish Medical Birth Registry (DMBR). The cohort included healthy women...

  20. Birth environment facilitation by midwives assisting in non-hospital births: a qualitative interview study.

    Science.gov (United States)

    Igarashi, Toshiko; Wakita, Mariko; Miyazaki, Kikuko; Nakayama, Takeo

    2014-07-01

    midwifery homes (similar to birth centres) are rich in midwifery wisdom and skills that differ from those in hospital obstetrical departments, and a certain percentage of pregnant women prefer birth in these settings. This study aimed to understand the organisation of the perinatal environment considered important by independent midwives in non-hospital settings and to clarify the processes involved. semi-structured qualitative interview study and constant comparative analysis. 14 independent midwives assisting at births in midwifery homes in Japan, and six independent midwives assisting at home births. Osaka, Kyoto, Nara, and Shiga, Japan. midwives assisting at non-hospital births organised the birth environment based on the following four categories: 'an environment where the mother and family are autonomous'; 'a physical environment that facilitates birth'; 'an environment that facilitates the movement of the mother for birth'; and 'scrupulous safety preparation'. These, along with their sub-categories, are presented in this paper. independent midwives considered it important to create a candid relationship between the midwife and the woman/family from the period of pregnancy to facilitate birth in which the woman and her family were autonomous. They also organised a distinctive environment for non-hospital birth, with preparations to guarantee safety. Experiential knowledge and skills played a major part in creating an environment to facilitate birth, and the effectiveness of this needs to be investigated objectively in future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. The Effect of Activity Restriction on Infant's Birth Weight and Gestational Age at Birth: PRAMS Data Analysis.

    Science.gov (United States)

    Omar, Abeer

    2018-01-01

    Activity restriction is extensively prescribed for pregnant women with major comorbidities despite the lack of evidence to support its effectiveness in preventing preterm birth or low birth weight. To determine the moderation effect of home activity restriction for more than a week on infant's birth weight and gestational age at birth for high-risk women with obstetrical and medical comorbidities. A secondary analysis of 2004-2008 New York Pregnancy Risk Assessment Monitoring System was conducted with 1426 high-risk women. High-risk group included 41% of women treated with activity restriction and 59% of those not treated with activity restriction. Women with preterm premature rupture of membrane (PPROM) who were treated with activity restriction had a lower infant birth weight ( b = -202.85, p = ≤.001) and gestational age at birth ( b = -.91, p = ≤.001) than those without activity restriction. However, women with preterm labor and hypertensive disorders of pregnancy who were not treated with activity restriction had lower infant gestational age at birth ( b = -96, p = ≤.01) and ( b = -92, p = ≤.001), respectively, compared to those who were treated with activity restriction. Findings suggest a contrary effect of activity restriction on infants born to women with PPROM, which is a major reason for prescribing activity restriction. The current study results may trigger the need to conduct randomized control trials to determine the effect of severity of activity restriction on maternal and infant outcomes.

  2. Gender issues in determining the service and research agenda for pregnancy and birth care: The case of home birth in the Netherlands

    NARCIS (Netherlands)

    Buitendijk, S.

    2011-01-01

    Worldwide, there are two conceptual models of pregnancy and child birth. In the first, 'male' model, pregnancy and the birth of a baby are biomedical processes. In the second, 'female' model, pregnancy and child birth are major psychosocial events for the woman. The research agenda of obstetricians

  3. Nonspecific effect of BCG vaccination at birth on early childhood infections

    DEFF Research Database (Denmark)

    Kjærgaard, Jesper; Birk, Nina Marie; Nissen, Thomas N

    2016-01-01

    BACKGROUND: Childhood infections are common and Bacillus Calmette-Guérin (BCG) vaccination at birth may prevent these via nonspecific effects. METHODS: A randomized, clinical multicenter trial. All women planning to give birth (n = 16,521) at the three study sites were invited during the recruitm......BACKGROUND: Childhood infections are common and Bacillus Calmette-Guérin (BCG) vaccination at birth may prevent these via nonspecific effects. METHODS: A randomized, clinical multicenter trial. All women planning to give birth (n = 16,521) at the three study sites were invited during...... during the first 3 mo....

  4. Galactic Doppelgängers: The Chemical Similarity Among Field Stars and Among Stars with a Common Birth Origin

    Science.gov (United States)

    Ness, M.; Rix, H.-W.; Hogg, David W.; Casey, A. R.; Holtzman, J.; Fouesneau, M.; Zasowski, G.; Geisler, D.; Shetrone, M.; Minniti, D.; Frinchaboy, Peter M.; Roman-Lopes, Alexandre

    2018-02-01

    We explore to what extent stars within Galactic disk open clusters resemble each other in the high-dimensional space of their photospheric element abundances and contrast this with pairs of field stars. Our analysis is based on abundances for 20 elements, homogeneously derived from APOGEE spectra (with carefully quantified uncertainties of typically 0.03 dex). We consider 90 red giant stars in seven open clusters and find that most stars within a cluster have abundances in most elements that are indistinguishable (in a {χ }2-sense) from those of the other members, as expected for stellar birth siblings. An analogous analysis among pairs of > 1000 field stars shows that highly significant abundance differences in the 20 dimensional space can be established for the vast majority of these pairs, and that the APOGEE-based abundance measurements have high discriminating power. However, pairs of field stars whose abundances are indistinguishable even at 0.03 dex precision exist: ∼0.3% of all field star pairs and ∼1.0% of field star pairs at the same (solar) metallicity [Fe/H] = 0 ± 0.02. Most of these pairs are presumably not birth siblings from the same cluster, but rather doppelgängers. Our analysis implies that “chemical tagging” in the strict sense, identifying birth siblings for typical disk stars through their abundance similarity alone, will not work with such data. However, our approach shows that abundances have extremely valuable information for probabilistic chemo-orbital modeling, and combined with velocities, we have identified new cluster members from the field.

  5. CHANGES IN SEX RATIO AT BIRTH IN CHINA: A DECOMPOSITION BY BIRTH ORDER.

    Science.gov (United States)

    Jiang, Quanbao; Yu, Qun; Yang, Shucai; Sánchez-Barricarte, Jesús J

    2017-11-01

    The long-term high sex ratio at birth (SRB) is a serious issue in China. In this study, changes in SRB were decomposed into variations in SRB by birth order and compositional changes in female births by birth order. With SRB data from China's surveys and censuses, and SRB data from South Korea's vital registration and censuses from 1980-2015, the trend and decomposition results in SRB were compared between China and South Korea, and the decomposition results for urban and rural SRBs, and for provinces, are presented. In both China and South Korea the rise in the SRB was driven by a rise in the SRB at all birth orders, which was only partly counteracted by the change in the distribution of births by order. The overall rise in the SRB ended when there was a decline in the SRB at second birth or above in South Korea. In China the total effect of variations in SRB of all birth orders increased more for the rural population than for the urban population before 2000, resulting in a higher total SRB for rural than urban population. After 2000, the total effect of variations in SRB of all birth orders lowered the total SRB for the rural population, whereas the effect of compositional change increased the total SRB, leading to a very slight rise in the total SRB for the rural population. At the province level, there was no spatial autocorrelation for the changes in total SRB by province, the total effect of variations in SRB of all birth orders or the effect of compositional change. The effect of variations in SRB by birth order accounted for the majority of changes in total SRB in most provinces.

  6. The novice birthing: theorising first-time mothers' experiences of birth at home and in hospital in Australia.

    Science.gov (United States)

    Dahlen, Hannah G; Barclay, Lesley M; Homer, Caroline S E

    2010-02-01

    to explore first-time mothers' experiences of birth at home and in hospital in Australia. a grounded theory methodology was used. Data were generated from in-depth interviews with women in their own homes. Sydney, Australia. 19 women were interviewed. Seven women who gave in a public hospital and seven women who gave birth for the first time at home were interviewed and their experiences were contrasted with two mothers who gave birth for the first time in a birth centre, one mother who gave birth for the first time in a private hospital and two women who had given birth more than once. three categories emerged from the analysis: preparing for birth, the novice birthing and processing the birth. These women shared a common core experience of seeing that they gave birth as 'novices'. The basic social process running through their experience of birth, regardless of birth setting, was that, as novices, they were all 'reacting to the unknown'. The mediating factors that influenced the birth experiences of these first-time mothers were preparation, choice and control, information and communication, and support. The quality of midwifery care both facilitated and hindered these needs, contributing to the women's perceptions of being 'honoured'. The women who gave birth at home seemed to have more positive birth experiences. identifying the novice status of first-time mothers and understanding the way in which they experience birth better explains previous research that reports unrealistic expectations and fear that may be associated with first-time birthing. It demonstrates how midwives can contribute to positive birth experiences by being aware that first-time mothers, irrespective of birth setting, are essentially reacting to the unknown as they negotiate the experience of birth. Copyright 2008 Elsevier Ltd. All rights reserved.

  7. Analysis of birth weights of a rural hospital

    Directory of Open Access Journals (Sweden)

    Ashtekar Shyam

    2010-01-01

    Full Text Available Background: Low birth weight remains a major reason behind childhood malnutrition. The NFHS findings show no dent in this problem. Objective: This study was undertaken to explore change in birth weights in a period from 1989 to 2007 and any associations thereof. Materials and Methods: All birth records of a private rural hospital spanning two decades (1989-2007 were analyzed for birth weight, age of mother, gender, birth order of the baby, proportion of pre-term babies and low birth weight babies. Results: No change was observed in the average birth weights (average 2.71 kg over the period. Although the birth weight shows some expected variance with the age of mother, it was found to have no relation with the baby′s birth order and gender. The low birth weight proportion is about 24% and shows little difference before and after the series midpoint of year 1998. Conclusion: The birth weights have hardly changed in this population in the two decades.

  8. Analysis of Birth Weights of a Rural Hospital

    Science.gov (United States)

    Ashtekar, Shyam V; Kulkarni, Madhav B; Sadavarte, Vaishali S; Ashtekar, Ratna S

    2010-01-01

    Background: Low birth weight remains a major reason behind childhood malnutrition. The NFHS findings show no dent in this problem. Objective: This study was undertaken to explore change in birth weights in a period from 1989 to 2007 and any associations thereof. Materials and Methods: All birth records of a private rural hospital spanning two decades (1989-2007) were analyzed for birth weight, age of mother, gender, birth order of the baby, proportion of pre-term babies and low birth weight babies. Results: No change was observed in the average birth weights (average 2.71 kg) over the period. Although the birth weight shows some expected variance with the age of mother, it was found to have no relation with the baby’s birth order and gender. The low birth weight proportion is about 24% and shows little difference before and after the series midpoint of year 1998. Conclusion: The birth weights have hardly changed in this population in the two decades. PMID:20922101

  9. References of birth weights for gestational age and sex from a large cohort of singleton births in cameroon.

    Science.gov (United States)

    Kemfang Ngowa, Jean Dupont; Domkam, Irénée; Ngassam, Anny; Nguefack-Tsague, Georges; Dobgima Pisoh, Walter; Noa, Cyrille; Kasia, Jean Marie

    2014-01-01

    Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

  10. References of Birth Weights for Gestational Age and Sex from a Large Cohort of Singleton Births in Cameroon

    Directory of Open Access Journals (Sweden)

    Jean Dupont Kemfang Ngowa

    2014-01-01

    Full Text Available Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

  11. Birthing Healthy Babies (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2018-01-11

    Birth defects are common, costly, and critical. If you’re pregnant or planning to get pregnant, you can take steps to improve your chances of giving birth to a healthy child. This podcast discusses ways to prevent birth defects.  Created: 1/11/2018 by MMWR.   Date Released: 1/11/2018.

  12. Midwife-attended births in the United States, 1990-2012: results from revised birth certificate data.

    Science.gov (United States)

    Declercq, Eugene

    2015-01-01

    Data on attendance at birth by midwives in the United States have been available on the national level since 1989, allowing for the documentation of long-term trends. New items on payer source and prepregnancy body mass index (BMI) from a 2003 revision of the birth certificate provide an opportunity to examine additional aspects of US midwifery practice. The data in this report are based on records on birth attendant gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), which allows users to create and download specialized tables. Analysis of new items on prepregnancy BMI and birth payer source are limited to the 38 states (86% of US births) that adopted the revised birth certificate by 2012. Between 1989 and 2012, the proportion of all births attended by certified nurse-midwives (CNMs) increased from 3.3% to 7.9%. The proportion of vaginal births attended by CNMs reached an all-time high of 11.9%. Births attended by "other midwives" (typically certified professional midwives) rose to a peak of 28,343, or 0.7% of all US births. The distribution of payer source for CNM-attended births (44% Medicaid; 44% private insurance; 6% self-pay) is very similar to the national distribution, whereas the majority (53%) of births attended by other midwives are self-pay. Women whose births are attended by other midwives are less likely (13%) to have a prepregnancy BMI in the obese range than women attended by CNMs (19%) or overall (24%). The total number of births attended by CNMs and other midwives has remained steady or grown at a time when total US births have declined, resulting in the largest proportions of midwife-attended births in the quarter century that such data have been collected. © 2015 by the American College of Nurse-Midwives.

  13. Labor market segmentation and relative black/white teenage birth rates.

    Science.gov (United States)

    Mccrate, E

    1990-01-01

    "Teenage mothers typically have lower educational attainment than other women. Most observers have argued that this is a major reason for their greater risk of poverty. This article takes the opposite view: that circumstances associated with poverty contribute to a greater likelihood of teenage childbearing. In particular, poor educational quality and the chances of secondary sector employment are more common for black women, regardless of their age at first birth. Hence the payoffs to education may be quite low for these women, which may be the reason for early motherhood. This argument is presented in terms of segmented labor market theory. Data to support it is presented from the [U.S.] National Longitudinal Survey of Youth. Other common explanations of teenage motherhood are critiqued." excerpt

  14. Inequality in access to health care in Cambodia: socioeconomically disadvantaged women giving birth at home assisted by unskilled birth attendants.

    Science.gov (United States)

    Hong, Rathavuth; Them, Rathnita

    2015-03-01

    Cambodia faces major challenges in its effort to provide access to health care for all. Although there is a sharp improvement in health and health care in Cambodia, 6 in 10 women still deliver at home assisted by unskilled birth attendants. This practice is associated with higher maternal and infant deaths. This article analyzes the 2005 Cambodia Demographic and Health Survey data to examine the relationship between socioeconomic inequality and deliveries at home assisted by unskilled birth attendants. It is evident that babies in poorer households are significantly more likely to be delivered at home by an unskilled birth attendant than those in wealthier households. Moreover, delivery at home by an unskilled attendant is associated with mothers who have no education, live in a rural residence, and are farmers, and with higher birth order children. Results from this analysis demonstrate that socioeconomic inequality is still a major factor contributing to ill health in Cambodia. © 2011 APJPH.

  15. Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

    Science.gov (United States)

    Hermus, M A A; Boesveld, I C; Hitzert, M; Franx, A; de Graaf, J P; Steegers, E A P; Wiegers, T A; van der Pal-de Bruin, K M

    2017-07-03

    During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all

  16. Progesterone for preterm birth prevention

    Directory of Open Access Journals (Sweden)

    Miha Lucovnik

    2015-10-01

    Full Text Available Background: Progesterone is important in maintaining pregnancy. Progesterone supplementation may reduce risk of preterm birth in certain populations of pregnant women. The objective of this review was to develop evidence-based clinical recommendation for progesterone treatment in the prevention of preterm birth.Methods: A search in the Medline database was performed using keywords: progesterone, pregnancy, preterm birth, preterm labour, preterm delivery, randomized trial, and randomized controlled trial. We only included studies of vaginal progesterone treatments for the prevention of preterm birth and excluded studies on 17-α-hydroksiprogesterone caproate.Results: We report findings from twelve randomized trials conducted since 2003. These trials differ regarding inclusion criteria, progesterone dose, vehicle used, and duration of treatment. Inclusion criteria were: short uterine cervix (two trials, history of previous preterm birth (two trials, signs and symptoms of preterm labour (three trials, twin pregnancies (three trials, and multiple risk factors (among these history of previous preterm birth was the most common (two trials. Six of these twelve trials showed a significant reduction in preterm birth in the progesterone groups.Conclusions: Based on current evidence we recommend treatment with 200 mg of micronized progesterone daily, administered vaginally, in pregnant women found to have a short cervix (≤ 25 mm at 19-24 weeks. The treatment should be continued until 37 weeks.

  17. Beating Birth Defects (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-01-17

    Each year in the U.S., one in 33 babies is affected by a major birth defect. Women can greatly improve their chances of giving birth to a healthy baby by avoiding some of the risk factors for birth defects before and during pregnancy. In this podcast, Dr. Stuart Shapira discusses ways to improve the chances of giving birth to a healthy baby.  Created: 1/17/2013 by MMWR.   Date Released: 1/17/2013.

  18. Maternal nutrition and birth outcomes.

    Science.gov (United States)

    Abu-Saad, Kathleen; Fraser, Drora

    2010-01-01

    In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

  19. Preterm Birth: An Overview of Risk Factors and Obstetrical Management

    Science.gov (United States)

    Stewart, Amanda; Graham, Ernest

    2010-01-01

    Preterm birth is the leading cause of neonatal mortality and a major public health concern. Risk factors for preterm birth include a history of preterm birth, short cervix, infection, short interpregnancy interval, smoking, and African-American race. The use of progesterone therapy to treat mothers at risk for preterm delivery is becoming more…

  20. Prevention of preterm birth.

    LENUS (Irish Health Repository)

    Flood, Karen

    2012-02-01

    Preterm birth (delivery before 37 completed weeks of gestation) is common and rates are increasing. In the past, medical efforts focused on ameliorating the consequences of prematurity rather than preventing its occurrence. This approach resulted in improved neonatal outcomes, but it remains costly in terms of both the suffering of infants and their families and the economic burden on society. Increased understanding of the pathophysiology of preterm labor has altered the approach to this problem, with increased focus on preventive strategies. Primary prevention is a limited strategy which involves public education, smoking cessation, improved nutritional status and avoidance of late preterm births. Secondary prevention focuses on recurrent preterm birth which is the most recognisable risk factor. Widely accepted strategies include cervical cerclage, progesterone and dedicated clinics. However, more research is needed to explore the role of antibiotics and anti-inflammatory treatments in the prevention of this complex problem.

  1. Home births and postnatal practices in madagali, North.Eastern ...

    African Journals Online (AJOL)

    Background: Home births are common in resource poor countries and postnatal practices vary from one community to the other. Objective: To determine the proportion of home births, reasons for home delivery, and evaluate postnatal practices in Madagali, north.eastern Nigeria. Materials and Methods: This was a ...

  2. Prevalence and Predictors of Antibiotic Administration during Pregnancy and Birth

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Schjørring, Susanne; Pedersen, Louise

    2013-01-01

    Antibiotic treatment during pregnancy and birth is very common. In this study, we describe the estimated prevalence of antibiotic administration during pregnancy and birth in the COPSAC2010 pregnancy cohort, and analyze dependence on social and lifestyle-related factors....

  3. Out-of-hospital births, U.S., 1978: birth weight and Apgar scores as measures of outcome.

    OpenAIRE

    Declercq, E R

    1984-01-01

    An examination of 1978 natality data for the United States disclosed that low birth weight was less common among 30,819 infants born out of hospital than among 3,294,101 infants born in hospital in that year. When controls were applied for birth attendant, infants' race, and mothers' education, age, nativity, and parity, the data revealed that white, well-educated women between 25 and 39 years of age, who were having their second babies and were attended by midwives out of hospital, were at l...

  4. Cluster analysis of spontaneous preterm birth phenotypes identifies potential associations among preterm birth mechanisms.

    Science.gov (United States)

    Esplin, M Sean; Manuck, Tracy A; Varner, Michael W; Christensen, Bryce; Biggio, Joseph; Bukowski, Radek; Parry, Samuel; Zhang, Heping; Huang, Hao; Andrews, William; Saade, George; Sadovsky, Yoel; Reddy, Uma M; Ilekis, John

    2015-09-01

    We sought to use an innovative tool that is based on common biologic pathways to identify specific phenotypes among women with spontaneous preterm birth (SPTB) to enhance investigators' ability to identify and to highlight common mechanisms and underlying genetic factors that are responsible for SPTB. We performed a secondary analysis of a prospective case-control multicenter study of SPTB. All cases delivered a preterm singleton at SPTB ≤34.0 weeks' gestation. Each woman was assessed for the presence of underlying SPTB causes. A hierarchic cluster analysis was used to identify groups of women with homogeneous phenotypic profiles. One of the phenotypic clusters was selected for candidate gene association analysis with the use of VEGAS software. One thousand twenty-eight women with SPTB were assigned phenotypes. Hierarchic clustering of the phenotypes revealed 5 major clusters. Cluster 1 (n = 445) was characterized by maternal stress; cluster 2 (n = 294) was characterized by premature membrane rupture; cluster 3 (n = 120) was characterized by familial factors, and cluster 4 (n = 63) was characterized by maternal comorbidities. Cluster 5 (n = 106) was multifactorial and characterized by infection (INF), decidual hemorrhage (DH), and placental dysfunction (PD). These 3 phenotypes were correlated highly by χ(2) analysis (PD and DH, P cluster 3 of SPTB. We identified 5 major clusters of SPTB based on a phenotype tool and hierarch clustering. There was significant correlation between several of the phenotypes. The INS gene was associated with familial factors that were underlying SPTB. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Prevalence and determinants of low birth weight: the situation in a ...

    African Journals Online (AJOL)

    Background: The traditional birth attendant delivers majority of pregnant women in Nigeria. Objective: This study aimed at determining the prevalence and associated risk factors for delivery of low birth weight (LBW) neonates in a Traditional Birth Home (TBH)in Benin City, Nigeria. Methods: A total of 780 pregnant women ...

  6. The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

    Science.gov (United States)

    Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen

    1998-07-01

    Objective: The search for quality, cost-effective health care programs in the United States is now a major focus in the era of health care reform. New programs need to be evaluated as alternatives are developed in the health care system. The BirthPlace program provides comprehensive perinatal services with certified nurse-midwives and obstetricians working together in an integrated collaborative practice serving a primarily low-income population. Low-risk women are delivered by nurse-midwives in a freestanding birth center (The BirthPlace), which is one component of a larger integrated health network. All others are delivered by team obstetricians at the affiliated tertiary hospital. Wellness, preventive measures, early intervention, and family involvement are emphasized. The San Diego Birth Center Study is a 4-year research project funded by the U.S. Federal Agency for Health Care Policy and Research (#R01-HS07161) to evaluate this program. The National Birth Center Study (NEJM, 1989; 321(26): 1801-11) described the advantages and safety of freestanding birth centers. However, a prospective cohort study with a concurrent comparison group of comparable risk had not been conducted on a collaborative practice-freestanding birth center model to address questions of safety, cost, and patient satisfaction.Methods: The specific aims of this study are to compare this collaborative practice model to the traditional model of perinatal health care (physician providers and hospital delivery). A prospective cohort study comparing these two health care models was conducted with a final expected sample size of approximately 2,000 birth center and 1,350 traditional care subjects. Women were recruited from both the birth center and traditional care programs (private physicians offices and hospital based clinics) at the beginning of prenatal care and followed through the end of the perinatal period. Prenatal, intrapartum, postpartum and infant morbidity and mortality are being

  7. Trends in characteristics of women choosing contraindicated home births.

    Science.gov (United States)

    Zafman, Kelly B; Stone, Joanne L; Factor, Stephanie H

    2018-04-12

    To characterize the American College of Obstetricians and Gynecologists (ACOG) contraindicated home births and the women who are receiving these births in hopes of identifying venues for intervention. The National Center for Health Statistics (NCHS) birth certificate records from 1990 to 2015 were used. "Planned home births" were defined as those births in which birthplace was coded as "residence" and birth attendant was coded as "certified nurse midwife (CNM)" or "other midwife". Contraindicated home births were defined as "planned home births" from 1990 to 2015 that had one or more of the ACOG risk factors for home births, which include vaginal birth after prior cesarean delivery (VBAC), breech presentation and multiple gestations. A review of trends in contraindicated home births from 1990 to 2015 suggests that they are increasing in number (481-1396) and as a percentage of total births (0.01%-0.04%, P95%), which is most frequently initiated in the first trimester. The majority of home births were paid out-of-pocket (65%-69%). The increasing number of contraindicated home births in the United States requires public health action. Home births are likely a matter of choice rather than a lack of resources. It is unclear if women choose home births while knowing the risk or due to a lack of information. Prenatal education about contraindicated home births is possible, as almost all women receive prenatal care.

  8. Birth Order and Openness to Experience: Brief communication

    OpenAIRE

    Silvio José Lemos Vasconcellos; Felipe Valentini; Nelson Hauck Filho; Claudio Simon Hutz

    2014-01-01

    Birth order is defined as a person’s rank by age among his or her siblings. Openness to experience is one of five major domains of personality. The purpose of this research was to investigate the relationship between birth order and openness to experience in a sample of 472 university students (mean age = 24.6 years; SD = 8.8). Results showed distinct effects for men and women regarding the influence of birth order. Authors discuss the results in light of possible cultural features and of the...

  9. Obesity-susceptibility loci have a limited influence on birth weight: a meta-analysis of up to 28,219 individuals

    DEFF Research Database (Denmark)

    Kilpelaeinen, T. O.; den Hoed, M.; Ong, K. K.

    2011-01-01

    High birth weight is associated with adult body mass index (BMI). We hypothesized that birth weight and BMI may partly share a common genetic background.......High birth weight is associated with adult body mass index (BMI). We hypothesized that birth weight and BMI may partly share a common genetic background....

  10. Low birth weight in the United States.

    Science.gov (United States)

    Goldenberg, Robert L; Culhane, Jennifer F

    2007-02-01

    Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.

  11. Neonatal Bacteraemia Among 112,360 Live Births

    LENUS (Irish Health Repository)

    Huggard, D

    2016-10-01

    Our aims were to determine the incidence of bacteraemia in a cohort of neonatal patients over a 14 year period, to describe the organisms involved, and to establish the rates of sepsis with regard to both early onset sepsis (EOS) and late onset sepsis (LOS). Lastly, we investigated the trends of neonatal sepsis, to determine whether changes in clinical practice influenced the rate of blood culture positivity. With regards to EOS, GBS was the predominant pathogen, followed by E.coli, CoNS, and S. aureus . The overall mean EO rate per 1000 live births (LBs) was 1.19. Looking at LOS, S. aureus , CoNS , Enterococcus spp. were the most common bacteria cultured. The mean LOS rate was 1.88 per 1000 live births. The overall rate of EOS remained fairly steady. GBS remains the major pathogen in EOS; however its incidence has remained largely unchanged over time in relation to both EOS and LOS. Conversely the rate of LOS peaked from ’05-’09, mainly due to an increase in Staphylococcus aureus , CoNS and Enterococcus spp. cases, and then improved dramatically in the following years. This was likely due to a change in hospital policies in relation to hand hygiene and intravenous line placement and maintenance.

  12. Improving identification and treatment of women with increased risk of preterm birth

    NARCIS (Netherlands)

    Hermans, F.J.R.

    2017-01-01

    Preterm birth is one of the major global health problems. It is globally defined as birth before 37 weeks of gestation. Annually 15 million babies are born preterm worldwide, with an incidence rate varying between five and fifteen percent. Preterm birth and its associated complications are held

  13. Seasonally adjusted birth frequencies follow the Poisson distribution.

    Science.gov (United States)

    Barra, Mathias; Lindstrøm, Jonas C; Adams, Samantha S; Augestad, Liv A

    2015-12-15

    Variations in birth frequencies have an impact on activity planning in maternity wards. Previous studies of this phenomenon have commonly included elective births. A Danish study of spontaneous births found that birth frequencies were well modelled by a Poisson process. Somewhat unexpectedly, there were also weekly variations in the frequency of spontaneous births. Another study claimed that birth frequencies follow the Benford distribution. Our objective was to test these results. We analysed 50,017 spontaneous births at Akershus University Hospital in the period 1999-2014. To investigate the Poisson distribution of these births, we plotted their variance over a sliding average. We specified various Poisson regression models, with the number of births on a given day as the outcome variable. The explanatory variables included various combinations of years, months, days of the week and the digit sum of the date. The relationship between the variance and the average fits well with an underlying Poisson process. A Benford distribution was disproved by a goodness-of-fit test (p Poisson process when monthly and day-of-the-week variation is included. The frequency is highest in summer towards June and July, Friday and Tuesday stand out as particularly busy days, and the activity level is at its lowest during weekends.

  14. Birth Order and Openness to Experience: Brief communication

    Directory of Open Access Journals (Sweden)

    Silvio José Lemos Vasconcellos

    2014-08-01

    Full Text Available Birth order is defined as a person’s rank by age among his or her siblings. Openness to experience is one of five major domains of personality. The purpose of this research was to investigate the relationship between birth order and openness to experience in a sample of 472 university students (mean age = 24.6 years; SD = 8.8. Results showed distinct effects for men and women regarding the influence of birth order. Authors discuss the results in light of possible cultural features and of the personality assessment method employed.

  15. What Research Shows About Birth Order, Personality, and IQ.

    Science.gov (United States)

    Yahraes, Herbert

    This brief report summarizes the findings and conclusions of studies concerning the relation between birth order and various aspects of personality and intellectual development. Major topics discussed are the relation between birth order of the child and: (1) the effects of sex and spacing between siblings on personality characteristics of the…

  16. Transfers to hospital in planned home birth in four Nordic countries

    DEFF Research Database (Denmark)

    Blix, Ellen; Kumle, Merethe H; Ingversen, Karen

    2016-01-01

    INTRODUCTION: Women planning a home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs....../572) of the nulliparas were transferred to hospital, 137 (24.0%) during labor and 49 (8.6%) after the birth. Of the multiparas, 195/2446 (8.0%) were transferred, 118 (4.8%) during labor and 77 (3.2%) after birth. The most common indication for transfers during labor was slow progress. In transfers after birth...

  17. A Role for the Liver in Parturition and Preterm Birth.

    Science.gov (United States)

    Mawson, Anthony R

    Neither the mechanisms of parturition nor the pathogenesis of preterm birth are well understood. Poor nutritional status has been suspected as a major causal factor, since vitamin A concentrations are low in preterm infants. However, even large enteral doses of vitamin A from birth fail to increase plasma concentrations of vitamin A or improve outcomes in preterm and/or extremely low birthweight infants. These findings suggest an underlying impairment in the secretion of vitamin A from the liver, where about 80% of the vitamin is stored. Vitamin A accumulates in the liver and breast during pregnancy in preparation for lactation. While essential in low concentration for multiple biological functions, vitamin A in higher concentration can be pro-oxidant, mutagenic, teratogenic and cytotoxic, acting as a highly surface-active, membrane-seeking and destabilizing compound. Regarding the mechanism of parturition, it is conjectured that by nine months of gestation the hepatic accumulation of vitamin A (retinol) from the liver is such that mobilization and secretion are impaired to the point where stored vitamin A compounds in the form of retinyl esters and retinoic acid begin to spill or leak into the circulation, resulting in amniotic membrane destabilization and the initiation of parturition. If, however, the accumulation and spillage of stored retinoids reaches a critical threshold prior to nine months, e.g., due to cholestatic liver disease, which is common in mothers of preterm infants, the increased retinyl esters and/or retinoic acid rupture the fetal membranes, inducing preterm birth and its complications, including retinopathy, necrotizing enterocolitis and bronchopulmonary dysplasia. Subject to testing, the model suggests that measures taken prior to and during pregnancy to improve liver function could reduce the risk of adverse birth outcomes, including preterm birth.

  18. Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey

    OpenAIRE

    Fleming, Susan E.; Donovan-Batson, Colleen.; Burduli, Ekaterina.; Barbosa-Leiker, Celestina.; Hollins Martin, Caroline J.; Martin, Colin R.

    2016-01-01

    Objective:\\ud to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R).\\ud Study design:\\ud a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected...

  19. Home birth after hospital birth: women's choices and reflections.

    Science.gov (United States)

    Bernhard, Casey; Zielinski, Ruth; Ackerson, Kelly; English, Jessica

    2014-01-01

    The number of US women choosing home birth is increasing. Little is known about women who choose home birth after having experienced hospital birth; therefore, the purpose of this research was to explore reasons why these women choose home birth and their perceptions regarding their birth experiences. Qualitative description was the research design, whereby focus groups were conducted with women who had hospital births and subsequently chose home birth. Five focus groups were conducted (N = 20), recorded, and transcribed verbatim. Qualitative content analysis was undertaken allowing themes to emerge. Five themes emerged from the women's narratives: 1) choices and empowerment: with home birth, women felt they were given real choices rather than perceived choices, giving them feelings of empowerment; 2) interventions and interruptions: women believed things were done that were not helpful to the birth process, and there were interruptions associated with their hospital births; 3) disrespect and dismissal: participants believed that during hospital birth, providers were more focused on the laboring woman's uterus, with some experiencing dismissal from their hospital provider when choosing to birth at home; 4) birth space: giving birth in their own home, surrounded by people they chose, created a peaceful and calm environment; and 5) connection: women felt connected to their providers, families, newborns, and bodies during their home birth. For most participants, dissatisfaction with hospital birth influenced their subsequent decision to choose home birth. Despite experiencing challenges associated with this decision, women expressed satisfaction with their home birth. © 2014 by the American College of Nurse-Midwives.

  20. Factors predisposing to low birth weight in Jimma Hospital South ...

    African Journals Online (AJOL)

    Background: Low birth weight continues to remain a major public health problem in Ethiopia in contrast to what is observed in many developing countries. Objectives: To assess some of the predisposing factors to low birth weight among deliveries in Jimma hospital. Design: Cross-sectional case referent study.

  1. Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey.

    Science.gov (United States)

    Fleming, Susan E; Donovan-Batson, Colleen; Burduli, Ekaterina; Barbosa-Leiker, Celestina; Hollins Martin, Caroline J; Martin, Colin R

    2016-10-01

    to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R). a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected using electronic linkages (Qualtrics ™ ). a convenience sample of childbearing women (n=2229) who had planned to birth in their home or birth center from the US (United States) participated. Participants were recruited via professional and personal contacts, primarily their midwives. the total 30-item BSS score mean was 128.98 (SD 16.92) and the 10-item BSS-R mean score was 31.94 (SD 6.75). Sub-scale mean scores quantified the quality of care provision, women's personal attributes, and stress experienced during labour. Satisfaction was higher for women with vaginal births compared with caesareans deliveries. In addition, satisfaction was higher for women who had both planned to deliver in a home or a birth centre, and who had actually delivered in a home or a birth center. total and subscale birth satisfaction scores were positive and high for the overall sample IMPLICATIONS FOR PRACTICE: the BSS and the BSS-R provide a robust tool to quantify women's experiences of childbirth between variables such as birth types, birth settings and providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Thyroid Medication Use and Birth Defects in the National Birth Defects Prevention Study.

    Science.gov (United States)

    Howley, Meredith M; Fisher, Sarah C; Van Zutphen, Alissa R; Waller, Dorothy K; Carmichael, Suzan L; Browne, Marilyn L

    2017-11-01

    Thyroid disorders are common among reproductive-aged women, with hypothyroidism affecting 2 to 3% of pregnancies, and hyperthyroidism affecting an additional 0.1 to 1%. We examined associations between thyroid medications and individual birth defects using data from the National Birth Defects Prevention Study (NBDPS). The NBDPS is a multisite, population-based, case-control study that included pregnancies with estimated delivery dates from 1997 to 2011. We analyzed self-reported thyroid medication use from mothers of 31,409 birth defect cases and 11,536 unaffected controls. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression for birth defects with five or more exposed cases, controlling for maternal age, race/ethnicity, and study center. Crude ORs and exact 95% CIs were estimated for defects with 3 to 4 exposed cases. Thyroid hormone was used by 738 (2.3%) case and 237 (2.1%) control mothers, and was associated with anencephaly (OR = 1.68; 95% CI, 1.03-2.73), holoprosencephaly (OR = 2.48; 95% CI, 1.13-5.44), hydrocephaly (1.77; 95% CI, 1.07-2.95) and small intestinal atresia (OR = 1.81; 95% CI, 1.04-3.15). Anti-thyroid medication was used by 34 (0.1%) case and 10 (<0.1%) control mothers, and was associated with aortic valve stenosis (OR = 6.91; 95% CI, 1.21-27.0). While new associations were identified, our findings are relatively consistent with previous NBDPS analyses. Our findings suggest thyroid medication use is not associated with most birth defects studied in the NBDPS, but may be associated with some specific birth defects. These results should not be interpreted to suggest that medications used to treat thyroid disease are teratogens, as the observed associations may reflect effects of the underlying thyroid disease. Birth Defects Research 109:1471-1481, 2017.© 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. The association of birth model with resilience variables and birth experience: Home versus hospital birth.

    Science.gov (United States)

    Handelzalts, Jonathan E; Zacks, Arni; Levy, Sigal

    2016-05-01

    to study home, natural hospital, and medical hospital births, and the association of these birth models to resilience and birth experience. cross-section retrospective design. participants were recruited via an online survey system. Invitations to participate were posted in five different Internet forums for women on maternity leave, from September 2014 to August 2015. the sample comprised 381 post partum healthy women above the age of 20, during their maternity leave. Of the participants: 22% gave birth at home, 32% gave birth naturally in a hospital, and 46% of the participants had a medical birth at the hospital. life Orientation Test Revised (LOT-R), General Self-Efficacy Scale, Sense of Mastery Scale, Childbirth Experience Questionnaire (CEQ). women having had natural births, whether at home or at the hospital, significantly differed from women having had medical births in all aspects of the birth experience, even when controlling for age and optimism. Birth types contributed to between 14% and 24% of the explained variance of the various birth experience aspects. home and natural hospital births were associated with a better childbirth experience. Optimism was identified as a resilience factor, associated both with preference as well as with childbirth experience. physically healthy and resilient women could be encouraged to explore the prospect of home or natural hospital births as a means to have a more positive birth experience. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Birth Spacing of Pregnant Women in Nepal: A Community-Based Study.

    Science.gov (United States)

    Karkee, Rajendra; Lee, Andy H

    2016-01-01

    Optimal birth spacing has health advantages for both mother and child. In developing countries, shorter birth intervals are common and associated with social, cultural, and economic factors, as well as a lack of family planning. This study investigated the first birth interval after marriage and preceding interbirth interval in Nepal. A community-based prospective cohort study was conducted in the Kaski district of Nepal. Information on birth spacing, demographic, and obstetric characteristics was obtained from 701 pregnant women using a structured questionnaire. Logistic regression analyses were performed to ascertain factors associated with short birth spacing. About 39% of primiparous women gave their first child birth within 1 year of marriage and 23% of multiparous women had short preceding interbirth intervals (gender equality in society.

  5. Developmental outcome of low birth-weight and preterm newborns: a re-view of current evidence

    Directory of Open Access Journals (Sweden)

    Farin Soleimani

    2013-12-01

    Full Text Available Low birth weight (LBW and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems. Global statistics demonstrates an increase in the prevalence of low birth weight in the developing countries. Low birth weight infants are exposed to complications such as major neurosensory impairements, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances. The majority of infant's death and developmental disorders were due to disorders relating to prematurity and unspecified low birth weight. Infants weighing less than 2500 g, is a major determinant of both neonatal and infant mortality rates and, together with congenital anomalies (e.g., cardiac, central nervous system, and respiratory, contributes significantly to childhood morbidity. Various studies indicate that low birth weight infants are suffering from physiological and psychosocial disabilities, two to three times more than the other children. At school age, preterm and low birth weight infants have poorer physical growth, cognitive function, and school performance. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Although the survival rates have increased dramatically and the incidence of morbidities has decreased, the complications are still considered to be associated with economical and social burdens. Most children with Low birth weight suffer from multiple disabilities. Therefore, they need special and consistent care. On demand of reducing the infant mortality rate, the need to decrease the complications in low birth weight and preterm infants should be considered by the policy makers in health care system. In this review article, we assessed current evidences on developmental outcomes of low birth weight and

  6. Grand multiparae's evolving experiences of birthing and technology in U.S. hospitals.

    Science.gov (United States)

    Fleming, Susan E; Vandermause, Roxanne

    2011-01-01

    To explore the nature of birthing in United States (U.S.) hospitals from 1973-2007 and to explicate and interpret common, often overlooked, birthing experiences and nursing care. A Heideggerian phenomenological approach utilizing in-depth interviews. Participants' homes in Washington, Idaho, and Oregon. A purposive sample of grand multiparaes (N = 14). Data were collected via open conversational interviews of 60-90 minutes recorded on digital media and completion of a demographic and birth attribute form. Field notes and interpretive commentary were used as additional data sources and were analyzed using an established Heideggerian approach. The participants came from diverse religious and ethical backgrounds and experienced 116 births (8.29 births per woman, 79% unmedicated), a Cesarean rate of 6%, and a breastfeeding rate of 99% with a mean duration of 12 months. Two overarching patterns emerged: pursuing the "'good birth": a safe passage for baby and being in-and-out of control: body, technology, others. Each pattern subsumed several overlapping themes. The first pattern revealed that women often desire a good birth in the safety of a hospital by navigating their options prior to and during the birth. The second pattern revealed a common, yet often unachievable, desire by all of those involved in the process to control birth. Harmonizing an exchange of ideas in a technologically advanced environment prevalent in hospitals today can increase the quality of intrapartum care. Encouraging anchored companions and promoting normal physiological birth will make hospitals places where women can experience a good birth and feel safe. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  7. Fathers' birth experience in relation to midwifery care.

    Science.gov (United States)

    Hildingsson, Ingegerd; Cederlöf, Linnea; Widén, Sara

    2011-09-01

    The aim was to identify the proportion of fathers having a positive experience of a normal birth and to explore factors related to midwifery care that were associated with a positive experience. Research has mainly focused on the father's supportive role during childbirth rather than his personal experiences of birth. 595 new fathers living in a northern part of Sweden, whose partner had a normal birth, were included in the study. Data was collected by questionnaires. Odds Ratios with 95% confidence interval and logistic regression analysis were used. The majority of fathers (82%) reported a positive birth experience. The strongest factors associated with a positive birth experience were midwife support (OR 4.0; 95 CI 2.0-8.1), the midwife's ongoing presence in the delivery room (OR 2.0; 1.1-3.9), and information about the progress of labour (OR 3.1; 1.6-5.8). Most fathers had a positive birth experience. Midwifery support, the midwife's presence and sufficient information about the progress of labour are important aspects in a father's positive birth experience. The role of the midwife during birth is important to the father, and his individual needs should be considered in order to enhance a positive birth experience. Copyright © 2010 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  8. Skilled attendance at delivery; how skilled are institutional birth attendants? : An explorative study on birth attendants at Bansang Hospital, The Gambia

    OpenAIRE

    Kreyberg, Ina; Helsingen, Lise Mørkved

    2010-01-01

    Abstract Background: As reflected in the United Nations Millennium Development Goals (UN MDG 5), reducing maternal mortality represents an important area of concern. The common causes of maternal deaths may be preventable and treatable by having access to emergency obstetric care (EmOC), including skilled birth attendance (SBA), when needed. Measuring the presence of a birth attendant has been the main focus until now, not their skills and qualifications, and by this we cannot presuppose ...

  9. Agricultural Compounds in Water and Birth Defects.

    Science.gov (United States)

    Brender, Jean D; Weyer, Peter J

    2016-06-01

    Agricultural compounds have been detected in drinking water, some of which are teratogens in animal models. The most commonly detected agricultural compounds in drinking water include nitrate, atrazine, and desethylatrazine. Arsenic can also be an agricultural contaminant, although arsenic often originates from geologic sources. Nitrate has been the most studied agricultural compound in relation to prenatal exposure and birth defects. In several case-control studies published since 2000, women giving birth to babies with neural tube defects, oral clefts, and limb deficiencies were more likely than control mothers to be exposed to higher concentrations of drinking water nitrate during pregnancy. Higher concentrations of atrazine in drinking water have been associated with abdominal defects, gastroschisis, and other defects. Elevated arsenic in drinking water has also been associated with birth defects. Since these compounds often occur as mixtures, it is suggested that future research focus on the impact of mixtures, such as nitrate and atrazine, on birth defects.

  10. Maltreatment in multiple-birth children.

    Science.gov (United States)

    Lang, Cathleen A; Cox, Matthew J; Flores, Glenn

    2013-12-01

    The rate of multiple births has increased over the last two decades. In 1982, an increased frequency of injuries among this patient population was noted, but few studies have evaluated the increased incidence of maltreatment in twins. The study aim was to evaluate the features of all multiple-birth children with substantiated physical abuse and/or neglect over a four-year period at a major children's hospital. A Retrospective chart review was conducted of multiple-gestation children in which at least one child in the multiple set experienced child maltreatment from January 2006 to December 2009. Data regarding the child, injuries, family, and perpetrators were abstracted. We evaluated whether family and child characteristics were associated with maltreatment, and whether types of injuries were similar within multiple sets. For comparison, data from the same time period for single-birth maltreated children also were abstracted, including child age, gestational age at birth, and injury type. There were 19 sets of multiple births in which at least one child had abusive injuries and/or neglect. In 10 of 19 sets (53%), all multiples were found to have a form of maltreatment, and all children in these multiple sets shared at least one injury type. Parents lived together in 63% of cases. Fathers and mothers were the alleged perpetrator in 42% of the cases. Multiple-gestation-birth maltreated children were significantly more likely than single-birth maltreated children to have abdominal trauma (13% vs. 1%, respectively; pchildren often, but not always, were abused. In sets with two maltreated children, children usually shared the same modes of maltreatment. Multiples are significantly more likely than singletons to be younger and experience fractures and abdominal trauma. The findings support the current standard practice of evaluating all children in a multiple set when one is found to be abused or neglected. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Near miss and minor occupational injury: Does it share a common causal pathway with major injury?

    Science.gov (United States)

    Alamgir, Hasanat; Yu, Shicheng; Gorman, Erin; Ngan, Karen; Guzman, Jaime

    2009-01-01

    An essential assumption of injury prevention programs is the common cause hypothesis that the causal pathways of near misses and minor injuries are similar to those of major injuries. The rates of near miss, minor injury and major injury of all reported incidents and musculoskeletal incidents (MSIs) were calculated for three health regions using information from a surveillance database and productive hours from payroll data. The relative distribution of individual causes and activities involved in near miss, minor injury and major injury were then compared. For all reported incidents, there were significant differences in the relative distribution of causes for near miss, minor, and major injury. However, the relative distribution of causes and activities involved in minor and major MSIs were similar. The top causes and activities involved were the same across near miss, minor, and major injury. Finding from this study support the use of near miss and minor injury data as potential outcome measures for injury prevention programs. (c) 2008 Wiley-Liss, Inc.

  12. Is low back pain in youth associated with weight at birth?

    DEFF Research Database (Denmark)

    Hestbæk, Lise; Leboeuf-Yde, Charlotte; Kyvik, Kirsten Ohm

    2003-01-01

    INTRODUCTION: Low back pain has been associated with an increased risk of several diseases and with poor general health. Also low birth weight has been associated with an increased susceptibility to various diseases as well as with poor general health. Thus, low birth weight could be a common fac...

  13. Birth defects and genetic disorders among Arab Americans--Michigan, 1992-2003.

    Science.gov (United States)

    Yanni, Emad A; Copeland, Glenn; Olney, Richard S

    2010-06-01

    Birth defects and genetic disorders are leading causes of infant morbidity and mortality in many countries. Population-based data on birth defects among Arab-American children have not been documented previously. Michigan has the second largest Arab-American community in the United States after California. Using data from the Michigan Birth Defects Registry (MBDR), which includes information on parents' country of birth and ancestry, birth prevalences were estimated in offspring of Michigan women of Arab ancestry for 21 major categories of birth defects and 12 congenital endocrine, metabolic, and hereditary disorders. Compared with other non-Hispanic white children in Michigan, Arab-American children had similar or lower birth prevalences of the selected types of structural birth defects, with higher rates of certain hereditary blood disorders and three categories of metabolic disorders. These estimates are important for planning preconception and antenatal health care, genetic counseling, and clinical care for Arab Americans.

  14. Experiences of South African multiparous labouring women using the birthing ball to encourage vaginal births

    Directory of Open Access Journals (Sweden)

    Sindiwe James

    2017-10-01

    Full Text Available The article explores the experiences of South African multiparous labouring women on their use of the birthing ball during the first stage of labour. The authors used a qualitative research approach using unstructured audiotaped interviews as the data collection method and data were collected over a period of one calendar month. The sample for the study were women who were six hours to six weeks post-delivery, had at least one child already, used the birthing ball, were on no medication, and had delivered a live infant. The sample consisted of twelve purposively selected participants, two of whom were used for the pilot study. The data analysis method was Data Analysis Spiral. The authors made use of an independent coder to assist with coding the data and three major themes were identified. The results revealed that the labouring women experienced the birthing ball as a useful labour tool, as shortening the labour process and as empowering them during labour.

  15. Relationship between birth order, birth weight, colostrum intake, acquisition of passive immunity and pre-weaning mortality of piglets

    Directory of Open Access Journals (Sweden)

    Jean Le Dividich

    2017-07-01

    Full Text Available This study investigates the relation between birth order (BO, birth weight (BW0, colostrum intake (CI, level of passive immunity and pre-weaning mortality of piglets. The animals used were 551 cross-bred piglets [Piétrain × (Large-White × Landrace] born from 40 sows. Colostrum immunoglobulins G (IgG determinations were made from 17 sows. Colostrum samples were obtained at birth of the first piglet then at 3, 6, 12, 24, and 36 h later, and on the first-two and the last-two piglets born. Serum IgG determinations from 68 piglets were made at 2d of age and at weaning. Individual CI was estimated from body weight gain. Relative birth order (RBO and BW0 within-litter were weakly (R20.10 but increased by 26 ± 1.6 g per 100 g increase in BW0 (p0.10. It was concluded that despite last-born piglets obtained less passive immunity than first-born, they were not at higher risk of dying before weaning. Major causes of mortality were low birth weight and insufficient colostrum (energy intake.

  16. A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children

    NARCIS (Netherlands)

    Geldof, C.J.A.; van Wassenaer-Leemhuis, A.G.; Dik, M.; Kok, J.H.; Oosterlaan, J.

    2015-01-01

    Background:Cerebral visual impairment (CVI) is a major cause of visual impairment, with very preterm birth/very low birth weight (VP/VLBW) being a major risk factor. There is no generally accepted definition of CVI. This study aims to investigate the usefulness of an empirically-based functional

  17. Cesarean Birth

    Science.gov (United States)

    ... QUESTIONS LABOR, DELIVERY, AND POSTPARTUM CARE FAQ006 Cesarean Birth (C-section) • What is cesarean birth? • What are the reasons for cesarean birth? • Is a cesarean birth necessary if I have ...

  18. The joy at birth: an interpretive hermeneutic literature review.

    Science.gov (United States)

    Crowther, Susan; Smythe, Elizabeth; Spence, Deb

    2014-04-01

    this literature review examines the experience of joy at birth and what that joy means. The premise is that the whole of the birthing experience has not been fully explicated in the literature and that something of significance remains unexplored and unspoken. It is argued that a hermeneutic phenomenological approach to reviewing literature provides unique insights and leads to deeper understandings about birth and the experience of joy that attunes at that moment. the philosophical underpinnings informed by Heidegger and Gadamer are central to this review and therefore the process of reviewing literature hermeneutically is described. Heideggerian phenomenology is used as the method to ask the questions of the literature in order that concealed and hidden experiences of joy at birth are made visible where they are gleaned from the literature. A hermeneutic lens is used to uncover relationships within the phenomenon of joy at birth and meaning. although a vast birth literature was reviewed joy at birth was often ignored, hidden or covered over. Reviewing the literature on relationships, professional presence, place of birth, birth satisfaction studies and birth as peak and spiritual experience provides glimpses of the phenomenon 'joy at birth'. it is argued that joy at birth remains largely neglected as a phenomenon worthy of consideration. Plausible interpretations are presented that suggest that joy at birth points to something significant and meaningful. Spiritual and sacred meaning is alluded to in the papers reviewed yet the majority of papers that investigate birth leave this meaning unspoken. The review highlights a need for further thinking and questioning about birth that would direct on-going investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Impact of race on male predisposition to birth asphyxia.

    Science.gov (United States)

    Mohamed, M A; Aly, H

    2014-06-01

    To examine the associations of: (a) neonatal sex with mild-to-moderate and severe birth asphyxia, (b) fetal sex with mortality due to birth asphyxia and (c) neonatal race with severe birth asphyxia. We used the Nationwide Inpatient Sample (NIS) Database including the years 1993 to 2008 or its pediatric sub portion Kid's Inpatient Database (KID) for the years 1997, 2000, 2003 and 2006. NIS database is collected annually from more than 1000 hospitals across the United States for millions of inpatient discharge summaries. We included newborns older than 36 weeks gestational age or more than 2500 g at birth. We excluded newborns with congenital heart disease, major congenital anomalies and chromosomal disorders. We compared birth asphyxia in males to females, and in each race compared with whites, and examined effect of sex in association with birth asphyxia within each race/ethnicity. There were 9 708 251 term infants (51.8% males) included in the study. There were 15 569 newborns diagnosed with severe birth asphyxia (1.6 in 1000); of them 56.1% were males. Odds ratio (OR)to have severe birth asphyxia in male newborns was 1.16 (confidence interval (CI): 1.12 to 1.20, Psex was associated with increased birth asphyxia in all races but Native American. Male sex and African-American race were associated with increased prevalence of birth asphyxia.

  20. Finding Autonomy in Birth*

    Science.gov (United States)

    Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret; Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M.; Harris, Lisa

    2009-01-01

    Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside of this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women’s agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be ‘for’ or ‘against’ women’s access to cesarean delivery in the absence of traditional medical indications - and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach, but rather, taking the value of women’s autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women’s full inclusion in a safe and positive birth process. PMID:19076937

  1. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-03-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  2. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-05-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  3. Residential proximity to major roads and obstetrical complications.

    Science.gov (United States)

    Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Doi, Hiroyuki

    2015-03-01

    Exposure to air pollution is linked with an increased risk of preterm births. To provide further evidence on this relationship, we evaluated the association between proximity to major roads--as an index for air pollution exposure--and various obstetrical complications. Data were extracted from a database maintained by the perinatal hospital in Shizuoka, Japan. We restricted the analysis to mothers with singleton pregnancies of more than 22 weeks of gestation from 1997 to 2012 (n=19,077). Using the geocoded residential information, each mother was assigned proximity to major roads. We then estimated multivariate adjusted odds ratios and their 95% confidence intervals (CIs) for the effects of proximity to major roads on various obstetrical complications (preeclampsia, gestational diabetes mellitus, placenta abruption, placenta previa, preterm premature rupture of membrane (pPROM), preterm labor, and preterm births). We found positive associations of proximity to major roads with preeclampsia and pPROM. Living within 200 m increased the odds of preeclampsia by 1.3 times (95% CI, 1.0-1.8) and pPROM by 1.6 times (95% CI, 1.1-2.2). Furthermore, living within 200 m increased the odds of preterm births by 1.4 fold (95% CI, 1.2-1.7). Exposure to traffic-related air pollution increased the risk of preeclampsia and pPROM in this study. We propose a mechanism responsible for the association between air pollution and preterm births. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. [Perinatal health: low birth weight and social class].

    Science.gov (United States)

    da Silva, A A; Barbieri, M A; Bettiol, H; Dal Bó, C M; Mucillo, G; Gomes, U A

    1991-04-01

    A survey was carried out in Ribeirão Preto, S. Paulo State, Brazil, between June 1978 and May 1979 with a view to studying the prevalence of low birth weight and its occurrence among different social classes. Data were collected from 8,878 singleton live births in eight maternity hospitals, accounting for 98% of all births in the area. Social classes were determinated by the use of a model proposed by Singer and modified for epidemiological purposes by Barros. Out of the 8,878 births, 660 (7.5%) were of low birth weight. The prevalence of deficient weight at birth (between 2,500 and 2,999 grams) was of 21.1%. Analysis indicated that 50.6% of children with low birth weight were at term and the majority of them suffered form intrauterine growth retardation. The prevalence of low birth weight according to social class was seen to be lower in the bourgeoisie classes (ranging from 2.8% to 3.9%) and higher in working classes (from 7% up to 9.5%). Low birth weight (defined as less than or equal to 2,500 grams) was used for purposes of comparison with other previous surveys. The percentage was lower in this study (8.3%) than that found in the Interamerican Investigation of Mortality in Childhood (8.7%), carried out in 1968-70. No statistically significant differences in the percentage of low birth weight were found in the case of Ribeirão Preto when these two surveys were compared.

  5. A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children

    NARCIS (Netherlands)

    Geldof, Christiaan J. A.; van Wassenaer-Leemhuis, Aleid G.; Dik, Marjolein; Kok, Joke H.; Oosterlaan, Jaap

    2015-01-01

    Cerebral visual impairment (CVI) is a major cause of visual impairment, with very preterm birth/very low birth weight (VP/VLBW) being a major risk factor. There is no generally accepted definition of CVI. This study aims to investigate the usefulness of an empirically-based functional definition of

  6. Out-of-hospital births in the United States 2009-2014.

    Science.gov (United States)

    Grunebaum, Amos; Chervenak, Frank A

    2016-10-01

    To evaluate recent trends of out-of-hospital births in the US from 2009 to 2014. We accessed data for all live births occurring in the US from the National Vital Statistics System, Natality Data Files for 2009-2014 through the interactive data tool, VitalStats. Out-of-hospital (OOH) births in the US increased from 2009 to 2014 by 80.2% from 32,596 to 58,743 (0.79%-1.47% of all live births). Home births (HB) increased by 77.3% and births in freestanding birthing centers (FBC) increased by 79.6%. In 2014, 63.8% of OOH births were HB, 30.7% were in FBC, and 5.5% were in other places, physicians offices, or clinics. The majority of women who had an OOH birth in 2014 were non-Hispanic White (82.3%). About in one in 47 non-Hispanic White women had an OOH in 2014, up from 1 in 87 in 2009. Women with a HB were older compared to hospital births (age ≥35: 21.5% vs. 15.4%), had a higher live birth order(≥5: 18.9% vs. 4.9%), 3.48% had infants home and in freestanding birthing centers has significantly increased in the US making it the country with the most out of hospital births among all developed countries. The root cause of the increase in planned OOH births should be identified and addressed by the medical community.

  7. Primate pelvic anatomy and implications for birth

    Science.gov (United States)

    Trevathan, Wenda

    2015-01-01

    The pelvis performs two major functions for terrestrial mammals. It provides somewhat rigid support for muscles engaged in locomotion and, for females, it serves as the birth canal. The result for many species, and especially for encephalized primates, is an ‘obstetric dilemma’ whereby the neonate often has to negotiate a tight squeeze in order to be born. On top of what was probably a baseline of challenging birth, locomotor changes in the evolution of bipedalism in the human lineage resulted in an even more complex birth process. Negotiation of the bipedal pelvis requires a series of rotations, the end of which has the infant emerging from the birth canal facing the opposite direction from the mother. This pattern, strikingly different from what is typically seen in monkeys and apes, places a premium on having assistance at delivery. Recently reported observations of births in monkeys and apes are used to compare the process in human and non-human primates, highlighting similarities and differences. These include presentation (face, occiput anterior or posterior), internal and external rotation, use of the hands by mothers and infants, reliance on assistance, and the developmental state of the neonate. PMID:25602069

  8. [Exploration of common biological pathways for attention deficit hyperactivity disorder and low birth weight].

    Science.gov (United States)

    Xiang, Bo; Yu, Minglan; Liang, Xuemei; Lei, Wei; Huang, Chaohua; Chen, Jing; He, Wenying; Zhang, Tao; Li, Tao; Liu, Kezhi

    2017-12-10

    To explore common biological pathways for attention deficit hyperactivity disorder (ADHD) and low birth weight (LBW). Thei-Gsea4GwasV2 software was used to analyze the result of genome-wide association analysis (GWAS) for LBW (pathways were derived from Reactome), and nominally significant (Ppathways were tested for replication in ADHD.Significant pathways were analyzed with DAPPLE and Reatome FI software to identify genes involved in such pathways, with each cluster enriched with the gene ontology (GO). The Centiscape2.0 software was used to calculate the degree of genetic networks and the betweenness value to explore the core node (gene). Weighed gene co-expression network analysis (WGCNA) was then used to explore the co-expression of genes in these pathways.With gene expression data derived from BrainSpan, GO enrichment was carried out for each gene module. Eleven significant biological pathways was identified in association with LBW, among which two (Selenoamino acid metabolism and Diseases associated with glycosaminoglycan metabolism) were replicated during subsequent ADHD analysis. Network analysis of 130 genes in these pathways revealed that some of the sub-networksare related with morphology of cerebellum, development of hippocampus, and plasticity of synaptic structure. Upon co-expression network analysis, 120 genes passed the quality control and were found to express in 3 gene modules. These modules are mainly related to the regulation of synaptic structure and activity regulation. ADHD and LBW share some biological regulation processes. Anomalies of such proces sesmay predispose to ADHD.

  9. Association between antibiotic use among pregnant women with urinary tract infections in the first trimester and birth defects, National Birth Defects Prevention Study 1997 to 2011.

    Science.gov (United States)

    Ailes, Elizabeth C; Gilboa, Suzanne M; Gill, Simerpal K; Broussard, Cheryl S; Crider, Krista S; Berry, Robert J; Carter, Tonia C; Hobbs, Charlotte A; Interrante, Julia D; Reefhuis, Jennita

    2016-11-01

    Previous studies noted associations between birth defects and some antibiotics (e.g., nitrofurantoin, sulfonamides) but not others (e.g., penicillins). It is unclear if previous findings were due to antibiotic use, infections, or chance. To control for potential confounding by indication, we examined associations between antibiotic use and birth defects, among women reporting urinary tract infections (UTIs). The National Birth Defects Prevention Study is a multi-site, population-based case-control study. Case infants/fetuses have any of over 30 major birth defects and controls are live-born infants without major birth defects. We analyzed pregnancies from 1997 to 2011 to estimate the association between maternally reported periconceptional (month before conception through the third month of pregnancy) use of nitrofurantoin, trimethoprim-sulfamethoxazole, or cephalosporins and specific birth defects, among women with periconceptional UTIs. Women with periconceptional UTIs who reported penicillin use served as the comparator. Periconceptional UTIs were reported by 7.8% (2029/26,068) of case and 6.7% (686/10,198) of control mothers. Most (68.2% of case, 66.6% of control mothers) also reported antibiotic use. Among 608 case and 231 control mothers reporting at least one periconceptional UTI and certain antibiotic use, compared with penicillin, nitrofurantoin use was associated with oral clefts in the offspring (adjusted odds ratio, 1.97 [95% confidence interval, 1.10-3.53]), trimethoprim-sulfamethoxazole use with esophageal atresia (5.31 [1.39-20.24]) and diaphragmatic hernia (5.09 [1.20-21.69]), and cephalosporin use with anorectal atresia/stenosis (5.01 [1.34-18.76]). Periconceptional exposure to some antibiotics might increase the risk for certain birth defects. However, because individual birth defects are rare, absolute risks should drive treatment decisions.Birth Defects Research (Part A) 106:940-949, 2016.© 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals

  10. Birth Defects

    Science.gov (United States)

    A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of ... in the United States is born with a birth defect. A birth defect may affect how the ...

  11. Multilevel factors influencing preterm birth in an urban setting

    Directory of Open Access Journals (Sweden)

    Saba W. Masho

    2014-01-01

    Full Text Available Racial disparity in preterm is a major problem in the US. Although significant strides have been made in identifying some of the risk factors, the complexities between community and individual factors are not understood. This study examines the influence of individual and community level factors affecting preterm birth among Black and White women in an urban setting. A 10-year live birth registry dataset from a mid-sized, racially diverse city was analyzed (N = 30,591. Data were geocoded and merged with block group level Census data. Five hierarchical models were examined using PROC GLIMMIX. Education, illicit drug use, pregnancy complications, previous preterm birth, paternal presence, inadequate and adequate plus prenatal care, and poverty were associated with preterm births in both Blacks and Whites. In Black women, increasing maternal age, maternal smoking, and a previous infant death were significant predictors of preterm births, which was not the case for White women. Residing in medium or high poverty neighborhoods resulted in 19% and 28% higher odds, respectively, of preterm birth for Black women. In addition to individual level factors, neighborhood poverty is an important risk factor influencing preterm birth. It is essential to engage multisectoral agencies in addressing factors influencing preterm birth.

  12. Overview of results and perspectives from the Shoreham major common-cause initiating events study

    International Nuclear Information System (INIS)

    Joksimovich, V.; Orvis, D.D.; Paccione, R.J.

    1986-01-01

    This study represents the continuation of a large effort by LILCO to fully understand the potential hazards posed by future operation of the Shoreham Nuclear Power Stations (SNPS). The Shoreham Probabilistic Risk Assessment, a level 3 PRA without external events, provided a characterization of the accident sequences that could leave the core in a condition in which it would be vulnerable to severe damage if further mitigating actions were not taken. It estimated the frequency and magnitude of the potential radioactivity releases associated with such sequences. The study was limited to accident sequences initiated by so called internal events to the plant including a loss of offsite power. It also characterized the public risk associated with those accident sequences. The ''Major Common-Cause Initiating Events Study'' (MCCI) for the Shoreham plant was performed to obtain insights into the plant's susceptibility to, and inherent defenses against, certain MCCIs. Major common-cause initiating events are occurrences which have the potential to initiate a plant transient or LOCA and, also, damage one or more plant systems needed to mitigate the effects of a transient or LOCA. The scope of the MCCI study included detailed analyses of seismic events and fires through the severe core damage and bounding analyses of aircraft crashes, windstorms, turbine missiles and release of hazardous materials near the plant

  13. Risk factors of extubation failure in extremely low birth weight infants: a five year retrospective analysis.

    Science.gov (United States)

    Lee, Chao-Yi; Su, Bai-Horng; Lin, Tsung-Wen; Lin, Hung-Chih; Li, Tsai-Chung; Wang, Nai-Phon

    2002-01-01

    Extubation failure is one of the most serious complications in extremely low birth weight infants (ELBWI) on mechanical ventilation therapy. We performed a 5-year retrospective analysis to realize the status of extubation failure in ELBWI. Extubation failure was defined as requirements of re-intubation within 72 hours after extubation. The extubation failure rate was 21% (29/138). The mean birth body weight was 808.3 +/- 140.4 gm. The mean gestational age was 25.8 +/- 1.2 wks. The incidence of chronic lung disease (CLD) in infants with extubation failure was 100% (29/29). Apnea of prematurity 49% (14/29) and post-extubation atelectasis 39% (11/29) were the most common reasons for reintubation. The major microbiology findings which correlated with nosocomial pneumonia in infants with extubation failure were Acinetobacter baumanni (21%), Klebsiella pneumonia (21%), Pseudomonas aeroginosa (14%), and Methicillin resistant staphylococcus aureus (14%). In conclusion, post-extubation atelectasis and apnea were the most common reasons for reintubation. ELBWI with extubation failure had higher incidences of post-extubation atelectasis, CLD, and nosocomial pneumonia. Further prospective studies are needed in order to clarify the appropriate extubation program for ELBWI and to prevent post-extubation atelectasis and nosocomial pneumonia.

  14. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: Results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    M.F. Hitzert (Marit); M.A.A. Hermus (Marieke A.A.); Boesveld, I.I.C. (Inge I.C.); A. Franx (Arie); K.M. van der Pal-De Bruin (Karin); E.A.P. Steegers (Eric); Van Den Akker-Van Marle, E.M.E. (Eiske M.E.)

    2017-01-01

    textabstractObjectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design

  15. Birth order and mortality: a population-based cohort study.

    Science.gov (United States)

    Barclay, Kieron; Kolk, Martin

    2015-04-01

    This study uses Swedish population register data to investigate the relationship between birth order and mortality at ages 30 to 69 for Swedish cohorts born between 1938 and 1960, using a within-family comparison. The main analyses are conducted with discrete-time survival analysis using a within-family comparison, and the estimates are adjusted for age, mother's age at the time of birth, and cohort. Focusing on sibships ranging in size from two to six, we find that mortality risk in adulthood increases with later birth order. The results show that the relative effect of birth order is greater among women than among men. This pattern is consistent for all the major causes of death but is particularly pronounced for mortality attributable to cancers of the respiratory system and to external causes. Further analyses in which we adjust for adult socioeconomic status and adult educational attainment suggest that social pathways only mediate the relationship between birth order and mortality risk in adulthood to a limited degree.

  16. Schooling, marriage, and age at first birth in Madagascar.

    Science.gov (United States)

    Glick, Peter; Handy, Christopher; Sahn, David E

    2015-01-01

    The low school attainment, early marriage, and low age at first birth of females are major policy concerns in less developed countries. This study jointly estimated the determinants of educational attainment, marriage age, and age at first birth among females aged 12-25 in Madagascar, explicitly accounting for the endogeneities that arose from modelling these related outcomes simultaneously. An additional year of schooling results in a delay to marriage of 1.5 years and marrying 1 year later delays age at first birth by 0.5 years. Parents' education and wealth also have important effects on schooling, marriage, and age at first birth, with a woman's first birth being delayed by 0.75 years if her mother had 4 additional years of schooling. Overall, our results provide rigorous evidence for the critical role of education-both individual women's own and that of their parents-in delaying the marriage and fertility of young women.

  17. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.M.; Boesveld, I.I.; Franx, A.; Pal-de Bruin, K.K. van der; Steegers, E.E.; Akker-van Marle, E.M. van den

    2017-01-01

    Objectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design Economic evaluation

  18. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth : Results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    Hitzert, Marit F.; Hermus, Marieke A. A.; Boesveld, Inge I.C.; Franx, Arie; van der Pal-de Bruin, Karin M.; Steegers, Eric A. P.; Van Den Akker-Van Marle, Eiske M.E.

    2017-01-01

    Objectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design Economic evaluation

  19. Associations of meteorology with adverse pregnancy outcomes: a systematic review of preeclampsia, preterm birth and birth weight.

    Science.gov (United States)

    Beltran, Alyssa J; Wu, Jun; Laurent, Olivier

    2013-12-20

    The relationships between meteorology and pregnancy outcomes are not well known. This article reviews available evidence on the relationships between seasonality or meteorology and three major pregnancy outcomes: the hypertensive disorders of pregnancy (including preeclampsia, eclampsia and gestational hypertension), gestational length and birth weight. In total 35, 28 and 27 studies were identified for each of these outcomes. The risks of preeclampsia appear higher for women with conception during the warmest months, and delivery in the coldest months of the year. Delivery in the coldest months is also associated with a higher eclampsia risk. Patterns of decreased gestational lengths have been observed for births in winter, as well as summer months. Most analytical studies also report decreases in gestational lengths associated with heat. Birth weights are lower for deliveries occurring in winter and in summer months. Only a limited number of studies have investigated the effects of barometric pressure on gestational length or the effects of temperature and sunshine exposure on birth weight, but these questions appear worth investigating further. Available results should encourage further etiological research aiming at enhancing our understanding of the relationships between meteorology and adverse pregnancy outcomes, ideally via harmonized multicentric studies.

  20. Birth weight and stuttering: Evidence from three birth cohorts.

    Science.gov (United States)

    McAllister, Jan; Collier, Jacqueline

    2014-03-01

    Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Survival of extremely low-birth-weight infants

    African Journals Online (AJOL)

    Survival of extremely low-birth-weight (ELBW) infants in a resource-limited public hospital setting is still low in South. Africa. is study aimed ... Mortality as a result of prematurity is the major contributor to .... reported from a large cohort study that.

  2. Distinctive and common neural underpinnings of major depression, social anxiety, and their comorbidity.

    Science.gov (United States)

    Hamilton, J Paul; Chen, Michael C; Waugh, Christian E; Joormann, Jutta; Gotlib, Ian H

    2015-04-01

    Assessing neural commonalities and differences among depression, anxiety and their comorbidity is critical in developing a more integrative clinical neuroscience and in evaluating currently debated categorical vs dimensional approaches to psychiatric classification. Therefore, in this study, we sought to identify patterns of anomalous neural responding to criticism and praise that are specific to and common among major depressive disorder (MDD), social anxiety disorder (SAD) and comorbid MDD-SAD. Adult females who met formal diagnostic criteria for MDD, SAD or MDD-SAD and psychiatrically healthy participants underwent functional magnetic resonance imaging as they listened to statements directing praise or criticism at them or at another person. MDD groups showed reduced responding to praise across a distributed cortical network, an effect potentially mediated by thalamic nuclei undergirding arousal-mediated attention. SAD groups showed heightened anterior insula and decreased default-mode network response to criticism. The MDD-SAD group uniquely showed reduced responding to praise in the dorsal anterior cingulate cortex. Finally, all groups with psychopathology showed heightened response to criticism in a region of the superior frontal gyrus implicated in attentional gating. The present results suggest novel neural models of anhedonia in MDD, vigilance-withdrawal behaviors in SAD, and poorer outcome in MDD-SAD. Importantly, in identifying unique and common neural substrates of MDD and SAD, these results support a formulation in which common neural components represent general risk factors for psychopathology that, due to factors that are present at illness onset, lead to distinct forms of psychopathology with unique neural signatures. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  3. Low birth weight,very low birth weight rates and gestational age-specific birth weight distribution of korean newborn infants.

    Science.gov (United States)

    Shin, Son-Moon; Chang, Young-Pyo; Lee, Eun-Sil; Lee, Young-Ah; Son, Dong-Woo; Kim, Min-Hee; Choi, Young-Ryoon

    2005-04-01

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. The mean birth weight and GA of a crude population are 3,188 +/-518 g and 38.7+/-2.1 weeks, respectively. The LBW and the VLBW rates are 7.2% and 1.4%, respectively. The preterm birth rate (less than 37 completed weeks of gestation) is 8.4% and the very preterm birth rate (less than 32 completed weeks of gestation) is 0.7%. The mean birth weights for female infants, multiple births, and births delivered by cesarean section were lower than those for male, singletons, and births delivered vaginally. The risk of delivering LBW or VLBW infant was higher for the teenagers and the older women (aged 35 yr and more). We have also obtained the percentile distribution of GA-specific birth weight in infants over 23 weeks of gestation.

  4. Poor birth weight recovery among low birth weight/preterm infants following hospital discharge in Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Namiiro Flavia B

    2012-01-01

    Full Text Available Abstract Background Healthy infants typically regain their birth weight by 21 days of age; however, failure to do so may be due to medical, nutritional or environmental factors. Globally, the incidence of low birth weight deliveries is high, but few studies have assessed the postnatal weight changes in this category of infants, especially in Africa. The aim was to determine what proportion of LBW infants had not regained their birth weight by 21 days of age after discharge from the Special Care Unit of Mulago hospital, Kampala. Methods A cross sectional study was conducted assessing weight recovery of 235 LBW infants attending the Kangaroo Clinic in the Special Care Unit of Mulago Hospital between January and April 2010. Infants aged 21 days with a documented birth weight and whose mothers gave consent to participate were included in the study. Baseline information was collected on demographic characteristics, history on pregnancy, delivery and postnatal outcome through interviews. Pertinent infant information like gestation age, diagnosis and management was obtained from the medical records and summarized in the case report forms. Results Of the 235 LBW infants, 113 (48.1% had not regained their birth weight by 21 days. Duration of hospitalization for more than 7 days (AOR: 4.2; 95% CI: 2.3 - 7.6; p value Conclusion Failure to regain birth weight among LBW infants by 21 days of age is a common problem in Mulago Hospital occurring in almost half of the neonates attending the Kangaroo clinic. Currently, the burden of morbidity in this group of high-risk infants is undetected and unaddressed in many developing countries. Measures for consideration to improve care of these infants would include; discharge after regaining birth weight and use of total parenteral nutrition. However, due to the pressure of space, keeping the baby and mother is not feasible at the moment hence the need for a strong community system to boost care of the infant. Close

  5. The relationship between preterm birth and underweight in Asian women.

    Science.gov (United States)

    Neggers, Yasmin H

    2015-08-15

    Although vast improvements have been made in the survival of preterm infants, the toll of preterm birth (PTB) is particularly severe in Asia, with the Indian subcontinent leading the preterm birth rate. Despite the obesity epidemic, maternal underweight remains a common occurrence in developing countries. An association between maternal underweight and preterm birth has been reported in developed countries. A review of epidemiological studies in Asian women in whom association between maternal body mass index (BMI) and risk of PTB was measured, indicated no significant association between low maternal BMI and preterm birth. A hindrance in comparison of these studies is the use of different cut-off point for BMI in defining maternal underweight. As a commentary on published studies it is proposed that that country-specific BMI cut points should be applied for defining underweight for Asian women for the purpose of evaluating the association between maternal underweight and preterm birth. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Profile and birthing practices of Maranao traditional birth attendants

    Directory of Open Access Journals (Sweden)

    Maghuyop-Butalid R

    2015-10-01

    Full Text Available Roselyn Maghuyop-Butalid, Norhanifa A Mayo, Hania T Polangi College of Nursing, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines Abstract: This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents’ modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents’ personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn. Keywords: intrapartum and newborn care, modern birthing practices, traditional birthing practices 

  7. Common variants at 2q11.2, 8q21.3, and 11q13.2 are associated with major mood disorders

    NARCIS (Netherlands)

    Xiao, X. (Xiao); Wang, L. (Lu); Wang, C. (Chuang); Yuan, T.-F. (Ti-Fei); Zhou, D. (Dongsheng); Zheng, F. (Fanfan); Li, L. (Lingyi); Grigoroiu-Serbanescu, M. (Maria); Ikeda, M. (Masashi); Iwata, N. (Nakao); Takahashi, A. (Atsushi); Y. Kamatani (Yoichiro); Kubo, M. (Michiaki); M. Preisig (Martin); Z. Kutalik (Zoltán); Castelao, E. (Enrique); G. Pistis (Giorgio); Amin, N. (Najaf); C.M. van Duijn (Cornelia); A.J. Forstner (Andreas); J. Strohmaier; Hecker, J. (Julian); T.G. Schulze (Thomas); B. Müller-Myhsok (B.); A. Reif (Andreas); Mitchell, P.B. (Philip B.); Martin, N.G. (Nicholas G.); C.J. Schofield (Christopher); S. Cichon (Sven); M.M. Nöthen (Markus); Chang, H. (Hong); X.-J. Luo (X.); Fang, Y. (Yiru); Yao, Y.-G. (Yong-Gang); Zhang, C. (Chen); M. Rietschel (Marcella); Li, M. (Ming)

    2017-01-01

    textabstractBipolar disorder (BPD) and major depressive disorder (MDD) are primary major mood disorders. Recent studies suggest that they share certain psychopathological features and common risk genes, but unraveling the full genetic architecture underlying the risk of major mood disorders remains

  8. Dietary Patterns and Birth Weight—a Review

    Directory of Open Access Journals (Sweden)

    Marte K.R. Kjøllesdal

    2014-11-01

    Full Text Available Being born with low birth weight (LBW is recognized as a disadvantage due to risk of early growth retardation, fast catch up growth, infectious disease, developmental delay, and death during infancy and childhood, as well as development of obesity and non-communicable diseases (NCDs later in life. LBW is an indicator of fetal response to a limiting intrauterine environment, which may imply developmental changes in organs and tissue. Numerous studies have explored the effect of maternal intake of various nutrients and specific food items on birth weight (BW. Taking into account that people have diets consisting of many different food items, extraction of dietary patterns has emerged as a common way to describe diets and explore the effects on health outcomes. The present article aims to review studies investigating the associations between dietary patterns derived from a posteriori analysis and BW, or being small for gestational age (SGA. A PubMed search was conducted with the Mesh terms “pregnancy” OR “fetal growth retardation” OR “fetal development” OR “infant, small for gestational age” OR “birth weight” OR “infant, birth weight, low” AND “diet” OR “food habits”. Final number of articles included was seven, all which assessed diet by use of food frequency questionnaire (FFQ. Five studies explored dietary patterns using principal component analyses (PCA, while one study used cluster analyses and one study logistic regression. The studies reported between one and seven dietary patterns. Those patterns positively associated with BW were labeled “nutrient dense”, “protein rich”, “health conscious”, and “Mediterranean”. Those negatively associated with BW were labeled “Western”, “processed”, “vegetarian”, “transitional”, and “wheat products”. The dietary patterns “Western” and “wheat products” were also associated with higher risk of SGA babies, whereas a

  9. Birth Control

    Science.gov (United States)

    Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ... eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive ...

  10. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  11. Birth spacing of pregnant women in Nepal: A community-based study

    Directory of Open Access Journals (Sweden)

    Rajendra Karkee

    2016-09-01

    Full Text Available BackgroundOptimal birth spacing has health advantages for both mother and child. In developing countries, shorter birth intervals are common and associated with social, cultural and economic factors, as well as a lack of family planning. This study investigated the first birth interval after marriage and preceding interbirth interval in Nepal.MethodsA community-based prospective cohort study was conducted in the Kaski district of Nepal. Information on birth spacing, demographic and obstetric characteristics was obtained from 701 pregnant women using a structured questionnaire. Logistic regression analyses were performed to ascertain factors associated with short birth spacing.ResultsAbout 39% of primiparous women gave their first child birth within one year of marriage and 23% of multiparous women had short preceding interbirth intervals (<24 months. The average birth spacing among the multiparous group was 44.9 (SD 21.8 months. Overall, short birth spacing appeared to be inversely associated with advancing maternal age.For the multiparous group, Janajati and lower caste women, and those whose newborn was female, were more likely to have short birth spacing.ConclusionsThe preceding interbirth interval was relatively long in the Kaski district of Nepal and tended to be associated with maternal age, caste, and sex of newborn infant. Optimal birth spacing programs should target Janajati and lower caste women, along with promotion of gender equality in society.

  12. Dopamine dysregulation hypothesis: the common basis for motivational anhedonia in major depressive disorder and schizophrenia?

    Science.gov (United States)

    Szczypiński, Jan Józef; Gola, Mateusz

    2018-03-24

    Abnormalities in reward processing are crucial symptoms of major depressive disorder (MDD) and schizophrenia (SCH). Recent neuroscientific findings regarding MDD have led to conclusions about two different symptoms related to reward processing: motivational and consummatory anhedonia, corresponding, respectively, to impaired motivation to obtain rewards ('wanting'), and diminished satisfaction from consuming them ('liking'). One can ask: which of these is common for MDD and SCH. In our review of the latest neuroscientific studies, we show that MDD and SCH do not share consummatory anhedonia, as SCH patients usually have unaltered liking. Therefore, we investigated whether motivational anhedonia is the common symptom across MDD and SCH. With regard to the similarities and differences between the neural mechanisms of MDD and SCH, here we expand the current knowledge of motivation deficits and present the common underlying mechanism of motivational anhedonia - the dopamine dysregulation hypothesis - stating that any prolonged dysregulation in tonic dopamine signaling that exceeds the given equilibrium can lead to striatal dysfunction and motivational anhedonia. The implications for further research and treatment of MDD and SCH are also discussed.

  13. Antimicrobials for Preterm Birth Prevention: An Overview

    Directory of Open Access Journals (Sweden)

    Akila Subramaniam

    2012-01-01

    Full Text Available Objective. Preterm birth (PTB remains a major cause of neonatal morbidity and mortality. The association between PTB and infection is clear. The purpose of this report is to present a focused review of information on the use of antibiotics to prevent PTB. Methods. We performed a search of the PubMed database restricted to clinical trials or meta-analyses published in English from 1990 through May 2011 using keywords “antibiotics or antimicrobials” and “preterm.” Results. The search yielded 67 abstracts for review. We selected 31 clinical trials (n=26 or meta-analysis (n=5 for further full-text review. Discussion of each eligible clinical trial, its specific inclusion criteria, antibiotic regimen used, and study results are presented. Overall, trials evaluating antibiotic treatment to prevent preterm birth have yielded mixed results regarding any benefit. Conclusion. Routine antibiotic prophylaxis is not recommended for prevention of preterm birth.

  14. Swedish and American studies show that initiatives to decrease maternal obesity could play a key role in reducing preterm birth.

    Science.gov (United States)

    Gould, Jeffrey B; Mayo, Jonathan; Shaw, Gary M; Stevenson, David K

    2014-06-01

    Maternal obesity is a major source of preventable perinatal morbidity, but studies of the relationship between obesity and preterm birth have been inconsistent. This review looks at two major studies covering just under 3.5 million births, from California, USA, and Sweden. Inconsistent findings in previous studies appear to stem from the complex relationship between obesity and preterm birth. Initiatives to decrease maternal obesity represent an important strategy in reducing preterm birth. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Leucine is a major regulator of muscle protein synthesis in neonates

    Science.gov (United States)

    Approximately 10 % of infants born in the United States are of low birth weight. Growth failure during the neonatal period is a common occurrence in low birth weight infants due to their inability to tolerate full feeds, concerns about advancing protein supply, and high nutrient requirements for gro...

  16. A Study Of 370 Live Births In A Rural Area Of Punjab

    Directory of Open Access Journals (Sweden)

    Singh Surinder

    1988-01-01

    Full Text Available The study was carried out in12 Anganwadi areas of ferozepur District in Punjab to know about the various aspects of reproduction of the population. A total of 13, 782 population was covered. The sex ratio of the surveyed population was 900.7 females to 1000 males. The crude Birth rate of the area came to be 26.83 per 1000 population. In 94.87% of the births, the delivery occurred at the completion of 36 weeks of Gestation period & majority of the births (91.63% occurred to the mothers in the age group of 20 to 35 years . 24.86% of the children were born to the mothers with parity of five and above. 46.75% of the births took place between the months of July and October. 96.22% of the deliveries were conducted at home and majority (93.79% of the mothers utilized the services of indigenous dais( 73.52% of trained dais and 20.27% of untrained dais for the conduction of delivery.

  17. Profile and birthing practices of Maranao traditional birth attendants.

    Science.gov (United States)

    Maghuyop-Butalid, Roselyn; Mayo, Norhanifa A; Polangi, Hania T

    2015-01-01

    This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs) in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents' modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC) Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents' personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn.

  18. Role of Placental VDR Expression and Function in Common Late Pregnancy Disorders

    Directory of Open Access Journals (Sweden)

    Julia Knabl

    2017-11-01

    Full Text Available Vitamin D, besides its classical role in bone metabolism, plays a distinct role in multiple pathways of the feto-maternal unit. Calcitriol is the major active ligand of the nuclear vitamin D receptor (VDR. The vitamin D receptor (VDR is expressed in different uteroplacental parts and exerts a variety of functions in physiologic pregnancy. It regulates decidualisation and implantation, influences hormone secretion and placental immune modulations. This review highlights the role of the vitamin D receptor in physiologic and disturbed pregnancy, as preeclampsia, fetal growth restriction, gestational diabetes and preterm birth. We discuss the existing literature regarding common VDR polymorphisms in these pregnancy disorders.

  19. Facilitating home birth.

    Science.gov (United States)

    Finigan, Valerie; Chadderton, Diane

    2015-06-01

    The birth of a baby is a family experience. However, in the United Kingdom birth often occurs outside the family environment, in hospital. Both home and hospital births have risks and benefits, but research shows that, for most women, it is as safe to give birth at home as it is in hospital. Women report home-birth to be satisfying with lowered risks of intervention and less likelihood of being separated from their family. It is also more cost effective for the National Health Service. Yet, whilst midwives are working hard to promote home birth as an option, it remains controversial. The aim of this paper is to raise awareness of the safety of home birth and the needs of women and midwives when a home birth is chosen. It provides an overview of care required and the role of the midwife in the ensuring care is woman-centred and personalised.

  20. Low Birth Weight, Very Low Birth Weight Rates and Gestational Age-Specific Birth Weight Distribution of Korean Newborn Infants

    OpenAIRE

    Shin, Son-Moon; Chang, Young-Pyo; Lee, Eun-Sil; Lee, Young-Ah; Son, Dong-Woo; Kim, Min-Hee; Choi, Young-Ryoon

    2005-01-01

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. ...

  1. Use of nonhuman primate models to investigate mechanisms of infection-associated preterm birth

    Science.gov (United States)

    Adams Waldorf, Kristina M.; Rubens, Craig E.; Gravett, Michael G.

    2010-01-01

    Preterm birth is the most important direct cause of neonatal mortality and remains a major challenge for obstetrics and global health. Intrauterine infection causes approximately 50% of early preterm births. Animal models using pregnant mice, rabbits, or sheep, demonstrate the key link between infection and premature birth, but differ in mechanisms of parturition and placental structure from humans. The nonhuman primate (NHP) is a powerful model which emulates many features of human placentation and parturition. The contributions of the NHP model to preterm birth research are reviewed emphasizing the role of infections, and potential development of preventative and therapeutic strategies. PMID:21040390

  2. Association of maternal CNVs in GSTT1/GSTT2 with smoking, preterm delivery, and low birth weight

    Directory of Open Access Journals (Sweden)

    Xiaojing eZheng

    2013-10-01

    Full Text Available Preterm delivery (PTD is an adverse birth outcome associated with increased infant mortality and negative lifelong health consequences. PTD may be the result of interactions between genetics and maternal/fetal environmental factors including smoking exposure (SMK. A common deletion in the GSTT1 gene was previously reported to affect birth outcomes in smokers. In this study, we dissect the associations among SMK, birth outcomes, and copy number variations (CNVs in the GSTT1/GSTT2 region.A preterm birth case-control dataset of 1937 mothers was part of the GENEVA preterm birth study, which included genome-wide genotyping used to identify CNVs. We examined the association of SMK with birth outcomes, detected CNVs within the GSTT1/GSTT2 region using PennCNV, and examined associations of the identified CNVs with preterm birth and with birth weight (BW in full term birth controls, including interactions with SMK. Finally, we tested the association of CNVs in GSTT1/GSTT2 with SMK.We confirmed the association of smoking with low BW and PTD. We identified 2 CNVs in GSTT2 (GSTT2a and GSTT2b, 1 CNV in GSTTP1 and 2 CNVs in GSTT1 (GSTT1a and GSTT1b. The GSTT2a deletion was associated with reduced BW (-284g, p=2.5E-7 in smokers, and was more common in smokers (odds ratio[OR]=1.3, p=0.036. We found that the size of the reported common deletion CNV in GSTT1 was larger than previously shown. The GSTTP1 and GSTT1b null genotypes were in high linkage disequilibrium (LD (D’=0.89 and less common in smokers (OR=0.68, p=0.019 and OR=0.73, p=0.055 respectively. These two deletions were in partial LD with GSTT2a and GSTT2b duplications. All 5 CNVs seem to be associated with increased risk of preterm birth before 35 completed weeks.CNVs in the GSTTT1/GSTT2 region appear associated with low BW and PTD outcomes, but LD complicated these CNVs in GSTT1/GSTT2. In genetic association studies of BW, multiple CNVs in this region need to be investigated instead of a single

  3. The sudden death and sudden birth of quantum discord.

    Science.gov (United States)

    Xia, Wei; Hou, Jin-Xing; Wang, Xiao-Hui; Liu, Si-Yuan

    2018-03-28

    The interaction of quantum system and its environment brings out abundant quantum phenomenons. The sudden death of quantum resources, including entanglement, quantum discord and coherence, have been studied from the perspective of quantum breaking channels (QBC). QBC of quantum resources reveal the common features of quantum resources. The definition of QBC implies the relationship between quantum resources. However, sudden death of quantum resources can also appear under some other quantum channels. We consider the dynamics of Bell-diagonal states under a stochastic dephasing noise along the z-direction, and the sudden death and sudden birth of quantum discord are investigated. Next we explain this phenomenon from the geometric structure of quantum discord. According to the above results, the states with sudden death and sudden birth can be filtered in three-parameter space. Then we provide two necessary conditions to judge which kind of noise channels can make Bell-diagonal states sudden death and sudden birth. Moreover, the relation between quantum discord and coherence indicates that the sudden death and sudden birth of quantum discord implies the sudden death and sudden birth of coherence in an optimal basis.

  4. Major congenital anomalies in babies born with Down syndrome

    DEFF Research Database (Denmark)

    Morris, Joan K; Garne, Ester; Wellesley, Diana

    2014-01-01

    Previous studies have shown that over 40% of babies with Down syndrome have a major cardiac anomaly and are more likely to have other major congenital anomalies. Since 2000, many countries in Europe have introduced national antenatal screening programs for Down syndrome. This study aimed...... to determine if the introduction of these screening programs and the subsequent termination of prenatally detected pregnancies were associated with any decline in the prevalence of additional anomalies in babies born with Down syndrome. The study sample consisted of 7,044 live births and fetal deaths with Down...... syndrome registered in 28 European population-based congenital anomaly registries covering seven million births during 2000-2010. Overall, 43.6% (95% CI: 42.4-44.7%) of births with Down syndrome had a cardiac anomaly and 15.0% (14.2-15.8%) had a non-cardiac anomaly. Female babies with Down syndrome were...

  5. The Burden of Provider-Initiated Preterm Birth and Associated Factors: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP.

    Directory of Open Access Journals (Sweden)

    Renato T Souza

    Full Text Available About 15 million children are born under 37 weeks of gestation worldwide. Prematurity is the leading cause of neonatal deaths and short/long term morbidities, entailing consequences not only for the individual, but also their family, health agencies, facilities and all community. The provider-initiated preterm birth is currently one of the most important obstetric conditions related to preterm births, particularly in middle and high income countries, thus decreasing the need for therapeutic preterm birth is essential to reduce global prematurity. Therefore detailed knowledge on the factors associated with provider-initiated preterm birth is essential for the efforts to reduce preterm birth rates and its consequences. In this current analysis we aimed to assess the proportion of provider-initiated (pi-PTB among preterm births in Brazil and identify associated factors.This is an analysis of a multicenter cross-sectional study with a nested case-control component called Brazilian Multicenter Study on Preterm Birth (EMIP. EMIP was conducted in 20 referral obstetric hospitals located in the three most populated of the five Brazilian regions. We analysed data of women with pi-PTB, defined as childbirth occurring at less than 37 weeks, medically indicated for maternal/fetal compromise or both; and women with term birth, childbirth at or after 37 weeks. Maternal, sociodemographic, obstetric, prenatal care, delivery, and postnatal characteristics were assessed as possible factors associated with pi-PTB, compared to term births. The overall prevalence of preterm births was 12.3%. Of these, approximately one-third of cases were initiated by the provider. Hypertensive disorders, placental abruption, and diabetes were the main maternal conditions leading to pi-PTB. Caesarean section was the most common mode of delivery. Chronic hypertension (OR 7.47; 95%CI 4.02-13.88, preeclampsia/eclampsia/HELLP syndrome (OR 15.35; 6.57-35.88, multiple pregnancy (OR 12

  6. The experience of being a traditional midwife: relationships with skilled birth attendants.

    Science.gov (United States)

    Dietsch, Elaine

    2010-01-01

    This article focuses on an unexpected finding of a research project which explored the experience of being a traditional midwife. The unexpected finding was that traditional midwives often perceive skilled (professional) birth attendants to be abusive of both them and the women who are transferred to hospital for emergency obstetric care. Eighty-four traditional midwives in the Western Province of Kenya were interviewed individually or in groups with a Bukusu/Kiswahili/English-speaking interpreter. Interviews were audiotaped and the English components were transcribed verbatim. Interview transcripts and observations were thematically analysed. A minority of relationships between traditional midwives and skilled birth attendants were based on mutual respect and collaborative practice. However, the majority of encounters with skilled birth attendants were perceived by the traditional midwives to be abusive for them and the women requiring emergency obstetric care. In the interests of improving health outcomes for women and their newborns, interpersonal skills, including maintaining respectful communication and relationships must be a core competency for all caregivers. Providing opportunities for reciprocal learning and strategies to enhance relationships between traditional midwives and skilled birth attendants are recommended. Current global strategies to reduce maternal and newborn mortality by increasing the number of women birthing with a skilled (professional) birth attendant in an enabling environment may be limited while the reasons for traditional midwives being the caregiver of choice for the majority of women living in areas such as Western Kenya remain unaddressed.

  7. Giant panda genomic data provide insight into the birth-and-death process of mammalian major histocompatibility complex class II genes.

    Directory of Open Access Journals (Sweden)

    Qiu-Hong Wan

    Full Text Available To gain an understanding of the genomic structure and evolutionary history of the giant panda major histocompatibility complex (MHC genes, we determined a 636,503-bp nucleotide sequence spanning the MHC class II region. Analysis revealed that the MHC class II region from this rare species contained 26 loci (17 predicted to be expressed, of which 10 are classical class II genes (1 DRA, 2 DRB, 2 DQA, 3 DQB, 1 DYB, 1 DPA, and 2 DPB and 4 are non-classical class II genes (1 DOA, 1 DOB, 1 DMA, and 1 DMB. The presence of DYB, a gene specific to ruminants, prompted a comparison of the giant panda class II sequence with those of humans, cats, dogs, cattle, pigs, and mice. The results indicated that birth and death events within the DQ and DRB-DY regions led to major lineage differences, with absence of these regions in the cat and in humans and mice respectively. The phylogenetic trees constructed using all expressed alpha and beta genes from marsupials and placental mammals showed that: (1 because marsupials carry loci corresponding to DR, DP, DO and DM genes, those subregions most likely developed before the divergence of marsupials and placental mammals, approximately 150 million years ago (MYA; (2 conversely, the DQ and DY regions must have evolved later, but before the radiation of placental mammals (100 MYA. As a result, the typical genomic structure of MHC class II genes for the giant panda is similar to that of the other placental mammals and corresponds to BTNL2 approximately DR1 approximately DQ approximately DR2 approximately DY approximately DO_box approximately DP approximately COL11A2. Over the past 100 million years, there has been birth and death of mammalian DR, DQ, DY, and DP genes, an evolutionary process that has brought about the current species-specific genomic structure of the MHC class II region. Furthermore, facing certain similar pathogens, mammals have adopted intra-subregion (DR and DQ and inter-subregion (between DQ and DP

  8. Dimorphism in the Size and Shape of the Birth Canal Across Anthropoid Primates.

    Science.gov (United States)

    Moffett, Elizabeth A

    2017-05-01

    It has long been noted that the human female birth canal is well adapted to giving birth to large-brained neonates. However, several species of nonhuman primates give birth to large-headed neonates compared to the maternal birth canal. The presence of such large cephalopelvic proportions in nonhuman primates presents the question of whether dimorphism in the birth canals of these other species is related to obstetric demand, as such dimorphism is presumed to be in humans. In this study, the hypothesis that either the presence or magnitude of dimorphism in the birth canal is related to large cephalopelvic proportions among anthropoid primates is directly tested. This study shows that birth canal dimorphism is common among anthropoids regardless of cephalopelvic proportions, but taxa with large cephalopelvic proportions have a higher magnitude of dimorphism than those that give birth to relatively small-headed neonates. Furthermore, humans have exceptionally high levels of dimorphism that cannot be explained based on our large cephalopelvic proportions alone. Anat Rec, 300:870-889, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Birth weight centiles by gestational age for twins born in south India.

    Science.gov (United States)

    Premkumar, Prasanna; Antonisamy, Belavendra; Mathews, Jiji; Benjamin, Santhosh; Regi, Annie; Jose, Ruby; Kuruvilla, Anil; Mathai, Mathews

    2016-03-24

    Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India. The study was conducted at the Christian Medical College, Vellore, south India. The birth records of all consecutive pregnancies resulting in twin births between 1991 and 2005 were reviewed. Only live twin births between 24 and 42 weeks of gestation were included. Birth weight centiles for gestational age were obtained using the methodology of generalized additive models for location, scale and shape (GAMLSS). Centiles curves were obtained separately for monochorionic and dichorionic twins. Of 1530 twin pregnancies delivered during the study period (1991-2005), 1304 were included in the analysis. The median gestational age at birth was 36 weeks (1st quartile 34, 3rd quartile 38 weeks). Smoothed percentile curves for birth weight by gestational age increased progressively till 38 weeks and levels off thereafter. Compared with dichorionic twins, monochorionic twins had lower birth weight for gestational age from after 27 weeks. We provide centile values of birth weight at 24 to 42 completed weeks of gestation for twins born in south India. These charts could be used both in routine clinical assessments and epidemiological studies.

  10. Birth weight discordance and perinatal mortality among triplets

    Directory of Open Access Journals (Sweden)

    Egić Amira

    2005-01-01

    Full Text Available INTRODUCTION. The incidence of multiple births has increased in the last decade. Perinatal mortality in triplets is significantly greater than in twin and singleton births. OBJECTIVE. The objective of this study was to describe the extent of birth weight discordance among triplets and to identify its association with an increased risk of perinatal mortality. METHOD A retrospective analysis of triplet births, for the period 1993-2003, was conducted at the Gynaecological-Obstetric Clinic "Narodni Front" in Belgrade. Birth weight discordance was defined as the difference in birth weight between the largest and the smallest triplet's weight of more than 20%. RESULTS. The rate of triplets has increased by almost 75% between the first (7.7% and the last (29.6% 5-year period of the last decade. Triplets are becoming more common because of the frequent use of assisted reproductive technology as a treatment for infertility. In the period 1993-2003, there were a total of 40 triplet live births (24 weeks and greater with incidence of 0.06%. There was no clear association between maternal age, parity, method of conception, birth gestational age, and disorders complicating pregnancy with birth discordance more than 20%. Regarding birth weight groups, statistical significance occurred only in the <999 grams group for discordant and in the 2000-2499 grams group for concordant triplets. Overall, the perinatal mortality rate in the group was 10.8%, the foetal mortality rate was 1.7% (2/120, and the neonatal (0-28 days mortality rate was 9.1% (11/120. An odds ratio of 95% confidence interval shows 3 times greater risk for adverse perinatal outcome in the discordant group. However, the difference was not significant. CONCLUSION. Increasing birth weight discordance may increase the risk of adverse perinatal outcome. Triplet pregnancies, being high risk, require intensive antenatal care in order to prevent preterm delivery and ultrasound in order to diagnose foetal

  11. Magnitude of Birth Defects in Central and Northwest Ethiopia from 2010-2014: A Descriptive Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Molla Taye

    Full Text Available Birth defects are defined as structural and functional defects that develop during the organogenesis period and present at birth or detected later in life. They are one of the leading causes of infant and child mortality, morbidity, and long term disability. The magnitude of birth defects varies from country to country and from race/ethnicity to race/ethnicity, and about 40-60% of their causes are unknown. The known causes of birth defects are genetic and environmental factors which may be prevented. For various reasons, there is lack of data and research on birth defects in Ethiopia.The major objective of this study is to estimate the magnitude of birth defects in Ethiopia.A hospital based, retrospective, cross sectional, descriptive study was conducted. The subjects were babies/children aged 0-17years who visited selected hospitals between 2010 and 2014. Fourteen hospitals (8 in Addis Ababa, 6 in Amhara Region were selected purposively based on case load. A data retrieving form was developed to extract relevant information from record books.In the hospitals mentioned, 319,776 various medical records of children aged 0-17years were found. Of these, 6,076 (1.9% with 95% CI: 1.85%-1.95% children were diagnosed as having birth defects. The majority (58.5% of the children were male and 41.5% female. A slightly more than half (51.1% of the children were urban dwellers, while 48.9% were from rural areas. Among the participants of the study the proportion of birth defects ranged as follows: orofacial (34.2%, neural tube (30.8%, upper and lower limb (12.8%, cardiovascular system (10.3%, digestive system and abdominal wall (4.8%, unspecified congenital malformations (2.5%, Down syndrome (2%, genitourinary system (2%, head, face, and neck defects (0.4%, and others (0.3%. The trend of birth defects increased linearly over time [Extended Mantel-Haenszel chi square for linear trend = 356.7 (P<0.0001]. About 275 (4.5% of the cases had multiple (associated

  12. TP53 gene polymorphism: Importance to cancer, ethnicity and birth ...

    Indian Academy of Sciences (India)

    1Functional Genomics Laboratory, Technology Development Centre (CDTec), Federal University of Pelotas. (UFPel) .... follows the definition: children whose birth weight for gestational ..... Welcome Trusts initiative entitled Major Awards for.

  13. Risk factors and birth prevalence of birth defects and inborn errors of ...

    African Journals Online (AJOL)

    raoul

    2011-02-23

    Feb 23, 2011 ... methylmalonic aciduria, and maple syrup urine disease (MSUD) had their diagnoses confirmed by enzyme assay. The diagnosis of all ... Personal information like date of birth, sex, area of residence, mother's age at birth, father's age, order of birth, birth weight, gestational age on birth, medical history and ...

  14. The Co-Occurrence of Autism and Birth Defects: Prevalence and Risk in a Population-Based Cohort

    Science.gov (United States)

    Schendel, Diana E.; Autry, Andrew; Wines, Roberta; Moore, Cynthia

    2009-01-01

    Aim: To estimate the prevalence of major birth defects among children with autism, the prevalence of autism in children with birth defects, and the risk for autism associated with having birth defects. Method: Retrospective cohort including all children born in Atlanta, GA, USA, 1986 to 1993, who survived to age 3 years and were identified through…

  15. Recent increase in sex ratio at birth in Viet Nam.

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    Christophe Z Guilmoto

    Full Text Available INTRODUCTION: Since the 1980s, sex ratio at birth (male births per 100 female births has increased in many Asian countries as a result of selective abortions, but to date there has been no such evidence for Viet Nam. Our aim in this paper is to ascertain the situation with respect to sex ratio at birth in Viet Nam over the past five years. MATERIALS AND METHODS: Original data were obtained from sample population surveys in Viet Nam recording annual birth rates since 2000 of about 450,000 women, as well as from two successive birth surveys conducted for the first time in 2007 (1.1 million births. The annual population surveys include specific information on birth history and mothers' characteristics to be used for the analysis of trends and differentials in sex ratio at birth. RESULTS AND DISCUSSION: Birth history statistics indicate that the SRB in Viet Nam has recorded a steady growth since 2001. Starting from a level probably close to the biological standard of 105, the SRB reached 108 in 2005 and 112 in 2006, a value significantly above the normal level. An independent confirmation of these results comes from the surveys of births in health facilities which yielded a SRB of 110 in 2006-07. High SRB is linked to various factors such as access to modern health care, number of prenatal visits, level of higher education and employment status, young age, province of residence and prenatal sex determination. These results suggest that prenatal sex determination followed by selective abortion has recently become more common in Viet Nam. This recent trend is a consequence of various factors such as preference for sons, declining fertility, easy access to abortion, economic development as well as the increased availability of ultrasonography facilities.

  16. Recent increase in sex ratio at birth in Viet Nam.

    Science.gov (United States)

    Guilmoto, Christophe Z; Hoàng, Xuyên; Van, Toan Ngo

    2009-01-01

    Since the 1980s, sex ratio at birth (male births per 100 female births) has increased in many Asian countries as a result of selective abortions, but to date there has been no such evidence for Viet Nam. Our aim in this paper is to ascertain the situation with respect to sex ratio at birth in Viet Nam over the past five years. Original data were obtained from sample population surveys in Viet Nam recording annual birth rates since 2000 of about 450,000 women, as well as from two successive birth surveys conducted for the first time in 2007 (1.1 million births). The annual population surveys include specific information on birth history and mothers' characteristics to be used for the analysis of trends and differentials in sex ratio at birth. Birth history statistics indicate that the SRB in Viet Nam has recorded a steady growth since 2001. Starting from a level probably close to the biological standard of 105, the SRB reached 108 in 2005 and 112 in 2006, a value significantly above the normal level. An independent confirmation of these results comes from the surveys of births in health facilities which yielded a SRB of 110 in 2006-07. High SRB is linked to various factors such as access to modern health care, number of prenatal visits, level of higher education and employment status, young age, province of residence and prenatal sex determination. These results suggest that prenatal sex determination followed by selective abortion has recently become more common in Viet Nam. This recent trend is a consequence of various factors such as preference for sons, declining fertility, easy access to abortion, economic development as well as the increased availability of ultrasonography facilities.

  17. Where Do You Feel Safest?: Demographic Factors and Place of Birth

    Science.gov (United States)

    Sperlich, M.; Gabriel, C.; Seng, J.

    2016-01-01

    Introduction The vast majority of planned out-of-hospital births in the United States occur among white women; no study has addressed whether black women prefer out-of-hospital birth less or whether this racial disparity is due to other causes such as constrained access. This study sought to answer the question of whether white and black women feel safest giving birth in out-of-hospital settings at different rates, and whether this answer is associated with other socioeconomic indicators. Methods An interview of 634 nulliparous women during the third trimester of their pregnancy in Michigan provided data regarding where women felt safest giving birth. Feeling safest giving birth out-of-hospital was examined in relation to socioeconomic factors including race, age, household income, education, residence in a high-crime neighborhood, partnered status, and type of insurance. Results This study found that black and white women say they feel safest giving birth in out-of-hospital settings at similar rates (11.5% and 13.1% respectively). Logistic regression results showed that poverty and having education beyond high school were the only sociodemographic indicators significantly associated with feeling safest giving birth out-of-hospital. Discussion Disparities evident in planned homebirth and birth center rates cannot be explained by racial differences in feelings toward out-of-hospital birth and should be addressed more specifically in public policy and future studies. PMID:27623132

  18. A Pleasing Birth

    NARCIS (Netherlands)

    Vries, De Raymond

    2005-01-01

    Women have long searched for a pleasing birth-a birth with a minimum of fear and pain, in the company of supportive family, friends, and caregivers, a birth that ends with a healthy mother and baby gazing into each other's eyes. For women in the Netherlands, such a birth is defined as one at home

  19. Where Do You Feel Safest? Demographic Factors and Place of Birth.

    Science.gov (United States)

    Sperlich, Mickey; Gabriel, Cynthia; Seng, Julia

    2017-01-01

    The vast majority of planned out-of-hospital births in the United States occur among white women; no study has addressed whether black women prefer out-of-hospital birth less or whether this racial disparity is due to other causes such as constrained access. This study sought to answer the question of whether white and black women feel safest giving birth in out-of-hospital settings at different rates and whether this answer is associated with other socioeconomic indicators. An interview of 634 nulliparous women during the third trimester of their pregnancy in Michigan provided data regarding where women felt safest giving birth. Feeling safest giving birth out-of-hospital was examined in relation to socioeconomic factors including race, age, household income, education, residence in a high-crime neighborhood, partnered status, and type of insurance. This study found that black and white women say they feel safest giving birth in out-of-hospital settings at similar rates (11.5% and 13.1%, respectively). Logistic regression results showed that poverty and having education beyond high school were the only sociodemographic indicators significantly associated with feeling safest giving birth out-of-hospital. Disparities evident in planned home birth and birth center rates cannot be explained by racial differences in feelings toward out-of-hospital birth and should be addressed more specifically in public policy and future studies. © 2016 by the American College of Nurse-Midwives.

  20. Factors affecting inter-birth in rural areas of Zarrindasht (Fars province

    Directory of Open Access Journals (Sweden)

    Najaf Zare

    2015-01-01

    Full Text Available Background: Proper time intervals among pregnancies has a major role in family provision. Investigating the dynamism of the birth spacing, identify factors and their effects on the time interval among pregnancies and determination of optimal spacing is the utmost importance for health planners and families. The purpose was to study the abortion and stillbirth due to short inter-birth spacing, factors affecting inter-births and optimal birth spacing. Material and Methods: In 2005, a cross-sectional study was conducted in a population of 1064 women of childbearing age in Fars province by multistage random sampling. Information on reproductive history was collected by resident health workers. Variables affecting inter-births were checked by the frailty recurrent events model using S-plus 2000 and SPSS 13 software. Results: The rate of abortion or stillbirth was 1.7%, which fell with increasing interval between births and reached their lowest (1.9% at 36-48 months. Mother's level of education, duration of breastfeeding of previous infant, maternal age at birth and father's job showed positive correlation with inter-birth. Mother's age at marriage, having a job other than household, socioeconomic status was negatively correlated with the the time interval to the next delivery. With increasing birth order, inter-birth of each delivery with regard to previous delivery increased on average by one to two months. Conclusion: The risk of abortion and stillbirth were observed more in subsequent delivery with very low or very long gap interval.

  1. Placentophagy among women planning community births in the United States: Frequency, rationale, and associated neonatal outcomes.

    Science.gov (United States)

    Benyshek, Daniel C; Cheyney, Melissa; Brown, Jennifer; Bovbjerg, Marit L

    2018-05-02

    Limited systematic research on maternal placentophagy is available to maternity care providers whose clients/patients may be considering this increasingly popular practice. Our purpose was to characterize the practice of placentophagy and its attendant neonatal outcomes among a large sample of women in the United States. We used a medical records-based data set (n = 23 242) containing pregnancy, birth, and postpartum information for women who planned community births. We used logistic regression to determine demographic and clinical predictors of placentophagy. Finally, we compared neonatal outcomes (hospitalization, neonatal intensive unit admission, or neonatal death in the first 6 weeks) between placenta consumers and nonconsumers, and participants who consumed placenta raw vs cooked. Nearly one-third (31.2%) of women consumed their placenta. Consumers were more likely to have reported pregravid anxiety or depression compared with nonconsumers. Most (85.7%) placentophagic mothers consumed their placentas in encapsulated form, and nearly half (49.1%) consumed capsules containing dehydrated, uncooked placenta. Placentophagy was not associated with any adverse neonatal outcomes. Women with home births were more likely to engage in placentophagy than women with birth center births. The most common reason given (58.6%) for engaging in placentophagy was to prevent postpartum depression. The majority of women consumed their placentas in uncooked/encapsulated form and hoping to avoid postpartum depression, although no evidence currently exists to support this strategy. Preparation technique (cooked vs uncooked) did not influence adverse neonatal outcomes. Maternity care providers should discuss the range of options available to prevent/treat postpartum depression, in addition to current evidence with respect to the safety of placentophagy. © 2018 Wiley Periodicals, Inc.

  2. Earliest Recollections and Birth Order: Two Adlerian Exercises.

    Science.gov (United States)

    Parrott, Les

    1992-01-01

    Presents two exercises designed to demonstrate the influence of two Adlerian principles on personality. Includes exercises dealing with birth order and earliest recollection. Concludes that the exercises actively demonstrate major concepts for counseling courses in Adlerian psychotherapy. Reports that students rated both exercises highly, with…

  3. Randomized trial of BCG vaccination at birth to low-birth-weight children

    DEFF Research Database (Denmark)

    Aaby, Peter; Roth, Adam Anders Edvin; Ravn, Henrik

    2011-01-01

    Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG.......Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG....

  4. Planned hospital birth versus planned home birth

    DEFF Research Database (Denmark)

    Olsen, O.; Clausen, J.A.

    2012-01-01

    Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998....

  5. Assessing the Causal Relationship of Maternal Height on Birth Size and Gestational Age at Birth: A Mendelian Randomization Analysis

    Science.gov (United States)

    Zhang, Ge; Bacelis, Jonas; Lengyel, Candice; Teramo, Kari; Hallman, Mikko; Helgeland, Øyvind; Johansson, Stefan; Myhre, Ronny; Sengpiel, Verena; Njølstad, Pål Rasmus; Jacobsson, Bo; Muglia, Louis

    2015-01-01

    Background Observational epidemiological studies indicate that maternal height is associated with gestational age at birth and fetal growth measures (i.e., shorter mothers deliver infants at earlier gestational ages with lower birth weight and birth length). Different mechanisms have been postulated to explain these associations. This study aimed to investigate the casual relationships behind the strong association of maternal height with fetal growth measures (i.e., birth length and birth weight) and gestational age by a Mendelian randomization approach. Methods and Findings We conducted a Mendelian randomization analysis using phenotype and genome-wide single nucleotide polymorphism (SNP) data of 3,485 mother/infant pairs from birth cohorts collected from three Nordic countries (Finland, Denmark, and Norway). We constructed a genetic score based on 697 SNPs known to be associated with adult height to index maternal height. To avoid confounding due to genetic sharing between mother and infant, we inferred parental transmission of the height-associated SNPs and utilized the haplotype genetic score derived from nontransmitted alleles as a valid genetic instrument for maternal height. In observational analysis, maternal height was significantly associated with birth length (p = 6.31 × 10−9), birth weight (p = 2.19 × 10−15), and gestational age (p = 1.51 × 10−7). Our parental-specific haplotype score association analysis revealed that birth length and birth weight were significantly associated with the maternal transmitted haplotype score as well as the paternal transmitted haplotype score. Their association with the maternal nontransmitted haplotype score was far less significant, indicating a major fetal genetic influence on these fetal growth measures. In contrast, gestational age was significantly associated with the nontransmitted haplotype score (p = 0.0424) and demonstrated a significant (p = 0.0234) causal effect of every 1 cm increase in maternal

  6. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study.

    Science.gov (United States)

    Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-02-03

    To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Prospective, cluster randomised and controlled effectiveness study. Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers' homes, in rural village settings. 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by intervention birth attendants (0.37, 0.17 to 0.81) and by 81% within the first two days

  7. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study

    NARCIS (Netherlands)

    Hitzert, M.; Hermes, M.A.; Scheerhagen, M.; Boesveld, L.C.; Wiegers, T.A.; Akker-van Marle, M.E.; Dommelen, P. van; Pal-de Bruin, K.M. de; Graaf, J.P. de

    2016-01-01

    Objective to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design this study is a cross-sectional study using the ReproQ

  8. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study.

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.; Scheerhagen, M.; Boesveld, I.C.; Wiegers, T.; Akker-van Marle, M.E. van den; Dommelen, P. van; Pal-de Bruin, K.M. van der; Graal, J. P. de

    2016-01-01

    Objective: to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design: this study is a cross-sectional study using the ReproQ

  9. Community perceptions towards the new role of traditional birth attendants as birth companions and nutrition advocates in Kakamega County, Kenya.

    Science.gov (United States)

    Anono, Esther L; Ochola, Sophie; Wawire, Salome; Ogada, Irene; Ndedda, Crispin; Kung'u, Jacqueline K

    2018-02-01

    Delivery with skilled birth attendants is important for reducing maternal mortality in developing countries. However, traditional birth attendants (TBAs) are abundant in such settings, managing deliveries without the skills and resources necessary to prevent mortality in this situations. Interventions that have been proposed to mitigate the situation include redefining the role of TBAs to nutrition advocates and birth companions for pregnant women to health facilities. We thus explored community perceptions on these new roles of TBAs, as birth companions and nutrition advocates, and their influence on health facility deliveries in Kakamega County, Kenya. Qualitative data was collected through key informant interviews with health workers and focus group discussions with lactating mothers, pregnant women, husbands, community leaders, community health volunteers, and TBA. Content analysis was conducted; data was organized into subthemes and conclusions made from each subtheme using Atlas.ti software. TBAs adopted their birth companion role as the majority offered companionship to mothers delivering at health facilities. Mothers were happy with this role as TBAs continued providing companionship even after delivery. The community members were happy with the new role of TBAs and reported increased deliveries at the health facilities. In contrast, TBAs did not adopt the nutrition advocacy role sufficiently. We found that redefining the role of the TBAs into birth companions to support facility-based delivery is thus feasible and acceptable. Nutrition advocacy by the TBAs should be strengthened to maximize on the opportunity provided by the close association between TBAs and mothers and the community. © 2018 John Wiley & Sons Ltd.

  10. Influence of birth cohort on age of onset cluster analysis in bipolar I disorder

    DEFF Research Database (Denmark)

    Bauer, M; Glenn, T; Alda, M

    2015-01-01

    Purpose: Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset...... cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared. Results: There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After...... on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more...

  11. Midwife-assisted planned home birth: an essential component of improving the safety of childbirth in Sub-Saharan Africa.

    Science.gov (United States)

    Dayyabu, Aliyu Labaran; Murtala, Yusuf; Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Levene, Malcolm I; Brent, Robert L; Monni, Giovanni; Sen, Cihat; Makatsariya, Alexander; Chervenak, Frank A

    2018-05-29

    Hospital births, when compared to out-of-hospital births, have generally led to not only a significantly reduced maternal and perinatal mortality and morbidity but also an increase in certain interventions. A trend seems to be emerging, especially in the US where some women are requesting home births, which creates ethical challenges for obstetricians and the health care organizations and policy makers. In the developing world, a completely different reality exists. Home births constitute the majority of deliveries in the developing world. There are severe limitations in terms of facilities, health personnel and deeply entrenched cultural and socio-economic conditions militating against hospital births. As a consequence, maternal and perinatal mortality and morbidity remain the highest, especially in Sub-Saharan Africa (SSA). Midwife-assisted planned home birth therefore has a major role to play in increasing the safety of childbirth in SSA. The objective of this paper is to propose a model that can be used to improve the safety of childbirth in low resource countries and to outline why midwife assisted planned home birth with coordination of hospitals is the preferred alternative to unassisted or inadequately assisted planned home birth in SSA.

  12. Economic implications of home births and birth centers: a structured review.

    Science.gov (United States)

    Henderson, Jane; Petrou, Stavros

    2008-06-01

    It is widely perceived that home births and birth centers may help decrease the costs of maternity care for women with uncomplicated pregnancies and deliveries. This structured review examines the literature relating to the economic implications of home births and birth center care compared with hospital maternity care. The bibliographic databases MEDLINE (from 1950), CINAHL (from 1982), EMBASE (from 1980), and an "in-house" database, Econ2, were searched for relevant English language publications using MeSH and free text terms. Data were extracted with respect to the study design, inclusion criteria, clinical and cost results, and details of what was included in the cost calculations. Eleven studies were included from the United Kingdom, United States, Australia, and Canada. Two studies focused on home births versus other forms and locations of care, whereas nine focused on birth centers versus other forms and locations of care. Resource use was generally lower for women cared for at home and in birth centers due to lower rates of intervention, shorter lengths of stay, or both. However, this fact did not always translate into lower costs because, in the U.K. where many studies were conducted, more midwives of a higher grade were employed to manage the birth centers than are usually employed in maternity units, and because of costs of converting existing facilities into delivery rooms. The quality of much of the literature was poor, although no studies were excluded for this reason. Selection bias was likely to be a problem in those studies not based on randomized controlled trials because, even where birth center eligibility was applied throughout, women who choose to deliver at home or in a birth center are likely to be different in terms of expectations and approach from women choosing to deliver in hospital. This review highlights the paucity of economic literature relating to home births and birth centers. Differences in results between studies may be

  13. High birth rates despite easy access to contraception and abortion

    DEFF Research Database (Denmark)

    Hognert, Helena; Skjeldestad, Finn E; Gemzell-Danielsson, Kristina

    2017-01-01

    INTRODUCTION: The aim of this study was to describe and compare contraceptive use, fertility, birth, and abortion rates in the Nordic countries. MATERIAL AND METHODS: National data on births, abortions, fertility rate (1975-2013), redeemed prescriptions of hormonal contraceptives and sales figures...... contraception followed by the levonorgestrel-releasing intrauterine system were the most common methods. During 1975-2013 abortion rates decreased in Denmark (from 27/1000 women to 15/1000 women aged 15-44/1000 women) and Finland (from 20 to 10/1000 women), remained stable in Norway (≈16) and Sweden (≈20......) and increased in Iceland (from 6 to 15/1000 women). Birth rates remained stable around 60/1000 women aged 15-44 in all countries except for Iceland where the birth rate decreased from 95 to 65/1000 women. Abortion rates were highest in the age group 20-24 years. In the same age group, Sweden had a lower...

  14. Young adults with very low birth weight: leaving the parental home and sexual relationships--Helsinki Study of Very Low Birth Weight Adults.

    Science.gov (United States)

    Kajantie, Eero; Hovi, Petteri; Räikkönen, Katri; Pesonen, Anu-Katriina; Heinonen, Kati; Järvenpää, Anna-Liisa; Eriksson, Johan G; Strang-Karlsson, Sonja; Andersson, Sture

    2008-07-01

    Although most children and adults who are born very preterm live healthy lives, they have, on average, lower cognitive scores, more internalizing behaviors, and deficits in social skills. This could well affect their transition to adulthood. We studied the tempo of first leaving the parental home and starting cohabitation with an intimate partner and sexual experience of young adults with very low birth weight (Adults, 162 very low birth weight individuals and 188 individuals who were born at term (mean age: 22.3 years [range: 18.5-27.1]) and did not have any major disability filled out a questionnaire. For analysis of their ages at events which had not occurred in all subjects, we used survival analysis (Cox regression), adjusted for gender, current height, parents' ages at the birth, maternal smoking during pregnancy, parental educational attainment, number of siblings, and parental divorce/death. During their late teens and early adulthood, these very low birth weight adults were less likely to leave the parental home and to start cohabiting with an intimate partner. In gender-stratified analyses, these hazard ratios were similar between genders, but the latter was statistically significant for women only. These very low birth weight adults were also less likely to experience sexual intercourse. This relationship was statistically significant for women but not for men; however, very low birth weight women and men both reported a smaller lifetime number of sex partners than did control subjects. Healthy young adults with very low birth weight show a delay in leaving the parental home and starting sexual activity and partnerships.

  15. Perinatal factors influencing infant feeding practices at birth: the Bedouin Infant Feeding Study.

    Science.gov (United States)

    Forman, M R; Berendest, H W; Lewando-Hundt, G; Sarov, B; Naggan, L

    1991-04-01

    Bedouin Arab women delivering newborns at Soroka Medical Center, Israel, during 1 year were interviewed in hospital to determine the factors influencing infant feeding practices at birth. Eighty-six per cent breastfed, 11% breast and bottlefed, and 3% bottlefed at birth. Based on a multiple logistic regression analysis, the factors that significantly reduced the odds ratio (OR) of exclusive breastfeeding vs. breast and bottle feeding or bottle feeding at birth include: delivering during the high birth season (OR = 0.49); maternal recall of feeling unwell during pregnancy (OR = 0.59); delivering a low birthweight newborn (OR = 0.10); a newborn diagnosed with major malformations (OR = 0.30) or with major illnesses (OR = 0.32); and delivering by Caesarean section (OR = 0.09). In contrast, multiparae experienced an increased odds (OR = 1.67) of breastfeeding. Among primiparae, the factors that significantly reduced the odds of exclusive breastfeeding include: delivering during the high birth season (OR = 0.47); delivering a low birthweight newborn (OR = 0.12); and delivering by Caesarean section (OR = 0.18). Mothers of high-risk neonates and those who deliver by Caesarean section need to be educated about the benefits of exclusive breastfeeding. Young primiparae are a challenge and require qualitative and quantitative research into the reasons precluding exclusive breastfeeding.

  16. Residential Agricultural Pesticide Exposures and Risks of Spontaneous Preterm Birth.

    Science.gov (United States)

    Shaw, Gary M; Yang, Wei; Roberts, Eric M; Kegley, Susan E; Stevenson, David K; Carmichael, Suzan L; English, Paul B

    2018-01-01

    Pesticides exposures are aspects of the human exposome that have not been sufficiently studied for their contribution to risk for preterm birth. We investigated risks of spontaneous preterm birth from potential residential exposures to 543 individual chemicals and 69 physicochemical groupings that were applied in the San Joaquin Valley of California during the study period, 1998-2011. The study population was derived from birth certificate data linked with Office of Statewide Health Planning and Development maternal and infant hospital discharge data. After exclusions, the analytic study base included 197,461 term control births and 27,913 preterm case births. Preterm cases were more narrowly defined as 20-23 weeks (n = 515), 24-27 weeks (n = 1,792), 28-31 weeks (n = 3,098), or 32-36 weeks (n = 22,508). The frequency of any (versus none) pesticide exposure was uniformly lower in each preterm case group relative to the frequency in term controls, irrespective of gestational month of exposure. All odds ratios were below 1.0 for these any versus no exposure comparisons. The majority of odds ratios were below 1.0, many of them statistically precise, for preterm birth and exposures to specific chemical groups or chemicals. This study showed a general lack of increased risk of preterm birth associated with a range of agriculture pesticide exposures near women's residences.

  17. Genetic parameters and factors influencing survival to 24 hrs after birth in Danish meat sheep breeds

    DEFF Research Database (Denmark)

    Maxa, J; Sharifi, A R; Pedersen, J

    2009-01-01

    In this study, influential factors and (co)variance components for survival to 24 h after birth were determined and estimated for Texel, Shropshire, and Oxford Down, the most common sheep breeds in Denmark. Data from 1992 to 2006 containing 138,813 survival records were extracted from the sheep...... recording database at the Danish Agricultural Advisory Service. Estimation of (co)variance components was carried out using univariate animal models, applying logistic link functions. The logistic functions were also used for estimation of fixed effects. Both direct and maternal additive genetic effects......, as well as common litter effects, were included in the models. The mean survival to 24 h after birth was 92.5, 91.7, and 88.5% for Texel, Shropshire, and Oxford Down, respectively. There was a curvilinear relationship between survival to 24 h after birth and birth weight, with survival less for light...

  18. CDC WONDER: Births

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Births (Natality) online databases in CDC WONDER report birth rates, fertility rates and counts of live births occurring within the United States to U.S....

  19. Vaginal birth after cesarean: neonatal outcomes and United States birth setting.

    Science.gov (United States)

    Tilden, Ellen L; Cheyney, Melissa; Guise, Jeanne-Marie; Emeis, Cathy; Lapidus, Jodi; Biel, Frances M; Wiedrick, Jack; Snowden, Jonathan M

    2017-04-01

    Women who seek vaginal birth after cesarean delivery may find limited in-hospital options. Increasing numbers of women in the United States are delivering by vaginal birth after cesarean delivery out-of-hospital. Little is known about neonatal outcomes among those who deliver by vaginal birth after cesarean delivery in- vs out-of-hospital. The purpose of this study was to compare neonatal outcomes between women who deliver via vaginal birth after cesarean delivery in-hospital vs out-of-hospital (home and freestanding birth center). We conducted a retrospective cohort study using 2007-2010 linked United States birth and death records to compare singleton, term, vertex, nonanomolous, and liveborn neonates who delivered by vaginal birth after cesarean delivery in- or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth-setting risk differences. Analyses were stratified by parity and history of vaginal birth. Sensitivity analyses that involved 3 transfer status scenarios were conducted. Of women in the United States with a history of cesarean delivery (n=1,138,813), only a small proportion delivered by vaginal birth after cesarean delivery with the subsequent pregnancy (n=109,970; 9.65%). The proportion of home vaginal birth after cesarean delivery births increased from 1.78-2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score birthing their second child by vaginal birth after cesarean delivery in out-of-hospital settings had higher odds of neonatal morbidity and death compared with women of higher parity. Women who had not birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery had higher odds of neonatal morbidity and mortality compared with women who had birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery. Sensitivity analyses generated distributions of plausible

  20. Giving birth with rape in one's past: a qualitative study.

    Science.gov (United States)

    Halvorsen, Lotta; Nerum, Hilde; Oian, Pål; Sørlie, Tore

    2013-09-01

    Rape is one of the most traumatizing violations a woman can be subjected to, and leads to extensive health problems, predominantly psychological ones. A large proportion of women develop a form of posttraumatic stress termed Rape Trauma Syndrome. A previous study by our research group has shown that women with a history of rape far more often had an operative delivery in their first birth and those who gave birth vaginally had second stages twice as long as women with no history of sexual assault. The aim of this study is to examine and illuminate how women previously subjected to rape experience giving birth for the first time and their advice on the kind of birth care they regard as good for women with a history of rape. A semi-structured interview with 10 women, who had been exposed to rape before their first childbirth. Data on the birth experience were analyzed by qualitative content analysis. The main theme was "being back in the rape" with two categories: "reactivation of the rape during labor," with subcategories "struggle," "surrender," and "escape" and "re-traumatization after birth," with the subcategories "objectified," "dirtied," and "alienated body." A rape trauma can be reactivated during the first childbirth regardless of mode of delivery. After birth, the women found themselves re-traumatized with the feeling of being dirtied, alienated, and reduced to just a body that another body is to come out of. Birth attendants should acknowledge that the common measures and procedures used during normal birth or cesarean section can contribute to a reactivation of the rape trauma. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

  1. Planned and unplanned home births and hospital births in Calgary, Alberta, 1984-87.

    Science.gov (United States)

    Abernathy, T J; Lentjes, D M

    1989-01-01

    Information collected on all home births in Calgary (Canada) between the years 1984 and 1987, was examined and analyzed according to whether the home birth environment had been planned or unplanned. The two groups were compared to each other and to all hospital births according to demographic characteristics of mothers, indicators of prenatal care, and birth outcome. Mothers who had planned their home birth were more likely to be primiparous, attend prenatal classes, obtain regular prenatal care from a physician, and have babies with a higher birth weight than either the unplanned or hospital group. Of particular concern, however, were the subset of unplanned home births who were primiparous. These mothers attended prenatal classes less frequently than any other group, reported the lowest number of physician visits, were youngest, and least likely to be married. In addition their babies averaged the shortest gestational age and the lowest birth weight. Findings in general show that planned and unplanned home births must be considered as heterogeneous groups in any comparison of risk factors and of birth outcome between home and hospital births. Further, within the unplanned group, multiparous women differ from primiparous women. Given the limitations inherent in this and similar studies, the apparent better outcome in the planned home birth group, as measured by birth weight, must be viewed with caution.

  2. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study

    OpenAIRE

    Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-01-01

    Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village s...

  3. Child neurology: Brachial plexus birth injury: what every neurologist needs to know.

    Science.gov (United States)

    Pham, Christina B; Kratz, Johannes R; Jelin, Angie C; Gelfand, Amy A

    2011-08-16

    While most often transient, brachial plexus birth injury can cause permanent neurologic injury. The major risk factors for brachial plexus birth injury are fetal macrosomia and shoulder dystocia. The degree of injury to the brachial plexus should be determined in the neonatal nursery, as those infants with the most severe injury--root avulsion--should be referred early for surgical evaluation so that microsurgical repair of the plexus can occur by 3 months of life. Microsurgical repair options include nerve grafts and nerve transfers. All children with brachial plexus birth injury require ongoing physical and occupational therapy and close follow-up to monitor progress.

  4. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  5. The association between birth order, sibship size and glioma development in adulthood.

    Science.gov (United States)

    Amirian, E; Scheurer, Michael E; Bondy, Melissa L

    2010-06-01

    The etiology of brain tumors is still largely unknown. Previous research indicates that infectious agents and immunological characteristics may influence adult glioma risk. The purpose of our study was to evaluate the effects of birth order and sibship size (total number of siblings), as indicators of the timing and frequency of early life infections, on adult glioma risk using a population of 489 cases and 540 cancer-free controls from the Harris County Brain Tumor Study. Odds ratios for birth order and sibship size were calculated separately from multivariable logistic regression models, adjusting for sex, family history of cancer, education, and age. Each one-unit increase in birth order confers a 13% decreased risk of glioma development in adulthood (OR = 0.87, 95% CI = 0.79-0.97). However, sibship size was not significantly associated with adult glioma status (OR = 0.97, 95% CI = 0.91-1.04). Our study indicates that individuals who were more likely to develop common childhood infections at an earlier age (those with a higher birth order) may be more protected against developing glioma in adulthood. More biological and epidemiological research is warranted to clarify the exact mechanisms through which the timing of common childhood infections and the course of early life immune development affect gliomagenesis.

  6. preterm births in a resource constrained setting: soci

    African Journals Online (AJOL)

    2015-12-01

    Dec 1, 2015 ... cerebral palsy, visual and hearing impairment are also more common in preterm infants. Preterm birth in it- ... vious history of induced abortion, previous history of pre-term delivery, history of antenatal ..... cioeconomic status with stress which has been found to be a trigger for preterm labour and delivery.6 ...

  7. Preterm Birth and Low Birth Weight Following Icsi- Pregnancies

    OpenAIRE

    Aygül Demirol; Süleyman Güven; Timur Gürgan

    2006-01-01

    OBJECTIVE: To report preterm birth and low birth weight rate of intracytoplasmic sperm injection (ICSI) related pregnancies and to compare our data with literature findings. STUDY DESIGN: Three-hundred and eighty-nine pregnancies following controlled ovarian hyperstimulation and intracytoplasmic sperm injection were retrospectively evaluated. Patients’ characteristics including age, gestational age at delivery and birth weight were noted from special clinic files. Women with early pregnanc...

  8. A study of neonatal outcome associated with preterm birth in a tertiary care hospital

    International Nuclear Information System (INIS)

    Iqbal, I.; Azhar, I.A.

    2013-01-01

    Preterm birth is the most significant problem in current obstetric practice and according to WHO is the direct cause accounting for 24% of neonatal deaths. Objective: To assess frequency and neonatal outcome in patients with preterm birth. Methodology: A prospective descriptive study was conducted at Gynae Unit III Jinnah Hospital Lahore over a period of one year (from 1st July 2011 to 30th June included in the study. For data collection two groups were made depending upon duration of pregnancy. Group l was allotted to women who were pregnant 2012) in collaboration with Paediatrics department. All labouring women who presented after 28 weeks and before 37 completed weeks of gestation were less ( ) than 32 weeks of gestation. Data was collected and analyzed by SPSS version 16. Results: During the study period total 5171 deliveries took place. Out of 5171 neonates born, 460 were preterm making the frequency of 8.86%. Majority 62.82% were > 32 weeks of gestation, 67.39% were male, 57.60% were > 1.5 kg by weight, 57.17% delivered vaginally and 80.86% were born alive. Neonatal morbidity was more common in neonates less than 32 weeks of gestation. Perinatal mortality was 10.48% in this study. Conclusion: Neonatal morbidity and mortality is more common in neonates less than 32 weeks of gestation, this can be improved by improving prenatal health services and advanced neonatal care. (author)

  9. Relationship between birth order and birth weight of the pig

    OpenAIRE

    Charneca, Rui; Freitas, Amadeu; Nunes, José; Le Dividich, Jean

    2013-01-01

    The objective of this study was to determine whether birth weight of the pig is related to its birth order. The study involved 292 sows from 2 genotypes (Large White x Landrace crossbred (LL), n= 247 and Alentejano (AL), n=45) of mixed parity and their piglets. Most sows farrowed naturally. Each piglet was identified, weighed (± 1g) (mummies excepted) and its birth order (BO) recorded within 2 min of birth. A total of 3418 LL and 375 AL piglets were born of which 43 and 7 were mummified, a...

  10. Season and preterm birth in Norway: A cautionary tale.

    Science.gov (United States)

    Weinberg, Clarice R; Shi, Min; DeRoo, Lisa A; Basso, Olga; Skjærven, Rolv

    2015-06-01

    Preterm birth is a common, costly and dangerous pregnancy complication. Seasonality of risk would suggest modifiable causes. We examine seasonal effects on preterm birth, using data from the Medical Birth Registry of Norway (2,321,652 births), and show that results based on births are misleading and a fetuses-at-risk approach is essential. In our harmonic-regression Cox proportional hazards model we consider fetal risk of birth between 22 and 37 completed weeks of gestation. We examine effects of both day of year of conception (for early effects) and day of ongoing gestation (for seasonal effects on labour onset) as modifiers of gestational-age-based risk. Naïve analysis of preterm rates across days of birth shows compelling evidence for seasonality (P distribution of the fetal population at risk. When we instead properly treat fetuses as the individuals at risk, restrict analysis to pregnancies with relatively accurate ultrasound-based assessment of gestational age (available since 1998) and adjust for socio-demographic factors and maternal smoking, we find modest effects of both time of year of conception and time of year at risk, with peaks for early preterm near early January and early July. Analyses of seasonal effects on preterm birth are demonstrably vulnerable to confounding by seasonality of conception, measurement error in conception dating, and socio-demographic factors. The seasonal variation based on fetuses reveals two peaks for early preterm, coinciding with New Year's Day and the early July beginning of Norway's summer break, and may simply reflect a holiday-related pattern of unintended conception. Published by Oxford University Press on behalf of the International Epidemiological Association 2015. This work is written by a US Government employee and is in the public domain in the US.

  11. Barriers and facilitators for vaginal breech births in Australia: Clinician's experiences.

    Science.gov (United States)

    Catling, C; Petrovska, K; Watts, N; Bisits, A; Homer, C S E

    2016-04-01

    Since the Term Breech Trial in 2000, few Australian clinicians have been able to maintain their skills to facilitate vaginal breech births. The overwhelming majority of women with a breech presentation have been given one birth option, that is, caesarean section. The aim of this study was to explore clinician's experiences of caring for women when facilitating a vaginal breech birth. A descriptive exploratory design was undertaken. Nine clinicians (obstetricians and midwives) from two tertiary hospitals in Australia who regularly facilitate vaginal breech birth were interviewed. The interviews were analysed thematically. Participants were five obstetricians and four midwives. There were two overarching themes that arose from the data: Facilitation of and Barriers to vaginal breech birth. A number of sub-themes are described in the paper. In order to facilitate vaginal breech birth and ensure it is given as an option to women, it is necessary to educate, upskill and support colleagues to increase their confidence and abilities, carefully counsel and select suitable women, and approach the option in a calm, collaborative way. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  12. Effects of infants' birth order, maternal age, and socio-economic status on birth weight.

    Science.gov (United States)

    Ghaemmaghami, Seyed J; Nikniaz, Leila; Mahdavi, Reza; Nikniaz, Zeinab; Razmifard, Farzad; Afsharnia, Farzaneh

    2013-09-01

    To determine the effects of infants' birth order, maternal age, and socioeconomic status (SES) on birth weight. This cross-sectional study included a sample of 858 mothers recruited over a 6-month period in 2010, in a defined population of 9 urban health centers, and who were admitted for their infants' first vaccination. Maternal clinical data, demographic data, and infants' birth weight were obtained from the interview and maternal hospital files. Multiple regression and analysis of variance were used for data analysis. First and fourth births had lower birth weights compared with second and third births in all maternal ages in controlling parity, birth weight increases with maternal age up to the early 24, and then tends to level off. Male gender, maternal age 20-24 years, second and third births had a significant positive effect on birth weight. Lower family economic status and higher educational attainment were significantly associated with lower birth weight. For women in the 15-19 and 40-44 years age groups, the second birth order was associated with the most undesirable effect on birth weight. Accessibility of health care services, parity, maternal age, and socioeconomic factors are strongly associated with infants' birth weight.

  13. Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives.

    Science.gov (United States)

    Leinweber, Julia; Creedy, Debra K; Rowe, Heather; Gamble, Jenny

    2017-02-01

    Midwives frequently witness traumatic birth events. Little is known about responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. To assess exposure to different types of birth trauma, peritraumatic reactions and prevalence of posttraumatic stress. Members of the Australian College of Midwives completed an online survey. A standardised measure assessed posttraumatic stress symptoms. More than two-thirds of midwives (67.2%) reported having witnessed a traumatic birth event that included interpersonal care-related trauma features. Midwives recalled strong emotions during or shortly after witnessing the traumatic birth event, such as feelings of horror (74.8%) and guilt (65.3%) about what happened to the woman. Midwives who witnessed birth trauma that included care-related features were significantly more likely to recall peritraumatic distress including feelings of horror (OR=3.89, 95% CI [2.71, 5.59]) and guilt (OR=1.90, 95% CI [1.36, 2.65]) than midwives who witnessed non-interpersonal birth trauma. 17% of midwives met criteria for probable posttraumatic stress disorder (95% CI [14.2, 20.0]). Witnessing abusive care was associated with more severe posttraumatic stress than other types of trauma. Witnessing care-related birth trauma was common. Midwives experience strong emotional reactions in response to witnessing birth trauma, in particular, care-related birth trauma. Almost one-fifth of midwives met criteria for probable posttraumatic stress disorder. Midwives carry a high psychological burden related to witnessing birth trauma. Posttraumatic stress should be acknowledged as an occupational stress for midwives. The incidence of traumatic birth events experienced by women and witnessed by midwives needs to be reduced. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  14. Ethics and professional responsibility: Essential dimensions of planned home birth.

    Science.gov (United States)

    McCullough, Laurence B; Grünebaum, Amos; Arabin, Birgit; Brent, Robert L; Levene, Malcolm I; Chervenak, Frank A

    2016-06-01

    Planned home birth is a paradigmatic case study of the importance of ethics and professionalism in contemporary perinatology. In this article we provide a summary of recent analyses of the Centers for Disease Control database on attendants and birth outcomes in the United States. This summary documents the increased risks of neonatal mortality and morbidity of planned home birth as well as bias in Apgar scoring. We then describe the professional responsibility model of obstetric ethics, which is based on the professional medical ethics of two major figures in the history of medical ethics, Drs. John Gregory of Scotland and Thomas Percival of England. This model emphasizes the identification and careful balancing of the perinatologist's ethical obligations to pregnant, fetal, and neonatal patients. This model stands in sharp contrast to one-dimensional maternal-rights-based reductionist model of obstetric ethics, which is based solely on the pregnant woman's rights. We then identify the implications of the professional responsibility model for the perinatologist's role in directive counseling of women who express an interest in or ask about planned home birth. Perinatologists should explain the evidence of the increased, preventable perinatal risks of planned home birth, recommend against it, and recommend planned hospital birth. Perinatologists have the professional responsibility to create and sustain a strong culture of safety committed to a home-birth-like experience in the hospital. By routinely fulfilling these professional responsibilities perinatologists can help to prevent the documented, increased risks planned home birth. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. From institutionalized birth to home birth

    Directory of Open Access Journals (Sweden)

    Clara Fróes de Oliveira Sanfelice

    2014-06-01

    Full Text Available The study aimed to describe the experiences of a group of nurse-midwives from the city of Campinas, SP, Brasil, regarding the transition process from attending institutionalized births to attending home births, in the period 2011 – 2013. The study is of the experience report type; the reflections, perceptions and challenges experienced in this process were collected using the technique of brainstorming. Content analysis, as proposed by Bardin, was used, which yielded four thematic categories: a the hospital experience; b living with obstetric violence; c returning home and d the challenges of home care. It is concluded that attending home births offers greater satisfaction to the nurses, even in the face of various obstacles, as it is possible to offer a care to the woman and new-born which covers both the concept of comprehensiveness and the current scientific recommendations.

  16. Fetal fibronectin in the prediction of preterm birth

    NARCIS (Netherlands)

    Bruijn, M.M.C.

    2016-01-01

    Accurate prediction of preterm birth is a big clinical challenge in obstetrics. Most of the women presenting with symptoms of preterm labour will not deliver within one week and the majority will even deliver at term. Correct discrimination between women with a high and a low risk to deliver on

  17. A multilevel approach to the relationship between birth order and intelligence.

    Science.gov (United States)

    Wichman, Aaron L; Rodgers, Joseph Lee; MacCallum, Robert C

    2006-01-01

    Many studies show relationships between birth order and intelligence but use cross-sectional designs or manifest other threats to internal validity. Multilevel analyses with a control variable show that when these threats are removed, two major results emerge: (a) birth order has no significant influence on children's intelligence and (b) earlier reported birth order effects on intelligence are attributable to factors that vary between, not within, families. Analyses on 7- to 8 - and 13- to 14-year-old children from the National Longitudinal Survey of Youth support these conclusions. When hierarchical data structures, age variance of children, and within-family versus between-family variance sources are taken into account, previous research is seen in a new light.

  18. Histological type and grade of breast cancer tumors by parity, age at birth, and time since birth: a register-based study in Norway

    International Nuclear Information System (INIS)

    Albrektsen, Grethe; Heuch, Ivar; Thoresen, Steinar Ø

    2010-01-01

    Some studies have indicated that reproductive factors affect the risk of histological types of breast cancer differently. The long-term protective effect of a childbirth is preceded by a short-term adverse effect. Few studies have examined whether tumors diagnosed shortly after birth have specific histological characteristics. In the present register-based study, comprising information for 22,867 Norwegian breast cancer cases (20-74 years), we examined whether histological type (9 categories) and grade of tumor (2 combined categories) differed by parity or age at first birth. Associations with time since birth were evaluated among 9709 women diagnosed before age 50 years. Chi-square tests were applied for comparing proportions, whereas odds ratios (each histological type vs. ductal, or grade 3-4 vs. grade 1-2) were estimated in polytomous and binary logistic regression analyses. Ductal tumors, the most common histological type, accounted for 81.4% of all cases, followed by lobular tumors (6.3%) and unspecified carcinomas (5.5%). Other subtypes accounted for 0.4%-1.5% of the cases each. For all histological types, the proportions differed significantly by age at diagnoses. The proportion of mucinous and tubular tumors decreased with increasing parity, whereas Paget disease and medullary tumors were most common in women of high parity. An increasing trend with increasing age at first birth was most pronounced for lobular tumors and unspecified carcinomas; an association in the opposite direction was seen in relation to medullary and tubular tumors. In age-adjusted analyses, only the proportions of unspecified carcinomas and lobular tumors decreased significantly with increasing time since first and last birth. However, ductal tumors, and malignant sarcomas, mainly phyllodes tumors, seemed to occur at higher frequency in women diagnosed <2 years after first childbirth. The proportions of medullary tumors and Paget disease were particularly high among women diagnosed 2

  19. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study

    Science.gov (United States)

    Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-01-01

    Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village settings. Participants 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Interventions Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). Main outcome measures The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Results Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by

  20. [Birthing institutions and births in Norwegian counties in the early 1990s].

    Science.gov (United States)

    Bergsjø, P; Daltveit, A K

    1996-05-20

    Between 1972 and 1993 the number of hospitals and maternity homes providing obstetric help in Norway fell from 158 to 67. Most of the decline is explained by the closing down of maternity homes and obstetrical units in small hospitals, partly due to a reduction in number of births and partly to a deliberate drive towards giving birth in larger units. 16 of the 19 counties of Norway contained four or fewer obstetric institutions in 1993. Nevertheless, most of the 60,000 births took place in institutions with between 500 and 2,999 births annually. Births at home accounted for 0.3%, and births during transport for 0.2% of the total in 1990 and 1993.

  1. Labor Dystocia: A Common Approach to Diagnosis.

    Science.gov (United States)

    Neal, Jeremy L; Lowe, Nancy K; Schorn, Mavis N; Holley, Sharon L; Ryan, Sharon L; Buxton, Margaret; Wilson-Liverman, Angela M

    2015-01-01

    Contemporary labor and birth population norms should be the basis for evaluating labor progression and determining slow progress that may benefit from intervention. The aim of this article is to present guidelines for a common, evidence-based approach for determination of active labor onset and diagnosis of labor dystocia based on a synthesis of existing professional guidelines and relevant contemporary publications. A 3-point approach for diagnosing active labor onset and classifying labor dystocia-related labor aberrations into well-defined, mutually exclusive categories that can be used clinically and validated by researchers is proposed. The approach comprises identification of 1) an objective point that strictly defines active labor onset (point of active labor determination); 2) an objective point that identifies when labor progress becomes atypical, beyond which interventions aimed at correcting labor dystocia may be justified (point of protraction diagnosis); and 3) an objective point that identifies when interventions aimed at correcting labor dystocia, if used, can first be determined to be unsuccessful, beyond which assisted vaginal or cesarean birth may be justified (earliest point of arrest diagnosis). Widespread adoption of a common approach for diagnosing labor dystocia will facilitate consistent evaluation of labor progress, improve communications between clinicians and laboring women, indicate when intervention aimed at speeding labor progress or facilitating birth may be appropriate, and allow for more efficient translation of safe and effective management strategies into clinical practice. Correct application of the diagnosis of labor dystocia may lead to a decrease in the rate of cesarean birth, decreased health care costs, and improved health of childbearing women and neonates. © 2015 by the American College of Nurse-Midwives.

  2. Breech birth

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000623.htm Breech birth To use the sharing features on this page, ... safer for your baby to pass through the birth canal. In the last weeks of pregnancy, your ...

  3. High risk for major nonlimb anomalies associated with lower-limb deficiency: a population-based study.

    Science.gov (United States)

    Syvänen, Johanna; Nietosvaara, Yrjänä; Ritvanen, Annukka; Koskimies, Eeva; Kauko, Tommi; Helenius, Ilkka

    2014-11-19

    The aims of this study were to determine the prevalence of congenital lower-limb reduction defects and associated mortality, to evaluate lower-limb deficiencies by type of reduction, and to identify patterns of associated anomalies. We conducted a population-based study with use of data from the Finnish Register of Congenital Malformations and Care Register for Health Care. All cases of lower-limb deficiency among live births, stillbirths, spontaneous abortions, and terminations of pregnancy due to fetal anomalies from 1993 to 2008 were included. We analyzed medical records and classified lower-limb reduction defects. Associated major anomalies were recorded, and perinatal mortality and infant mortality were calculated. Two hundred and sixty-six cases with lower-limb deficiency were identified, with a total prevalence of 2.8 per 10,000 births, a birth prevalence of 2.2 per 10,000 births, and a live-birth prevalence of 2.1 per 10,000 live births. Terminal transverse limb reductions accounted for 44.7% of the cases; longitudinal reductions, 22.9%; intercalary reductions, 7.9%; multiple reductions, 8.3%; and split-foot malformations, 4.5%. In addition to lower-limb deficiency, 47.7% of the cases had other major anomalies; anomalies of internal organs were noted in 26.3% of the cases, anomalies of the axial skeleton in 13.5% of cases, and central nervous system anomalies in 12.8%. Upper-limb reductions were observed in 32.0% of the cases. The relative risk (RR) for associated major anomalies was 12.54 (95% confidence interval [CI], 11.06 to 14.23) compared with the general figures for major congenital anomalies in Finland. The RR for associated anomalies was higher (1.75; 95% CI, 1.20 to 2.53) for longitudinal preaxial lower-limb deficiencies than for the other types of lower-limb reductions. Perinatal mortality was seventy-eight per 1000 births. All infant deaths were associated with chromosomal abnormalities, other known syndromes, or additional congenital

  4. Reducing radiation exposure in newborns with birth head trauma

    Directory of Open Access Journals (Sweden)

    Irina A. Kriukova

    2017-12-01

    Full Text Available Background. Birth head trauma causing intracranial injury is one of the most common causes of neonatal mortality and morbidity. In case of suspected cranial fractures and intracranial hematomas, diagnostic methods involving radiation, such as x-ray radiography and computed tomography, are recommended. Recently, an increasing number of studies have highlighted the risk of cancer complications associated with computed tomography in infants. Therefore, diagnostic methods that reduce radiation exposure in neonates are important. One such method is ultrasonography (US. Aim. We evaluated US as a non-ionizing radiation method for diagnosis of cranial bone fractures and epidural hematomas in newborns with cephalohematomas or other birth head traumas. Material and methods. The study group included 449 newborns with the most common variant of birth head trauma: cephalohematomas. All newborns underwent transcranial-transfontanelle US for detection of intracranial changes and cranial US for visualization of bone structure in the cephalohematoma region. Children with ultrasonic signs of cranial fractures and epidural hematomas were further examined at a children’s hospital by x-ray radiography and/or computed tomography. Results and discussion. We found that cranial US for diagnosis of cranial fractures and transcranial-transfontanelle US for diagnosis of epidural hematomas in newborns were highly effective. In newborns with parietal cephalohematomas (444 children, 17 (3.8% had US signs of linear fracture of the parietal bone, and 5 (1.1% had signs of ipsilateral epidural hematoma. Epidural hematomas were visualized only when US was performed through the temporal bone and not by using the transfontanelle approach. Sixteen cases of linear fractures and all epidural hematomas were confirmed by computed tomography. Conclusion. The use of US diagnostic methods reduced radiation exposure in newborns with birth head trauma. US methods (transcranial

  5. Urinary tract infection during pregnancy: current concepts on a common multifaceted problem.

    Science.gov (United States)

    Kalinderi, Kallirhoe; Delkos, Dimitrios; Kalinderis, Michail; Athanasiadis, Apostolos; Kalogiannidis, Ioannis

    2018-02-06

    Urinary tract infections (UTIs) are the most common bacterial infection in pregnancy, increasing the risk of maternal and neonatal morbidity and mortality. Urinary tract infections may present as asymptomatic bacteriuria, acute cystitis or pyelonephritis. Escherichia coli is the most common pathogen associated with both symptomatic and asymptomatic bacteriuria. If asymptomatic bacteriuria is untreated, up to 30% of mothers develop acute pyelonephritis, with an increased risk of multiple maternal and neonatal complications, such as preeclampsia, preterm birth, intrauterine growth restriction and low birth weight. Urinary tract infection is a common, but preventable cause of pregnancy complications, thus urinary tests, such as urine culture or new technologies such as high-throughput DNA sequence-based analyses, should be used in order to improve antenatal screening of pregnant women.

  6. The Impact of Twin Birth on Early Neonatal Outcomes.

    Science.gov (United States)

    Fumagalli, Monica; Schiavolin, Paola; Bassi, Laura; Groppo, Michela; Uccella, Sara; De Carli, Agnese; Passera, Sofia; Sirgiovanni, Ida; Dessimone, Francesca; Consonni, Dario; Acaia, Barbara; Ramenghi, Luca Antonio; Mosca, Fabio

    2016-01-01

    This study aims to describe the impact of twin birth, chorionicity, intertwin birth weight (BW) discordance and birth order on neonatal outcomes. We performed a hospital-based retrospective study on 2,170 twins (6.4% of all live births) and 2,217 singletons inborn 2007 to 2011. Data on neonatal characteristics, morbidities, and mortality were collected and compared. Univariate and multiple (adjusted for gestational age [GA] and gender) linear random intercept regression models were used. Overall, 62.3% of twins were born premature. At multiple regression, twins were similar to singletons for neonatal morbidities, but they were more likely to have lower BW and to be born by cesarean delivery. Monochorionic twins had lower GA and BW compared with dichorionic ones and were more likely to develop respiratory distress syndrome (odds ratio [OR], 1.7), hypoglycemia (OR, 3.3), need for transfusion, (OR, 3.4) but not brain abnormalities. Moderate and severe BW discordance were associated with longer length of stay and increased risk for morbidities but not for death. Birth order had no effects. Prematurity was the most common outcome in twins and accounted for the apparently increased risk in morbidities. Monochorionicity was confirmed as risk factor for lower GA and neonatal morbidities. BW discordance may play a role in developing neonatal complications and needs to be further investigated. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Histological type and grade of breast cancer tumors by parity, age at birth, and time since birth: a register-based study in Norway

    Directory of Open Access Journals (Sweden)

    Heuch Ivar

    2010-05-01

    Full Text Available Abstract Background Some studies have indicated that reproductive factors affect the risk of histological types of breast cancer differently. The long-term protective effect of a childbirth is preceded by a short-term adverse effect. Few studies have examined whether tumors diagnosed shortly after birth have specific histological characteristics. Methods In the present register-based study, comprising information for 22,867 Norwegian breast cancer cases (20-74 years, we examined whether histological type (9 categories and grade of tumor (2 combined categories differed by parity or age at first birth. Associations with time since birth were evaluated among 9709 women diagnosed before age 50 years. Chi-square tests were applied for comparing proportions, whereas odds ratios (each histological type vs. ductal, or grade 3-4 vs. grade 1-2 were estimated in polytomous and binary logistic regression analyses. Results Ductal tumors, the most common histological type, accounted for 81.4% of all cases, followed by lobular tumors (6.3% and unspecified carcinomas (5.5%. Other subtypes accounted for 0.4%-1.5% of the cases each. For all histological types, the proportions differed significantly by age at diagnoses. The proportion of mucinous and tubular tumors decreased with increasing parity, whereas Paget disease and medullary tumors were most common in women of high parity. An increasing trend with increasing age at first birth was most pronounced for lobular tumors and unspecified carcinomas; an association in the opposite direction was seen in relation to medullary and tubular tumors. In age-adjusted analyses, only the proportions of unspecified carcinomas and lobular tumors decreased significantly with increasing time since first and last birth. However, ductal tumors, and malignant sarcomas, mainly phyllodes tumors, seemed to occur at higher frequency in women diagnosed Conclusion Our results support previous observations that reproductive factors

  8. Births: preliminary data for 2005.

    Science.gov (United States)

    Hamilton, Brady E; Martin, Joyce A; Ventura, Stephanie J

    2006-12-28

    This report presents preliminary data for 2005 on births in the United States. U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother. Data on marital status, cesarean delivery, preterm births, and low birthweight (LBW) are also presented. Data in this report are based on 99.2 percent of births for 2005. The records are weighted to independent control counts of all births received in state vital statistics offices in 2005. Comparisons are made with 2004 data. The crude birth rate in 2005 was 14.0 births per 1,000 total population, unchanged from 2004. The general fertility rate, however, rose to 66.7 births per 1,000 women aged 15-44 years in 2005, the highest level since 1993. The birth rate for teenagers declined by 2 percent in 2005, falling to 40.4 births per 1,000 women aged 15-19 years, the lowest ever recorded in the 65 years for which a consistent series of rates are available. The rate declined for teenagers 15-17 years to 21.4 births per 1,000, but was essentially stable for older teenagers 18-19 years. The birth rate for women aged 20-24 years rose in 2005, whereas the rate for women aged 25-29 years was essentially unchanged. The birth rates for women aged 30 years and over rose to levels not seen in almost 40 years. Childbearing by unmarried women increased to record levels for the Nation in 2005. The birth rate rose 3 percent to 47.6 births per 1,000 unmarried women aged 15-44 years; the proportion of all births to unmarried women increased to 36.8 percent. The cesarean delivery rate rose by 4 percent in 2005 to 30.2 percent of all births, another record high for the Nation. The preterm birth rate continued to rise (to 12.7 percent in 2005) as did the rate for LBW births (8.2 percent).

  9. Increasing incidence of testicular cancer--birth cohort effects.

    Science.gov (United States)

    Ekbom, A; Akre, O

    1998-01-01

    The incidence of testicular cancer is rising in most Western populations. A collaborative study between nine population-based cancer registries in countries around the Baltic Sea was utilized in order to analyze in detail geographic variations and temporal trends in the occurrence of testicular cancer. There were 34,309 cases registered up until 1989 starting in Denmark in 1942 and most recently in Latvia in 1977. From the descriptive epidemiology it was obvious that there was a substantial variation in the age-standardized incidence amounting to about a 10-fold difference between the different countries ranging from 0.8 per 100,000 person-years in Lithuania to 7.6 per 100,000 person-years in Denmark. Previous studies have indicated that this increase is due to birth cohort effects. A more detailed analysis was therefore performed in those six countries with a sufficiently long period of cancer registration; Poland, former East Germany, Norway, Finland, Denmark and Sweden. This analysis showed that birth cohort is a more important determinant of testicular cancer risk than year of diagnosis. In Poland, former East Germany and Finland, there was an increasing risk for all birth cohorts. Among men born in Denmark, Norway or Sweden between 1930 and 1945, this increasing trend in risk was interrupted in these birth cohorts but followed thereafter by an uninterrupted increase by birth cohort. In conclusion, life time exposure to environmental factors which are associated with the incidence of testicular cancer appear to be more related to birth cohort than to year of diagnosis. Because testicular cancer typically occurs at an early age, major etiological factors therefore need to operate early in life, perhaps even in utero.

  10. Feeling like a group after a natural disaster: Common ingroup identity and relations with outgroup victims among majority and minority young children.

    Science.gov (United States)

    Vezzali, Loris; Cadamuro, Alessia; Versari, Annalisa; Giovannini, Dino; Trifiletti, Elena

    2015-09-01

    We conducted a field study to test whether the common ingroup identity model (Gaertner & Dovidio, 2000, reducing intergroup bias: The common ingroup identity model. Philadelphia, PA: Psychology Press) could be a useful tool to improve intergroup relations in the aftermath of a natural disaster. Participants were majority (Italian) and minority (immigrant) elementary school children (N = 517) living in the area struck by powerful earthquakes in May 2012. Results revealed that, among majority children, the perceived external threat represented by the earthquake was associated with greater perceptions of belonging to a common ingroup including both ingroup and outgroup. In turn, heightened one-group perceptions were associated with greater willingness to meet and help outgroup victims, both directly and indirectly via more positive outgroup attitudes. Among immigrant children, perceived disaster threat was not associated with any of the dependent variables; one-group perceptions were positively associated with outgroup attitudes, helping and contact intentions towards outgroup victims. Thus, one-group perceptions after a natural disaster may promote more positive and supporting relations between the majority and the minority group. We discuss the theoretical and practical implications of the findings. © 2014 The British Psychological Society.

  11. Factors associated with preterm, early preterm and late preterm birth in Malawi.

    Directory of Open Access Journals (Sweden)

    Nynke R van den Broek

    Full Text Available Assessment of risk factors for preterm birth in a population with high incidence of preterm birth and HIV infection.Secondary analysis of data for 2,149 women included in a community based randomized placebo controlled trial for the prevention of preterm birth (APPLe trial (ISRCTN84023116 with gestational age at birth determined through ultrasound measurement in early pregnancy. Multivariate Logistic Regression analyses to obtain models for three outcome variables: all preterm, early preterm, and late preterm birth.No statistical differences were noted for the prevalence of HIV infection (p = 0.30 or syphilis (p = 0.12 between women who delivered preterm versus term. BMI (Adjusted OR 0.91 (0.85-0.97; p = 0.005 and weight gain (Adjusted OR 0.89 (0.82-0.97; p = 0.006 had an independent, protective effect. Previous preterm birth doubled the odds of preterm birth (Adjusted OR 2.13 (1.198-3.80; p = 0.01. Persistent malaria (despite malaria prophylaxis increased the risk of late preterm birth (Adjusted OR 1.99 (1.05-3.79; p = 0.04. Age <20 (Adjusted OR 1.73 (1.03-2.90; p = 0.04 and anemia (Adjusted OR 1.95 (1.08-3.52; p = 0.03 were associated with early preterm birth (<34 weeks.Despite claims that HIV infection is an important cause of preterm birth in Africa, we found no evidence of an association in this population (unexposed to anti-retroviral treatment. Persistent malaria was associated with late preterm birth. Maternal undernourishment and anemia were independently associated with early preterm birth. The study did not assess whether the link was direct or whether a common precursor such as chronic infection was responsible for both maternal effects and early labour.

  12. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth.

    Science.gov (United States)

    Felder, Jennifer N; Baer, Rebecca J; Rand, Larry; Jelliffe-Pawlowski, Laura L; Prather, Aric A

    2017-09-01

    To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy. Sleep disorder was defined based on International Classification of Diseases, 9th Revision, Clinical Modification diagnostic code (n=2,265). Propensity score matching was used to select a referent population at a one-to-one ratio. Odds of preterm birth were examined by gestational age (less than 34 weeks, 34-36 weeks, and less than 37 weeks of gestation) and type (spontaneous, indicated). Prevalence of preterm birth (before 37 weeks of gestation) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis. Compared with the referent group, odds (95% CI, P value, percentage) of preterm birth were 1.3 (1.0-1.7, P=.023, 14.1%) for insomnia and 1.5 (1.2-1.8, P<.001, 15.5%) for sleep apnea. Risk varied by gestational age and preterm birth type. Odds of preterm birth were not significantly increased for sleep-related movement disorders or other sleep disorders. Insomnia and sleep apnea were associated with significantly increased risk of preterm birth. Considering the high prevalence of sleep disorders during pregnancy and availability of evidence-based nonpharmacologic interventions, current findings suggest that screening for severe presentations would be prudent.

  13. Adoptees' Contact with Birth Relatives in Emerging Adulthood

    Science.gov (United States)

    Farr, Rachel H.; Grant-Marsney, Holly A.; Musante, Danila S.; Grotevant, Harold D.; Wrobel, Gretchen Miller

    2014-01-01

    While openness in adoption has become more common in the United States, little research has examined contact between birth and adoptive families as adoptees become adults. Using quantitative and qualitative data from 167 emerging adult adoptees, factors characterizing contact (e.g., type, frequency, with whom), satisfaction with contact, and the…

  14. Epigenetic Consequences of Low Birth-Weight and Preterm Birth in Adult Twins

    DEFF Research Database (Denmark)

    Tan, Qihua

    2018-01-01

    could be detrimental to health later in life. Current epigenetic studies using genome-wide DNA methylation profiling have discovered molecular evidence confirming that, as important early life events, both low birth-weight and premature birth can result in long-lasting epigenetic consequences...... that impact health at adult ages. Results from our epigenome-wide association studies indicate that the two moderately correlated traits of adverse pregnancy outcome could be linked to increased susceptibility to different health problems with low birth-weight more relevant to metabolic disorders, while......Adverse birth outcomes including low birth-weight and preterm birth are associated with long-term morbidity and health consequences at adult ages. Molecular mechanisms including epigenetic modification may have been involved in the adaptation to the stressful condition in peridelivery period which...

  15. Separation anxiety among birth-assigned male children in a specialty gender identity service.

    Science.gov (United States)

    VanderLaan, Doug P; Santarossa, Alanna; Nabbijohn, A Natisha; Wood, Hayley; Owen-Anderson, Allison; Zucker, Kenneth J

    2018-01-01

    Previous research suggested that separation anxiety disorder (SAD) is overrepresented among birth-assigned male children clinic-referred for gender dysphoria (GD). The present study examined maternally reported separation anxiety of birth-assigned male children assessed in a specialty gender identity service (N = 360). SAD was determined in relation to DSM-III and DSM-IV criteria, respectively. A dimensional metric of separation anxiety was examined in relation to several additional factors: age, ethnicity, parental marital status and social class, IQ, gender nonconformity, behavioral and emotional problems, and poor peer relations. When defined in a liberal fashion, 55.8% were classified as having SAD. When using a more conservative criterion, 5.3% were classified as having SAD, which was significantly greater than the estimated general population prevalence for boys, but not for girls. Dimensionally, separation anxiety was associated with having parents who were not married or cohabitating as well as with elevations in gender nonconformity; however, the association with gender nonconformity was no longer significant when statistically controlling for internalizing problems. Thus, SAD appears to be common among birth-assigned males clinic-referred for GD when defined in a liberal fashion, and more common than in boys, but not girls, from the general population even when more stringent criteria were applied. Also, the degree of separation anxiety appears to be linked to generic risk factors (i.e., parental marital status, internalizing problems). As such, although separation anxiety is common among birth-assigned male children clinic-referred for GD, it seems unlikely to hold unique significance for this population based on the current data.

  16. Understanding the role of violence as a social determinant of preterm birth.

    Science.gov (United States)

    Masho, Saba W; Cha, Susan; Chapman, Derek A; Chelmow, David

    2017-02-01

    Preterm birth is one of the leading causes of infant morbidity and mortality. Although major strides have been made in identifying risk factors for preterm birth, the complexities between social and individual risk factors are not well understood. This study examines the association between neighborhood youth violence and preterm birth. A 10-year live birth registry data set (2004 through 2013) from Richmond, VA, a mid-sized, racially diverse city, was analyzed (N = 27,519). Data were geocoded and merged with census tract and police report data. Gestational age at birth was classified as rates were calculated for each census tract area and categorized into quartiles. Hierarchical models were examined fitting multilevel logistic regression models incorporating randomly distributed census tract-specific intercepts assuming a binary distribution and a logit link function. Nearly a fifth of all births occurred in areas with the highest quartiles of violence. After adjusting for maternal age, race/ethnicity, education, paternal presence, parity, adequacy of prenatal care, pregnancy complications, history of preterm birth, insurance, and tobacco, alcohol, and drug use, census tracts with the highest level of violence had 38% higher odds of very preterm births (adjusted odds ratio, 1.38; 95% confidence interval, 1.06-1.80), than census tracts with the lowest level of violence. There is an association between high rate of youth violence and very preterm birth. Findings from this study may help inform future research to develop targeted interventions aimed at reducing community violence and very preterm birth in vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Breastfeeding Trends Among Very Low Birth Weight, Low Birth Weight, and Normal Birth Weight Infants.

    Science.gov (United States)

    Campbell, Angela G; Miranda, Patricia Y

    2018-05-18

    To examine the change in breastfeeding behaviors over time, among low birth weight (LBW), very low birth weight (VLBW), and normal birth weight (NBW) infants using nationally representative US data. Univariate statistics and bivariate logistic models were examined using the Early Child Longitudinal Study-Birth Cohort (2001) and National Study of Children's Health (2007 and 2011/2012). Breastfeeding behaviors improved for infants of all birth weights from 2007 to 2011/2012. In 2011/2012, a higher percentage of VLBW infants were ever breastfed compared with LBW and NBW infants. In 2011/2012, LBW infants had a 28% lower odds (95% CI, 0.57-0.92) of ever breastfeeding and a 52% lower odds (95% CI, 0.38-0.61) of breastfeeding for ≥6 months compared with NBW infants. Among black infants, a larger percentage of VLBW infants were breastfed for ≥6 months (26.2%) compared with LBW infants (14.9%). Breastfeeding rates for VLBW and NBW infants have improved over time. Both VLBW and NBW infants are close to meeting the Healthy People 2020 ever breastfeeding goal of 81.9%. LBW infants are farther from this goal than VLBW infants. The results suggest a need for policies that encourage breastfeeding specifically among LBW infants. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Planned and unplanned home births and hospital births in Calgary, Alberta, 1984-87.

    OpenAIRE

    Abernathy, T J; Lentjes, D M

    1989-01-01

    Information collected on all home births in Calgary (Canada) between the years 1984 and 1987, was examined and analyzed according to whether the home birth environment had been planned or unplanned. The two groups were compared to each other and to all hospital births according to demographic characteristics of mothers, indicators of prenatal care, and birth outcome. Mothers who had planned their home birth were more likely to be primiparous, attend prenatal classes, obtain regular prenatal c...

  19. Penetrating abdominal injury and peritonitis: A rare case of birth Injury

    Directory of Open Access Journals (Sweden)

    Patankar Shreeprasad

    2008-01-01

    Full Text Available The incidence of birth injuries has decreased considerably because of the identification of risk factors at an earlier stage and taking the decision for caesarian section (LSCS at proper time. Fractures, nerve palsies and central nervous system injuries comprise the majority of "birth injuries." In this study, we report a newborn that had a birth injury during LSCS. The baby sustained a penetrating abdominal injury by the knife of the surgeon, while performing LSCS. The bowel was injured at two sites, proximal jejunum and descending colon. The baby developed meconeum spillage and peritonitis. Exploratory laprotomy was done and the injuries were identified. The injured portions were resected and bowel continuity was reestablished. The baby had an uneventful recovery.

  20. The birth beliefs scale - a new measure to assess basic beliefs about birth.

    Science.gov (United States)

    Preis, Heidi; Benyamini, Yael

    2017-03-01

    Basic beliefs about birth as a natural and safe or a medical and risky process are central in the decisions on where and how to birth. Despite their importance, they have not been studied separately from other childbirth-related constructs. Our aim was to develop a measure to assess these beliefs. Pregnant Israeli women (N = 850, gestational week ≥14) were recruited in women's health centers, in online natural birth forums, and through home midwives. Participants filled in questionnaires including sociodemographic and obstetric background, the Birth Beliefs Scale (BBS), dispositional desire for control (DC) and planned mode of delivery. Factor analyses revealed that the BBS is composed of two factors: beliefs about birth as a natural process and beliefs about birth as a medical process. Both subscales showed good internal and test-retest reliability. They had good construct validity, predicted birth choices, and were weakly correlated with DC. Women's medical obstetric history was associated with the BBS, further supporting the validity of the scale. Beliefs about birth may be the building blocks that make up perceptions of birth and drive women's preferences. The new scale provides an easy way to distinctly assess them so they can be used to further understand planned birth behaviors. Additional studies are needed to comprehend how these beliefs form in different cultural contexts and how they evolve over time.

  1. PLANNED HOME BIRTH: A REVIEW

    Directory of Open Access Journals (Sweden)

    Tamara Serdinšek

    2016-05-01

    Full Text Available Background: Home birth is as old as humanity, but still most middle- and high-income countries consider hospitals as the safest birth settings, as complications regarding birth are highly unpredictable. Despite this there are a few countries in which home birth in integrated into official healthcare system (the Netherlands, United Kingdom, Canada etc.. Home births can be divided into unplanned and planned, and the latter can be further categorized by the presence of the birth attendants. This review focuses on planned home births, which are differently represented throughout the world. In the United States 0.6-1.0% of all children are born at home, in the United Kingdom 2-3%, in Canada 1.6% and in the Netherlands 20-30%. For Slovenia, the number of planned home births is unknown; however, in 2010 0.1% of children were born outside medical facilities.Conclusions: The safety of home birth in still under the debate. While research confirms smaller number of obstetric interventions and some complications in mothers who give birth at home, the data regarding the neonatal and perinatal mortality and morbidity is still conflicting. This confirms the need for large multicentric trials in this field. Current home birth guidelines emphasize that women should be well informed regarding the possible advantages and disadvantages of home births. In addition, the emphasis is on definition of selection criteria for home birth, indications for intrapartal transfer to the hospital and appropriate education of birth attendants. 

  2. Saving lives at birth

    DEFF Research Database (Denmark)

    Daysal, N. Meltem; Trandafir, Mircea; van Ewijk, Reyn

    2015-01-01

    Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity...... in location of birth, we exploit the exogenous variation in distance from a mother’s residence to the closest hospital. We find that giving birth in a hospital leads to substantial reductions in newborn mortality. We provide suggestive evidence that proximity to medical technologies may be an important...

  3. STUDY CONCERNING THE COSTS OF BIRTH BY CAESAREAN SECTION COMPARED TO NATURAL BIRTH

    Directory of Open Access Journals (Sweden)

    Diana UIVAROȘAN

    2016-12-01

    Full Text Available The birth by caesarean section has become an expanding phenomenon in the recent years, natural births being more and more rare in Romania. The increasing incidence of these operations has been observed in the recent years, in the conditions of more effective fetal monitoring, modification of the malpractice law and increasing degree of information of the women. In Romania, depending on the hospital, the percentage of births by caesarean section ranges between 20-80%, even 90% (these latter percentage being valid especially in private clinics. The percentage of the operations is higher in big cities, and in Bucharest about 70% of the births are done by C-section. The World Health Organization recommends a maximum percentage surgical intervention of 10-15%. Fearing the labor pain, more and more women are choosing to bring their children into the world by Caesarean section. Also the number of doctors who claim that cesarean section is a better option is increasing. Both persons involved in the birth process have the responsibility of that decision - meaning both mother and doctor. The option of the mother is very important, but the recommendation of the doctor can make the difference. The decision is not only of the doctor, he just presents the information that the mother does not know, mother's wish being the most important. In this paper we conducted a study to determine the comparative costs of the vaginal births with those by Caesarean section. The retrospective study was conducted between 01.01.2015 - 31.12.2015, on 3607 births registered in the Obstetrics and Gynecology Clinics of Clinical Emergency County Hospital Oradea. Gemellary births were excluded from the study. We analyzed the comparative costs of a vaginal birth and of a birth by caesarean section in order to highlight the share of cesarean births compared to vaginal births.

  4. Effect of periodontal treatment on preterm birth rate: a systematic review of meta-analyses.

    Science.gov (United States)

    López, Néstor J; Uribe, Sergio; Martinez, Benjamín

    2015-02-01

    Preterm birth is a major cause of neonatal morbidity and mortality in both developed and developing countries. Preterm birth is a highly complex syndrome that includes distinct clinical subtypes in which many different causes may be involved. The results of epidemiological, molecular, microbiological and animal-model studies support a positive association between maternal periodontal disease and preterm birth. However, the results of intervention studies carried out to determine the effect of periodontal treatment on reducing the risk of preterm birth are controversial. This systematic review critically analyzes the methodological issues of meta-analyses of the studies to determine the effect of periodontal treatment to reduce preterm birth. The quality of the individual randomized clinical trials selected is of highest relevance for a systematic review. This article describes the methodological features that should be identified a priori and assessed individually to determine the quality of a randomized controlled trial performed to evaluate the effect of periodontal treatment on pregnancy outcomes. The AMSTAR and the PRISMA checklist tools were used to assess the quality of the six meta-analyses selected, and the bias domain of the Cochrane Collaboration's Tool was applied to evaluate each of the trials included in the meta-analyses. In addition, the methodological characteristics of each clinical trial were assessed. The majority of the trials included in the meta-analyses have significant methodological flaws that threaten their internal validity. The lack of effect of periodontal treatment on preterm birth rate concluded by four meta-analyses, and the positive effect of treatment for reducing preterm birth risk concluded by the remaining two meta-analyses are not based on consistent scientific evidence. Well-conducted randomized controlled trials using rigorous methodology, including appropriate definition of the exposure, adequate control of confounders for

  5. Relationship between Maternal Serum Copper Level and Birth Weight Neonate

    Directory of Open Access Journals (Sweden)

    Mirzarahimi M

    2012-01-01

    Full Text Available Background and Objectives: Low birth weight (LBW is a major public health problem. LBW is associated with increased neonatal morbidity and mortality. There is no consensus in the literature as to whether maternal copper nutrition is associated with pregnancy outcome or fetal growth. Methods: This case-control study was carried out at Alavi Hospital in Ardabil between August 2008 and August 2009. 56 women who had delivered low-birth- weight infants (<2500gr were taken as the case group, and from the mothers who had delivered normal birth weight infants (≥2500gr, 56 were selected at random as the control group. Venous blood samples were obtained from the mothers. Serum zinc level was determined by the Atomic Absorption Spectrophotometer method.Results: Mean of birth weight in infants, maternal age, body mass index in mothers and socioeconomic or demographic factors did not differ between cases and control groups. Maternal copper concentration (μg/dl differed between Cases and Controls; 231.75±38.12μg/dl vs. 204.42±31.30μg/dl respectively. There is a significant difference (p<0.001 in the serum copper concentration between the two groups.Conclusion: There is a negative relation between low infant birth weight and maternal copper concentration.

  6. Birth in Brazil: national survey into labour and birth

    Directory of Open Access Journals (Sweden)

    do Carmo Leal Maria

    2012-08-01

    Full Text Available Abstract Background Caesarean section rates in Brazil have been steadily increasing. In 2009, for the first time, the number of children born by this type of procedure was greater than the number of vaginal births. Caesarean section is associated with a series of adverse effects on the women and newborn, and recent evidence suggests that the increasing rates of prematurity and low birth weight in Brazil are associated to the increasing rates of Caesarean section and labour induction. Methods Nationwide hospital-based cohort study of postnatal women and their offspring with follow-up at 45 to 60 days after birth. The sample was stratified by geographic macro-region, type of the municipality and by type of hospital governance. The number of postnatal women sampled was 23,940, distributed in 191 municipalities throughout Brazil. Two electronic questionnaires were applied to the postnatal women, one baseline face-to-face and one follow-up telephone interview. Two other questionnaires were filled with information on patients’ medical records and to assess hospital facilities. The primary outcome was the percentage of Caesarean sections (total, elective and according to Robson’s groups. Secondary outcomes were: post-partum pain; breastfeeding initiation; severe/near miss maternal morbidity; reasons for maternal mortality; prematurity; low birth weight; use of oxygen use after birth and mechanical ventilation; admission to neonatal ICU; stillbirths; neonatal mortality; readmission in hospital; use of surfactant; asphyxia; severe/near miss neonatal morbidity. The association between variables were investigated using bivariate, stratified and multivariate model analyses. Statistical tests were applied according to data distribution and homogeneity of variances of groups to be compared. All analyses were taken into consideration for the complex sample design. Discussion This study, for the first time, depicts a national panorama of labour and birth

  7. Observations of the birth and fine structure of sunspot penumbrae

    International Nuclear Information System (INIS)

    Collados, M.; Garcia de la Rosa, J.I.; Moreno-Insertis, F.; Vazquez, M.

    1985-01-01

    High resolution white-light pictures of sunspot penumbrae are presented. These include pictures showing details of their filamentary structure and some instances of birth of a penumbra. The observations are discussed in the framework of current penumbra theories. A series of pictures have been presented, which give additional evidence of the existence of dark penumbral filaments as individual structures. With respect to the birth of the penumbra some new observational aspects can be seen. The existence of the filamentary penumbra even in the first moments, its non uniformity and its short length are the major aspects derived from the pictures

  8. Birthing Classes

    Science.gov (United States)

    ... management options. Breastfeeding basics. Caring for baby at home. Birthing classes are not just for new parents, though. ... midwife. Postpartum care. Caring for your baby at home, including baby first aid. Lamaze One of the most popular birthing techniques in the U.S., Lamaze has been around ...

  9. Birth weight and other perinatal characteristics and childhood leukemia in California.

    Science.gov (United States)

    Oksuzyan, S; Crespi, C M; Cockburn, M; Mezei, G; Kheifets, L

    2012-12-01

    We conducted a large registry-based study in California to investigate the association of perinatal factors and childhood leukemia with analysis of two major subtypes, acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML). We linked California cancer and birth registries to obtain information on 5788 cases and 5788 controls matched on age and sex (1:1). We examined the association of birth weight, gestational age, birth and pregnancy order, parental ages, and specific conditions during pregnancy and risk of total leukemia, ALL and AML using conditional logistic regression, with adjustment for potential confounders. The odds ratio (OR) per 1000 g increase in birth weight was 1.11 for both total leukemia and ALL. The OR were highest for babies weighing ≥ 4500 g with reference birth weight and LGA were associated with increased risk and SGA with decreased risk of total childhood leukemia and ALL, being first-born was associated with decreased risk of AML, and advanced paternal age was associated with increased risk of ALL. These findings suggest that associations of childhood leukemia and perinatal factors depend highly on subtype of leukemia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Saving Lives at Birth : The Impact of Home Births on Infant Outcomes

    NARCIS (Netherlands)

    Meltem Daysal, N.; Trandafir, M.; van Ewijk, R.

    2012-01-01

    Abstract: Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for

  11. Disparities in Birth Weight and Gestational Age by Ethnic Ancestry in South American countries

    Science.gov (United States)

    Wehby, George L.; Gili, Juan A.; Pawluk, Mariela; Castilla, Eduardo E.; López-Camelo, Jorge S.

    2015-01-01

    Objective We examine disparities in birth weight and gestational age by ethnic ancestry in 2000–2011 in eight South American countries. Methods The sample included 60480 singleton live-births. Regression models were estimated to evaluate differences in birth outcomes by ethnic ancestry controlling for time trends. Results Significant disparities were found in seven countries. In four countries – Brazil, Ecuador, Uruguay, and Venezuela – we found significant disparities in both low birth weight and preterm birth. Disparities in preterm birth alone were observed in Argentina, Bolivia, and Colombia. Several differences in continuous birth weight, gestational age, and fetal growth rate were also observed. There were no systematic patterns of disparities between the evaluated ethnic ancestry groups across the study countries, in that no racial/ethnic group consistently had the best or worst outcomes in all countries. Conclusions Racial/ethnic disparities in infant health are common in several South American countries. Differences across countries suggest that racial/ethnic disparities are driven by social and economic mechanisms. Researchers and policymakers should acknowledge these disparities and develop research and policy programs to effectively target them. PMID:25542227

  12. Birth control pills - combination

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000655.htm Birth control pills - combination To use the sharing features on ... both progestin and estrogen. What Are Combination Birth Control Pills? Birth control pills help keep you from ...

  13. Essure Permanent Birth Control

    Science.gov (United States)

    ... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Print Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

  14. Risk factors for premature birth in French Guiana: the importance of reducing health inequalities.

    Science.gov (United States)

    Leneuve-Dorilas, Malika; Favre, Anne; Carles, Gabriel; Louis, Alphonse; Nacher, Mathieu

    2017-11-27

    French Guiana has the highest birth rate in South America. This French territory also has the highest premature birth rate and perinatal mortality rate of all French territories. The objective was to determine the premature birth rate and to identify the prevalence of risk factors of premature birth in French Guiana. A retrospective study of all births in French Guiana was conducted between January 2013 and December 2014 using the computerized registry compiling all live births over 22 weeks of gestation on the territory. During this period 12 983 live births were reported on the territory. 13.5% of newborns were born before 37 (1755/12 983). The study of the registry revealed that common sociodemographic risk factors of prematurity were present. In addition, past obstetrical history was also important: a scarred uterus increased the risk of prematurity adjusted odds ratio =1.4, 95%CI (1.2-1.6). Similarly, obstetrical surveillance, the absence of preparation for birth or of prenatal interview increased the risk of prematurity by 2.4 and 2.3, the excess fraction in the population was 69% and 72.2%, respectively. Known classical risk factors are important. In the present study excess fractions were calculated in order to prioritize interventions to reduce the prematurity rate.

  15. Evolution of the Birth Plan

    OpenAIRE

    Kaufman, Tamara

    2007-01-01

    Many birth professionals are discarding the birth plan as an outdated and ineffectual document. This column discusses the past limitations and present uses of the birth plan in an effort to enhance current teaching on how expectant parents can write and use this important document. Encouraging expectant parents to prepare two separate, but corresponding, birth plans—the “Discussion Birth Plan” and the “Hospital Birth Plan”—is proposed. Teaching suggestions and possible implications are explor...

  16. PLANNED HOME BIRTH: A REVIEW

    OpenAIRE

    Tamara Serdinšek; Iztok Takač

    2016-01-01

    Background: Home birth is as old as humanity, but still most middle- and high-income countries consider hospitals as the safest birth settings, as complications regarding birth are highly unpredictable. Despite this there are a few countries in which home birth in integrated into official healthcare system (the Netherlands, United Kingdom, Canada etc.). Home births can be divided into unplanned and planned, and the latter can be further categorized by the presence of the birth attendants. Thi...

  17. Standard gestational birth weight ranges and Curve in Yaounde ...

    African Journals Online (AJOL)

    The aim of this study was to establish standard ranges and curve of mean gestational birth weights validated by ultrasonography for the Cameroonian population in Yaoundé. This cross sectional study was carried out in the Obstetrics & Gynaecology units of 4 major hospitals in the metropolis between March 5 and ...

  18. International variations in the gestational age distribution of births: an ecological study in 34 high-income countries.

    Science.gov (United States)

    Delnord, Marie; Mortensen, Laust; Hindori-Mohangoo, Ashna D; Blondel, Béatrice; Gissler, Mika; Kramer, Michael R; Richards, Jennifer L; Deb-Rinker, Paromita; Rouleau, Jocelyn; Morisaki, Naho; Nassar, Natasha; Bolumar, Francisco; Berrut, Sylvie; Nybo Andersen, Anne-Marie; Kramer, Michael S; Zeitlin, Jennifer

    2018-04-01

    Few studies have investigated international variations in the gestational age (GA) distribution of births. While preterm births (22-36 weeks GA) and early term births (37-38 weeks) are at greater risk of adverse health outcomes compared to full term births (39-40 weeks), it is not known if countries with high preterm birth rates also have high early term birth rates. We examined rate associations between preterm and early term births and mean term GA by mode of delivery onset. We used routine aggregate data on the GA distribution of singleton live births from up to 34 high-income countries/regions in 1996, 2000, 2004, 2008 and 2010 to study preterm and early term births overall and by spontaneous or indicated onset. Pearson correlation coefficients were adjusted for clustering in time trend analyses. Preterm and early term births ranged from 4.1% to 8.2% (median 5.5%) and 15.6% to 30.8% (median 22.2%) of live births in 2010, respectively. Countries with higher preterm birth rates in 2004-2010 had higher early term birth rates (r > 0.50, P birth rates suggest that common risk factors could underpin shifts in the GA distribution. Targeting modifiable population risk factors for delivery before 39 weeks GA may provide a useful preterm birth prevention paradigm.

  19. Saving Lives at Birth: The Impact of Home Births on Infant Outcomes

    NARCIS (Netherlands)

    Daysal, N.M.; Trandafir, M.; van Ewijk, R.

    2015-01-01

    Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity in

  20. Mode of birth in twins: data and reflections.

    Science.gov (United States)

    Reitter, A; Daviss, B A; Krimphove, M J; Johnson, K C; Schlößer, R; Louwen, F; Bisits, A

    2018-02-12

    Our primary objective was to compare neonatal and maternal outcomes in women with twin pregnancies, beyond 32 weeks, having a planned vaginal birth or a planned caesarean section (CS). This was a retrospective cohort study from a single tertiary centre over nine years. 534 sets of twins ≥32 + 0 weeks of gestation were included. 401 sets were planned vaginally and 133 sets were planned by CS. We compared a composite adverse perinatal outcome (perinatal mortality or serious neonatal morbidity; five minute APGAR score ≤4, neurological abnormality and need for intubation) and a composite maternal adverse outcome (major haemorrhage, trauma or infection) between the groups. There were no significant differences. Given the similarity of these results with several other larger studies of twin birth, we sought to look at reasons why there is still a rising rate of CS for twin births. We further make suggestions for keeping this rate to a sensible minimum. Impact statement What is already known on this subject? The largest randomised controlled study comparing planned vaginal birth with planned CSs for lower risk twins between 32 and 39 weeks of gestation, showed no added safety from planned CS. However, in most of the Western countries this conclusion has failed to increase the number of planned vaginal births for lower risk twins. What do the results of this study add? This observational study from a single tertiary centre provides external validation of the twin trial results in a practical day-to-day setting. It also provides insights as to how planned vaginal birth can be developed and maintained, with a key focus on safety and maternal participation in decision making. It does focus on consent and providing accurate data. What are the implications of these findings for clinical practice and/or further research? There are good grounds to encourage vaginal birth for low-risk twin pregnancies. The trend of rising caesarean rates in low-risk twin

  1. Risk factors and birth outcomes of anaemia in early pregnancy in a nulliparous cohort.

    Science.gov (United States)

    Masukume, Gwinyai; Khashan, Ali S; Kenny, Louise C; Baker, Philip N; Nelson, Gill

    2015-01-01

    Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality. The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of 'low risk' women participating in a large international multicentre prospective study (n = 5 609), to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation. The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints study. Anaemia was defined according to the World Health Organization's definition of anaemia in pregnancy (haemoglobin prevalence of anaemia (2.2%), that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78), and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score pregnancy outcomes were however more common in those with anaemia than in those without. In this low risk healthy pregnant population we found a low anaemia rate. The absence of a marital partner was a non-modifiable factor, albeit one which may reflect a variety of confounding factors, that should be considered for addition to anaemia's conceptual framework of determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy.

  2. Modeling The Effects of Mother’s Age at First Birth on Child Health at Birth

    OpenAIRE

    Mbu Daniel Tambi

    2014-01-01

    This study models the impact of mother’s age at first birth on child health at birth in Cameroon. The objectives are: (1) investigate the implication of mother’s age at first birth on child health at birth; (2) examine the impact of mother’s age groups on birth weight, and (3) suggest economic policies to ameliorate the mother’s age – child health relationship. We make used of the control function approach to determine the relationship between mother’s age at first birth and birth...

  3. Mode of birth and women’s psychological and physical wellbeing in the postnatal period

    Directory of Open Access Journals (Sweden)

    Rowlands Ingrid J

    2012-11-01

    Full Text Available Abstract Background Physical and psychological problems after childbirth are common, and may have a significant negative and long-term impact on women’s wellbeing and daily functioning. The method of birth may be a particularly important factor influencing women’s health and wellbeing following birth, however, population-wide evidence is limited. This study uses data from 5,332 women who responded to a national survey of women’s experiences of maternity care in England. We examined women’s postnatal wellbeing in the first three months after birth, and whether these varied by mode of birth. Methods This is a secondary analysis of survey data using a random sample of women selected from birth registration. We used multinomial logistic regression models to examine the association between women’s self-reported psychological symptoms, health problems and mode of birth. Results Women who had forceps-assisted vaginal births and unplanned caesarean section births reported the poorest health and wellbeing, while those of women who had unassisted vaginal births and planned caesarean section births were less affected by the birth process. Most women’s physical and emotional health appeared to improve with time, however, those who had a forceps-assisted vaginal birth were more likely to report ongoing posttraumatic-type symptoms several months after the birth. Conclusions Mode of birth was associated with differences in outcomes at three months. By comparison to women who had unassisted vaginal births, the risk of reduced postnatal health and wellbeing was higher amongst the women who had forceps-assisted vaginal births but not amongst women who had ventouse-assisted vaginal births. This would suggest that it is important to differentiate the different types of instrumental birth in outcome studies. Of concern was the higher rate of posttraumatic-type symptoms among women who had forceps-assisted vaginal births relative to the other modes of

  4. The Matrix Metalloproteases and Endothelin-1 in Infection-Associated Preterm Birth

    Directory of Open Access Journals (Sweden)

    Nicole S. Olgun

    2010-01-01

    Full Text Available Preterm birth (PTB is clinically defined as any delivery which occurs before the completion of 37 weeks of gestation, and is currently the most important problem in obstetrics. In the United States, PTB accounts for 12-13% of all live births, and, with the exception of fetuses suffering from anomalies, is the primary cause of perinatal mortality. While the risk factors for PTB are numerous, the single most common cause is intrauterine infection. As there is currently no FDA-approved therapy for infection-associated PTB, understanding the pathogenesis of preterm labor (PTL and delivery should be given high priority. The matrix metalloproteinases (MMPs are a family of enzymes that have been implicated in normal parturition as well as infection-triggered rupture of membranes and preterm birth. Several lines of evidence also suggest a role for endothelin-1 (ET-1 in infection-associated preterm delivery. This paper focuses on the evidence that the MMPs and ET-1 act in the same molecular pathway in preterm birth.

  5. Planned place of birth

    DEFF Research Database (Denmark)

    Overgaard, Charlotte; Coxon, Kirstie; Stewart, Mary

    Title Planned place of birth: issues of choice, access and equity. Outline In Northern European countries, giving birth is generally safe for healthy women with uncomplicated pregnancies, and their babies. However, place of birth can affect women’s outcomes and experiences of birth. Whilst tertiary...... countries, maternity care is provided free to women, through public financing of health care; universal access to care is therefore secured. Nevertheless, different models of care exist, and debates about the appropriateness of providing maternity care in different settings take place in both countries...... in Denmark Coxon K et al: Planned place of birth in England: perceptions of accessing obstetric units, midwife led units and home birth amongst women and their partners. How these papers interrelate These papers draw upon recent research in maternity care, undertaken in Denmark and in England. In both...

  6. Socioeconomic inequality in preterm birth in four Brazilian birth cohort studies

    Directory of Open Access Journals (Sweden)

    Ana Daniela Izoton de Sadovsky

    Full Text Available Abstract Objective: To analyze economic inequality (absolute and relative due to family income in relation to the occurrence of preterm births in Southern Brazil. Methods: Four birth cohort studies were conducted in the years 1982, 1993, 2004, and 2011. The main exposure was monthly family income and the primary outcome was preterm birth. The inequalities were calculated using the slope index of inequality and the relative index of inequality, adjusted for maternal skin color, education, age, and marital status. Results: The prevalence of preterm births increased from 5.8% to approximately 14% (p-trend < 0.001. Late preterm births comprised the highest proportion among the preterm births in all studies, although their rates decreased over the years. The analysis on the slope index of inequality demonstrated that income inequality arose in the 1993, 2004, and 2011 studies. After adjustment, only the 2004 study maintained the difference between the poorest and the richest subjects, which was 6.3 percentage points. The relative index of inequality showed that, in all studies, the poorest mothers were more likely to have preterm newborns than the richest. After adjustment for confounding factors, it was observed that the poorest mothers only had a greater chance of this outcome in 2004. Conclusion: In a final model, economic inequalities resulting from income were found in relation to preterm births only in 2004, although a higher prevalence of prematurity continued to be observed in the poorest population, in all the studies.

  7. Birth Order and Perceived Birth Order of Chemically Dependent and Academic Women.

    Science.gov (United States)

    Weeks, Kristie G.; Newlon, Betty J.

    Birth order as it relates to family constellation is one of the principle concepts of Adlerian theory, and has implications for the understanding of chemical addiction. Adler premised that it was the individual's interpretation of his/her birth circumstances that was more important than sequential birth order. This study examined whether…

  8. Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management.

    Science.gov (United States)

    Taavoni, Simin; Sheikhan, Fatemeh; Abdolahian, Somayeh; Ghavi, Fatemeh

    2016-08-01

    Labor pain and its management is a major concern for childbearing women, their families and health care providers. This study aimed to investigate the effects of two non-pharmacological methods such as birth ball and heat therapy on labor pain relief. This randomized control trial was undertaken on 90 primiparous women aged 18-35 years old who were randomly assigned to two intervention (birth ball and heat) and control groups. The pain score was recorded by using Visual Analogue Scale (VAS) before the intervention and every 30 min in three groups until cervical dilatation reached 8 cm. The mean pain severity score in the heat therapy group was less than that of in control group at 60 and 90 min after intervention (p pain scores in the birth ball group after all three investigated times in comparison to control group. Both heat therapy and birth ball can use as inexpensive complementary and low risk treatment for labor pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Prediction of low birth weight from other anthropometric parameters ...

    African Journals Online (AJOL)

    Background: Low birth weight is a global problem but presents a major burden on the neonatal services in developing countries such as Nigeria, and brings to bear a greater strain on the meagre resources available for health care delivery and family financing. In a resourceconstrained setting as ours, proper weighing of all ...

  10. Management and outcome of extremely low birth weight infants

    Directory of Open Access Journals (Sweden)

    Apostolos Papageorgiou

    2014-06-01

    Full Text Available Survival of extremely low birth weight (ELBW and extremely premature (EP infants has shown consistent improvement thanks to advances and innovations in perinatal and neonatal care. Regionalization, with high-risk deliveries in a tertiary perinatal center, offers the coordinated, collaborative, expert and specialized care needed by these mothers and their infants. Despite decreasing rates of the major neonatal morbidities observed in recent years, these continue still to be significant for ELBW/EP infants, impacting their overall prognosis. After NICU discharge and in the first years of life, issues with health, growth and development are common. In school age and adolescence, problems with behavior, socialization and cognition are prevalent. Adult outcomes of ELBW/EP need further clarity, emphasizing the importance for consistent long-term follow-up for this special cohort. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  11. Influence of birth order, birth weight, colostrum and serum immunoglobulin G on neonatal piglet survival.

    Science.gov (United States)

    Cabrera, Rafael A; Lin, Xi; Campbell, Joy M; Moeser, Adam J; Odle, Jack

    2012-12-23

    Intake of colostrum after birth is essential to stimulate intestinal growth and function, and to provide systemic immunological protection via absorption of Immunoglobulin G (IgG). The birth order and weight of 745 piglets (from 75 litters) were recorded during a one-week period of farrowing. Only pigs weighing greater than 0.68 kg birth weight were chosen for the trial. Sow colostrum was collected during parturition, and piglets were bled between 48 and 72 hours post-birth. Piglet serum IgG and colostral IgG concentrations were determined by radial immunodiffusion. Sow parity had a significant (P birth order accounted for another 4% of the variation observed in piglet serum IgG concentration (P birth weight had no detectable effect. Piglet serum IgG concentration had both a linear (P Birth order had no detectable effect on survival, but birth weight had a positive linear effect (P birth had a 68% survival rate, and those weighing 1.6 kg (n = 158) had an 89% survival. We found that the combination of sow colostrum IgG concentration and birth order can account for 10% of the variation of piglet serum IgG concentration and that piglets with less than 1,000 mg/dl IgG serum concentration and weight of 0.9 kg at birth had low survival rate when compared to their larger siblings. The effective management of colostrum uptake in neonatal piglets in the first 24 hrs post-birth may potentially improve survival from birth to weaning.

  12. Association between Birth Characteristics and Cardiovascular Autonomic Function at Mid-Life.

    Directory of Open Access Journals (Sweden)

    Nelli Perkiömäki

    Full Text Available Low birth weight is associated with an increased risk of cardiovascular diseases in adulthood. As abnormal cardiac autonomic function is a common feature in cardiovascular diseases, we tested the hypothesis that low birth weight may also be associated with poorer cardiac autonomic function in middle-aged subjects.At the age of 46, the subjects of the Northern Finland Birth Cohort 1966 were invited to examinations including questionnaires about health status and life style and measurement of vagally-mediated heart rate variability (rMSSD from R-R intervals (RRi and spontaneous baroreflex sensitivity (BRS in both seated and standing positions. Maternal parameters had been collected in 1965-1966 since the 16th gestational week and birth variables immediately after delivery. For rMSSD, 1,799 men and 2,279 women without cardiorespiratory diseases and diabetes were included and 902 men and 1,020 women for BRS. The analyses were adjusted for maternal (age, anthropometry, socioeconomics, parity, gestational smoking and adult variables (life style, anthropometry, blood pressure, glycemic and lipid status potentially confounding the relationship between birth weight and autonomic function.In men, birth weight correlated negatively with seated (r = -0.058, p = 0.014 and standing rMSSD (r = -0.090, p<0.001, as well as with standing BRS (r = -0.092, p = 0.006. These observations were verified using relevant birth weight categories (<2,500 g; 2,500-3,999 g; ≥4,000 g. In women, birth weight was positively correlated with seated BRS (r = 0.081, p = 0.010, but none of the other measures of cardiovascular autonomic function. These correlations remained significant after adjustment for potential confounders (p<0.05 for all.In men, higher birth weight was independently associated with poorer cardiac autonomic function at mid-life. Same association was not observed in women. Our findings suggest that higher, not lower, birth weight in males may contribute to less

  13. Birth Defects (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Birth Defects KidsHealth / For Parents / Birth Defects What's in ... Prevented? Print en español Anomalías congénitas What Are Birth Defects? While still in the womb, some babies ...

  14. Birth defects risk associated with maternal sport fish consumption: potential effect modification by sex of offspring.

    Science.gov (United States)

    Mendola, Pauline; Robinson, Luther K; Buck, Germaine M; Druschel, Charlotte M; Fitzgerald, Edward F; Sever, Lowell E; Vena, John E

    2005-02-01

    Contaminated sport fish consumption may result in exposure to various reproductive and developmental toxicants, including pesticides and other suspected endocrine disruptors. We investigated the relation between maternal sport fish meals and risk of major birth defects among infants born to members of the New York State (NYS) Angler Cohort between 1986 and 1991 (n=2237 births). Birth defects (n=125 cases) were ascertained from both newborn medical records and the NYS Congenital Malformations Registry. For sport fish meals eaten during pregnancy, the odds ratio (OR) for all major malformations combined was slightly elevated for or =2 meals/month (OR=1.51, CI=0.74, 3.09), with no meals during pregnancy as the reference category. Higher ORs were consistently observed among male offspring compared with females. For > or =2 meals/month, the risk for males was significantly elevated (males: OR=3.01, CI: 1.2, 7.5; females: OR=0.73, CI: 0.2, 2.4). Exposure during pregnancy and effect modification by infants sex could be important considerations for future studies of birth outcomes associated with endocrine disruptors.

  15. Birth Control

    Science.gov (United States)

    ... even if you aren’t going for birth control. What doesn’t work to prevent pregnancy? top It’s ... and taking care of a baby’s many needs. What if I need birth control in an emergency? top Emergency contraception (EC) is ...

  16. Vascular Alterations Underlie Developmental Problems Manifested in Cloned Cattle before or after Birth

    Science.gov (United States)

    Favaron, Phelipe Oliveira; dos Santos, Caio Rodrigues; Alberto, Miryan Lanca; Meirelles, Flavio Vieira; Miglino, Maria Angelica

    2015-01-01

    Although assisted reproductive techniques are commonly applied in humans and animals, they are frequently associated with major developmental deficits and reduced viability. To explore abnormalities associated with cloning or nuclear transfer (NT) as the most invasive of these methods, we used a bovine model to characterize abnormalities. Detailed necropsy examinations were done on 13 calves that died soon after birth; in addition, we included data from embryos and fetuses (produced by NT) that terminated prematurely. Bovine clones that survived until the neonatal period differed quantitatively and qualitatively from in-vivo-derived cattle. Although alterations affected a variety of organs (e.g. heart, lung and liver), there was a clear association with abberant vascular developmental during the early intrauterine phase. Therefore, we concluded that vascular problems were key alterations induced by cloning (presumably via epigenetic modifications). PMID:25584533

  17. Risk factors and birth prevalence of birth defects and inborn errors of ...

    African Journals Online (AJOL)

    Children with any birth defect or metabolic errors of metabolism at birth or in the neonatology section were our sample for study. Control group was randomly selected from the cases with normal live births. Blood tests were performed for children suspected to suffer from genetic blood disorders. The principal BD as per the ...

  18. Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth

    DEFF Research Database (Denmark)

    Edqvist, Malin; Blix, Ellen; Hegaard, Hanne K

    2016-01-01

    at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. METHODS: A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth...... by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. RESULTS: Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included.......26-1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10-0.54). CONCLUSION: A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum...

  19. Maternal attitudes towards home birth and their effect on birth outcomes in Iceland: A prospective cohort study.

    Science.gov (United States)

    Halfdansdottir, Berglind; Olafsdottir, Olof A; Hildingsson, Ingegerd; Smarason, Alexander Kr; Sveinsdottir, Herdis

    2016-03-01

    to examine the relationship between attitudes towards home birth and birth outcomes, and whether women's attitudes towards birth and intervention affected this relationship. a prospective cohort study. the study was set in Iceland, a sparsely populated island with harsh terrain, 325,000 inhabitants, high fertility and home birth rates, and less than 5000 births a year. a convenience sample of women who attended antenatal care in Icelandic health care centres, participated in the Childbirth and Health Study in 2009-2011, and expressed consistent attitudes towards home birth (n=809). of the participants, 164 (20.3%) expressed positive attitudes towards choosing home birth and 645 (79.7%) expressed negative attitudes. Women who had a positive attitude towards home birth had significantly more positive attitudes towards birth and more negative attitudes towards intervention than did women who had a negative attitude towards home birth. Of the 340 self-reported low-risk women that answered questionnaires on birth outcomes, 78 (22.9%) had a positive attitude towards home birth and 262 (77.1%) had a negative attitude. Oxytocin augmentation (19.2% (n=15) versus 39.1% (n=100)), epidural analgesia (19.2% (n=15) versus 33.6% (n=88)), and neonatal intensive care unit admission rates (0.0% (n=0) versus 5.0% (n=13)) were significantly lower among women who had a positive attitude towards home birth. Women's attitudes towards birth and intervention affected the relationship between attitudes towards home birth and oxytocin augmentation or epidural analgesia. the beneficial effect of planned home birth on maternal outcome in Iceland may depend to some extent on women's attitudes towards birth and intervention. Efforts to de-stigmatise out-of-hospital birth and de-medicalize women's attitudes towards birth might increase women׳s use of health-appropriate birth services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. 'Reacting to the unknown': experiencing the first birth at home or in hospital in Australia.

    Science.gov (United States)

    Dahlen, Hannah G; Barclay, Lesley; Homer, Caroline S E

    2010-08-01

    to explore the experiences of a small group of first-time mothers giving birth at home or in hospital. a grounded theory methodology was used. Data were generated from in-depth interviews with women in their own homes. Sydney, Australia. 19 women were interviewed. Seven women who gave birth for the first time in a public hospital and seven women who gave birth for the first time at home were interviewed, and their experiences were contrasted with two mothers who gave birth for the first time in a birth centre, one mother who gave birth for the first time in a private hospital and two women who had given birth more than once. these women shared common experiences of giving birth as 'novices'. Regardless of birth setting, they were all 'reacting to the unknown'. As they entered labour, the women chose different levels of responsibility for their birth. They also readjusted their expectations when the reality of labour occurred, reacted to the 'force' of labour, and connected or disconnected from the labour and eventually the baby. knowing that first-time mothers, irrespective of birth setting, are essentially 'reacting to the unknown' as they negotiate the experience of birth, could alter the way in which care is provided and increase the sensitivity of midwives to women's needs. Most importantly, midwives need to be aware of the need to help women adjust their expectations during labour and birth. Identifying the 'novice' status of first-time mothers also better explains previous research that reports unrealistic expectations and fear that may be associated with first-time birthing. Crown Copyright 2008. Published by Elsevier Ltd. All rights reserved.

  1. Birth Settings and the Validation of Neonatal Seizures Recorded in Birth Certificates Compared to Medicaid Claims and Hospital Discharge Abstracts Among Live Births in South Carolina, 1996-2013.

    Science.gov (United States)

    Li, Qing; Jenkins, Dorothea D; Kinsman, Stephen L

    2017-05-01

    Objective Neonatal seizures in the first 28 days of life often reflect underlying brain injury or abnormalities, and measure the quality of perinatal care in out-of-hospital births. Using the 2003 revision of birth certificates only, three studies reported more neonatal seizures recorded among home births ​or planned out-of-hospital births compared to hospital births. However, the validity of recording neonatal seizures or serious neurologic dysfunction across birth settings in birth certificates has not been evaluated. We aimed to validate seizure recording in birth certificates across birth settings using multiple datasets. Methods We examined checkbox items "seizures" and "seizure or serious neurologic dysfunction" in the 1989 and 2003 revisions of birth certificates in South Carolina from 1996 to 2013. Gold standards were ICD-9-CM codes 779.0, 345.X, and 780.3 in either hospital discharge abstracts or Medicaid encounters jointly. Results Sensitivity, positive predictive value, false positive rate, and the kappa statistic of neonatal seizures recording were 7%, 66%, 34%, and 0.12 for the 2003 revision of birth certificates in 547,177 hospital births from 2004 to 2013 and 5%, 33%, 67%, and 0.09 for the 1998 revision in 396,776 hospital births from 1996 to 2003, and 0, 0, 100%, -0.002 among 660 intended home births from 2004 to 2013 and 920 home births from 1996 to 2003, respectively. Conclusions for Practice Despite slight improvement across revisions, South Carolina birth certificates under-reported or falsely reported seizures among hospital births and especially home births. Birth certificates alone should not be used to measure neonatal seizures or serious neurologic dysfunction.

  2. VAGINAL PROGESTERONE VERSUS CERVICAL CERCLAGE FOR THE PREVENTION OF PRETERM BIRTH IN WOMEN WITH A SONOGRAPHIC SHORT CERVIX, SINGLETON GESTATION, AND PREVIOUS PRETERM BIRTH: A SYSTEMATIC REVIEW AND INDIRECT COMPARISON META-ANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustin; ROMERO, Roberto; NICOLAIDES, Kypros; CHAIWORAPONGSA, Tinnakorn; O'BRIEN, John M.; CETINGOZ, Elcin; DA FONSECA, Eduardo; CREASY, George; SOMA-PILLAY, Priya; FUSEY, Shalini; CAM, Cetin; ALFIREVIC, Zarko; HASSAN, Sonia S.

    2012-01-01

    OBJECTIVE No randomized controlled trial has directly compared vaginal progesterone and cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous spontaneous preterm birth. We performed an indirect comparison of vaginal progesterone versus cerclage, using placebo/no cerclage as the common comparator. STUDY DESIGN Adjusted indirect meta-analysis of randomized controlled trials. RESULTS Four studies evaluating vaginal progesterone versus placebo (158 patients) and five evaluating cerclage versus no cerclage (504 patients) were included. Both interventions were associated with a statistically significant reduction in the risk of preterm birth <32 weeks of gestation and composite perinatal morbidity and mortality compared with placebo/no cerclage. Adjusted indirect meta-analyses did not show statistically significant differences between vaginal progesterone and cerclage in reducing preterm birth or adverse perinatal outcomes. CONCLUSION Based on state-of-the-art methodology for indirect comparisons, either vaginal progesterone or cerclage are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous preterm birth. The selection of the optimal treatment may depend upon adverse events, cost and patient/clinician preferences. PMID:23157855

  3. Differences in optimality index between planned place of birth in a birth centre and alternative planned places of birth, a nationwide prospective cohort study in The Netherlands: results of the Dutch Birth Centre Study

    NARCIS (Netherlands)

    Hermus, M.A.A.; Hitzert, M.; Boesveld, I.I.; Akker-van Marle, E.M. van den; Dommelen, P. van; Franx, A.; Graaf, J.P. de; Lith, J.M.M. van; Steegers, E.E.; Wiegers, T.A.; Pal-de Bruin, K.K. van der

    2017-01-01

    Objectives To compare the Optimality Index of planned birth in a birth centre with planned birth in a hospital and planned home birth for low-risk term pregnant women who start labour under the responsibility of a community midwife. Design Prospective cohort study. Setting Low-risk pregnant women

  4. Common symptoms during pregnancy to predict depression and health status 14 years post partum.

    Science.gov (United States)

    Khatun, Mohsina; Clavarino, Alexandra M; Callaway, Leonie; Alati, Rosa; Najman, Jake M; Williams, Gail; Al Mamun, Abdullah

    2009-03-01

    To examine the prospective association between symptoms commonly experienced during pregnancy and the mental and general health status of women 14 years post partum. Data used were from the Mater-University of Queensland Study of Pregnancy, a community-based prospective birth cohort study begun in Brisbane, Australia, in 1981. Logistic regression analyses were conducted. Data were available for 5118 women. Women who experienced a higher burden of symptoms during pregnancy were at greater risk of becoming depressed and reporting poorer health status 14 years post partum. Women who experienced major problems during pregnancy were 4 times more likely to be depressed and nearly 8 times more likely to report poorer health status 14 years after the index pregnancy compared with women who experienced few problems. Findings suggest that pregnant women who experience common symptoms during pregnancy are likely to experience poorer mental and self-reported general health 14 years after the pregnancy.

  5. Does tea consumption during early pregnancy have an adverse effect on birth outcomes?

    Science.gov (United States)

    Lu, Jin-Hua; He, Jian-Rong; Shen, Song-Ying; Wei, Xue-Ling; Chen, Nian-Nian; Yuan, Ming-Yang; Qiu, Lan; Li, Wei-Dong; Chen, Qiao-Zhu; Hu, Cui-Yue; Xia, Hui-Min; Bartington, Suzanne; Cheng, Kar Keung; Lam, Kin Bong Hubert; Qiu, Xiu

    2017-09-01

    Tea, a common beverage, has been suggested to exhibit a number of health benefits. However, one of its active ingredients, caffeine, has been associated with preterm birth and low birthweight. We investigated whether tea consumption during early pregnancy is associated with an increased risk of preterm birth and abnormal fetal growth. A total of 8775 pregnant women were included from the Born in Guangzhou Cohort Study. Tea consumption (type, frequency, and strength) during their first trimester and social and demographic factors were obtained by way of questionnaires administered during pregnancy. Information on birth outcomes and complications during pregnancy was obtained from hospital medical records. Overall habitual tea drinking (≥1 serving/week) prevalence among pregnant women was low, at 16%. After adjustment for potential confounding factors (eg, maternal age, educational level, monthly income) tea drinking during early pregnancy was not associated with an increased risk of preterm birth or abnormal fetal growth (small or large for gestational age) (P>.05). We did not identify a consistent association between frequency of tea consumption or tea strength and adverse birth outcomes among Chinese pregnant women with low tea consumption. Our findings suggest that occasional tea drinking during pregnancy is not associated with increased risk of preterm birth or abnormal fetal growth. Given the high overall number of annual births in China, our findings have important public health significance. © 2017 Wiley Periodicals, Inc.

  6. Atopy risk factors at birth and in adulthood.

    Science.gov (United States)

    Ferraz, Erica; Garcia, Clécia Aparecida; Bettiol, Heloísa; Caldeira, Roseane Durães; Cardoso, Viviane Cunha; Arruda, Luiza Karla; Barbieri, Marco Antônio; Vianna, Elcio Oliveira

    2011-01-01

    To study the association between atopy and variables such as weight, length, and socioeconomic level at birth and in young adulthood. A total of 2,063 subjects were investigated in a prospective birth cohort study of individuals born in Ribeirão Preto, Brazil, in 1978/1979, and examined at the age of 23-25 years. Skin prick tests (SPT) for eight common allergens in Brazil were performed. Subjects with a wheal reaction ≥ 3 mm to one or more of the eight allergens tested were considered to be atopic. We used the log-binomial model (generalized linear model) in order to assess the association between atopy and birth or adult variables. The prevalence of positive SPT was 47.6%. Male gender was associated with an increased risk of atopy (relative risk [RR] = 1.18; 95% confidence interval [95%CI] 1.07-1.30). Low level of schooling was a protective factor against atopy, with a RR = 0.74; 95%CI 0.62-0.89. Living with a smoker in childhood was also associated with lower risk of atopy (RR = 0.87; 95%CI 0.79-0.96). Birth weight, length and order, maternal age, and intrauterine growth restriction were not associated with positive SPT. This study showed that male gender was associated with an increased risk of atopy. Low socioeconomic status, assessed by low level of schooling, was a protective factor against atopy. These data agree with the hygiene hypothesis.

  7. Cardiovascular transition at birth: a physiological sequence.

    Science.gov (United States)

    Hooper, Stuart B; Te Pas, Arjan B; Lang, Justin; van Vonderen, Jeroen J; Roehr, Charles Christoph; Kluckow, Martin; Gill, Andrew W; Wallace, Euan M; Polglase, Graeme R

    2015-05-01

    The transition to newborn life at birth involves major cardiovascular changes that are triggered by lung aeration. These include a large increase in pulmonary blood flow (PBF), which is required for pulmonary gas exchange and to replace umbilical venous return as the source of preload for the left heart. Clamping the umbilical cord before PBF increases reduces venous return and preload for the left heart and thereby reduces cardiac output. Thus, if ventilation onset is delayed following cord clamping, the infant is at risk of superimposing an ischemic insult, due to low cardiac output, on top of an asphyxic insult. Much debate has centered on the timing of cord clamping at birth, focusing mainly on the potential for a time-dependent placental to infant blood transfusion. This has prompted recommendations for delayed cord clamping for a set time after birth in infants not requiring resuscitation. However, recent evidence indicates that ventilation onset before cord clamping mitigates the adverse cardiovascular consequences caused by immediate cord clamping. This indicates that the timing of cord clamping should be based on the infant's physiology rather than an arbitrary period of time and that delayed cord clamping may be of greatest benefit to apneic infants.

  8. roles of traditional birth attendants and perceptions on the policy

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... the perceptions of TBAs and Skilled Birth Attendants (SBAs) towards the policy discouraging home ... improve maternal health, with the targets of reducing maternal ... Asia, where the majority of maternal deaths occur (3). These two ..... The SBA, with an attitude of cultural humility, could learn from the.

  9. Translating in the public sphere: Birth pangs of a developing ...

    African Journals Online (AJOL)

    Translating in the public sphere: Birth pangs of a developing democracy in today's Russia. ... the article considers the dramatic consequences of the failure to give full consideration to translation as a major factor in the public sphere, especially in countries with developing democracies, such as present-day Putinite Russia.

  10. Birth Order and Child Health

    OpenAIRE

    Lundberg, Evelina; Svaleryd, Helena

    2017-01-01

    Previous research has established that birth order affects outcomes such as educational achievements, IQ and earnings. The mechanisms behind these effects are, however, still largely unknown. In this paper, we examine birth-order effects on health, and whether health at young age could be a transmission channel for birth-order effects observed later in life. We find no support for the birth-order effect having a biological origin; rather firstborns have worse health at birth. This disadvantag...

  11. Demographic and Socio-economic Determinants of Birth Interval Dynamics in Manipur: A Survival Analysis

    Directory of Open Access Journals (Sweden)

    Sanajaoba Singh N,

    2011-01-01

    Full Text Available The birth interval is a major determinant of levels of fertility in high fertility populations. A house-to-house survey of 1225 women in Manipur, a tiny state in North Eastern India was carried out to investigate birth interval patterns and its determinants. Using survival analysis, among the nine explanatory variables of interest, only three factors – infant mortality, Lactation and use of contraceptive devices have highly significant effect (P<0.01 on the duration of birth interval and only three factors – age at marriage of wife, parity and sex of child are found to be significant (P<0.05 on the duration variable.

  12. Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician.

    Science.gov (United States)

    Janssen, Patricia A; Saxell, Lee; Page, Lesley A; Klein, Michael C; Liston, Robert M; Lee, Shoo K

    2009-09-15

    Studies of planned home births attended by registered midwives have been limited by incomplete data, nonrepresentative sampling, inadequate statistical power and the inability to exclude unplanned home births. We compared the outcomes of planned home births attended by midwives with those of planned hospital births attended by midwives or physicians. We included all planned home births attended by registered midwives from Jan. 1, 2000, to Dec. 31, 2004, in British Columbia, Canada (n = 2889), and all planned hospital births meeting the eligibility requirements for home birth that were attended by the same cohort of midwives (n = 4752). We also included a matched sample of physician-attended planned hospital births (n = 5331). The primary outcome measure was perinatal mortality; secondary outcomes were obstetric interventions and adverse maternal and neonatal outcomes. The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00-1.03) in the group of planned home births; the rate in the group of planned hospital births was 0.57 (95% CI 0.00-1.43) among women attended by a midwife and 0.64 (95% CI 0.00-1.56) among those attended by a physician. Women in the planned home-birth group were significantly less likely than those who planned a midwife-attended hospital birth to have obstetric interventions (e.g., electronic fetal monitoring, relative risk [RR] 0.32, 95% CI 0.29-0.36; assisted vaginal delivery, RR 0.41, 95% 0.33-0.52) or adverse maternal outcomes (e.g., third- or fourth-degree perineal tear, RR 0.41, 95% CI 0.28-0.59; postpartum hemorrhage, RR 0.62, 95% CI 0.49-0.77). The findings were similar in the comparison with physician-assisted hospital births. Newborns in the home-birth group were less likely than those in the midwife-attended hospital-birth group to require resuscitation at birth (RR 0.23, 95% CI 0.14-0.37) or oxygen therapy beyond 24 hours (RR 0.37, 95% CI 0.24-0.59). The findings were similar in the comparison with

  13. Is low cognitive functioning a predictor or consequence of major depressive disorder? A test in two longitudinal birth cohorts.

    Science.gov (United States)

    Schaefer, Jonathan D; Scult, Matthew A; Caspi, Avshalom; Arseneault, Louise; Belsky, Daniel W; Hariri, Ahmad R; Harrington, Honalee; Houts, Renate; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E

    2017-11-16

    Cognitive impairment has been identified as an important aspect of major depressive disorder (MDD). We tested two theories regarding the association between MDD and cognitive functioning using data from longitudinal cohort studies. One theory, the cognitive reserve hypothesis, suggests that higher cognitive ability in childhood decreases risk of later MDD. The second, the scarring hypothesis, instead suggests that MDD leads to persistent cognitive deficits following disorder onset. We tested both theories in the Dunedin Study, a population-representative cohort followed from birth to midlife and assessed repeatedly for both cognitive functioning and psychopathology. We also used data from the Environmental Risk Longitudinal Twin Study to test whether childhood cognitive functioning predicts future MDD risk independent of family-wide and genetic risk using a discordant twin design. Contrary to both hypotheses, we found that childhood cognitive functioning did not predict future risk of MDD, nor did study members with a past history of MDD show evidence of greater cognitive decline unless MDD was accompanied by other comorbid psychiatric conditions. Our results thus suggest that low cognitive functioning is related to comorbidity, but is neither an antecedent nor an enduring consequence of MDD. Future research may benefit from considering cognitive deficits that occur during depressive episodes from a transdiagnostic perspective.

  14. Low birth weight infants and Calmette-Guérin bacillus vaccination at birth

    DEFF Research Database (Denmark)

    Roth, Adam Anders Edvin; Jensen, Henrik; Garly, May-Lill

    2004-01-01

    In developing countries, low birth weight (LBW) children are often not vaccinated with Calmette-Guérin bacillus (BCG) at birth. Recent studies have suggested that BCG may have a nonspecific beneficial effect on infant mortality. We evaluated the consequences of not vaccinating LBW children at birth...

  15. Common variation in ISL1 confers genetic susceptibility for human congenital heart disease.

    Directory of Open Access Journals (Sweden)

    Kristen N Stevens

    Full Text Available Congenital heart disease (CHD is the most common birth abnormality and the etiology is unknown in the overwhelming majority of cases. ISLET1 (ISL1 is a transcription factor that marks cardiac progenitor cells and generates diverse multipotent cardiovascular cell lineages. The fundamental role of ISL1 in cardiac morphogenesis makes this an exceptional candidate gene to consider as a cause of complex congenital heart disease. We evaluated whether genetic variation in ISL1 fits the common variant-common disease hypothesis. A 2-stage case-control study examined 27 polymorphisms mapping to the ISL1 locus in 300 patients with complex congenital heart disease and 2,201 healthy pediatric controls. Eight genic and flanking ISL1 SNPs were significantly associated with complex congenital heart disease. A replication study analyzed these candidate SNPs in 1,044 new cases and 3,934 independent controls and confirmed that genetic variation in ISL1 is associated with risk of non-syndromic congenital heart disease. Our results demonstrate that two different ISL1 haplotypes contribute to risk of CHD in white and black/African American populations.

  16. Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-02-01

    We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home). Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility. A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores. Copyright 2010 Mosby, Inc. All rights reserved.

  17. Efficacy of prophylactic phototherapy for prevention of hyperbilirubinemia in very low birth weight newborns

    Directory of Open Access Journals (Sweden)

    M. A. Mannan

    2016-08-01

    Full Text Available Background: Jaundice is a common clinical condition in newborn occurring in approximately 60% of term and 80% of preterm infants. Unconjugated hyperbilirubinemia is universally common in all preterm infants especially in newborns with very low biLth weight. Low birth weight and premature infants are at major risk for exaggerated hyperbilirubinemia that can lead to bilirubin encephalopathy. Significant heterogeneity in the approach to the treatment of jaundiced neonates exists throughout the world. Phototherapy is the most common treatment for neonatal hyperbilirubinemia and could be most effective in preventing the sequelae of hyperbilirubinemia if initiated prophylactically. This randomized clinical trial has been proposed with the objective of assessing the efficacy of prophylactic photo therapy in preventing significant rise of unconjugated hyperbilirubinemia in premature neonates weighing less than 1500 gram and therefore to decrease the need for exchange transfusion and finally to reduce hospital stay due to hyperbilirubinemia. Methods: This randomized controlled clinical trial enrolled sixty newborns with birth weight less than 1500 gram. They were divided into two groups: 1 Prophylactic group, in whom phototherapy was started within 24 hours of birth and continued for 7 days and 2 Control group in whom therapeutic phototherapy was started considering serum bilirubin level and other clinical condi­tions as per institutional guidelines. Mean value of total serum bilirubin (TSB, duration of phototherapy, the need for exchange transfusion and duration of hospital stay in both groups were analyzed.Results: The maximum mean TSB level in prophylactic group was observed on 7th day and in control group it was observed on 3rd day of life. The total serum bilirubin levels were significantly lower in the 3rd and 5th days of life in the prophylactic group in comparison to control group (P value 0.001. Total serum bilirubin level exceeded therapeutic

  18. The relationships among acculturation, biobehavioral risk, stress, corticotropin-releasing hormone, and poor birth outcomes in Hispanic women.

    Science.gov (United States)

    Ruiz, R Jeanne; Dolbier, Christyn L; Fleschler, Robin

    2006-01-01

    To determine the predictive ability of acculturation as an antecedent of stress, biobehavioral risk, corticotropin-releasing hormone levels, and poor birth outcomes in pregnant Hispanic women. A prospective, observational design with data collected at 22-25 weeks of gestation and at birth through medical record review. Public prenatal health clinics in south Texas serving low-income women. Self-identified Hispanic women who had singleton pregnancies, no major medical risk complications, and consented to answer questionnaires as well as a venipuncture and review of their prenatal and birth medical records. Gestational age, Apgar scores, length, weight, percentile size, and head circumference of the infant at birth. Significant differences were seen in infant birth weight, head circumference, and percentile size by acculturation. English acculturation predicted stress, corticotropin-releasing hormone, biobehavioral risk, and decreased gestational age at birth. Investigation must continue to understand the circumstances that give rise to the decline in birth outcomes observed in Hispanics with acculturation to the dominant English culture in the United States.

  19. Birth Control Shot

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Shot KidsHealth / For Teens / Birth Control Shot What's ...

  20. Birth Control Ring

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Ring KidsHealth / For Teens / Birth Control Ring What's ...

  1. Birth Control Pill

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Pill KidsHealth / For Teens / Birth Control Pill What's ...

  2. Birth Control Patch

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Patch KidsHealth / For Teens / Birth Control Patch What's ...

  3. Physical violence during pregnancy: maternal complications and birth outcomes.

    Science.gov (United States)

    Cokkinides, V E; Coker, A L; Sanderson, M; Addy, C; Bethea, L

    1999-05-01

    To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes. We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of "partner-inflicted physical hurt and being involved in a physical fight." Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes. The prevalence of physical violence was 11.1%. Among women who experienced physical violence, 54% reported having been involved in physical fights only and 46% had been hurt by husbands or partners. In the latter group, 70% also reported having been involved in fighting. Compared with those not reporting physical violence, women who did were more likely to deliver by cesarean and be hospitalized before delivery for maternal complications such as kidney infection, premature labor, and trauma due to falls or blows to the abdomen. Physical violence during the 12 months before delivery is common and is associated with adverse maternal conditions. The findings support the need for research on how to screen for physical violence early in pregnancy and to prevent its consequences.

  4. Narcissism and birth order.

    Science.gov (United States)

    Eyring, W E; Sobelman, S

    1996-04-01

    The purpose of this investigation was to clarify the relationship between birth-order position and the development of narcissism, while refining research and theory. The relationship between birth-order status and narcissism was examined with a sample of 79 undergraduate students (55 women and 24 men). These subjects were placed in one of the four following birth-order categories of firstborn, second-born, last-born, and only children. These categories were chosen given their significance in Adlerian theory. Each subject completed the Narcissistic Personality Inventory and a demographic inventory. Based on psychodynamic theory, it was hypothesized that firstborn children were expected to score highest, but statistical significance was not found for an association between narcissism and birth order. Further research is urged to investigate personality theory as it relates to parenting style and birth order.

  5. Births: final data for 2004.

    Science.gov (United States)

    Martin, Joyce A; Hamilton, Brady E; Sutton, Paul D; Ventura, Stephanie J; Menacker, Fay; Kirmeyer, Sharon

    2006-09-29

    This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise

  6. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2012-01-31

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  7. Secondary recurrent miscarriage is associated with previous male birth.

    LENUS (Irish Health Repository)

    Ooi, Poh Veh

    2011-01-01

    Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53\\/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32\\/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78\\/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16\\/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19\\/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13\\/32 vs. 6\\/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level.

  8. Geometric ergodicity and quasi-stationarity in discrete-time birth-death processes

    NARCIS (Netherlands)

    van Doorn, Erik A.; Schrijner, Pauline

    1995-01-01

    We study two aspects of discrete-time birth-death processes, the common feature of which is the central role played by the decay parameter of the process. First, conditions for geometric ergodicity and bounds for the decay parameter are obtained. Then the existence and structure of quasi-stationary

  9. Effect of multiple micronutrient supplementation during pregnancy on maternal and birth outcomes

    Directory of Open Access Journals (Sweden)

    Yakoob Mohammad

    2011-04-01

    , the SGA outcome remained significant only in women with mean body mass index (BMI ≥ 22 kg/m2. There was an increased risk of neonatal mortality in studies with majority of births at home [RR = 1.47, 95% CI: 1.13-1.92]; such an effect was not evident where ≥ 60% of births occurred in facility settings [RR = 0.94, 95% CI: 0.81-1.09]. Overall there was no increase in the risk of neonatal mortality [RR = 1.05, 95% CI: 0.92 – 1.19 (fixed model]. Conclusion This review provides evidence of a significant benefit of MMN supplementation during pregnancy on reducing SGA births as compared to iron-folate, with no significant increase in the risk of neonatal mortality in populations where skilled birth care is available and majority of births take place in facilities. Given comparability of impacts on maternal anemia, the decision to replace iron-folate with multiple micronutrients during pregnancy may be taken in the context of available services in health systems and birth outcomes monitored.

  10. Transfer in planned home births in Sweden--effects on the experience of birth: a nationwide population-based study.

    Science.gov (United States)

    Lindgren, Helena E; Rådestad, Ingela J; Hildingsson, Ingegerd M

    2011-08-01

    More than 10% of all planned home births in high-income countries are completed in the hospital. The aim of this study was to compare the birth experiences among women who planned to give birth at home and completed the birth at home and women who were transferred to hospital during or immediately after the birth. All women in Sweden who had a planned home birth between 1998 and 2005 (n=671) were invited to participate in the study. The women who agreed to participate received one questionnaire for each planned home birth. Mixed methods were used for the analysis. Women who had been transferred during or immediately after the planned home birth had a more negative birth experience in general. In comparison with women who completed the birth at home, the odds ratio for being less satisfied was 13.5, CI 8.1-22.3. Reasons for being dissatisfied related to organizational factors, the way the women were treated or personal ability. Being transferred during a planned home birth negatively affects the birth experience. Treatments as well as organizational factors are considered to be obstacles for a positive birth experience when transfer is needed. Established links between the home birth setting and the hospital might enhance the opportunity for a positive birth experience irrespective of where the birth is completed. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Safety Culture to Prevent Infection in Normal Birth Care by Village Midwives Ateast Lombok Nusa Tenggara Barat

    OpenAIRE

    Bartini, Istri

    2015-01-01

    Background: Normal birth care is one of midwife's competence within the most of risks to both women and midwife. Limited of health facilities and social culture are major problem of midwifery care. In fact, infection cases have been occurring and become a significant cause in maternal death. At East Lombok most of 93,33% birth was provided by midwife. It was a tricky to explain that midwife does not work as well.Aim: to describe safety culture to prevent infection during normal birth care at ...

  12. Analysis of premature births for the period from 2009. to 2013. in Health Center Kosovska Mitrovica

    Directory of Open Access Journals (Sweden)

    Adžić V.

    2015-01-01

    Full Text Available Delivery before 37th week of gestation is defined as preterm, independently of body mass of babies, according to the World Health Organization. Premature birth is the current problem in the world due to the high risk of neonatal morbidity and mortality and incompletely clear etiology. In our country the frequency of preterm delivery is 6%. We have retrospectively analyzed early deliveries in Health Center Kosovska Mitrovica in the period from 2009 to 2013. In this five-year period, there were totaly 3398 deliveries, of which 148 or 4.35 % were preterm delivery. The aim of this study was to investigate the incidence of premature birth in the five-year period in relation to: the total number of births in a given period, the age of the patients, the manner of completion of delivery, gestational week of pregnancy, parity and the most common causes that led to the PTP. In the analysis we have included the body weight and Apgar score of premature infants. We have used protocols of births, maternal history of disease, neonatal protocols and lists of newborns. Most of them were multiparas (41.2 %,56.7 % of pregnant women were aged of 21-30 years and pregnancy in 79.9 % of cases ended with 33 to 37 ng. Vaginal deliveries were completed in 84.4% of premature births, and caesarean in 15.6%. Twin pregnancies with preterm deliveries were represented in 10.2%. The most common weight of premature infants ranged from 2000 to 2500 grams (48.6 %. The most common causes that led to the PTP were PPROM (22.9 %, unknown causes (27. 1 %, multiple pregnancy (18.2 %, genital infection (8.7 %, cervical incompetence (6.7 %, IUGR (5.4%, PIH (4.2%, placental abruption and placenta previa (2.1 % and other (4.7% .

  13. Prospective study of determinants and costs of home births in Mumbai slums.

    Science.gov (United States)

    Das, Sushmita; Bapat, Ujwala; More, Neena Shah; Chordhekar, Latika; Joshi, Wasundhara; Osrin, David

    2010-07-30

    Around 86% of births in Mumbai, India, occur in healthcare institutions, but this aggregate figure hides substantial variation and little is known about urban home births. We aimed to explore factors influencing the choice of home delivery, care practices and costs, and to identify characteristics of women, households and the environment which might increase the likelihood of home birth. As part of the City Initiative for Newborn Health, we used a key informant surveillance system to identify births prospectively in 48 slum communities in six wards of Mumbai, covering a population of 280,000. Births and outcomes were documented prospectively by local women and mothers were interviewed in detail at six weeks after delivery. We examined the prevalence of home births and their associations with potential determinants using regression models. We described 1708 (16%) home deliveries among 10,754 births over two years, 2005-2007. The proportion varied from 6% to 24%, depending on area. The most commonly cited reasons for home birth were custom and lack of time to reach a healthcare facility during labour. Seventy percent of home deliveries were assisted by a traditional birth attendant (dai), and 6% by skilled health personnel. The median cost of a home delivery was US$ 21, of institutional delivery in the public sector US$ 32, and in the private sector US$ 118. In an adjusted multivariable regression model, the odds of home delivery increased with illiteracy, parity, socioeconomic poverty, poorer housing, lack of water supply, population transience, and hazardous location. We estimate 32,000 annual home births to residents of Mumbai's slums. These are unevenly distributed and cluster with other markers of vulnerability. Since cost does not appear to be a dominant disincentive to institutional delivery, efforts are needed to improve the client experience at public sector institutions. It might also be productive to concentrate on intensive outreach in vulnerable areas by

  14. Birthing the Pill at the University of Vermont (1970-1976)

    Science.gov (United States)

    Christmas, William A.; Schultz, J. Donald

    2008-01-01

    The introduction of the birth control pill in 1960 precipitated 2 decades of intense social change in the United States, particularly in the area of sexuality. Colleges and universities were not immune to these changes. The author examines the struggles at 1 land-grant university to find common ground on this issue among students, faculty,…

  15. High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support

    Science.gov (United States)

    Osteopenia and rickets are common among extremely low birth weight infants (ELBW, <1000 g birth weight) despite current practices of vitamin and mineral supplementation. Few data are available evaluating the usual course of markers of mineral status in this population. Our objectives in this study w...

  16. Prevalence at birth of congenital malformations in communities near the Hanford site

    International Nuclear Information System (INIS)

    Sever, L.E.; Hessol, N.A.; Gilbert, E.S.; McIntyre, J.M.

    1988-01-01

    The authors examined the prevalence of congenital malformations among births in Benton and Franklin counties, in southeastern Washington State, from 1968 through 1980. The Hanford Site is in this area and serves as a major employer. In addition, various agriculturally and chemically related activities are in the area. Hospital and vital records were used to identify 454 malformation cases among 23,319 births; this yielded a malformation rate of 19.6 per 1000 births, a rate similar to those reported in other studies. The rates of specific malformations ascertained during the first year of life were compared with combined rates from the states of Washington, Oregon, and Idaho from the Birth Defects Monitoring Program. Among defects that would be expected to be comparably ascertained, a statistically significant elevated rate of neural tube defects was observed (1.72 per 1000 births vs. 0.99 per 1000). Rates of cleft lip were significantly lower in Benton and Franklin counties than in the Birth Defects Monitoring Program (0.59 per 1,000 vs. 1.17 per 1000). For congenital heart defects, pyloric stenosis, and Down syndrome, which are often not diagnosed in the newborn period, Birth Defects Monitoring Program data did not offer appropriate comparisons. The rates of these defects did not appear to be elevated in relation to rates found in other relevant populations. When rates of neural tube defects were compared with those in populations other than the Birth Defects Monitoring Program, the Benton and Franklin county rates were still considered to be elevated. The increased bicounty rate cannot be explained by employment of the parents at Hanford or by the impact of plant emissions on the local population

  17. Genome-wide meta-analysis of common variant differences between men and women

    Science.gov (United States)

    Boraska, Vesna; Jerončić, Ana; Colonna, Vincenza; Southam, Lorraine; Nyholt, Dale R.; William Rayner, Nigel; Perry, John R.B.; Toniolo, Daniela; Albrecht, Eva; Ang, Wei; Bandinelli, Stefania; Barbalic, Maja; Barroso, Inês; Beckmann, Jacques S.; Biffar, Reiner; Boomsma, Dorret; Campbell, Harry; Corre, Tanguy; Erdmann, Jeanette; Esko, Tõnu; Fischer, Krista; Franceschini, Nora; Frayling, Timothy M.; Girotto, Giorgia; Gonzalez, Juan R.; Harris, Tamara B.; Heath, Andrew C.; Heid, Iris M.; Hoffmann, Wolfgang; Hofman, Albert; Horikoshi, Momoko; Hua Zhao, Jing; Jackson, Anne U.; Hottenga, Jouke-Jan; Jula, Antti; Kähönen, Mika; Khaw, Kay-Tee; Kiemeney, Lambertus A.; Klopp, Norman; Kutalik, Zoltán; Lagou, Vasiliki; Launer, Lenore J.; Lehtimäki, Terho; Lemire, Mathieu; Lokki, Marja-Liisa; Loley, Christina; Luan, Jian'an; Mangino, Massimo; Mateo Leach, Irene; Medland, Sarah E.; Mihailov, Evelin; Montgomery, Grant W.; Navis, Gerjan; Newnham, John; Nieminen, Markku S.; Palotie, Aarno; Panoutsopoulou, Kalliope; Peters, Annette; Pirastu, Nicola; Polašek, Ozren; Rehnström, Karola; Ripatti, Samuli; Ritchie, Graham R.S.; Rivadeneira, Fernando; Robino, Antonietta; Samani, Nilesh J.; Shin, So-Youn; Sinisalo, Juha; Smit, Johannes H.; Soranzo, Nicole; Stolk, Lisette; Swinkels, Dorine W.; Tanaka, Toshiko; Teumer, Alexander; Tönjes, Anke; Traglia, Michela; Tuomilehto, Jaakko; Valsesia, Armand; van Gilst, Wiek H.; van Meurs, Joyce B.J.; Smith, Albert Vernon; Viikari, Jorma; Vink, Jacqueline M.; Waeber, Gerard; Warrington, Nicole M.; Widen, Elisabeth; Willemsen, Gonneke; Wright, Alan F.; Zanke, Brent W.; Zgaga, Lina; Boehnke, Michael; d'Adamo, Adamo Pio; de Geus, Eco; Demerath, Ellen W.; den Heijer, Martin; Eriksson, Johan G.; Ferrucci, Luigi; Gieger, Christian; Gudnason, Vilmundur; Hayward, Caroline; Hengstenberg, Christian; Hudson, Thomas J.; Järvelin, Marjo-Riitta; Kogevinas, Manolis; Loos, Ruth J.F.; Martin, Nicholas G.; Metspalu, Andres; Pennell, Craig E.; Penninx, Brenda W.; Perola, Markus; Raitakari, Olli; Salomaa, Veikko; Schreiber, Stefan; Schunkert, Heribert; Spector, Tim D.; Stumvoll, Michael; Uitterlinden, André G.; Ulivi, Sheila; van der Harst, Pim; Vollenweider, Peter; Völzke, Henry; Wareham, Nicholas J.; Wichmann, H.-Erich; Wilson, James F.; Rudan, Igor; Xue, Yali; Zeggini, Eleftheria

    2012-01-01

    The male-to-female sex ratio at birth is constant across world populations with an average of 1.06 (106 male to 100 female live births) for populations of European descent. The sex ratio is considered to be affected by numerous biological and environmental factors and to have a heritable component. The aim of this study was to investigate the presence of common allele modest effects at autosomal and chromosome X variants that could explain the observed sex ratio at birth. We conducted a large-scale genome-wide association scan (GWAS) meta-analysis across 51 studies, comprising overall 114 863 individuals (61 094 women and 53 769 men) of European ancestry and 2 623 828 common (minor allele frequency >0.05) single-nucleotide polymorphisms (SNPs). Allele frequencies were compared between men and women for directly-typed and imputed variants within each study. Forward-time simulations for unlinked, neutral, autosomal, common loci were performed under the demographic model for European populations with a fixed sex ratio and a random mating scheme to assess the probability of detecting significant allele frequency differences. We do not detect any genome-wide significant (P < 5 × 10−8) common SNP differences between men and women in this well-powered meta-analysis. The simulated data provided results entirely consistent with these findings. This large-scale investigation across ∼115 000 individuals shows no detectable contribution from common genetic variants to the observed skew in the sex ratio. The absence of sex-specific differences is useful in guiding genetic association study design, for example when using mixed controls for sex-biased traits. PMID:22843499

  18. Self-reported practices among traditional birth attendants surveyed in western Kenya: a descriptive study.

    Science.gov (United States)

    Bucher, Sherri; Konana, Olive; Liechty, Edward; Garces, Ana; Gisore, Peter; Marete, Irene; Tenge, Constance; Shipala, Evelyn; Wright, Linda; Esamai, Fabian

    2016-08-12

    The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help inform conversations regarding the roles that traditional birth attendants can play in maternal-newborn health care. A structured questionnaire was used in a survey that included one hundred unskilled birth attendants in western Kenya. Descriptive statistics were employed. Inappropriate or outdated practices were reported in relation to some obstetric complications and newborn care. Encouraging results were reported with regard to positive relationships that traditional birth attendants have with their local health facilities. Furthermore, high rates of referral to health facilities was reported for many common obstetric emergencies and similar rates for reporting of pregnancy outcomes to village elders and chiefs. Potentially harmful or outdated practices with regard to maternal and newborn care among traditional birth attendants in western Kenya were revealed by this study. There were high rates of traditional birth attendant referrals of pregnant mothers with obstetric complications to health facilities. Policy makers may consider re-educating and re-defining the roles and responsibilities of traditional birth attendants in maternal and neonatal health care based on the findings of this survey.

  19. Birth defects risk associated with maternal sport fish consumption: potential effect modification by sex of offspring

    International Nuclear Information System (INIS)

    Mendola, Pauline; Robinson, L.K.; Buck, G.M.; Druschel, C.M.; Fitzgerald, E.F.; Sever, L.E.; Vena, J.E.

    2005-01-01

    Contaminated sport fish consumption may result in exposure to various reproductive and developmental toxicants, including pesticides and other suspected endocrine disruptors. We investigated the relation between maternal sport fish meals and risk of major birth defects among infants born to members of the New York State (NYS) Angler Cohort between 1986 and 1991 (n=2237 births). Birth defects (n=125 cases) were ascertained from both newborn medical records and the NYS Congenital Malformations Registry. For sport fish meals eaten during pregnancy, the odds ratio (OR) for all major malformations combined was slightly elevated for ≤1 meal/month (OR=1.26, 95% confidence interval (CI): 0.84, 1.89) and ≥2 meals/month (OR=1.51, CI=0.74, 3.09), with no meals during pregnancy as the reference category. Higher ORs were consistently observed among male offspring compared with females. For ≥2 meals/month, the risk for males was significantly elevated (males: OR=3.01, CI: 1.2, 7.5; females: OR=0.73, CI: 0.2, 2.4). Exposure during pregnancy and effect modification by infants sex could be important considerations for future studies of birth outcomes associated with endocrine disruptors

  20. Accredited Birth Centers

    Science.gov (United States)

    ... Danbury, CT 06810 203-748-6000 Accredited Since March 1998 Corvallis Birth & Women's Health Center Accredited 2314 NW Kings Blvd, Suite ... Washington, DC 20002 202-398-5520 Accredited Since March 2001 Flagstaff Birth and Women's Center Accredited 401 West Aspen Avenue Flagstaff, AZ ...

  1. Born with low birth weight in rural Southern India

    DEFF Research Database (Denmark)

    Thomas, Nihal; Grunnet, Louise G; Poulsen, Pernille

    2012-01-01

    Low birth weight (LBW) is common in the Indian population and may represent an important predisposing factor for type 2 diabetes (T2D) and the metabolic syndrome. Intensive metabolic examinations in ethnic LBW Asian Indians have been almost exclusively performed in immigrants living outside India....... Therefore, we aimed to study the metabolic impact of being born with LBW in a rural non-migrant Indian population....

  2. Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.

    Science.gov (United States)

    Wax, Joseph R; Lucas, F Lee; Lamont, Maryanne; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-09-01

    We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth. We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated. Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates. Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate. Copyright 2010 Mosby, Inc. All rights reserved.

  3. Twins: prevalence, problems, and preterm births.

    Science.gov (United States)

    Chauhan, Suneet P; Scardo, James A; Hayes, Edward; Abuhamad, Alfred Z; Berghella, Vincenzo

    2010-10-01

    The rate of twin pregnancies in the United States has stabilized at 32 per 1000 births in 2006. Aside from determining chorionicity, first-trimester screening and second-trimester ultrasound scanning should ascertain whether there are structural or chromosomal abnormalities. Compared with singleton births, genetic amniocentesis-related loss at births is higher (0.9% vs 2.9%, respectively). Selective termination for an anomalous fetus is an option, although the pregnancy loss rate is 7% at experienced centers. For singleton and twin births for African American and white women, approximately 50% of preterm births are indicated; approximately one-third of these births are spontaneous, and 10% of the births occur after preterm premature rupture of membranes. From 1989-2000, the rate of preterm twin births increased, for African American and white women alike, although the perinatal mortality rate has actually decreased. As with singleton births, tocolytics should be used judiciously and only for a limited time (births. Administration of antenatal corticosteroids is an evidence-based recommendation. Copyright © 2010 Mosby, Inc. All rights reserved.

  4. Birth weight in relation to leisure time physical activity in adolescence and adulthood

    DEFF Research Database (Denmark)

    Andersen, Lise Geisler; Ängquist, Lars; Gamborg, Michael Orland

    2009-01-01

    . METHODS/PRINCIPAL FINDINGS: We investigated the association between birth weight and leisure time physical activity (LTPA) in 43,482 adolescents and adults from 13 Nordic cohorts. Random effects meta-analyses were performed on categorical estimates from cohort-, age-, sex- and birth weight specific......BACKGROUND: Prenatal life exposures, potentially manifested as altered birth size, may influence the later risk of major chronic diseases through direct biologic effects on disease processes, but also by modifying adult behaviors such as physical activity that may influence later disease risk...... weight categories of 1.26-1.75, 1.76-2.25, 2.26-2.75, and 4.76-5.25 kg, had odds ratios of 0.67 (95% confidence interval: 0.47, 0.94), 0.72 (0.59, 0.88), 0.89 (0.79, 0.99), and 0.65 (0.50, 0.86), respectively. The shape and strength of the birth weight-LTPA association was virtually independent of sex...

  5. Hospital costs of multiple-birth and singleton-birth children during the first 5 years of life and the role of assisted reproductive technology.

    Science.gov (United States)

    Chambers, Georgina M; Hoang, Van Phuong; Lee, Evelyn; Hansen, Michele; Sullivan, Elizabeth A; Bower, Carol; Chapman, Michael

    2014-11-01

    The unprecedented increase in multiple births during the past 3 decades is a major public health concern and parallels the uptake of medically assisted conception. The economic implications of such births are not well understood. To conduct a comprehensive economic and health services assessment of the frequency, duration, and cost of hospital admissions during the first 5 years of life for singleton, twin, and higher-order multiple (HOM) children and to examine the contribution of assisted reproductive technology (ART) to the incidence and cost of multiple births. A retrospective population cohort study using individually linked birth, hospital, and death records among 233,850 infants born in Western Australia between October 1993 and September 2003, and followed up to September 2008. Multiple-gestation delivery and ART conception. Odds of stillbirth, prematurity and low birth weight, frequency and length of hospital admissions, the mean costs by plurality, and the independent effect of prematurity on childhood costs. Of 226,624 singleton, 6941 twin, and 285 HOM infants, 1.0% of singletons, 15.4% of twins, and 34.7% of HOM children were conceived following ART. Compared with singletons, twins and HOMs were 3.4 and 9.6 times, respectively, more likely to be stillborn and were 6.4 and 36.7 times, respectively, more likely to die during the neonatal period. Twins and HOMs were 18.7 and 525.1 times, respectively, more likely to be preterm, and 3.6 and 2.8 times, respectively, more likely to be small for gestational age. The mean hospital costs of a singleton, twin, and HOM child to age 5 years were $2730, $8993, and $24,411 (in 2009-2010 US dollars), respectively, with cost differences concentrated in the neonatal period and during the first year of life. Almost 15% of inpatient costs for multiple births could have been avoided if ART twins and HOMs had been born as singletons. Compared with singletons, multiple-birth infants consume significantly more hospital

  6. Relationship of birth order and the marketing-related variable of materialism.

    Science.gov (United States)

    Zemanek, J E; Claxton, R P; Zemanek, W H

    2000-04-01

    The relationship between the birth order and materialism scores was investigated using materialism conceptualized as a consumer value. Data were collected from 275 alumni of a major southwestern university. The analysis indicated that first-borns in this sample scored significantly lower on materialism than younger siblings.

  7. The extent and distribution of inequalities in childhood mortality by cause of death according to parental socioeconomic positions: a birth cohort study in South Korea.

    Science.gov (United States)

    Kim, Jongoh; Son, Mia; Kawachi, Ichiro; Oh, Juhwan

    2009-10-01

    It has been shown that childhood mortality is affected by parental socioeconomic positions; in this article, we investigate the extent and distribution of inequalities across major causes of childhood death. We built a retrospective birth cohort using individually linked national birth and death records in South Korea. 1,329,540 children were followed up to exact age eight from 1995 to 1996 and total observed person-years were 10,594,168.18. Causes of death were identified from death records while parental education, occupation and birth characteristics were identified from birth records. Survival analysis was performed according to parental socioeconomic positions. Cox proportional hazard analysis was done according to parental education and occupation with adjustment of birth characteristics such as sex, parental age, gestational age, birth weight, multiple birth, the number of total births, and previous death of children. Cumulative incidence of mortality by age was obtained through a competing-risk method in each cause according to maternal education. From these results, distribution of inequalities across major causes of death was calculated. In total, 7018 deaths occurred during the eight years and mortality rate was 66.24 per 100,000 person-years. External cause was the most common cause of death followed by congenital malformations, nervous system diseases, perinatal diseases, cancer, respiratory, cardiovascular, infectious and gastrointestinal diseases. For all-cause mortality, hazard ratios (HR) were 1.98 (95% CI: 1.83-2.13) for paternal education, 1.90 (1.75-2.07) for maternal education, 1.40 (1.33-1.47) for paternal occupation and 2.33(1.98-2.73) for maternal occupation (between middle school graduation or lower and university or more for education, between manual and non-manual for occupation). Mortality differentials were found in every cause of death. External cause, respiratory, cardiovascular and infectious diseases showed larger HR than all

  8. Birth weight and perinatal mortality: A comparison of "optimal" birth weight in seven western European countries

    NARCIS (Netherlands)

    Graafmans, W.C.; Richardus, J.H.; Borsboom, G.J.J.M.; Bakketeig, L.; Langhoff-Roos, J.; Bergsjø, P.; Macfarlane, A.; Verloove-Vanhorick, P.; Mackenbach, J.; Aelvoet, W.; Alderdice, F.; Amelink, M.; Bakoula, C.; Blondel, B.; Bødker, B.; Bolumar, F.; Davidson, L.; Gissler, M.; Hartikainen, A.L.; Holt, J.; Kaminski, M.; Leidinger, J.; Lekea, V.; Lindmark, G.; Masuy-Stroobant, G.; Pal, K. van der; Penney, G.; Purificação Araújo, M. Da; Rantakallio, P.; Rebagliato, M.

    2002-01-01

    Background. Previous studies have suggested that a population's entire birth weight distribution may be shifted towards higher or lower birth weights, and that optimal birth weight may be lower in populations with a lower average birth weight. We evaluated this hypothesis for seven western European

  9. The Common Vision: Parenting and Educating for Wholeness.

    Science.gov (United States)

    Marshak, David

    2003-01-01

    Presents a spiritually based view of needs and potentials of children and youth, from birth through age 21, based on works of Rudolf Steiner, Sri Aurobindo Ghose, and Hazrat Inayat Khan. Focuses on their common vision of the true nature of human beings, the course of human growth, and the desired functions of child rearing and education.…

  10. Vicarious birth experiences and childbirth fear: does it matter how young canadian women learn about birth?

    Science.gov (United States)

    Stoll, Kathrin; Hall, Wendy

    2013-01-01

    In our secondary analysis of a cross-sectional survey, we explored predictors of childbirth fear for young women (n = 2,676). Young women whose attitudes toward pregnancy and birth were shaped by the media were 1.5 times more likely to report childbirth fear. Three factors that were associated with reduced fear of birth were women's confidence in reproductive knowledge, witnessing a birth, and learning about pregnancy and birth through friends. Offering age-appropriate birth education during primary and secondary education, as an alternative to mass-mediated information about birth, can be evaluated as an approach to reduce young women's childbirth fear.

  11. Birth control pills - progestin only

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000656.htm Birth control pills - progestin only To use the sharing features ... estrogen in them. What Are Progestin Only Birth Control Pills? Birth control pills help keep you from ...

  12. Births: preliminary data for 2000.

    Science.gov (United States)

    Martin, J A; Hamilton, B E; Ventura, S J

    2001-07-24

    This report presents preliminary data for 2000 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Data in this report are based on more than 96 percent of births for 2000. The records are weighted to independent control counts of births received in State vital statistics offices in 2000. Comparisons are made with 1999 final data. The number of births rose 3 percent between 1999 and 2000. The crude birth rate increased to 14.8 per 1,000 population in 2000, 2 percent higher than the 1999 rate. The fertility rate rose 3 percent to 67.6 per 1,000 women aged 15-44 years between 1999 and 2000. The birth rate for teenagers, which has been falling since 1991, declined 2 percent in 2000 to 48.7 births per 1,000 females aged 15-19 years, another historic low. The rate for teenagers 15-17 years fell 4 percent, and the rate for 18-19 year olds was down 1 percent. Since 1991, rates have fallen 29 percent for teenagers 15-17 years and 16 percent for teenagers 18-19 years. Birth rates for all of the older age groups increased for 1999-2000: 1 percent among women aged 20-24 years, 3 percent for women aged 25-29 years, and 5 percent for women in their thirties. Rates for women aged 40-54 years were also up for 2000. The birth rate for unmarried women increased 2 percent to 45.2 births per 1,000 unmarried women aged 15-44 years in 2000, but was still lower than the peak reached in 1994. The number of births to unmarried women was up 3 percent, the highest number ever reported in the United States. However, the number of births to unmarried teenagers declined. The proportion of women who began prenatal care in the first trimester of pregnancy (83.2 percent) did not improve for 2000, nor did the rate of low birthweight (7.6 percent). The total cesarean rate rose for the fourth consecutive year to 22.9 percent, the result of both a

  13. The birth order puzzle.

    Science.gov (United States)

    Zajonc, R B; Markus, H; Markus, G B

    1979-08-01

    Studies relating intellectual performance to birth order report conflicting results, some finding intellectual scores to increase, others to decrease with birth order. In contrast, the relationship between intellectual performance and family size is stable and consistently replicable. Why do these two highly related variables generate such divergent results? This birth order puzzle is resolved by means of the confluence model that quantifies the influences upon intellectual growth arising within the family context. At the time of a new birth, two opposing influences act upon intellectual growth of the elder sibling: (a) his or her intellectual environment is "diluted" and (b) he or she loses the "last-born's handicap" and begins serving as an intellectual resource to the younger sibling. Since these opposite effects are not equal in magnitude, the differences in intellectual performance among birth ranks are shown to be age dependent. While elder children may surpass their younger siblings in intellectual performance at some ages, they may be overtaken by them at others. Thus when age is taken into consideration, the birth order literature loses its chaotic character and an orderly pattern of results emerges.

  14. The Chernobyl accident, the male to female ratio at birth and birth rates.

    Science.gov (United States)

    Grech, Victor

    2014-01-01

    The male:female ratio at birth (male births divided by total live births - M/T) has been shown to increase in response to ionizing radiation due to gender-biased fetal loss, with excess female loss. M/T rose sharply in 1987 in central-eastern European countries following the Chernobyl accident in 1986. This study analyses M/T and births for the former Soviet Republics and for the countries most contaminated by the event. Annual birth data was obtained from the World Health Organisation. The countries with the highest exposure levels (by ¹³⁷Cs) were identified from an official publication of the International Atomic Energy Agency. All of the former Soviet states were also analysed and the periods before and after 1986 were compared. Except for the Baltic States, all regions in the former USSR showed a significant rise in M/T from 1986. There were significant rises in M/T in the three most exposed (Belarus, Ukraine and the Russian Federation). The birth deficit in the post-Soviet states for the ten years following Chernobyl was estimated at 2,072,666, of which 1,087,924 are accounted by Belarus and Ukraine alone. Chernobyl has resulted in the loss of millions of births, a process that has involved female even more than male fetuses. This is another and oft neglected consequence of widespread population radiation contamination.

  15. Influence of birth order, birth weight, colostrum and serum immunoglobulin G on neonatal piglet survival

    Directory of Open Access Journals (Sweden)

    Cabrera Rafael A

    2012-12-01

    Full Text Available Abstract Background Intake of colostrum after birth is essential to stimulate intestinal growth and function, and to provide systemic immunological protection via absorption of Immunoglobulin G (IgG. The birth order and weight of 745 piglets (from 75 litters were recorded during a one-week period of farrowing. Only pigs weighing greater than 0.68 kg birth weight were chosen for the trial. Sow colostrum was collected during parturition, and piglets were bled between 48 and 72 hours post-birth. Piglet serum IgG and colostral IgG concentrations were determined by radial immunodiffusion. Results Sow parity had a significant (P Conclusion We found that the combination of sow colostrum IgG concentration and birth order can account for 10% of the variation of piglet serum IgG concentration and that piglets with less than 1,000 mg/dl IgG serum concentration and weight of 0.9 kg at birth had low survival rate when compared to their larger siblings. The effective management of colostrum uptake in neonatal piglets in the first 24 hrs post-birth may potentially improve survival from birth to weaning.

  16. Precipitous Birth

    Directory of Open Access Journals (Sweden)

    Jennifer Yee

    2017-09-01

    Full Text Available Audience: This scenario was developed to educate emergency medicine residents on the management of a precipitous birth in the emergency department (ED. The case is also appropriate for teaching of medical students and advanced practice providers, as well as reviewing the principles of crisis resource management, teamwork, and communication. Introduction: Patients with precipitous birth require providers to manage two patients simultaneously with limited time and resources. Crisis resource management skills will be tested once baby is delivered, and the neonate will require assessment for potential neonatal resuscitation. Objectives: At the conclusion of the simulation session, learners will be able to manage women who have precipitous deliveries, as well as perform neonatal assessment and management. Method: This session was conducted using high-fidelity simulation, followed by a debriefing session and lecture on precipitous birth management and neonatal evaluation.

  17. Are women deciding against home births in low and middle income countries?

    Science.gov (United States)

    Amoako Johnson, Fiifi; Padmadas, Sabu S; Matthews, Zoë

    2013-01-01

    Although there is evidence to tracking progress towards facility births within the UN Millennium Development Goals framework, we do not know whether women are deciding against home birth over their reproductive lives. Using Demographic and Health Surveys (DHS) data from 44 countries, this study aims to investigate the patterns and shifts in childbirth locations and to determine whether these shifts are in favour of home or health settings. The analyses considered 108,777 women who had at least two births in the five years preceding the most recent DHS over the period 2000-2010. The vast majority of women opted for the same place of childbirth for their successive births. However, about 14% did switch their place and not all these decisions favoured health facility over home setting. In 24 of the 44 countries analysed, a higher proportion of women switched from a health facility to home. Multilevel regression analyses show significantly higher odds of switching from home to a facility for high parity women, those with frequent antenatal visits and more wealth. However, in countries with high infant mortality rates, low parity women had an increased probability of switching from home to a health facility. There is clear evidence that women do change their childbirth locations over successive births in low and middle income countries. After two decades of efforts to improve maternal health, it might be expected that a higher proportion of women will be deciding against home births in favour of facility births. The results from this analysis show that is not the case.

  18. Are women deciding against home births in low and middle income countries?

    Directory of Open Access Journals (Sweden)

    Fiifi Amoako Johnson

    Full Text Available Although there is evidence to tracking progress towards facility births within the UN Millennium Development Goals framework, we do not know whether women are deciding against home birth over their reproductive lives. Using Demographic and Health Surveys (DHS data from 44 countries, this study aims to investigate the patterns and shifts in childbirth locations and to determine whether these shifts are in favour of home or health settings.The analyses considered 108,777 women who had at least two births in the five years preceding the most recent DHS over the period 2000-2010. The vast majority of women opted for the same place of childbirth for their successive births. However, about 14% did switch their place and not all these decisions favoured health facility over home setting. In 24 of the 44 countries analysed, a higher proportion of women switched from a health facility to home. Multilevel regression analyses show significantly higher odds of switching from home to a facility for high parity women, those with frequent antenatal visits and more wealth. However, in countries with high infant mortality rates, low parity women had an increased probability of switching from home to a health facility.There is clear evidence that women do change their childbirth locations over successive births in low and middle income countries. After two decades of efforts to improve maternal health, it might be expected that a higher proportion of women will be deciding against home births in favour of facility births. The results from this analysis show that is not the case.

  19. Profile and birthing practices of Maranao traditional birth attendants

    OpenAIRE

    Maghuyop-Butalid, Roselyn; Mayo, Norhanifa A; Polangi, Hania T

    2015-01-01

    Roselyn Maghuyop-Butalid, Norhanifa A Mayo, Hania T Polangi College of Nursing, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines Abstract: This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs) in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A quest...

  20. Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India.

    Science.gov (United States)

    Madhivanan, Purnima; Kumar, Bhavana N; Adamson, Paul; Krupp, Karl

    2010-09-22

    There is little research on HIV awareness and practices of traditional birth attendants (TBA) in India. This study investigated knowledge and attitudes among rural TBA in Karnataka as part of a project examining how traditional birth attendants could be integrated into prevention-of-mother-to-child transmission of HIV (PMTCT) programs in India. A cross-sectional survey was conducted between March 2008 and January 2009 among TBA in 144 villages in Mysore Taluk, Karnataka. Following informed consent, TBA underwent an interviewer-administered questionnaire in the local language of Kannada on practices and knowledge around birthing and HIV/PMTCT. Of the 417 TBA surveyed, the median age was 52 years and 96% were Hindus. A majority (324, 77.7%) had no formal schooling, 88 (21.1%) had up to 7 years and 5 (1%) had more than 7 yrs of education. Only 51 of the 417 TBA (12%) reported hearing about HIV/AIDS. Of those who had heard about HIV/AIDS, only 36 (72%) correctly reported that the virus could be spread from mother to child; 37 (74%) identified unprotected sex as a mode of transmission; and 26 (51%) correctly said healthy looking people could spread HIV. Just 22 (44%) knew that infected mothers could lower the risk of transmitting the virus to their infants. An overwhelming majority of TBA (401, 96.2%) did not provide antenatal care to their clients. Over half (254, 61%) said they would refer the woman to a hospital if she bled before delivery, and only 53 (13%) felt referral was necessary if excessive bleeding occurred after birth. Traditional birth attendants will continue to play an important role in maternal child health in India for the foreseeable future. This study demonstrates that a majority of TBA lack basic information about HIV/AIDS and safe delivery practices. Given the ongoing shortage of skilled birth attendance in rural areas, more studies are needed to examine whether TBA should be trained and integrated into PMTCT and maternal child health programs in

  1. [Outcomes after planned home births].

    Science.gov (United States)

    Blix, Ellen; Øian, Pål; Kumle, Merethe

    2008-11-06

    About 150 planned home births take place in Norway annually. Professionals have different opinions on whether such births are safe or not. The aim of the present study was to perform a systematic literature review on maternal and neonatal outcomes after planned home births. A review was performed of literature retrieved from searches in MEDLINE, PubMed, Embase, Cinahl and The Cochrane Library and relevant references found in the articles. The searches were limited to studies published in 1985 and later. 10 studies with data from 30 204 women who had planned and were selected to home birth at the onset of labour were included. Three of the studies had control groups including women with planned hospital births. All included studies were assessed to be of medium quality. Between 9.9 and 23.1 % of women and infants were transferred to hospital during labour or after birth. There were few caesarean sections, other interventions or complications in the studies assessed; the total perinatal mortality rate was 2.9/1000 and the intrapartum mortality rate 0.8/1000. There is no sound basis for discouraging low-risk women from planning a home birth. Results from the included studies do not directly apply to Norwegian conditions. Outcomes and transfers after planned home births should be systematically registered.

  2. Effect of use of insecticide treated nets on birth outcomes among ...

    African Journals Online (AJOL)

    The major impact of malaria during pregnancy in these regions is caused by persistent or recurrent, predominantly low-grade, sometimes sub-patent, parasitaemia. In Nigeria, malaria has severe negative effects on maternal health and birth outcomes, resulting in maternal anaemia, a high incidence of miscarriages and low ...

  3. On the α-classification of birth-death and quasi-birth-death processes

    NARCIS (Netherlands)

    van Doorn, Erik A.

    2006-01-01

    In several recent papers criteria for the α-classification of birth-death and quasi-birth-death processes have been proposed. In this paper the relations between the various criteria are brought to light.

  4. Preterm birth, an unresolved issue

    OpenAIRE

    Beliz?n, Jose M; Hofmeyr, Justus; Buekens, Pierre; Salaria, Natasha

    2013-01-01

    Premature birth is the world?s leading cause of neonatal mortality with worldwide estimates indicating 11.1% of all live births were preterm in 2010. Preterm birth rates are increasing in most countries with continual differences in survival rates amongst rich and poor countries. Preterm birth is currently an important unresolved global issue with research efforts focusing on uterine quiescence and activation, the ?omics? approaches and implementation science in order to reduce the incidence ...

  5. Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial.

    Science.gov (United States)

    Larsson, Birgitta; Karlström, Annika; Rubertsson, Christine; Ternström, Elin; Ekdahl, Johanna; Segebladh, Birgitta; Hildingsson, Ingegerd

    2017-12-01

    Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n=258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n=127) or standard care (face-to-face counselling) (n=131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth. Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience. Women's birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Maternal short stature: A risk factor for low birth weight in neonates

    Directory of Open Access Journals (Sweden)

    Vipin Chandra Kamathi

    2012-08-01

    Full Text Available Low birth weight (LBW is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths. On the other hand, maternal short stature is known to cause a lot of obstetric complications like cephalopelvic disproportion and arrest of labor, intrauterine asphyxia, intrauterine growth retardation. The objective of our study was to find out whether there was any significant statistical association between maternal height and the birth weight of the neonate. We identified a group of low birth weight neonates (n=54 and a control group (n=51 of normal weight neonates at term in Mediciti Hospital over a period of 1 year and retrospectively looked the maternal heights for both groups. Inclusion criteria being mothers who delivered at term, mothers who had a hemoglobin level more than 10 gm/dl, mothers with relatively uneventful antenatal without any significant obstetric or medical complications during the pregnancy, and neonates with relatively uneventful post-natal periods without any significant pediatric or medical complications. The odds of having been born of a mother of short stature are more than three times greater for a low birth weight baby than a normal weight baby. The mean of birth weights of babies born to mothers of normal height is more than the mean of birth weights of babies born to mothers of short stature by 277.01 gm. This study reaffirms the observation that maternal height has a direct effect on the weight of the newborn and we propose that maternal short stature be identified as an independent risk factor for low birth weight.

  7. THE CHERNOBYL ACCIDENT, THE MALE TO FEMALE RATIO AT BIRTH AND BIRTH RATES

    Directory of Open Access Journals (Sweden)

    Victor Grech

    2014-01-01

    Full Text Available Introduction: The male:female ratio at birth (male births divided by total live births – M/T has been shown to increase in response to ionizing radiation due to gender-biased fetal loss, with excess female loss. M/T rose sharply in 1987 in central-eastern European countries following the Chernobyl accident in 1986. This study analyses M/T and births for the former Soviet Republics and for the countries most contaminated by the event. Methods: Annual birth data was obtained from the World Health Organisation. The countries with the highest exposure levels (by 137Cs were identified from an official publication of the International Atomic Energy Agency. All of the former Soviet states were also analysed and the periods before and after 1986 were compared. Results: Except for the Baltic States, all regions in the former USSR showed a significant rise in M/T from 1986. There were significant rises in M/T in the three most exposed (Belarus, Ukraine and the Russian Federation. The birth deficit in the post-Soviet states for the ten years following Chernobyl was estimated at 2,072,666, of which 1,087,924 are accounted by Belarus and Ukraine alone. Discussion: Chernobyl has resulted in the loss of millions of births, a process that has involved female even more than male fetuses. This is another and oft neglected consequence of widespread population radiation contamination.

  8. A blueprint for the prevention of preterm birth: vaginal progesterone in women with a short cervix

    Science.gov (United States)

    Romero, Roberto; Yeo, Lami; Miranda, Jezid; Hassan, Sonia; Conde-Agudelo, Agustin; Chaiworapongsa, Tinnakorn

    2014-01-01

    Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and is the most important challenge to modern obstetrics. A major obstacle has been that preterm birth is treated (implicitly or explicitly) as a single condition. Two-thirds of preterm births occur after the spontaneous onset of labor, and the remaining one-third after “indicated” preterm birth; however, the causes of spontaneous preterm labor and “indicated” preterm birth are different. Spontaneous preterm birth is a syndrome caused by multiple etiologies, one of which is a decline in progesterone action, which induces cervical ripening. A sonographic short cervix (identified in the midtrimester) is a powerful predictor of spontaneous preterm delivery. Randomized clinical trials and individual patient meta-analyses have shown that vaginal progesterone reduces the rate of preterm delivery at cervix, and therefore, the compound of choice is natural progesterone (not the synthetic progestin). Routine assessment of the risk of preterm birth with cervical ultrasound coupled with vaginal progesterone for women with a short cervix is cost-effective, and implementation of such a policy is urgently needed. Vaginal progesterone is as effective as cervical cerclage in reducing the rate of preterm delivery in women with a singleton gestation, history of preterm birth, and a short cervix (<25mm). PMID:23314512

  9. Magnitude and Correlates of Low Birth Weight at Term in Rural Wardha, Central India

    Directory of Open Access Journals (Sweden)

    Kumar V

    2016-05-01

    Full Text Available Introduction: Birth weight is one of the most important determinant of the neonatal and infant survival. The goal of reducing low birth weight incidence by at least one third between 2000 and 2010 was one of the major goals in ‘A World Fit for Children’. The prevention of low birth weight is a public health priority, particularly in developing countries with high magnitude. Knowledge regarding magnitude and correlates help prevent the condition. Hence, the present study was carried out to study the magnitude and the correlates of low birth weight. Methodology: Two hundred and six newborn babies were recruited on a birth cohort from two Primary Health Centres (PHC of Wardha district to study growth in first year of life. Here, we present the baseline analysis of 172 children who were born full term to study the correlates of low birth weight babies born full term. The children were recruited within first week of their birth. Data was collected on socio-demographic profile, birth history, and maternal characteristics. Proportion of low birth weight was expressed in percentage along with 95% confidence interval. Univariate and multivariate logistic regression was used to study the correlates. Findings are expressed in odds ratios with their 95% confidence intervals. Results: The magnitude of low birth weight at term was found to be 33.1% (95% CI: 26.4%-40.4%. On univariate analysis, significant correlates of low birth weight were consumption of less than 50 iron-folic acid tables and being born to than mother. On multivariate analysis, the significant correlates were female sex of child (OR=2.856, being born to thin mother (OR=5.320, consumption of less than 50 tablets (OR=4.648, and complications of pregnancy (OR=2.917. Conclusions: The magnitude of low birth weight is very high and modifiable correlates of low birth weight are nutritional status of mother, lower consumption of IFA tablets and complications of pregnancy.

  10. Astrological birth signs in suicide: hypothesis or speculation?

    Science.gov (United States)

    Salib, Emad

    2003-04-01

    Astrology is no longer regarded as a science by many, because its claims are almost impossible to test empirically in controlled laboratory conditions and it can not meet the scientific need to be reproducible. However, the majority of those who read their 'star signs' can identify aspects of their personality in what they read and it is possible that this may influence their attitudes and actions. The literature has neglected astrological signs as a possible predictor of suicide ideation. To see whether astrological birth signs are associated with suicide and the method used, data was collected from the Public Health Department in North Cheshire representing all the Cheshire Coroner's verdicts of suicide, and open verdicts, in all deceased aged 60 and above between 1989 and 2000. The observed occurrence of deaths due to natural causes, and suicide, in relation to birth signs did not differ significantly from what would be expected from chance. However, the distribution of suicide by hanging appeared significantly higher in those with a birth sign of Virgo and lowest in Sagittarius and Scorpio. The distribution of violent and non-violent suicides in relation to star signs showed higher occurences of violent death in persons born in the summer months.

  11. First-trimester exposure to metformin and risk of birth defects: a systematic review and meta-analysis.

    Science.gov (United States)

    Cassina, Matteo; Donà, Marta; Di Gianantonio, Elena; Litta, Pietro; Clementi, Maurizio

    2014-01-01

    Metformin is generally considered a non-teratogenic drug; however, only a few studies specifically designed to assess the rate of congenital anomalies after metformin use have been published in the literature. The objects of the present study were to review all of the prospective and retrospective studies reporting on women treated with metformin at least during the first trimester of their pregnancy and to estimate the overall rate of major birth defects. Databases were searched for English language articles until December 2013. Inclusion criteria for the meta-analysis were: a case group of women with PCOS or pre-pregnancy type 2 diabetes and first-trimester exposure to metformin; a disease-matched control group which was not exposed to metformin or other oral anti-diabetic agents; and a list of the major anomalies in both the study and the control groups. A random effects model was used for the meta-analysis of data, using odds ratios. Studies not fulfilling the inclusion criteria for the meta-analysis but reporting relevant data on major malformations in women diagnosed with PCOS were then used to estimate the overall birth defects rate. Meta-analysis of nine controlled studies with women affected by PCOS detected that the rate of major birth defects in the metformin-exposed group was not statistically increased compared with the disease-matched control group and that there was no significant heterogeneity among the studies. The metformin-exposed sample was composed of 351 pregnancies and the OR of major birth defects was 0.86 (95% confidence interval: 0.18-4.08; Pheterogeneity = 0.71). By evaluating all of the non-overlapping PCOS studies reported in the literature, even those without an appropriate control group, the overall rate of major anomalies was 0.6% in the sample of 517 women who discontinued the therapy upon conception or confirmation of pregnancy and 0.5% in the sample of 634 women who were treated with metformin throughout the first trimester of

  12. The interaction of pregnancy, substance use and mental illness on birthing outcomes in Australia.

    Science.gov (United States)

    Zhao, Lin; McCauley, Kay; Sheeran, Leanne

    2017-11-01

    this study aimed to (1) assess the prevalence, and demographic features of women with a history of mental illness during pregnancy and childbirth, (2) investigate maternal and perinatal outcomes in relation to mental illness and substance use, and (3) determine the effects of maternal characteristics, history of mental illness and substance use on birth outcomes. the records of 22,193 pregnant women who gave birth at one tertiary level health service comprising three maternity settings in Victoria, Australia from 2009 to 2011 were reviewed.Univariate comparisons for socio-demographic and birthing outcome variables by substance use and mental illness category were performed. A multivariable logistic regression model was developed to examine the effects of maternal characteristics on birth outcomes. mental illness was recorded for 1.08/1,000 delivery hospitalisations.Mothers with a history of mental illness had a significantly higher proportion of babies born with low birth weight (OR = 1.85, 95% CI 1.64 -2.09) and low Apgar 1 scoresmental illness and substance use on birth weight. This interaction effect was not significant for gestational age. Logistic regression showed the strongest predictor of reporting a premature birth and low birth weight was using substances, recording an odds ratio of 1.95 (95% CI 1.50-2.53) and 2.73 (95% CI 2.15-3.47) respectively. mental health history should be highlighted as being a common morbidity and the increased risk of poorer birth outcomes especially when the women were also using substances, alcohol or tobacco should be acknowledged by the health practitioners. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Perception of orthodox health care centers among pregnant women attending traditional birth attendants clinics in two local government areas of Lagos State

    Directory of Open Access Journals (Sweden)

    A Okewole

    2013-01-01

    Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of

  14. Path analysis of risk factors leading to premature birth.

    Science.gov (United States)

    Fields, S J; Livshits, G; Sirotta, L; Merlob, P

    1996-01-01

    The present study tested whether various sociodemographic, anthropometric, behavioral, and medical/physiological factors act in a direct or indirect manner on the risk of prematurity using path analysis on a sample of Israeli births. The path model shows that medical complications, primarily toxemia, chorioammionitis, and a previous low birth weight delivery directly and significantly act on the risk of prematurity as do low maternal pregnancy weight gain and ethnicity. Other medical complications, including chronic hypertension, preclampsia, and placental abruption, although significantly correlated with prematurity, act indirectly on prematurity through toxemia. The model further shows that the commonly accepted sociodemographic, anthropometric, and behavioral risk factors act by modifying the development of medical complications that lead to prematurity as opposed to having a direct effect on premature delivery. © 1996 Wiley-Liss, Inc. Copyright © 1996 Wiley-Liss, Inc.

  15. Reasons Why Women Choose Home Birth

    Directory of Open Access Journals (Sweden)

    Mary Angelie P. Andrino

    2016-11-01

    Full Text Available Maternal deaths in the Philippines remain high. These deaths are mostly due to the large proportion of home births, complications of pregnancy and delivery, and lack of access to facilities and competently trained staff. Utilizing a descriptive, one-shot survey design, the study aimed to determine the reasons why women in a municipality in Iloilo prefer home birth. The respondents were interviewed using a validated questionnaire. Descriptive statistics were used to analyze and interpret the findings. The study revealed that the proportion of home births progressively declined from 2012 to 2014. Birth being imminent or inevitable is the number one reason that supports home birth. Autonomy, safety, affordability, readily available birthing equipment and supplies, accessibility of birth attendant, remote access by going to the birthing center, lack of transportation, and bad weather conditions also led women to give birth at home. Women from the rural areas of the municipality utilized available resources in the community which prompted the predominance of home deliveries assisted by traditional birth attendants (TBAs and even midwives, who were readily available nearby. This study recommends continuous improvement in existing maternal health interventions and strategies through engagement of women in policy planning, improvement of health service delivery, infrastructural enhancement, better care practices and continuous health education.

  16. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

  17. Ultrasound cervical length in predicting preterm birth: Prospective study

    Directory of Open Access Journals (Sweden)

    Achour Radhouane

    2017-08-01

    Full Text Available Background Preterm birth is a leading cause of perinatal morbidity and mortality and represents a major public health problem. It is associated with a 15–20 per cent mortality rate and remains responsible for 75 per cent of perinatal deaths in foetuses without anomalies. Aims The aim of this study was to evaluate the importance of cervical length measured in the first trimester (11–14 Weeks of amenorrhea “WA” and the second trimester (20–24 Weeks of amenorrhea” WA” in an asymptomatic population of singleton pregnancies to assess the risk of spontaneous preterm birth compared to the digital assessment. Methods We conducted a prospective, longitudinal study involving 117 asymptomatic women with singleton pregnancies between January and December 2015. Results In our study, the clinical examination had a low positive predictive value and a low sensibility for screening women at risk of preterm delivery. Cervical length less than 35mm between 12–14WA and 30mm between 22–24WA predicts the occurrence of preterm birth with a high sensitivity (Se, and specificity (Sp. Conclusion We conclude that ultrasound screening of preterm delivery is now highly recommended.

  18. Social representations of premature birth from the perspective of individuals born preterm in the 1990s.

    Science.gov (United States)

    Leavy, Pía; Violeta Prina, Martina; Martínez Cáceres, María José; Bauer, Gabriela

    2015-01-01

    Prematurity is a public health problem that calls to focus on its causes and consequences through a trans disciplinary approach. There are no studies analyzing premature birth from the perspective of individuals born preterm. To identify social representations associated with premature birth of individuals born preterm in the 1990s in Argentina. Twelve focus groups were conducted with individuals born preterm with a birth weightparents' memories and experiences, overprotection body, education, relationship with the medical practice and knowledge. The methodology used allowed to create a space for mutual recognition and reflection for participants. Prematurity is a significant element, especially in those who suffered major sequelae. Adolescents and youth give a warning on the negative effects caused by overprotective parents and reveal the possibility of redefining the challenges associated with their history of premature birth.

  19. Sphingosine Kinase: A Novel Putative Target for the Prevention of Infection-Triggered Preterm Birth

    Directory of Open Access Journals (Sweden)

    Vibhuti Vyas

    2013-01-01

    Full Text Available Preterm birth is defined as any delivery before 37 complete weeks of gestation. It is a universal challenge in the field of obstetrics owing to its high rate of mortality, long-term morbidity, associated human suffering and economic burden. In the United States, about 12.18% deliveries in 2009 were preterm, producing an exorbitant cost of $5.8 billion. Infection-associated premature rupture of membranes (PROM accounts for 40% of extremely preterm births (<28 weeks of gestation. Major research efforts are directed towards improving the understanding of the pathophysiology of preterm birth and ways to prevent or at least postpone delivery. Endothelin-1 (ET-1 is a potent vasoconstrictor that plays a significant role in infection-triggered preterm birth. Its involvement in a number of pathological mechanisms and its elevation in preterm delivered amniotic fluid samples implicate it in preterm birth. Sphingosine kinase (SphK is a ubiquitous enzyme responsible for the production of sphingosine-1-phosphate (S1P. S1P acts as second messenger in a number of cell proliferation and survival pathways. SphK is found to play a key role in ET-1 mediated myometrial contraction. This review highlights SphK as a prospective target with great potential to prevent preterm birth.

  20. Mode of delivery has an independent impact on neonatal condition at birth.

    Science.gov (United States)

    Prior, Tomas; Kumar, Sailesh

    2014-10-01

    Current intra-partum monitoring techniques are often criticized for their poor specificity, with their performance frequently evaluated using measures of the neonatal condition at birth as a surrogate marker for intra-partum fetal compromise. However, these measures may potentially be influenced by a multitude of other factors, including the mode of delivery itself. This study aimed to investigate the impact of mode of delivery on neonatal condition at birth. This prospective observational study, undertaken at a tertiary referral maternity unit in London, UK, included 604 'low risk' women recruited prior to delivery. Commonly assessed neonatal outcome variables (Apgar score at 1 and 5min, umbilical artery pH and base excess, neonatal unit admission, and a composite neonatal outcome score) were used to compare the condition at birth between babies born by different modes of delivery, using one-way ANOVA and chi-squared testing. Infants born by instrumental delivery for presumed fetal compromise had the poorest condition at birth (mean composite score=1.20), whereas those born by Cesarean section for presumed fetal compromise had a better condition at birth (mean composite score=0.64) (p=surrogate marker of intra-partum fetal compromise. When evaluating the efficacy of intra-partum monitoring techniques, the isolated use of Apgar scores, umbilical artery acidosis and neonatal unit admission should be discouraged. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Concordance between maternal recall of birth complications and data from obstetrical records.

    Science.gov (United States)

    Keenan, Kate; Hipwell, Alison; McAloon, Rose; Hoffmann, Amy; Mohanty, Arpita; Magee, Kelsey

    2017-02-01

    Prenatal complications are associated with poor outcomes in the offspring. Access to medical records is limited in the United States and investigators often rely on maternal report of prenatal complications. We tested concordance between maternal recall and birth records in a community-based sample of mothers participating in a longitudinal study in order to determine the accuracy of maternal recall of perinatal complications. Participants were 151 biological mothers, who were interviewed about gestational age at birth, birthweight, and the most commonly occurring birth complications: nuchal cord and meconium aspiration when the female child was on average 6years old, and for whom birth records were obtained. Concordance between reports was assessed using one-way random intra-class coefficients for continuous measures and kappa coefficients for dichotomous outcomes. Associations between maternal demographic and psychological factors and discrepancies also were tested. Concordance was excellent for continuously measured birthweight (ICC=0.85, pbirth record and absence according to maternal recall. Receipt of public assistance was associated with a decrease in discrepancy in report of nuchal cord. Concordance between maternal retrospective report and medical birth records varies across different types of perinatal events. There was little evidence that demographic or psychological factors increased the risk of discrepancies. Maternal recall based on continuous measures of perinatal factors may yield more valid data than dichotomous outcomes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. Birth year distribution in reported hepatitis C cases in Switzerland.

    Science.gov (United States)

    Bruggmann, Philip; Richard, Jean-Luc

    2015-02-01

    Data of the national hepatitis C virus (HCV) notification system and the Swiss hepatitis C cohort study have been analysed for birth year distribution. Persons born between 1955 and 1974 are disproportionally affected by HCV, accounting for 61% of all reported infections. Over the course of the reporting period from 1988 to 2012, the majority of affected persons were born in the mid-60s and a sharply increasing proportion between 1975 and 1984 (from 0.6 to 19.5%). To enhance the so far insufficient HCV detection rates in Switzerland, additional testing strategies such as birth cohort screening must be further evaluated and discussed. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  3. Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

    NARCIS (Netherlands)

    Hermus, M.A.A.; Boesveld, I.C.; Hilzert, M.; Franx, A.; Graaf, J.P. de; Steegers, E.A.P.; Wiegers, T.A.; Pal-de Bruin, K.M. van der

    2017-01-01

    Background: During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not

  4. Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study

    NARCIS (Netherlands)

    Hermus, Marieke A. A.; Boesveld, I. C.; Hitzert, Marrit M; Franx, A.; de Graaf, J. P.; Steegers, E. A P; Wiegers, Therese A.; van der Pal-de Bruin, Karin M.

    2017-01-01

    Background: During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not

  5. 28 CFR 551.21 - Birth control.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Birth control. 551.21 Section 551.21... Birth Control, Pregnancy, Child Placement, and Abortion § 551.21 Birth control. Medical staff shall provide an inmate with advice and consultation about methods for birth control and, where medically...

  6. Preterm birth, an unresolved issue.

    Science.gov (United States)

    Belizán, Jose M; Hofmeyr, Justus; Buekens, Pierre; Salaria, Natasha

    2013-11-15

    Premature birth is the world's leading cause of neonatal mortality with worldwide estimates indicating 11.1% of all live births were preterm in 2010. Preterm birth rates are increasing in most countries with continual differences in survival rates amongst rich and poor countries. Preterm birth is currently an important unresolved global issue with research efforts focusing on uterine quiescence and activation, the 'omics' approaches and implementation science in order to reduce the incidence and increase survival rates of preterm babies. The journal Reproductive Health has published a supplement entitled Born Too Soon which addresses factors in the preconception and pregnancy period which may increase the risk of preterm birth and also outlines potential interventions which may reduce preterm birth rates and improve survival of preterm babies by as much as 84% annually. This is critical in order to achieve the Millennium Development Goal (MDG 4) for child survival by 2015 and beyond.

  7. Maternal asthma, diabetes, and high blood pressure are associated with low birth weight and increased hospital birth and delivery charges; Hawai'i hospital discharge data 2003-2008.

    Science.gov (United States)

    Hayes, Donald K; Feigal, David W; Smith, Ruben A; Fuddy, Loretta J

    2014-02-01

    Asthma, diabetes, and high blood pressure are common maternal conditions that can impact birth outcomes. Data from hospital discharges in Hawai'i were analyzed for 107,034 singleton births from 2003-2008. Categories were determined using the International Statistical Classification of Diseases, ninth revision (ICD-9) from linked delivery records of mother and infant. Prevalence estimates of asthma (ICD-9: 493), diabetes (ICD-9: 250,648.0, 648.8), high blood pressure (ICD-9: 401-405,642) as coded on the delivery record, low birth weight (4500 grams), Cesarean delivery, and median hospital charges were calculated. Median regression analysis assessed total hospital charges adjusting for maternal age, maternal race, insurance, and Cesarean delivery. Maternal asthma was present in 4.3% (95% confidence interval=4.1-4.4%), maternal diabetes was present in 7.7% (95% CI=7.6-7.9%), and maternal high blood pressure was present in 9.2% (95% CI=9.0-9.3%) of births. In the adjusted median regression analysis, mothers with asthma had $999 (95% CI: $886 to $1,112) higher hospital charges compared to those without; mothers with diabetes had $743 (95% CI: $636 to $850) higher charges compared to those without; and mothers with high blood pressure had $2,314 (95% CI: $2,194 to $2,434) higher charges compared to those without. Asthma, diabetes, and high blood pressure are associated with higher hospital delivery charges and low birth weight. Diabetes and high blood pressure were also associated with Cesarean delivery. An increased awareness of the impact of these conditions on both adverse birth outcomes and the development of chronic disease is needed.

  8. The birth and survival of wildebeest calves.

    Science.gov (United States)

    Estes, R D; Estes, R K

    1979-05-01

    This paper describes social organization, parturition, post partum behavior of wildebeest mothers and offspring, and calf predation during the annual birth peak in Ngorongoro Crater, Tanzania. The wildebeest's "follower-calf" system, unique among the Bovidae, is remarkably effective in protecting neonates. Even during hte one-month peak, the major predator on calves, the spotted hyena, is unable to feed to satiation. Calf survival is consistently high, despite large fluctuations in the numbers of wildebeest, with consequent effects on the size of the yearly calf crop.

  9. the z-transform applied to a birth-death process having varying birth

    African Journals Online (AJOL)

    DEPT OF AGRICULTURAL ENGINEERING

    model can be used to study practical queuing and birth-death systems where the arrival, birth, ser- vice and death rates ... for systems operating in fading environments (Hueda and ... mobile computing (Lee et al., 1999) and the transmission ...

  10. Birth order and risk of childhood cancer in the Danish birth cohort of 1973-2010.

    Science.gov (United States)

    Schüz, Joachim; Luta, George; Erdmann, Friederike; Ferro, Gilles; Bautz, Andrea; Simony, Sofie Bay; Dalton, Susanne Oksbjerg; Lightfoot, Tracy; Winther, Jeanette Falck

    2015-11-01

    Many studies have investigated the possible association between birth order and risk of childhood cancer, although the evidence to date has been inconsistent. Birth order has been used as a marker for various in utero or childhood exposures and is relatively straightforward to assess. Data were obtained on all children born in Denmark between 1973 and 2010, involving almost 2.5 million births and about 5,700 newly diagnosed childhood cancers before the age of 20 years. Data were analyzed using Poisson regression models. We failed to observe associations between birth order and risk of any childhood cancer subtype, including acute lymphoblastic leukemia; all rate ratios were close to one. Further analyses stratified by birth cohort (those born between 1973 and 1990, and those born between 1991 and 2010) also failed to show any associations. Considering stillbirths and/or controlling for birth weight and parental age in the analyses had no effect on the results. Analyses by years of birth (those born between 1973 and 1990, and those born between 1991 and 2010) did not show any changes in the overall pattern of no association. In this large cohort of all children born in Denmark over an almost 40-year period, we did not observe an association between birth order and the risk of childhood cancer.

  11. Socioeconomic inequality in preterm birth in four Brazilian birth cohort studies.

    Science.gov (United States)

    Sadovsky, Ana Daniela Izoton de; Matijasevich, Alicia; Santos, Iná S; Barros, Fernando C; Miranda, Angelica Espinosa; Silveira, Mariangela Freitas

    To analyze economic inequality (absolute and relative) due to family income in relation to the occurrence of preterm births in Southern Brazil. Four birth cohort studies were conducted in the years 1982, 1993, 2004, and 2011. The main exposure was monthly family income and the primary outcome was preterm birth. The inequalities were calculated using the slope index of inequality and the relative index of inequality, adjusted for maternal skin color, education, age, and marital status. The prevalence of preterm births increased from 5.8% to approximately 14% (p-trendinequality demonstrated that income inequality arose in the 1993, 2004, and 2011 studies. After adjustment, only the 2004 study maintained the difference between the poorest and the richest subjects, which was 6.3 percentage points. The relative index of inequality showed that, in all studies, the poorest mothers were more likely to have preterm newborns than the richest. After adjustment for confounding factors, it was observed that the poorest mothers only had a greater chance of this outcome in 2004. In a final model, economic inequalities resulting from income were found in relation to preterm births only in 2004, although a higher prevalence of prematurity continued to be observed in the poorest population, in all the studies. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  12. Ethics and "normal birth".

    Science.gov (United States)

    Lyerly, Anne Drapkin

    2012-12-01

    The concept of "normal birth" has been promoted as ideal by several international organizations, although debate about its meaning is ongoing. In this article, I examine the concept of normalcy to explore its ethical implications and raise a trio of concerns. First, in its emphasis on nonuse of technology as a goal, the concept of normalcy may marginalize women for whom medical intervention is necessary or beneficial. Second, in its emphasis on birth as a socially meaningful event, the mantra of normalcy may unintentionally avert attention to meaning in medically complicated births. Third, the emphasis on birth as a normal and healthy event may be a contributor to the long-standing tolerance for the dearth of evidence guiding the treatment of illness during pregnancy and the failure to responsibly and productively engage pregnant women in health research. Given these concerns, it is worth debating not just what "normal birth" means, but whether the term as an ideal earns its keep. © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.

  13. Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles.

    Science.gov (United States)

    Smith, Andrew D A C; Tilling, Kate; Nelson, Scott M; Lawlor, Debbie A

    The likelihood of achieving a live birth with repeat in vitro fertilization (IVF) is unclear, yet treatment is commonly limited to 3 or 4 embryo transfers. To determine the live-birth rate per initiated ovarian stimulation IVF cycle and with repeated cycles. Prospective study of 156,947 UK women who received 257,398 IVF ovarian stimulation cycles between 2003 and 2010 and were followed up until June 2012. In vitro fertilization, with a cycle defined as an episode of ovarian stimulation and all subsequent separate fresh and frozen embryo transfers. Live-birth rate per IVF cycle and the cumulative live-birth rates across all cycles in all women and by age and treatment type. Optimal, prognosis-adjusted, and conservative cumulative live-birth rates were estimated, reflecting 0%, 30%, and 100%, respectively, of women who discontinued due to poor prognosis and having a live-birth rate of 0 had they continued. Among the 156,947 women, the median age at start of treatment was 35 years (interquartile range, 32-38; range, 18-55), and the median duration of infertility for all 257,398 cycles was 4 years (interquartile range, 2-6; range, cycle was 29.5% (95% CI, 29.3%-29.7%). This remained above 20% up to and including the fourth cycle. The cumulative prognosis-adjusted live-birth rate across all cycles continued to increase up to the ninth cycle, with 65.3% (95% CI, 64.8%-65.8%) of women achieving a live birth by the sixth cycle. In women younger than 40 years using their own oocytes, the live-birth rate for the first cycle was 32.3% (95% CI, 32.0%-32.5%) and remained above 20% up to and including the fourth cycle. Six cycles achieved a cumulative prognosis-adjusted live-birth rate of 68.4% (95% CI, 67.8%-68.9%). For women aged 40 to 42 years, the live-birth rate for the first cycle was 12.3% (95% CI, 11.8%-12.8%), with 6 cycles achieving a cumulative prognosis-adjusted live-birth rate of 31.5% (95% CI, 29.7%-33.3%). For women older than 42 years, all rates within each cycle

  14. Prospective study of determinants and costs of home births in Mumbai slums

    Directory of Open Access Journals (Sweden)

    Das Sushmita

    2010-07-01

    Full Text Available Abstract Background Around 86% of births in Mumbai, India, occur in healthcare institutions, but this aggregate figure hides substantial variation and little is known about urban home births. We aimed to explore factors influencing the choice of home delivery, care practices and costs, and to identify characteristics of women, households and the environment which might increase the likelihood of home birth. Methods As part of the City Initiative for Newborn Health, we used a key informant surveillance system to identify births prospectively in 48 slum communities in six wards of Mumbai, covering a population of 280 000. Births and outcomes were documented prospectively by local women and mothers were interviewed in detail at six weeks after delivery. We examined the prevalence of home births and their associations with potential determinants using regression models. Results We described 1708 (16% home deliveries among 10 754 births over two years, 2005-2007. The proportion varied from 6% to 24%, depending on area. The most commonly cited reasons for home birth were custom and lack of time to reach a healthcare facility during labour. Seventy percent of home deliveries were assisted by a traditional birth attendant (dai, and 6% by skilled health personnel. The median cost of a home delivery was US$ 21, of institutional delivery in the public sector US$ 32, and in the private sector US$ 118. In an adjusted multivariable regression model, the odds of home delivery increased with illiteracy, parity, socioeconomic poverty, poorer housing, lack of water supply, population transience, and hazardous location. Conclusions We estimate 32 000 annual home births to residents of Mumbai's slums. These are unevenly distributed and cluster with other markers of vulnerability. Since cost does not appear to be a dominant disincentive to institutional delivery, efforts are needed to improve the client experience at public sector institutions. It might also be

  15. Risk factors and birth outcomes of anaemia in early pregnancy in a nulliparous cohort.

    Directory of Open Access Journals (Sweden)

    Gwinyai Masukume

    Full Text Available Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality.The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of 'low risk' women participating in a large international multicentre prospective study (n = 5 609, to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation.The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints study. Anaemia was defined according to the World Health Organization's definition of anaemia in pregnancy (haemoglobin < 11g/dL. Binary logistic regression with adjustment for potential confounders (country, maternal age, having a marital partner, ethnic origin, years of schooling, and having paid work was the main method of analysis.The hallmark findings were the low prevalence of anaemia (2.2%, that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78, and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score < 7 at one and five minutes. Adverse pregnancy outcomes were however more common in those with anaemia than in those without.In this low risk healthy pregnant population we found a low anaemia rate. The absence of a marital partner was a non-modifiable factor, albeit one which may reflect a variety of confounding factors, that should be considered for addition to anaemia's conceptual framework of determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy.

  16. Subfecundity as a correlate of preeclampsia: A study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Basso, Olga; Weinberg, Clarice R.; Baird, Donna D.

    2003-01-01

    A long interpregnancy interval is associated with preeclampsia. If some women experiencing a long interval between births had difficulty conceiving, subfecundity and preeclampsia may share a common etiology. Therefore, the authors examined the association between subfecundity and preeclampsia. By...

  17. Bias from conditioning on live birth in pregnancy cohorts: an illustration based on neurodevelopment in children after prenatal exposure to organic pollutants

    Science.gov (United States)

    Liew, Zeyan; Olsen, Jørn; Cui, Xin; Ritz, Beate; Arah, Onyebuchi A

    2015-01-01

    Only 60–70% of fertilized eggs may result in a live birth, and very early fetal loss mainly goes unnoticed. Outcomes that can only be ascertained in live-born children will be missing for those who do not survive till birth. In this article, we illustrate a common bias structure (leading to ‘live-birth bias’) that arises from studying the effects of prenatal exposure to environmental factors on long-term health outcomes among live births only in pregnancy cohorts. To illustrate this we used prenatal exposure to perfluoroalkyl substances (PFAS) and attention-deficit/hyperactivity disorder (ADHD) in school-aged children as an example. PFAS are persistent organic pollutants that may impact human fecundity and be toxic for neurodevelopment. We simulated several hypothetical scenarios based on characteristics from the Danish National Birth Cohort and found that a weak inverse association may appear even if PFAS do not cause ADHD but have a considerable effect on fetal survival. The magnitude of the negative bias was generally small, and adjusting for common causes of the outcome and fetal loss can reduce the bias. Our example highlights the need to identify the determinants of pregnancy loss and the importance of quantifying bias arising from conditioning on live birth in observational studies. PMID:25604449

  18. Low-birthweight rates higher among Bangladeshi neonates measured during active birth surveillance compared to national survey data.

    Science.gov (United States)

    Klemm, Rolf D W; Merrill, Rebecca D; Wu, Lee; Shamim, Abu Ahmed; Ali, Hasmot; Labrique, Alain; Christian, Parul; West, Keith P

    2015-10-01

    Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small-for-gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth size distributions were explored based on raw values as well as after z-score standardisation in reference to World Health Organization (WHO) 2006 growth standards. Mean (SD) birthweight (g), length (cm) and head circumference (cm) measurements, completed within [median (25th, 75th percentile)] 15 (8, 23) h of life, were 2433 (425), 46.4 (2.4) and 32.4 (1.6), respectively. Twenty-two per cent were born preterm. Over one-half (55.3%) of infants were born low birthweight; 46.6%, 37.0% and 33.6% had a weight, length and head circumference below -2 z-scores of the WHO growth standard at birth; and 70.9%, 72.2% and 59.8% were SGA for weight based on Alexander et al., Oken et al. and Olsen et al. references, respectively. Infants in this typical rural Bangladesh setting were commonly born small, reflecting a high burden of fetal growth restriction and preterm birth. Our findings, produced by active birth surveillance, suggest that low birthweight is far more common than suggested by cross-sectional survey estimates. Interventions that improve fetal growth during pregnancy may have the largest impact on reducing SGA rates. © 2013 John Wiley & Sons Ltd.

  19. The mystery of missing female children in the Caucasus: an analysis of sex ratios by birth order.

    Science.gov (United States)

    Michael, Marc; King, Lawrence; Guo, Liang; McKee, Martin; Richardson, Erica; Stuckler, David

    2013-06-01

    Official data on sex ratios at birth suggest a rise in sex-selective abortions in some post-Soviet states following the introduction of ultrasonography. However, questions remain about the validity of official data in these nations as well as whether the high sex ratios at birth are a statistical artifact. Trends in sex ratios at birth from 1985 to 2009 for 12 post-Soviet states were examined using vital registration data. For the three countries that had had a Demographic and Health Survey (DHS) in 2005-2010 (Armenia, Azerbaijan and Moldova), survey data were used to calculate sex ratios at birth according to birth order, and vital registration data for 2010 were used to estimate the number of "missing" female births (if any). Official data revealed elevated sex ratios at birth in Armenia (117), Azerbaijan (116) and Georgia (121), but not in other post-Soviet states. According to DHS data, sex ratios were high in Armenia and Azerbaijan for first births (138 and 113, respectively); if the first child was a girl, the sex ratio in Armenia was even higher for the second birth (154). Overall, the number of girls born in these countries in 2010 was 10% lower than expected, consistent with 1,972 sex-selective abortions in Armenia and 8,381 in Azerbaijan. Sex ratios did not vary by birth order in Moldova. Sex-selective abortion appears to be common in Azerbaijan and Armenia. Family planning and legal interventions are needed to address this issue.

  20. Effects on metabolic parameters in young rats born with low birth weight after exposure to a mixture of pesticides

    DEFF Research Database (Denmark)

    Svingen, Terje; Ramhøj, Louise; Egebjerg, Karen Mandrup

    2018-01-01

    Pesticide exposure during fetal life can lead to low birth weight and is commonly observed in reproductive toxicology studies. Associations have also been found in low birth weight babies born from pesticide-exposed gardeners. Since low birth weight is also linked to metabolic disorders, it can...... be speculated that early life exposure to pesticides could increase the risk of becoming obese or developing diabetes later in life. We have analyzed potential long-term effects of gestational and lactational exposure to a low dose mixture of six pesticides that individually can cause low birth weight....... Our results suggest that early-life exposure to pesticides may contribute to the development of metabolic disorders later in life....

  1. Effects of Maternal Age and Age-Specific Preterm Birth Rates on Overall Preterm Birth Rates - United States, 2007 and 2014.

    Science.gov (United States)

    Ferré, Cynthia; Callaghan, William; Olson, Christine; Sharma, Andrea; Barfield, Wanda

    2016-11-04

    Reductions in births to teens and preterm birth rates are two recent public health successes in the United States (1,2). From 2007 to 2014, the birth rate for females aged 15-19 years declined 42%, from 41.5 to 24.2 per 1,000 females. The preterm birth rate decreased 8.4%, from 10.41% to 9.54% of live births (1). Rates of preterm births vary by maternal age, being higher among the youngest and oldest mothers. It is unknown how changes in the maternal age distribution in the United States have affected preterm birth rates. CDC used birth data to assess the relative contributions of changes in the maternal age distribution and in age-specific preterm birth rates to the overall decrease in preterm birth rates. The preterm birth rate declined in all age groups. The effects of age distribution changes on the preterm birth rate decrease were different in younger and older mothers. The decrease in the proportion of births to mothers aged ≤19 and 20-24 years and reductions in age-specific preterm rates in all age groups contributed to the overall decline in the preterm birth rate. The increase in births to mothers aged ≥30 years had no effect on the overall preterm birth rate decrease. The decline in preterm births from 2007 to 2014 is related, in part, to teen pregnancy prevention and the changing maternal age distribution. Effective public health strategies for further reducing preterm birth rates need to be tailored to different age groups.

  2. Preterm Labor and Birth

    Science.gov (United States)

    ... Facebook Twitter Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about ... is called preterm labor (or premature labor). A birth that occurs before 37 weeks is considered a ...

  3. Maternal dental radiography during pregnancy is not associated with term low birth weight

    International Nuclear Information System (INIS)

    Mortazavi, S.M.J.; Center for Radiation Research, Shiraz University, Shiraz; Aminzadeh, F.; Manshouri, A.; Kamali, M.; Rezaiean, M.; Vazirinejad, R.

    2007-01-01

    Complete text of publication follows. Objective: In a report published in JAMA in 2004, Hujoel and colleagues indicated that maternal dental radiography during pregnancy may be associated with term low birth weight. Interestingly, they concluded that dental radiographies cause measurable radiation doses to the hypothalamus-pituitary-thyroid axis and the radiation effects on this axis is the reason for term low birth weight. On the other hand, low birth weight is the second leading cause of infant death. In this paper the results obtained in a 2 year study conducted at a midwifery hospital in Rafsanjan, IR Iran are reported. Methods: Four hundred seventy-five singleton infants with gestational periods of 37-44 wk born between 2006 and 2007 at the Niknafs Teaching Hospital affiliated with Rafsanjan University of Medical Sciences and met the inclusion criteria were enrolled in the study. Demographic data and clinical findings at birth including gestation age, sex of infant, birth order, season of birth, maternal age, and maternal education were collected from maternal and newborn hospital records and by interviews with parents. Maternal history of exposure to common sources of man-made ionizing and non-ionizing (exposure to radiations emitted by mobile phones, CRTs, cordless phones) radiation before and during pregnancy were carefully recorded. Results: Among the 475 infants who were studied, there were only 15 cases with a history of maternal dental radiography during pregnancy. The average newborn infants' birth weight in non-exposed and exposed (maternal dental radiography during pregnancy) groups were 3166.69±481.31 g and 3118.67±341.42 g respectively. This difference was not statistically significant. Conclusions: In this study, low birth weight was not associated with maternal dental radiography during pregnancy. These results are generally inconsistent with those reported by Hujoel and colleagues.

  4. Socioeconomic inequalities in very preterm birth rates.

    Science.gov (United States)

    Smith, L K; Draper, E S; Manktelow, B N; Dorling, J S; Field, D J

    2007-01-01

    To investigate the extent of socioeconomic inequalities in the incidence of very preterm birth over the past decade. Ecological study of all 549 618 births in the former Trent health region, UK, from 1 January 1994 to 31 December 2003. All singleton births of 22(+0) to 32(+6) weeks gestation (7 185 births) were identified from population surveys of neonatal services and stillbirths. Poisson regression was used to calculate incidence of very preterm birth (22-32 weeks) and extremely preterm birth (22-28 weeks) by year of birth and decile of deprivation (child poverty section of the Index of Multiple Deprivation). Incidence of very preterm singleton birth rose from 11.9 per 1000 births in 1994 to 13.7 per 1000 births in 2003. Those from the most deprived decile were at nearly twice the risk of very preterm birth compared with those from the least deprived decile, with 16.4 per 1000 births in the most deprived decile compared with 8.5 per 1000 births in the least deprived decile (incidence rate ratio 1.94; 95% CI (1.73 to 2.17)). This deprivation gap remained unchanged throughout the 10-year period. The magnitude of socio-economic inequalities was the same for extremely preterm births (22-28 weeks incidence rate ratio 1.94; 95% CI (1.62 to 2.32)). This large, unique dataset of very preterm births shows wide socio-economic inequalities that persist over time. These findings are likely to have consequences on the burden of long-term morbidity. Our research can assist future healthcare planning, the monitoring of socio-economic inequalities and the targeting of interventions in order to reduce this persistent deprivation gap.

  5. Maternal malaria status and metabolic profiles in pregnancy and in cord blood: relationships with birth size in Nigerian infants

    Directory of Open Access Journals (Sweden)

    Ayoola Omolola O

    2012-03-01

    Full Text Available Abstract Background Malaria is more common in pregnant than in non-pregnant Nigerian women, and is associated with small birth size and the attendant short- and long-term health risks. The influence of malaria on maternal metabolic status in pregnancy and in cord blood and how this relates to birth size has not been studied. The study objective was to define relationships between maternal and cord serum metabolic markers, maternal malaria status and birth size. Methods During pregnancy, anthropometric measurements, blood film for malaria parasites and assays for lipids, glucose, insulin and TNF were obtained from 467 mothers and these analytes and insulin-like growth factor-I (IGF-I were obtained from cord blood of 187 babies. Results Overall prevalence of maternal malaria was 52%, associated with younger age, anaemia and smaller infant birth size. Mothers with malaria had significantly lower cholesterol (total, HDL and LDL and higher TNF, but no difference in triglyceride. In contrast, there was no effect of maternal malaria on cord blood lipids, but the median (range cord IGF-I was significantly lower in babies whose mothers had malaria: 60.4 (24,145μg/L, versus no malaria: 76.5 (24, 150μg/L, p = 0.03. On regression analysis, the key determinants of birth weight included maternal total cholesterol, malarial status and cord insulin and IGF-I. Conclusions Malaria in pregnancy was common and associated with reduced birth size, lower maternal lipids and higher TNF. In the setting of endemic malaria, maternal total cholesterol during pregnancy and cord blood insulin and IGF-I levels are potential biomarkers of foetal growth and birth size.

  6. Quality assessment of home births in Denmark

    DEFF Research Database (Denmark)

    Jensen, Sabrina; Colmorn, Lotte B.; Schroll, Anne-Mette

    2017-01-01

    INTRODUCTION: The safety of home births has been widely debated. Observational studies examining maternal and neonatal outcomes of home births have become more frequent, and the quality of these studies has improved. The aim of the present study was to describe neonatal outcomes of home births...... compared with hospital births and to discuss which data are needed to evaluate the safety of home births. METHODS: This was a register-based cohort study. Data on all births in Denmark (2003-2013) were collected from the Danish Medical Birth Registry (DMBR). The cohort included healthy women...... with uncomplicated pregnancies and no medical interventions during delivery. A total of 6,395 home births and 266,604 hospital births were eligible for analysis. Comparative analyses were performed separately in nulliparous and multiparous women. The outcome measures were neonatal mortality and morbidity. RESULTS...

  7. Early weight changes after birth and serum high-molecular-weight adiponectin level in preterm infants.

    Science.gov (United States)

    Yoshida, Tomohide; Nagasaki, Hiraku; Asato, Yoshihide; Ohta, Takao

    2011-12-01

    Extra-uterine growth retardation (EUGR) is associated with an increased risk for cardiometabolic diseases later in life. The aim of the present study was to examine the relationship between early weight change after birth in preterm infants and adiponectin (adn) multimeric complexes. Subjects included 28 preterm infants born between weeks 24 and 33 of gestation. Serum adn multimeric complexes and the anthropometric parameters were measured in preterm infants at birth and at corrected term. Bodyweight (BW) decreased during the first week of life, with birthweight restored at approximately 19 days after birth. Nineteen of the subjects had EUGR at corrected term. Total (T)-adn, high-molecular-weight (H)-adn, and the ratio of H-adn to T-adn (H/T-adn) were significantly elevated at corrected term than at birth. Postmenstrual age, birthweight, birth length and lowest BW after birth were positively correlated with H-adn and H/T-adn. Weight reduction after birth was negatively correlated with H-adn. Age to restore birthweight was negatively correlated with T-adn, H-adn and H/T-adn. Stepwise multiple regression analysis indicated age to restore birthweight as the major predictor of T-adn and H-adn. Early weight changes after birth may alter serum adn level in preterm infants at corrected term. The appropriate nutritional support in the early postnatal period could reduce the prevalence of EUGR and the future risk for cardiometabolic diseases. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  8. Effects of fine particulate matter and its constituents on low birth weight among full-term infants in California

    International Nuclear Information System (INIS)

    Basu, Rupa; Harris, Maria; Sie, Lillian; Malig, Brian; Broadwin, Rachel; Green, Rochelle

    2014-01-01

    Relationships between prenatal exposure to fine particles (PM 2.5 ) and birth weight have been observed previously. Few studies have investigated specific constituents of PM 2.5 , which may identify sources and major contributors of risk. We examined the effects of trimester and full gestational prenatal exposures to PM 2.5 mass and 23 PM 2.5 constituents on birth weight among 646,296 term births in California between 2000 and 2006. We used linear and logistic regression models to assess associations between exposures and birth weight and risk of low birth weight (LBW; 2.5 mass and several PM 2.5 constituents were significantly associated with reductions in term birth weight. The largest reductions in birth weight were associated with exposure to vanadium, sulfur, sulfate, iron, elemental carbon, titanium, manganese, bromine, ammonium, zinc, and copper. Several of these PM 2.5 constituents were associated with increased risk of term LBW. Reductions in birth weight were generally larger among younger mothers and varied by race/ethnicity. Exposure to specific constituents of PM 2.5 , especially traffic-related particles, sulfur constituents, and metals, were associated with decreased birth weight in California. -- Highlights: • Examine full gestational and trimester fine particle and its constituents on term birth weight. • Fine particles and several of its constituents associated with birth weight reductions. • Largest reductions for traffic-related particles, sulfur constituents, and metals. • Greater birth weight reductions for younger mothers, and varied by race/ethnicity

  9. Coping and help in birth: An investigation into 'normal' childbirth as described by new mothers and their attending midwives.

    Science.gov (United States)

    Darra, Susanne; Murphy, Fiona

    2016-09-01

    to investigate how 'normal' childbirth is described by new mothers and their attending midwives. a qualitative, reflexive, narrative study was used to explore birth stories using in-depth, un-structured interviews. 21 new mothers and their 16 attending midwives were recruited from the locality surrounding a district general hospital in South Wales, United Kingdom (UK). the findings identified that the mothers wanted to cope with labour and birth, by breathing through it and using some birth interventions with the help of knowledgeable midwives. Midwives aimed to achieve 'normality' in birth but also commonly utilised birth interventions. Consequently the notion of 'normal' birth as not involving interventions in birth was not found to be a useful defining concept in this study. Furthermore, current dichotomous models and theories of birth and midwifery in particular those relating to pain management did not fully explain the perspectives of these women and their midwives. dichotomous models and theories for birth and midwifery practice and those which incorporate the term 'normal' birth are shown to be not entirely useful to fully explain the contemporary complexity of childbirth in the UK. Therefore it is now necessary to consider avoiding using dichotomous models of birth and midwifery in the UK and to instead concentrate on developing integrated models that reflect the real life current experiences of women and their midwives. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Twin's Birth-Order Differences in Height and Body Mass Index From Birth to Old Age

    DEFF Research Database (Denmark)

    Yokoyama, Yoshie; Jelenkovic, Aline; Sund, Reijo

    2016-01-01

    of age was 397,466. As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood. After adjusting the results for birth weight, the birth order differences decreased and were no longer...

  11. [Inclusion of traditional birth attendants in the public health care system in Brazil: reflecting on challenges].

    Science.gov (United States)

    Gusman, Christine Ranier; Viana, Ana Paula de Andrade Lima; Miranda, Margarida Araújo Barbosa; Pedrosa, Mayane Vilela; Villela, Wilza Vieira

    2015-05-01

    The present article describes an experience with traditional birth attendants carried out in the state of Tocantins, Brazil, between 2010 and 2014. The experience was part of a diagnostic project to survey home deliveries in the state of Tocantins and set up a registry of traditional birth attendants for the Health Ministry's Working with Traditional Birth Attendants Program (PTPT). The project aimed to articulate the home deliveries performed by traditional birth attendants to the local health care systems (SUS). Sixty-seven active traditional birth attendants were identified in the state of Tocantins, and 41 (39 indigenous) participated in workshops. During these workshops, they discussed their realities, difficulties, and solutions in the context of daily adversities. Birth attendants were also trained in the use of biomedical tools and neonatal resuscitation. Based on these experiences, the question came up regarding the true effectiveness of the strategy to include traditional birth attendants in the SUS. The present article discusses this theme with support from the relevant literature. The dearth of systematic studies focusing on the impact of PTPT actions on the routine of traditional birth attendants, including perinatal outcomes and remodeling of health practices in rural, riverfront, former slave, forest, and indigenous communities, translates into a major gap in terms of the knowledge regarding the effectiveness of such initiatives.

  12. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... Educators Search English Español Birthing Centers and Hospital Maternity Services KidsHealth / For Parents / Birthing Centers and Hospital Maternity Services What's in this article? Giving Birth at ...

  13. How Would Children Register Their Own Births? Insights from a Survey of Students Regarding Birth Registration Knowledge and Policy Suggestions in Kenya.

    Directory of Open Access Journals (Sweden)

    Matthew Pelowski

    Full Text Available Birth registration and obtaining physical birth certificates impose major challenges in developing countries, with impact on child and community health, education, planning, and all levels of development. However despite initiatives, universal registration is elusive, leading to calls for new approaches to understanding the decisions of parents. In this paper, we report results of a survey of students in grades six to eight (age ~12-16 in an under-registered area of Kenya regarding their own understanding of registration issues and their suggestions for improvement. These students were selected because they themselves were also nearing the age for high school enrollment/entrance examinations, which specifically requires possession of a birth certificate. This assessment was also a companion to our previous representative survey of adults in the same Kenyan region, allowing for parent-child comparison. Results supported previous research, showing that only 43% had birth certificates. At the same time, despite these low totals, students were themselves quite aware of registration factors and purposes. The students also made quite prescient sources for understanding their households' motivations, with many of their suggestions-for focus on communication of pragmatic benefits, or automatic measures shifting responsibility from parents-mirroring our own previous suggestions, and showing a level of pragmatism not witnessed when surveying their parents. This paper therefore adds evidence to the discussion of registration policy planning. More generally, it also builds on an important trend regarding the treatment of children as stakeholders and important sources of information, and raising an intriguing new avenue for future research.

  14. Nasal birth trauma: a review of appropriate treatment.

    LENUS (Irish Health Repository)

    Cashman, E C

    2012-02-01

    The aetiology of nasal deformity has frequently included birth trauma. There is no consensus in the literature as to whether nasal surgery, in the form of closed reduction, is indicated in neonates. The majority of studies in the literature that advocate intervention have inadequate followup periods and there is a paucity of evidence for the adverse effects of conservative management. This case highlights the therapeutic dilemma posed by such nasal injuries in the neonate and, to the best of the authors\\' knowledge, at the time of writing, represents the earliest reported case in the literature of nasal deformity in the neonate. The term nasal deformity is used to denote deformity of the nasal pyramid, soft tissue, and septum. Three main aspects of neonatal nasal deformity are addressed including, firstly, if nasal deformity at birth needs to be addressed, secondly, if left unaltered, what the long-term effects are and, finally, if intervention alters the normal course of midfacial development.

  15. Maternal Asthma, Diabetes, and High Blood Pressure are Associated with Low Birth Weight and Increased Hospital Birth and Delivery Charges; Hawai‘i Hospital Discharge Data 2003–2008

    Science.gov (United States)

    Feigal, David W; Smith, Ruben A; Fuddy, Loretta J

    2014-01-01

    Asthma, diabetes, and high blood pressure are common maternal conditions that can impact birth outcomes. Data from hospital discharges in Hawai‘i were analyzed for 107,034 singleton births from 2003–2008. Categories were determined using the International Statistical Classification of Diseases, ninth revision (ICD-9) from linked delivery records of mother and infant. Prevalence estimates of asthma (ICD-9: 493), diabetes (ICD-9: 250,648.0, 648.8), high blood pressure (ICD-9: 401–405,642) as coded on the delivery record, low birth weight (4500 grams), Cesarean delivery, and median hospital charges were calculated. Median regression analysis assessed total hospital charges adjusting for maternal age, maternal race, insurance, and Cesarean delivery. Maternal asthma was present in 4.3% (95% confidence interval=4.1–4.4%), maternal diabetes was present in 7.7% (95% CI=7.6–7.9%), and maternal high blood pressure was present in 9.2% (95% CI=9.0–9.3%) of births. In the adjusted median regression analysis, mothers with asthma had $999 (95% CI: $886 to $1,112) higher hospital charges compared to those without; mothers with diabetes had $743 (95% CI: $636 to $850) higher charges compared to those without; and mothers with high blood pressure had $2,314 (95% CI: $2,194 to $2,434) higher charges compared to those without. Asthma, diabetes, and high blood pressure are associated with higher hospital delivery charges and low birth weight. Diabetes and high blood pressure were also associated with Cesarean delivery. An increased awareness of the impact of these conditions on both adverse birth outcomes and the development of chronic disease is needed. PMID:24567868

  16. Environmental exposure assessment in European birth cohorts: results from the ENRIECO project

    Directory of Open Access Journals (Sweden)

    Gehring Ulrike

    2013-01-01

    Full Text Available Abstract Environmental exposures during pregnancy and early life may have adverse health effects. Single birth cohort studies often lack statistical power to tease out such effects reliably. To improve the use of existing data and to facilitate collaboration among these studies, an inventory of the environmental exposure and health data in these studies was made as part of the ENRIECO (Environmental Health Risks in European Birth Cohorts project. The focus with regard to exposure was on outdoor air pollution, water contamination, allergens and biological organisms, metals, pesticides, smoking and second hand tobacco smoke (SHS, persistent organic pollutants (POPs, noise, radiation, and occupational exposures. The review lists methods and data on environmental exposures in 37 European birth cohort studies. Most data is currently available for smoking and SHS (N=37 cohorts, occupational exposures (N=33, outdoor air pollution, and allergens and microbial agents (N=27. Exposure modeling is increasingly used for long-term air pollution exposure assessment; biomonitoring is used for assessment of exposure to metals, POPs and other chemicals; and environmental monitoring for house dust mite exposure assessment. Collaborative analyses with data from several birth cohorts have already been performed successfully for outdoor air pollution, water contamination, allergens, biological contaminants, molds, POPs and SHS. Key success factors for collaborative analyses are common definitions of main exposure and health variables. Our review emphasizes that such common definitions need ideally be arrived at in the study design phase. However, careful comparison of methods used in existing studies also offers excellent opportunities for collaborative analyses. Investigators can use this review to evaluate the potential for future collaborative analyses with respect to data availability and methods used in the different cohorts and to identify potential partners

  17. CALF CIRCUMFERENCE AT BIRTH: A SCREENING METHOD FOR DETECTION OF LOW BIRTH WEIGHT

    Directory of Open Access Journals (Sweden)

    Sandip Kumar

    2012-12-01

    Full Text Available Background: Low Birth Weight (LBW babies run a higher risk of morbidity and mortality in the perinatal period. However, in our country where almost 70-80% births take place at home and peripheral hospitals, taking accurate weight is a problem due to unavailability of weighing scale and trained personnel. Hence there is a constant search for newer methods to detect LBW babies so that early interventions can be instituted. Various authors have used different surrogate anthropometric measurements from different parts of our country. In the present study, an attempt was made to validate the feasibility of using calf circumference as a predictor of LBW babies that can be used by a trained or untrained person. Objectives: To study various anthropometric measurements including calf circumference in newborns and to correlate various measurements with birth weight. Methods: The present study was conducted in the department of Social & Preventive Medicine, MLB Medical College, Jhansi (UP for a period of one year. The study included 1100 consecutively delivered neonates in the maternity ward of MLB Medical College Hospital, Jhansi (UP. The birth weight (Wt, crown heel length (CHL, crown rump length (CRL, head circumference (HC, chest circumference (CC, mid arm circumference (MAC, thigh circumference (TC and calf circumference (CC by standard techniques. All the measurements were taken by a single person throughout the study period with in 24 hours of delivery. Standard statistical methods were adopted for determination of critical limit, sensitivity, specificity and correlation coefficient of different anthropometric measurements in relation to birth weight. Results: Analysis of data indicates that out of 1100 newborns, 55.64% were low birth weight. The percentage of newborns > 2500gm was 44.36. Overall average birth weight was 2348 ± 505gm. Out of 1100 newborns, 608 (55.27% were males and 492 (44.73% were females. Average birth weight for males was 2412

  18. Social causes of low birth weight.

    OpenAIRE

    Kogan, M D

    1995-01-01

    The manifest importance of reducing the incidence of low birth weight is most obvious for the first year of life: low birth weight is the single most important factor affecting infant morbidity and mortality. However, there is growing evidence that the adverse consequences of low birth weight continue throughout the life cycle. This review deals primarily with social causes of low birth weight.

  19. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

    Directory of Open Access Journals (Sweden)

    Amos Grünebaum

    Full Text Available Over the last decade, planned home births in the United States (US have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status.The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States.This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM, nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board.Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53 than home births attended by certified midwives (NNM: 10.0/10,000; RR 1 and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]. The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2.This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal

  20. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Brent, Robert L; Levene, Malcolm I; Chervenak, Frank A

    2016-01-01

    Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States. This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life) in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams) without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM), nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board. Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53) than home births attended by certified midwives (NNM: 10.0/10,000; RR 1) and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]). The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2). This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal mortality rates

  1. Going public: do risk and choice explain differences in caesarean birth rates between public and private places of birth in Australia?

    Science.gov (United States)

    Miller, Yvette D; Prosser, Samantha J; Thompson, Rachel

    2012-10-01

    women who birth in private facilities in Australia are more likely to have a caesarean birth than women who birth in public facilities and these differences remain after accounting for sector differences in the demographic and health risk profiles of women. However, the extent to which women's preferences and/or freedom to choose their mode of birth further account for differences in the likelihood of caesarean birth between the sectors remains untested. women who birthed in Queensland, Australia during a two-week period in 2009 were mailed a self-report survey approximately 3 months after birth. Seven hundred and fifty-seven women provided cross-sectional retrospective data on where they birthed (public or private facility), mode of birth (vaginal or caesarean) and risk factors, along with their preferences and freedom to choose their mode of birth. A hierarchical logistic regression was conducted to determine the extent to which maternal risk and freedom to choose one's mode of birth explain sector differences in the likelihood of having a caesarean birth. while there was no sector difference in women's preference for mode of birth, women who birthed in private facilities had higher odds of feeling able to choose either a vaginal or caesarean birth, and feeling able to choose only a caesarean birth. Women had higher odds of having caesarean birth if they birthed in private facilities, even after accounting for significant risk factors such as age, body mass index, previous caesarean and use of assisted reproductive technology. However, there was no association between place of birth and odds of having a caesarean birth after also accounting for freedom to choose one's mode of birth. these findings call into question suggestions that the higher caesarean birth rate in the private sector in Australia is attributable to increased levels of obstetric risk among women birthing in the private sector or maternal preferences alone. Instead, the determinants of sector

  2. Geospatial Association between Low Birth Weight and Arsenic in Groundwater in New Hampshire, USA

    Science.gov (United States)

    Shi, Xun; Ayotte, Joseph D.; Onda, Akikazu; Miller, Stephanie; Rees, Judy; Gilbert-Diamond, Diane; Onega, Tracy; Gui, Jiang; Karagas, Margaret; Moeschler, John

    2015-01-01

    Background There is increasing evidence of the role of arsenic in the etiology of adverse human reproductive outcomes. Since drinking water can be a major source of arsenic to pregnant women, the effect of arsenic exposure through drinking water on human birth may be revealed by a geospatial association between arsenic concentration in groundwater and birth problems, particularly in a region where private wells substantially account for water supply, like New Hampshire, US. Methods We calculated town-level rates of preterm birth and term low birth weight (term LBW) for New Hampshire, using data for 1997-2009 and stratified by maternal age. We smoothed the rates using a locally-weighted averaging method to increase the statistical stability. The town-level groundwater arsenic values are from three GIS data layers generated by the US Geological Survey: probability of local groundwater arsenic concentration > 1 μg/L, probability > 5 μg/L, and probability > 10 μg/L. We calculated Pearson's correlation coefficients (r) between the reproductive outcomes (preterm birth and term LBW) and the arsenic values, at both state and county levels. Results For preterm birth, younger mothers (maternal age arsenic level based on the data of probability > 10 μg/L; For older mothers, r = 0.19 when the smoothing threshold = 3,500; A majority of county level r values are positive based on the arsenic data of probability > 10 μg/L. For term LBW, younger mothers (maternal age arsenic level based on the data of probability > 1 μg/L; For older mothers, r = 0.14 when the rates are smoothed with a threshold = 1,000 births and also adjusted by town median household income in 1999, and the arsenic values are the town minimum based on probability > 10 μg/L. At the county level, for younger mothers positive r values prevail, but for older mothers it is a mix. For both birth problems, the several most populous counties - with 60-80% of the state's population and clustering at the southwest

  3. Geospatial association between adverse birth outcomes and arsenic in groundwater in New Hampshire, USA.

    Science.gov (United States)

    Shi, Xun; Ayotte, Joseph D; Onda, Akikazu; Miller, Stephanie; Rees, Judy; Gilbert-Diamond, Diane; Onega, Tracy; Gui, Jiang; Karagas, Margaret; Moeschler, John

    2015-04-01

    There is increasing evidence of the role of arsenic in the etiology of adverse human reproductive outcomes. Because drinking water can be a major source of arsenic to pregnant women, the effect of arsenic exposure through drinking water on human birth may be revealed by a geospatial association between arsenic concentration in groundwater and birth problems, particularly in a region where private wells substantially account for water supply, like New Hampshire, USA. We calculated town-level rates of preterm birth and term low birth weight (term LBW) for New Hampshire, by using data for 1997-2009 stratified by maternal age. We smoothed the rates by using a locally weighted averaging method to increase the statistical stability. The town-level groundwater arsenic probability values are from three GIS data layers generated by the US Geological Survey: probability of local groundwater arsenic concentration >1 µg/L, probability >5 µg/L, and probability >10 µg/L. We calculated Pearson's correlation coefficients (r) between the reproductive outcomes (preterm birth and term LBW) and the arsenic probability values, at both state and county levels. For preterm birth, younger mothers (maternal age arsenic level based on the data of probability >10 µg/L; for older mothers, r = 0.19 when the smoothing threshold = 3,500; a majority of county level r values are positive based on the arsenic data of probability >10 µg/L. For term LBW, younger mothers (maternal age arsenic concentration based on the data of probability >1 µg/L; for older mothers, r = 0.14 when the rates are smoothed with a threshold = 1,000 births and also adjusted by town median household income in 1999, and the arsenic values are the town minimum based on probability >10 µg/L. At the county level for younger mothers, positive r values prevail, but for older mothers, it is a mix. For both birth problems, the several most populous counties-with 60-80 % of the state's population and clustering at the

  4. Correlates of Low Birth Weight

    Directory of Open Access Journals (Sweden)

    Ankur Barua MD, PhD

    2014-12-01

    Full Text Available Background. Low birth weight is the single most important factor that determines the chances of child survival. A recent annual estimation indicated that nearly 8 million infants are born with low birth weight in India. The infant mortality rate is about 20 times greater for all low birth weight babies. Methods. A matched case–control study was conducted on 130 low birth weight babies and 130 controls for 12 months (from August 1, 2007, to July 31, 2008 at the Central Referral Hospital, Tadong, East District of Sikkim, India. Data were analyzed using the Statistical Package for Social Sciences, version 10.0 for Windows. Chi-square test and multiple logistic regression were applied. A P value less than .05 was considered as significant. Results. In the first phase of this study, 711 newborn babies, borne by 680 mothers, were screened at the Central Referral Hospital of Sikkim during the 1-year study period, and the proportion of low birth weight babies was determined to be 130 (18.3%. Conclusion. Multiple logistic regression analysis, conducted in the second phase, revealed that low or middle socioeconomic status, maternal underweight, twin pregnancy, previous history of delivery of low birth weight babies, smoking and consumption of alcohol during pregnancy, and congenital anomalies had independent significant association with low birth weight in this study population.

  5. Birth prevalence for congenital limb defects in the northern Netherlands: a 30-year population-based study.

    Science.gov (United States)

    Vasluian, Ecaterina; van der Sluis, Corry K; van Essen, Anthonie J; Bergman, Jorieke E H; Dijkstra, Pieter U; Reinders-Messelink, Heleen A; de Walle, Hermien E K

    2013-11-16

    Reported birth prevalences of congenital limb defects (CLD) vary between countries: from 13/10,000 in Finland for the period 1964-1977 to 30.4/10,000 births in Scotland from 1964-1968. Epidemiological studies permit the timely detection of trends in CLD and of associations with other birth defects. The aim of this study is to describe the birth prevalence of CLD in the northern Netherlands. In a population-based, epidemiological study we investigated the birth prevalences of CLD for 1981-2010. Data were collected by the European Surveillance of Congenital Anomalies in the northern Netherlands (EUROCAT-NNL). We excluded malpositions, club foot, and dislocation/dysplasia of hips or knees. Trends were analysed for the 19-year period 1992-2010 using χ² tests, as well as CLD association with anomalies affecting other organs. The birth prevalence of CLD was 21.1/10,000 births for 1981-2010. There was an overall decrease in non-syndromic limb defects (P = 0.023) caused by a decrease in the prevalence of non-syndromic syndactyly (P CLD, 55% were males, 57% had isolated defects, 13% had multiple congenital anomalies (MCA), and 30% had a recognised syndrome. The upper:lower limb ratio was 2:1, and the left:right side ratio was 1.2:1. Cardiovascular and urinary tract anomalies were common in combination with CLD (37% and 25% of cases with MCA). Digestive-tract anomalies were significantly associated with CLD (P = 0.016). The birth prevalence of CLD in the northern Netherlands was 21.1/10,000 births. The birth prevalence of non-syndromic syndactyly dropped from 5.2/10,000 to 1.1/10,000 in 1992-2010.

  6. Scrotal enteric fistula in an extremely low birth weight premature neonate

    Directory of Open Access Journals (Sweden)

    Caitlin A. Smith

    2018-03-01

    Full Text Available Congenital inguinal hernia is a common condition in the pediatric population. Incarceration of inguinal hernias is known to result in significant morbidity such as necrotic bowel, and if not recognized promptly, has the potential to present as a scrotal fecal fistula. We present an extremely low birth weight premature male infant who developed spontaneous fecal drainage from his right scrotum.

  7. Birth outcomes for women using free-standing birth centers in South Auckland, New Zealand.

    Science.gov (United States)

    Bailey, David John

    2017-09-01

    This study investigates maternal and perinatal outcomes for women with low-risk pregnancies laboring in free-standing birth centers compared with laboring in a hospital maternity unit in a large New Zealand health district. The study used observational data from 47 381 births to women with low-risk pregnancies in South Auckland maternity facilities 2003-2010. Adjusted odds ratios with 95% confidence intervals were calculated for instrumental delivery, cesarean section, blood transfusion, neonatal unit admission, and perinatal mortality. Labor in birth centers was associated with significantly lower rates of instrumental delivery, cesarean section and blood transfusion compared with labor in hospital. Neonatal unit admission rates were lower for infants of nulliparous women laboring in birth centers. Intrapartum and neonatal mortality rates for birth centers were low and were not significantly different from the hospital population. Transfers to hospital for labor and postnatal complications occurred in 39% of nulliparous and 9% of multiparous labors. Risk factors identified for transfer were nulliparity, advanced maternal age, and prolonged pregnancy ≥41 weeks' gestation. Labor in South Auckland free-standing birth centers was associated with significantly lower maternal intervention and complication rates than labor in the hospital maternity unit and was not associated with increased perinatal morbidity. © 2017 Wiley Periodicals, Inc.

  8. Home births in the United States, 1990-2009.

    Science.gov (United States)

    MacDorman, Marian F; Mathews, T J; Declercq, Eugene

    2012-01-01

    After 14 years of decline, the percentage of home births rose by 29% from 2004 to 2009, to the point where it is at the highest level since data on this item began to be collected in 1989. The overall increase in home births was driven mostly by a 36% increase for non-Hispanic white women. About 1 out of every 90 births to non-Hispanic white women are now home births. The percentage of home births for non-Hispanic white women was three to five times higher than for any other racial or ethnic group. Home births have a lower risk profile than hospital births, with fewer births to teenagers or unmarried women, and with fewer preterm, low birthweight, and multiple births. The lower risk profile of home compared with hospital births suggests that home birth attendants are selecting low-risk women as candidates for home birth. The increase in the percentage of home births from 2004 to 2009 was widespread and involved selected states from every region of the country. The large variations in the percentage of home births by state may be influenced by differences among states in laws pertaining to births are more prevalent among non-Hispanic white women (7). midwifery practice or out-of-hospital birth (8,9), as well as by differences in the racial and ethnic composition of state populations, as home Studies have suggested that most home births are intentional or planned home births, whereas others are unintentional or unplanned, because of an emergency situation (i.e., precipitous labor, labor complications, or unable to get to the hospital in time) (3,6). Although not representative of all U.S. births (see "Data source and methods"), 87% of home births in a 26-state reporting area (comprising 50% of U.S. births) were planned in 2009. For non-Hispanic white women, 93% of home births were planned (10). Women may prefer a home birth over a hospital birth for a variety of reasons, including a desire for a low-intervention birth in a familiar environment surrounded by family

  9. Outcome of Very Low Birth Weight Infants Over 3 Years Report From an Iranian Center

    Science.gov (United States)

    Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Fallahi, Minoo; Esmaili, Fatemeh

    2013-01-01

    Objective Very low birth weight (VLBW) infants are at high risk for morbidity and mortality. This article determines the frequency of disease, rate od survival, complications and risk factors for morbidity and mortality in VLBW neonates admitted to a level III neonatal intensive care unit (NICU) at Mahdieh Hospital in Tehran. Methods This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates. Relevant pre- and peri-natal data up to the time of discharge from the hospital or death, including complications during the course of hospitalization, were collected from the case notes, documented on a pre-designed questionnaire and analyzed. Findings Out of 13197 neonates, 564 (4.3%) were VLBW with 51.4% males. Mean gestational age was 29.6±2.5 weeks; mean birth weight 1179±257 grams. Mean birth weight, gestational age and Apgar scores were significantly higher in babies who survived than in those who died, (1275±189 vs. 944±253 grams; 30.5±2.2 vs. 27.5±2 weeks and 6.9±1.7 vs. 5±2.1 respectively, P<0.001 in all instances). Overall survival was 70.9%; in extremely low birth weight (ELBW) newborns this figure was 33.3% rising to 84.1% in infants weighing between 1001-1500 grams. Respiratory failure resulting from RDS in ELBW babies was the major factor leading to death. Need for mechanical ventilation, pulmonary hemorrhage and gastro-intestinal bleeding were also significant predictive factors for mortality. Conclusion Birth weight and mechanical ventilation are the major factors predicting VLBW survival. PMID:24800021

  10. Limb defects associated with major congenital anomalies : Clinical and epidemiological study from the international clearinghouse for birth defects monitoring systems

    NARCIS (Netherlands)

    Rosano, A; Botto, LD; Olney, RS; Khoury, MJ; Ritvanen, A; Goujard, J; Stoll, C; Cocchi, G; Merlob, P; Mutchinick, O; Cornel, MC; Castilla, EE; Martinez-Frias, ML; Zampino, G; Erickson, JD; Mastroiacovo, P

    2000-01-01

    Although limb defects associated with other congenital anomalies are rarely studied, they may provide insights into limb development that may be useful for etiologic studies and public health monitoring, me pooled data from II birth defect registries that are part of the International Clearinghouse

  11. Maternal age at child birth, birth order, and suicide at a young age: a sibling comparison.

    Science.gov (United States)

    Bjørngaard, Johan Håkon; Bjerkeset, Ottar; Vatten, Lars; Janszky, Imre; Gunnell, David; Romundstad, Pål

    2013-04-01

    Previous studies have reported strong associations between birth order, maternal age, and suicide, but these results might have been confounded by socioeconomic and other factors. To control for such factors, we compared suicide risk between siblings and studied how maternal age at child birth and birth order influenced risk in a cohort study of 1,690,306 Norwegians born in 1967-1996 who were followed up until 2008. Using stratified Cox regression, we compared suicide risk within families with 2 or more children in which one died from suicide. Altogether, 3,005 suicides occurred over a mean follow-up period of 15 years; 2,458 of these suicides occurred among 6,741 siblings within families of 2 or more siblings. Among siblings, a higher position in the birth order was positively associated with risk; each increase in birth order was associated with a 46% (adjusted hazard ratio = 1.46, 95% confidence interval: 1.29, 1.66) higher risk of suicide. For each 10-year increase in maternal age at child birth, the offspring's suicide risk was reduced by 57% (adjusted hazard ratio = 0.43, 95% confidence interval: 0.30, 0.62). Our study suggests that confounding due to familial factors is not likely to explain the associations of birth order and maternal age at child birth with suicide risk.

  12. Low birth weight and fetal anaemia as risk factors for infant morbidity ...

    African Journals Online (AJOL)

    Low birth weight (LBW) and fetal anaemia (FA) are common in malaria endemic areas. To investigate the ... In sub-Saharan Africa, infant morbidity and mortality are excessively high and reductions in mortality rates .... lower respiratory infection for children under two months of age, for older infants, a cut-off value of 50 per ...

  13. Outcomes of planned home births with certified professional midwives: large prospective study in North America.

    Science.gov (United States)

    Johnson, Kenneth C; Daviss, Betty-Anne

    2005-06-18

    To evaluate the safety of home births in North America involving direct entry midwives, in jurisdictions where the practice is not well integrated into the healthcare system. Prospective cohort study. All home births involving certified professional midwives across the United States (98% of cohort) and Canada, 2000. All 5418 women expecting to deliver in 2000 supported by midwives with a common certification and who planned to deliver at home when labour began. Intrapartum and neonatal mortality, perinatal transfer to hospital care, medical intervention during labour, breast feeding, and maternal satisfaction. 655 (12.1%) women who intended to deliver at home when labour began were transferred to hospital. Medical intervention rates included epidural (4.7%), episiotomy (2.1%), forceps (1.0%), vacuum extraction (0.6%), and caesarean section (3.7%); these rates were substantially lower than for low risk US women having hospital births. The intrapartum and neonatal mortality among women considered at low risk at start of labour, excluding deaths concerning life threatening congenital anomalies, was 1.7 deaths per 1000 planned home births, similar to risks in other studies of low risk home and hospital births in North America. No mothers died. No discrepancies were found for perinatal outcomes independently validated. Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

  14. Body size at birth and blood pressure among children in developing countries.

    Science.gov (United States)

    Law, C M; Egger, P; Dada, O; Delgado, H; Kylberg, E; Lavin, P; Tang, G H; von Hertzen, H; Shiell, A W; Barker, D J

    2001-02-01

    Studies in developed countries have shown that reduced fetal growth is related to raised blood pressure in childhood and adult life. Little is known about this association in developing countries, where fetal growth retardation is common. In 1994-1995, we measured blood pressure in 1570 3-6-year-old children living in China, Guatemala, Chile, Nigeria and Sweden. We related their blood pressure to patterns of fetal growth, as measured by body proportions at birth. The children were all born after 37 weeks gestation and weighed more than 2.5 kg at birth. In each country, blood pressure was positively related to the child's current weight. After adjusting for this and gender, systolic pressure was inversely related to size at birth in all countries except Nigeria. In Chile, China and Guatemala, children who were proportionately small at birth had raised systolic pressure. For example, in Chile, systolic pressure adjusted for current weight increased by 4.9 mmHg (95% CI : 2.1, 7.7) for every kilogram decrease in birthweight, by 1 mmHg (95% CI : 0.4, 1.6) for every centimetre decrease in birth length, and by 1.3 mmHg (95% CI : 0.4, 2.2) for every centimetre decrease in head circumference at birth. In Sweden, systolic pressure was higher in children who were disproportionately small, that is thin, at birth. Systolic pressure increased by 0.3 mmHg (95% CI : 0.0, 0.6) for every unit (kg/m3) decrease in ponderal index at birth. These associations were independent of the duration of gestation. Raised blood pressure among children in three samples from China, Central and South America is related to proportionate reduction in body size at birth, which results from reduced growth throughout gestation. The relation between fetal growth and blood pressure may be different in African populations. Proportionately reduced fetal growth is the prevalent pattern of fetal growth retardation in developing countries, and is associated with chronic undernutrition among women. Improvement

  15. Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

    Science.gov (United States)

    Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

    2014-01-01

    Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

  16. Paternal occupation and birth defects: findings from the National Birth Defects Prevention Study.

    NARCIS (Netherlands)

    Desrosiers, T.A.; Herring, A.H.; Shapira, S.K.; Hooiveld, M.; Luben, T.J.; Herdt-Losavio, M.L.; Lin, S.; Olshan, A.F.

    2012-01-01

    Objectives: Several epidemiological studies have suggested that certain paternal occupations may be associated with an increased prevalence of birth defects in offspring. Using data from the National Birth Defects Prevention Study, the authors investigated the association between paternal occupation

  17. Teen Birth Rates for Urban and Rural Areas in the United States, 2007-2015.

    Science.gov (United States)

    Hamilton, Brady E; Rossen, Lauren M; Branum, Amy M

    2016-11-01

    Data from the National Vital Statistics System •Birth rates for teenagers aged 15-19 declined in urban and rural counties from 2007 through 2015, with the largest declines in large urban counties and the smallest declines in rural counties. •From 2007 through 2015, the teen birth rate was lowest in large urban counties and highest in rural counties. •Declines in teen birth rates in all urban counties between 2007 and 2015 were largest in Arizona, Massachusetts, Connecticut, Minnesota, and Colorado, with 17 states experiencing a decline of 50% or more. •Declines in teen birth rates in all rural counties between 2007 and 2015 were largest (50% or more) in Colorado and Connecticut. •In 2015, teen birth rates were highest in rural counties and lowest in large urban counties for non-Hispanic white, non-Hispanic black, and Hispanic females. Teen birth rates have demonstrated an unprecedented decline in the United States since 2007 (1). Declines occurred in all states and among all major racial and Hispanic-origin groups, yet disparities by both geography and demographic characteristics persist (2,3). Although teen birth rates and related declines have been described by state, patterns by urban-rural location have not yet been examined. This report describes trends in teen birth rates in urban (metropolitan) and rural (nonmetropolitan) areas in the United States overall and by state from 2007 through 2015 and by race and Hispanic origin for 2015. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  18. Why do women choose an unregulated birth worker to birth at home in Australia: a qualitative study.

    Science.gov (United States)

    Rigg, Elizabeth Christine; Schmied, Virginia; Peters, Kath; Dahlen, Hannah Grace

    2017-03-28

    In Australia the choice to birth at home is not well supported and only 0.4% of women give birth at home with a registered midwife. Recent changes to regulatory requirements for midwives have become more restrictive and there is no insurance product that covers private midwives for intrapartum care at home. Freebirth (planned birth at home with no registered health professional) with an unregulated birth worker who is not a registered midwife or doctor (e.g. Doula, ex-midwife, lay midwife etc.) appears to have increased in Australia. The aim of this study is to explore the reasons why women choose to give birth at home with an unregulated birth worker (UBW) from the perspective of women and UBWs. Nine participants (five women who had UBWs at their birth and four UBWs who had themselves used UBWs in the past for their births) were interviewed in-depth and the data analysed using thematic analysis. Four themes were found: 'A traumatising system', 'An inflexible system'; 'Getting the best of both worlds' and 'Treated with love and respect versus the mechanical arm on the car assembly line'. Women interviewed for this study either experienced or were exposed to mainstream care, which they found traumatising. They were not able to access their preferred birth choices, which caused them to perceive the system as inflexible. They interpreted this as having no choice when choice was important to them. The motivation then became to seek alternative options of care that would more appropriately meet their needs, and help avoid repeated trauma through mainstream care. Women who engaged UBWs viewed them as providing the best of both worlds - this was birthing at home with a knowledgeable person who was unconstrained by rules or regulations and who respected and supported the woman's philosophical view of birth. Women perceived UBWs as not only the best opportunity to achieve a natural birth but also as providing 'a safety net' in case access to emergency care was required.

  19. Etiopathogenetic, clinical and histopathological aspects regarding the involvement of dental focal infection in premature births with fetal hypotrophy.

    Science.gov (United States)

    Rîcă, Gabriel Radu; Badi, Claudia Paula; Rîcă, Ana Maria; Sîrbu, Carmen Mirela; Rîcă, Nicolae

    2014-01-01

    The study conducted on a total of 1344 preterm births, of which 403 hypotrophic fetuses births (between 2010-2012 within the Maternal Clinics of Craiova, Romania), studied the involvement of dental inflammatory infections in the chorioamnionitis onset. The possibility of transferring germs, toxins and degraded materials into the blood flow, and them entering the chorioamniotic structures is quite a common issue. Subclinically often evolving chorioamniotic membrane and its existence is clearly established after birth by histopathological and bacteriological examinations, being partially responsible for the growth delay of the conception product. Our study revealed this fact, by using clinical examinations, ultrasound exams, bacteriological determinations of the amniotic fluid and the placenta, alongside the histopathological examinations. The chorioamnionitis inflammatory process is responsible for premature birth, through a high synthesis of interleukins (IL) and prostaglandins, causing uterine contractions. Our IL-6 dosage determinations show its growth that can be considered a prediction marker for preterm birth.

  20. Planned home birth: the professional responsibility response.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit

    2013-01-01

    This article addresses the recrudescence of and new support for midwife-supervised planned home birth in the United States and the other developed countries in the context of professional responsibility. Advocates of planned home birth have emphasized patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and identify professionally appropriate responses of obstetricians and other concerned physicians to planned home birth. We start with patient safety and show that planned home birth has unnecessary, preventable, irremediable increased risk of harm for pregnant, fetal, and neonatal patients. We document that the persistently high rates of emergency transport undermines patient safety and satisfaction, the raison d'etre of planned home birth, and that a comprehensive analysis undermines claims about the cost-effectiveness of planned home birth. We then argue that obstetricians and other concerned physicians should understand, identify, and correct the root causes of the recrudescence of planned home birth; respond to expressions of interest in planned home birth by women with evidence-based recommendations against it; refuse to participate in planned home birth; but still provide excellent and compassionate emergency obstetric care to women transported from planned home birth. We explain why obstetricians should not participate in or refer to randomized clinical trials of planned home vs planned hospital birth. We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Birth Experience through an Existential Lens

    DEFF Research Database (Denmark)

    Prinds, Christina

    Background: The moment of birth is seen as a miracle, a journey and even a religious act. Research stress how giving birth might facilitate interference with previous conceptions of how to make meaning of life existentially. However, birth as an existential life transformative event, has been...... explored only briefly in empirical research. The aim of this study was two-fold: Firstly, to explore how first-time mothers experienced their first birth in relation to existential meaning-making. Secondly, to describe the relationship between considerations related to existential meaning-making and time...... of birth. Method: The study was based on a nationwide questionnaire, conducted among Danish first time mothers, who had given birth either preterm or full-term (n=517). The questionnaire consisted of 46 overall items. Eight core items were analysed in this study. Findings Preliminary findings show that new...

  2. Commission for the Accreditation of Birth Centers

    Science.gov (United States)

    ... Learning Login: Commissioners Birth Centers CABC Learning Place Home Accredited Birth Centers Find CABC Accredited Birth Centers What does ... In the Pursuit of Excellence You are here: Home In the ... for the Accreditation of Birth Centers (CABC) provides support, education, and accreditation to ...

  3. Bias from conditioning on live birth in pregnancy cohorts: an illustration based on neurodevelopment in children after prenatal exposure to organic pollutants

    NARCIS (Netherlands)

    Liew, Zeyan; Olsen, Jørn; Cui, Xin; Ritz, Beate; Arah, Onyebuchi A.

    2015-01-01

    Only 60-70% of fertilized eggs may result in a live birth, and very early fetal loss mainly goes unnoticed. Outcomes that can only be ascertained in live-born children will be missing for those who do not survive till birth. In this article, we illustrate a common bias structure (leading to

  4. Birth order and psychopathology.

    Science.gov (United States)

    Risal, Ajay; Tharoor, Hema

    2012-07-01

    Ordinal position the child holds within the sibling ranking of a family is related to intellectual functioning, personality, behavior, and development of psychopathology. To study the association between birth order and development of psychopathology in patients attending psychiatry services in a teaching hospital. Hospital-based cross-sectional study. Retrospective file review of three groups of patients was carried out. Patient-related variables like age of onset, birth order, family type, and family history of mental illness were compared with psychiatry diagnosis (ICD-10) generated. SPSS 13; descriptive statistics and one-way analysis of variance (ANOVA) were used. Mean age of onset of mental illness among the adult general psychiatry patients (group I, n = 527) was found to be 33.01 ± 15.073, while it was 11.68 ± 4.764 among the child cases (group II, n = 47) and 26.74 ± 7.529 among substance abuse cases (group III, n = 110). Among group I patients, commonest diagnosis was depression followed by anxiety and somatoform disorders irrespective of birth order. Dissociative disorders were most prevalent in the first born child (36.7%) among group II patients. Among group III patients, alcohol dependence was maximum diagnosis in all birth orders. Depression and alcohol dependence was the commonest diagnosis in adult group irrespective of birth order.

  5. Prevalence and predictors of antibiotic administration during pregnancy and birth.

    Directory of Open Access Journals (Sweden)

    Jakob Stokholm

    Full Text Available BACKGROUND: Antibiotic treatment during pregnancy and birth is very common. In this study, we describe the estimated prevalence of antibiotic administration during pregnancy and birth in the COPSAC2010 pregnancy cohort, and analyze dependence on social and lifestyle-related factors. METHODS: 706 pregnant women from the novel unselected Copenhagen Prospective Study on Asthma in Childhood (COPSAC2010 pregnancy cohort participated in this analysis. Detailed information on oral antibiotic prescriptions during pregnancy filled at the pharmacy was obtained and verified longitudinally. Information on intrapartum antibiotics, social, and lifestyle-factors was obtained by personal interviews. RESULTS: The prevalence of antibiotic use was 37% during pregnancy and 33% intrapartum. Lower maternal age at birth; adjusted odds ratio (aOR 0.94, 95% CI, [0.90-0.98], p = 0.003 and maternal smoking; aOR 1.97, 95% CI, [1.07-3.63], p = 0.030 were associated with use of antibiotics for urinary tract infection during pregnancy. Maternal educational level (low vs. high, aOR 2.32, 95% CI, [1.24-4.35], p = 0.011, maternal asthma; aOR 1.99, 95% CI, [1.33-2.98], p < 0.001 and previous childbirth; aOR 1.80, 95% CI, [1.21-2.66], p = 0.004 were associated with use of antibiotics for respiratory tract infection during pregnancy. Lower gestational age; aOR 0.72, 95% CI, [0.61-0.85], p < 0.001, maternal smoking; aOR 2.84, 95% CI, [1.33-6.06], p = 0.007, and nulliparity; aOR 1.79, 95% CI, [1.06-3.02], p = 0.030 were associated with administration of intrapartum antibiotics in women giving birth vaginally. CONCLUSION: Antibiotic administration during pregnancy and birth may be influenced by social and lifestyle-factors. Understanding such risk factors may guide preventive strategies in order to avoid unnecessary use of antibiotics.

  6. Transfer to hospital in planned home births: a systematic review.

    Science.gov (United States)

    Blix, Ellen; Kumle, Merethe; Kjærgaard, Hanne; Øian, Pål; Lindgren, Helena E

    2014-05-29

    There is concern about the safety of homebirths, especially in women transferred to hospital during or after labour. The scope of transfer in planned home births has not been assessed in a systematic review. This review aimed to describe the proportions and indications for transfer from home to hospital during or after labour in planned home births. The databases Pubmed, Embase, Cinahl, Svemed+, and the Cochrane Library were searched using the MeSH term "home childbirth". Inclusion criteria were as follows: the study population was women who chose planned home birth at the onset of labour; the studies were from Western countries; the birth attendant was an authorised midwife or medical doctor; the studies were published in 1985 or later, with data not older than from 1980; and data on transfer from home to hospital were described. Of the 3366 titles identified, 83 full text articles were screened, and 15 met the inclusion criteria. Two of the authors independently extracted the data. Because of the heterogeneity and lack of robustness across the studies, there were considerable risks for bias if performing meta-analyses. A descriptive presentation of the findings was chosen. Fifteen studies were eligible for inclusion, containing data from 215,257 women. The total proportion of transfer from home to hospital varied from 9.9% to 31.9% across the studies. The most common indication for transfer was labour dystocia, occurring in 5.1% to 9.8% of all women planning for home births. Transfer for indication for foetal distress varied from 1.0% to 3.6%, postpartum haemorrhage from 0% to 0.2% and respiratory problems in the infant from 0.3% to 1.4%. The proportion of emergency transfers varied from 0% to 5.4%. Future studies should report indications for transfer from home to hospital and provide clear definitions of emergency transfers.

  7. Creation and validation of the Singapore birth nomograms for birth weight, length and head circumference based on a 12-year birth cohort.

    Science.gov (United States)

    Poon, Woei Bing; Fook-Chong, Stephanie M C; Ler, Grace Y L; Loh, Zhi Wen; Yeo, Cheo Lian

    2014-06-01

    Both gestation and birth weight have significant impact on mortality and morbidity in newborn infants. Nomograms at birth allow classification of infants into small for gestational age (SGA) and large for gestational age (LGA) categories, for risk stratification and more intensive monitoring. To date, the growth charts for preterm newborn infants in Singapore are based on the Fenton growth charts, which are constructed based on combining data from various Western growth cohorts. Hence, we aim to create Singapore nomograms for birth weight, length and head circumference at birth, which would reflect the norms and challenges faced by local infants. Growth parameters of all babies born or admitted to our unit from 2001 to 2012 were retrieved. Following exclusion of outliers, nomograms for 3 percentiles of 10th, 50th, and 90th were generated for the gestational age (GA) ranges of 25 to 42 weeks using quantile regression (QR) combined with the use of restricted cubic splines. Various polynomial models (second to third degrees) were investigated for suitability of fit. The optimum QR model was found to be a third degree polynomial with a single knotted cubic spline in the mid-point of the GA range, at 33.5 weeks. Check for goodness of fit was done by visual inspection first. Next, check was performed to ensure the correct proportion: 10% of all cases fall above the upper 90th percentile and 10% fall below the lower 10th percentile. Furthermore, an alternative formula-based method of nomogram construction, using mean, standard deviation (SD) and assumption of normality at each gestational age, was used for counterchecking. A total of 13,403 newborns were included in the analysis. The new infant-foetal growth charts with respect to birth weight, heel-crown length and occipitofrontal circumference from 25 to 42 weeks gestations with the 10th, 50th and 90th were presented. Nomograms for birth weight, length and head circumference at birth had significant impact on neonatal

  8. Primary birthing attendants and birth outcomes in remote Inuit communities—a natural “experiment” in Nunavik, Canada

    Science.gov (United States)

    Simonet, F; Wilkins, R; Labranche, E; Smylie, J; Heaman, M; Martens, P; Fraser, W D; Minich, K; Wu, Y; Carry, C; Luo, Z-C

    2010-01-01

    Background There is a lack of data on the safety of midwife-led maternity care in remote or indigenous communities. In a de facto natural “experiment”, birth outcomes were assessed by primary birthing attendant in two sets of remote Inuit communities. Methods A geocoding-based retrospective birth cohort study in 14 Inuit communities of Nunavik, Canada, 1989–2000: primary birth attendants were Inuit midwives in the Hudson Bay (1529 Inuit births) vs western physicians in Ungava Bay communities (1197 Inuit births). The primary outcome was perinatal death. Secondary outcomes included stillbirth, neonatal death, post-neonatal death, preterm, small-for-gestational-age and low birthweight birth. Multilevel logistic regression was used to obtain the adjusted odds ratios (aOR) controlling for maternal age, marital status, parity, education, infant sex and plurality, community size and community-level random effects. Results The aORs (95% confidence interval) for perinatal death comparing the Hudson Bay vs Ungava Bay communities were 1.29 (0.63 to 2.64) for all Inuit births and 1.13 (0.48 to 2.47) for Inuit births at ≥28 weeks of gestation. There were no statistically significant differences in the crude or adjusted risks of any of the outcomes examined. Conclusion Risks of perinatal death were somewhat but not significantly higher in the Hudson Bay communities with midwife-led maternity care compared with the Ungava Bay communities with physician-led maternity care. These findings are inconclusive, although the results excluding extremely preterm births are more reassuring concerning the safety of midwife-led maternity care in remote indigenous communities. PMID:19286689

  9. Effects of fine particulate matter and its constituents on low birth weight among full-term infants in California

    Energy Technology Data Exchange (ETDEWEB)

    Basu, Rupa, E-mail: Rupa.Basu@oehha.ca.gov [California Office of Environmental Health Hazard Assessment, Air Pollution Epidemiology Section, Oakland, CA (United States); Harris, Maria [School of Public Health, Boston University, Boston, MA (United States); Sie, Lillian [School of Public Health, University of California, Berkeley, CA (United States); Malig, Brian; Broadwin, Rachel; Green, Rochelle [California Office of Environmental Health Hazard Assessment, Air Pollution Epidemiology Section, Oakland, CA (United States)

    2014-01-15

    Relationships between prenatal exposure to fine particles (PM{sub 2.5}) and birth weight have been observed previously. Few studies have investigated specific constituents of PM{sub 2.5}, which may identify sources and major contributors of risk. We examined the effects of trimester and full gestational prenatal exposures to PM{sub 2.5} mass and 23 PM{sub 2.5} constituents on birth weight among 646,296 term births in California between 2000 and 2006. We used linear and logistic regression models to assess associations between exposures and birth weight and risk of low birth weight (LBW; <2500 g), respectively. Models were adjusted for individual demographic characteristics, apparent temperature, month and year of birth, region, and socioeconomic indicators. Higher full gestational exposures to PM{sub 2.5} mass and several PM{sub 2.5} constituents were significantly associated with reductions in term birth weight. The largest reductions in birth weight were associated with exposure to vanadium, sulfur, sulfate, iron, elemental carbon, titanium, manganese, bromine, ammonium, zinc, and copper. Several of these PM{sub 2.5} constituents were associated with increased risk of term LBW. Reductions in birth weight were generally larger among younger mothers and varied by race/ethnicity. Exposure to specific constituents of PM{sub 2.5}, especially traffic-related particles, sulfur constituents, and metals, were associated with decreased birth weight in California. -- Highlights: • Examine full gestational and trimester fine particle and its constituents on term birth weight. • Fine particles and several of its constituents associated with birth weight reductions. • Largest reductions for traffic-related particles, sulfur constituents, and metals. • Greater birth weight reductions for younger mothers, and varied by race/ethnicity.

  10. Prevalence and risk factors affecting low birth weight in a district hospital at Perambalur, Tamilnadu

    Directory of Open Access Journals (Sweden)

    Rahul Hanumant Dandekar

    2014-03-01

    Full Text Available The low birth weight is an index of our status of public health in general and of maternal health and nutrition in particular. The major challenge in the field of public health is to identify the factors influencing low birth weight and to institute remedial measures. This hospital based cross-sectional study was conducted to know the prevalence and to identify risk factors affecting low birth weight in a District Hospital at Perambalur, Tamilnadu during six months period. All pregnant mothers who delivered babies in District Hospital were included in this study. Sample size 300 was calculated by taking 25% as the minimum prevalence of low birth weight with 20% permissible error. The statistical analysis was done by Epi Info™ 7 (7.1.2 software packages. The prevalence of LBW was found as 11.67% in 300 mothers while it was 21.5% in NFHS-3. Significant association was found between Low birth weight and weight gain in pregnancy. Though the prevalence of LBW is lower than national level, it is the need of the hour to strengthen the existing maternal services at the basic level of community.

  11. Gestational age and adolescent mental health: evidence from Hong Kong's 'Children of 1997' birth cohort.

    Science.gov (United States)

    Wang, Hui; Leung, Gabriel M; Lam, H S; Schooling, C Mary

    2015-09-01

    Preterm, and more recently early term, birth has been identified as a risk factor for poor health. Whether the sequelae of late preterm or early term birth extends to poor mental health and well-being in adolescence is unclear and has not been systematically assessed. Linear regression was used to assess the adjusted associations of gestational age (very/moderate preterm (self-reported self-esteem at ∼11 years (n=6935), parent-reported Rutter score assessing the common emotional and behavioural problems at ∼7 years (n=6292) and ∼11 years (n=5596) and self-reported depressive symptoms at ∼13 years (n=5795) in a population-representative Hong Kong Chinese birth cohort 'Children of 1997' where gestational age has little social patterning. Very/moderate preterm birth was associated with higher Rutter subscore for hyperactivity (ß coefficients 0.5, 95% CI 0.01 to 1.00) at ∼7 years but not at ∼11 years, adjusted for sex, age, socio-economic position, parents' age at birth, birth order and secondhand smoke exposure. Similarly adjusted, late preterm, early term, late term and post-term birth were not associated with self-esteem or depressive symptoms. In a population-representative birth cohort from a non-Western-developed setting, gestational age had few associations with mental health and well-being in adolescence, whereas very preterm birth was specifically associated with hyperactivity in childhood. Inconsistencies with studies from Western settings suggest setting specific unmeasured confounding may underlie any observed associations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Outcomes of planned home births attended by certified nurse-midwives in southeastern Pennsylvania, 1983-2008.

    Science.gov (United States)

    Cox, Kim J; Schlegel, Ruth; Payne, Pat; Teaf, Dusty; Albers, Leah

    2013-01-01

    In this study, we examined the perinatal outcomes of planned home births over a 25-year period (1983-2008) in a group of primarily Amish women (98%) attended by certified nurse-midwives (CNMs) in southeastern Pennsylvania. This was a retrospective, descriptive analysis of data (N = 1836 births) from several CNM practices. Data were abstracted for 25 items, including demographics, labor, and birth. Initially, 2 investigators abstracted 15 records to compare assessments and standardize definitions. Charts were then divided and abstracted individually by one investigator. Several relationships were examined in 2 by 2 tables using the chi-square procedure for the difference in proportions. Maternal and newborn transfers to the hospital were included in the analysis. Of the women who planned home birth for 1836 pregnancies, 1733 of the births occurred at home. Although more than one-third of the women were of high parity (gravida 5-13), rates of postpartum hemorrhage were low (n = 96, 5.5%). There were no maternal deaths. Nearly half of the maternal transfers to the hospital (n = 103, 5.6%) were for ruptured membranes without labor (n = 25, 1.4%) and/or failure to progress (n = 23, 1.3%). The neonatal hospital admission rate also was low (n = 13, 0.75%). Of the 7 (0.4%) early neonatal deaths, all were attributed to lethal congenital anomalies that are common to this population. This study is the first to describe the outcomes of planned home births in a primarily Amish population cared for by CNMs. It also adds to the literature on planned home births in the United States and supports the findings from previous studies that women who have home births attended by CNMs have safety profiles equal to or better than profiles of women who had hospital births in similar populations. © 2013 by the American College of Nurse-Midwives.

  13. Birth-death processes and associated polynomials

    NARCIS (Netherlands)

    van Doorn, Erik A.

    2003-01-01

    We consider birth-death processes on the nonnegative integers and the corresponding sequences of orthogonal polynomials called birth-death polynomials. The sequence of associated polynomials linked with a sequence of birth-death polynomials and its orthogonalizing measure can be used in the analysis

  14. A review of the literature: midwifery decision-making and birth.

    Science.gov (United States)

    Jefford, Elaine; Fahy, Kathleen; Sundin, Deborah

    2010-12-01

    Clinical decision-making was initially studied in medicine where hypothetico-deductive reasoning is the model for decision-making. The nursing perspective on clinical decision-making has largely been shaped by Patricia Benner's ground breaking work. Benner claimed expert nurses use humanistic-intuitive ways of making clinical decisions rather than the 'rational reasoning' as claimed by medicine. Clinical decision-making in midwifery is not the same as either nursing or medical decision-making because of the woman-midwife partnership where the woman is the ultimate decision-maker. CINHAL, Medline and Cochrane databases were systematically searched using key words derived from the guiding question. A review of the decision-making research literature in midwifery was undertaken where studies were published in English. The selection criteria for papers were: only research papers of direct relevance to the guiding research question were included in the review. Decision-making is under-researched in midwifery and more specifically birth, as only 4 research articles met the inclusion criteria in this review. Three of the studies involved qualified midwives, and one involved student midwives. Two studies were undertaken in England, one in Scotland and one in Sweden. The major findings synthesised from this review, are that; (1) midwifery decision-making during birth is socially negotiated involving hierarchies of surveillance and control; (2) the role of the woman in shared decision-making during birth has not been explored by midwifery research; (3) clinical decision-making encompasses clinical reasoning as essential but not sufficient for midwives to actually implement their preferred decision. We argue that existing research does not inform the discipline of the complexity of midwifery clinical decision-making during birth. A well-designed study would involve investigating the clinical reasoning skills of the midwife, her relationship with the woman, the context of the

  15. Common and distinct patterns of grey-matter volume alteration in major depression and bipolar disorder: evidence from voxel-based meta-analysis.

    Science.gov (United States)

    Wise, T; Radua, J; Via, E; Cardoner, N; Abe, O; Adams, T M; Amico, F; Cheng, Y; Cole, J H; de Azevedo Marques Périco, C; Dickstein, D P; Farrow, T F D; Frodl, T; Wagner, G; Gotlib, I H; Gruber, O; Ham, B J; Job, D E; Kempton, M J; Kim, M J; Koolschijn, P C M P; Malhi, G S; Mataix-Cols, D; McIntosh, A M; Nugent, A C; O'Brien, J T; Pezzoli, S; Phillips, M L; Sachdev, P S; Salvadore, G; Selvaraj, S; Stanfield, A C; Thomas, A J; van Tol, M J; van der Wee, N J A; Veltman, D J; Young, A H; Fu, C H; Cleare, A J; Arnone, D

    2017-10-01

    Finding robust brain substrates of mood disorders is an important target for research. The degree to which major depression (MDD) and bipolar disorder (BD) are associated with common and/or distinct patterns of volumetric changes is nevertheless unclear. Furthermore, the extant literature is heterogeneous with respect to the nature of these changes. We report a meta-analysis of voxel-based morphometry (VBM) studies in MDD and BD. We identified studies published up to January 2015 that compared grey matter in MDD (50 data sets including 4101 individuals) and BD (36 data sets including 2407 individuals) using whole-brain VBM. We used statistical maps from the studies included where available and reported peak coordinates otherwise. Group comparisons and conjunction analyses identified regions in which the disorders showed common and distinct patterns of volumetric alteration. Both disorders were associated with lower grey-matter volume relative to healthy individuals in a number of areas. Conjunction analysis showed smaller volumes in both disorders in clusters in the dorsomedial and ventromedial prefrontal cortex, including the anterior cingulate cortex and bilateral insula. Group comparisons indicated that findings of smaller grey-matter volumes relative to controls in the right dorsolateral prefrontal cortex and left hippocampus, along with cerebellar, temporal and parietal regions were more substantial in major depression. These results suggest that MDD and BD are characterised by both common and distinct patterns of grey-matter volume changes. This combination of differences and similarities has the potential to inform the development of diagnostic biomarkers for these conditions.

  16. Socio-economic inequality in preterm birth

    DEFF Research Database (Denmark)

    Petersen, Christina Bjørk; Mortensen, Laust Hvas; Morgen, Camilla Schmidt

    2009-01-01

    increased slightly over time in very preterm births in Denmark, while there was a slight narrowing of the gap in Sweden. In moderately preterm births, the educational inequality gap was constant over the study period in Denmark, Norway and Sweden, but narrowed in Finland. The educational gradient in preterm...... birth remained broadly stable from 1981 to 2000 in all four countries. Consequently, the socio-economic inequalities in preterm birth were not strongly influenced by structural changes during the period....

  17. Vaginal birth after cesarean section: an update on physician trends and patient perceptions.

    Science.gov (United States)

    Penso, C

    1994-10-01

    The increased number of women having a vaginal birth after a cesarean section can be attributed to changing physician trends. Women eligible for vaginal birth after cesarean section include those with previous low vertical incisions, multiple previous incisions and even unknown scars, regardless of the method of closure or previous indication. Limited data suggest that in carefully selected women a current twin gestation, breech presentation, or the presence of fetal macrosomia are not contraindications for a trial of labor, in the presence of a uterine scar. Changing trends in the management of labor may also contribute to an increase in successful trial of labor with the use of oxytocin for the induction or augmentation of labor, the administration of epidural anesthesia for pain relief, and the instillation of prostaglandin E2 gel for cervical ripening. External cephalic version and amnioinfusion may also be reasonable alternatives in appropriately selected cases. Despite the documented safety and success of vaginal birth after cesarean section, and the lack of increased morbidity of failed trial of labor, 50% of women who are eligible for vaginal birth after cesarean section will decline an attempt, even after extensive counseling and encouragement. Patient resistance, largely attributed to the fear and inconvenience of labor, is still a major deterrent to a further rise in vaginal birth after cesarean section rates.

  18. Intelligence, birth order, and family size.

    Science.gov (United States)

    Kanazawa, Satoshi

    2012-09-01

    The analysis of the National Child Development Study in the United Kingdom (n = 17,419) replicates some earlier findings and shows that genuine within-family data are not necessary to make the apparent birth-order effect on intelligence disappear. Birth order is not associated with intelligence in between-family data once the number of siblings is statistically controlled. The analyses support the admixture hypothesis, which avers that the apparent birth-order effect on intelligence is an artifact of family size, and cast doubt on the confluence and resource dilution models, both of which claim that birth order has a causal influence on children's cognitive development. The analyses suggest that birth order has no genuine causal effect on general intelligence.

  19. Fat and fat-free mass at birth

    DEFF Research Database (Denmark)

    Andersen, Gregers Stig; Girma, Tsinuel; Wells, Jonathan CK

    2011-01-01

    LBW increases the risk of a number of noncommunicable diseases in adulthood. However, birth weight (BW) cannot describe variability in infant body composition (BC). Variability in fat mass (FM) and fat-free mass (FFM) at birth may be particularly important in low-income countries because they und......LBW increases the risk of a number of noncommunicable diseases in adulthood. However, birth weight (BW) cannot describe variability in infant body composition (BC). Variability in fat mass (FM) and fat-free mass (FFM) at birth may be particularly important in low-income countries because...... they undergo nutritional transition. There is a need for data on birth BC and its predictors from low-income countries in transition. We assessed absolute FM and FFM at birth and examined the role of gender, parity, GA, and LBW as predictors of birth BC. FM and FFM were assessed within 48 h of birth on 350...... Ethiopian newborns using air displacement plethysmography (ADP). Female gender and being an infant of primi- or secundiparous mothers predicted lower BW and lower birth FFM but not FM, compared with male gender and infants of multiparous mothers, respectively. There was a positive linear relationship...

  20. Birth seasonality in Korean Prader-Willi syndrome with chromosome 15 microdeletion

    Directory of Open Access Journals (Sweden)

    Aram Yang

    2015-03-01

    Full Text Available PurposePrader-Willi syndrome (PWS is a well-known genetic disorder, and microdeletion on chromosome 15 is the most common causal mechanism. Several previous studies have suggested that various environmental factors might be related to the pathogenesis of microdeletion in PWS. In this study, we investigated birth seasonality in Korean PWS.MethodsA total of 211 PWS patients born from 1980 to 2014 were diagnosed by methylation polymerase chain reaction at Samsung Medical Center. Of the 211 patients, 138 were born from 2000-2013. Among them, the 74 patients of a deletion group and the 22 patients of a maternal uniparental disomy (UPD group were compared with general populations born from 2000 using the Walter and Elwood method and cosinor analysis.ResultsThere was no statistical significance in seasonal variation in births of the total 211 patients with PWS (χ2=7.2522, P=0.2982. However, a significant difference was found in the monthly variation between PWS with the deletion group and the at-risk general population (P<0.05. In the cosinor model, the peak month of birth for PWS patients in the deletion group was January, while the nadir occurred in July, with statistical significance (amplitude=0.23, phase=1.2, low point=7.2. The UPD group showed the peak birth month in spring; however, this result was not statistically significant (χ2=3.39, P=0.1836.ConclusionCorrelation with birth seasonality was identified in a deletion group of Korean PWS patients. Further studies are required to identify the mechanism related to seasonal effects of environmental factors on microdeletion on chromosome 15.

  1. Roentgenodiagnosis of vertebrae birth injury

    International Nuclear Information System (INIS)

    Mikhajlov, M.K.

    1983-01-01

    Birth injuries of vertebrae and spinal cord is the new problem of child neutropathology. Basic roentgenological symptoms of birth injuries of vertebrae and spinal cord of different localizations have been described for the first time. These data are compared with neurological, electrophysiological, and Morphological data, that enables not only to describe each symptom, but also to evaluate its clinical significance. Roeptgenological classification of birth injuries of vertebrae and spinal cord in children is suggested

  2. Birth characteristics of Syrian refugees and Turkish citizens in Turkey in 2015.

    Science.gov (United States)

    Demirci, Hakan; Yildirim Topak, Nevruz; Ocakoglu, Gokhan; Karakulak Gomleksiz, Mehtap; Ustunyurt, Emin; Ulku Turker, Ayse

    2017-04-01

    To compare the birth characteristics of Syrian refugees with those of Turkish citizens. In a retrospective study, data were obtained for singleton live births that occurred at a hospital in Bursa, Turkey, between June 1 and December 31, 2015. All Syrian refugees were eligible for inclusion; one Turkish citizen was included for each refugee. Overall, 545 Syrian refugees and 545 Turkish citizens were included. Cesarean delivery was undertaken for 176 (32.3%) Syrians and 235 (43.1%) Turks (PSyrian refugees (3110 g, range 540-4790; PSyrian refugees (PSyrians (P=0.014). Cesarean delivery is more common among pregnant Turkish citizens than among Syrian refugees. Other notable differences between the groups were recorded. © 2016 International Federation of Gynecology and Obstetrics.

  3. [Birth rates evolution in Spain. Birth trends in Spain from 1941 to 2010].

    Science.gov (United States)

    Andrés de Llano, J M; Alberola López, S; Garmendia Leiza, J R; Quiñones Rubio, C; Cancho Candela, R; Ramalle-Gómara, E

    2015-01-01

    The aim of this study was to analyse trends of births in Spain and its Autonomous Communities (CCAA) over a 70 year period (1941-2010). The crude birth rates per 1,000 inhabitants/year were calculated by CCAA using Joinpoint regression models. Change points in trend and annual percentage of change (APC) were identified. The distribution of 38,160,305 births between 1941 and 2010 shows important changes in trends both nationally and among the CCAA. There is a general pattern for the whole country, with 5 turning points being identified with changes in trend and annual percentage change (APC). Differences are also found among regions. The analysis of trends in birth rates and the annual rates of change should enable public health authorities to properly plan pediatric care resources in our country. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  4. Challenges and Consequences of Preterm Birth

    Directory of Open Access Journals (Sweden)

    Sribas Goswami

    2014-11-01

    Full Text Available Preterm births have been a challenge to obstetricians and paediatricians. Preterm births affect all population irrespective of age, race and economic status due to lack of seriousness and awareness among the pregnant women. Preterm birth is one of the leading causes of infant morbidity and mortality, amounting to billions of dollars each year, thus increasing the cost for health care. Proper awareness programs about preterm birth may help the women population to know and understand better the signs and symptoms of preterm labour. Preterm birth is a complex cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, neighborhood characteristics, environmental exposures, medical conditions, infertility treatments, biological factors and genetics. Many of these factors occur in combination, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. The empirical investigation was carried out to draw correlation between preterm birth and eventuality through this study.

  5. Maternal periodontal disease and preterm birth: A case-control study

    Directory of Open Access Journals (Sweden)

    Pushpalatha Govindaraju

    2015-01-01

    Full Text Available Background and Objective: Preterm birth (PTB is an important issue in public health and is a major cause for infant mortality and morbidity. There is a growing consensus that systemic diseases elsewhere in the body may influence PTB. Recent studies have hypothesized that maternal periodontitis could be a high-risk factor for PTB. The aim of the present study was to investigate the relationship between maternal periodontitis on PTB. Materials and Methods: Forty systemically healthy primiparous mothers aged 18–35 years were recruited for the study. Based on inclusion and exclusion criteria, they were categorized into PTB group as cases and full term birth group (FTB as controls. PTB cases (n = 20 defined as spontaneous delivery before/<37 completed weeks of gestation. Controls (FTB were normal births at or after 37 weeks of gestation. Data on periodontal status, pregnancy outcome variables, and information on other factors that may influence adverse pregnancy outcomes were collected within 2 days of labor. Data were subjected to Student's t-test and Pearson's correlation coefficient statistical analysis. Results: Statistically significant difference with respect to the gestational period at the time of delivery and birth weight of the infants in (PTB group (<0.001 compared to (FTB group was observed. Overall, there was statistically significant poor periodontal status in the (PTB group compared to (FTB group. The statistical results also showed a positive correlation between gestational age and clinical parameters. Conclusion: An observable relationship was noticed between periodontitis and gestational age, and a positive correlation was found with respect to PTB and periodontitis. Further studies should be designed to establish periodontal disease as an independent risk factor for PTB/preterm low birth weight.

  6. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

    Science.gov (United States)

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

    2017-05-01

    The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Maternal occupation during pregnancy, birth weight, and length of gestation: combined analysis of 13 European birth cohorts

    NARCIS (Netherlands)

    Casas, Maribel; Cordier, Sylvaine; Martínez, David; Barros, Henrique; Bonde, Jens Peter; Burdorf, Alex; Costet, Nathalie; dos Santos, Ana Cristina; Danileviciute, Asta; Eggesbø, Merete; Fernandez, Mariana; Fevotte, Joelle; García, Ana M.; Gražuleviciene, Regina; Hallner, Eva; Hanke, Wojciech; Kogevinas, Manolis; Kull, Inger; Stemann Larsen, Pernille; Melaki, Vasiliki; Monfort, Christine; Nordby, Karl-Christian; Nybo Andersen, Anne-Marie; Patelarou, Evridiki; Polanska, Kinga; Richiardi, Lorenzo; Santa Marina, Loreto; Snijder, Claudia; Tardón, Adonina; van Eijsden, Manon; Vrijkotte, Tanja G. M.; Zugna, Daniela; Nieuwenhuijsen, Mark; Vrijheid, Martine

    2015-01-01

    We assessed whether maternal employment during pregnancy - overall and in selected occupational sectors - is associated with birth weight, small for gestational age (SGA), term low birth weight (LBW), length of gestation, and preterm delivery in a population-based birth cohort design. We used data

  8. Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant : A Systematic Review

    NARCIS (Netherlands)

    Miltenburg, Andrea Solnes; Roggeveen, Yadira; Shields, Laura; van Elteren, Marianne; van Roosmalen, Jos; Stekelenburg, Jelle; Portela, Anayda

    2015-01-01

    Background Increased preparedness for birth and complications is an essential part of antenatal care and has the potential to increase birth with a skilled attendant. We conducted a systematic review of studies to assess the effect of birth preparedness and complication readiness interventions on

  9. The Green Bay cesarean section study. III. Falling cesarean birth rates without a formal curtailment program.

    Science.gov (United States)

    Sandmire, H F; DeMott, R K

    1994-06-01

    We observed decreases in cesarean birth rates at two Green Bay hospitals after the 1990 publication of our first cesarean section study. The purpose of this study was to determine the causes of those decreases and to see whether any outcome changes occurred with lower rates. An additional objective was to determine the perceptions of the 10 physicians regarding the determinants of cesarean birth rates. We compared recent cesarean birth rates (1990 to 1992) to former rates (1986 to 1988) for 10 of the 11 physicians analyzed in our previous studies. Newborn outcomes were analyzed to determine whether variations occur in comparing low to high cesarean rate physician groups. The total, primary, and repeat cesarean birth rates declined from 13.3% to 10.2%, 8.6% to 6.8%, and 4.7% to 3.4%, respectively, between 1986 to 1988 and 1990 to 1992. Variations in cesarean rates occurred among physicians and groups of physicians. Higher cesarean rates did not result in better perinatal outcome. Literature reports, residency training, continuing medical education attendance, and liability risks were the major determinants of cesarean birth as perceived by the 10 physicians in the study. The least important determinant, rated fifteenth of 15, was the national cesarean birth rate.

  10. Effect of Maternal and Pregnancy Risk Factors on Early Neonatal Death in Planned Home Births Delivering at Home.

    Science.gov (United States)

    Bachilova, Sophia; Czuzoj-Shulman, Nicholas; Abenhaim, Haim Arie

    2018-05-01

    The prevalence of home birth in the United States is increasing, although its safety is undetermined. The objective of this study was to investigate the effects of obstetrical risk factors on early neonatal death in planned home births delivering at home. The authors conducted a retrospective 3-year cohort study consisting of planned home births that delivered at home in the United States between 2011 and 2013. The study excluded infants with congenital and chromosomal anomalies and infants born at ≤34 weeks' gestation. Multivariate logistic regression models were used to estimate the adjusted effects of individual obstetrical variables on early neonatal deaths within 7 days of delivery. During the study period, there were 71 704 planned and delivered home births. The overall early neonatal death rate was 1.5 deaths per 1000 planned home births. The risks of early neonatal death were significantly higher in nulliparous births (OR 2.71; 95% CI 1.71-4.31), women with a previous CS (OR 2.62, 95% CI 1.25-5.52), non-vertex presentations (OR 4.27; 95% CI 1.33-13.75), plural births (OR 9.79; 95% CI 4.25-22.57), preterm births (OR 4.68; 95% CI 2.30-9.51), and births at ≥41 weeks of gestation (OR 1.76; 95% CI 1.09-2.84). Early neonatal deaths occur more commonly in certain obstetrical contexts. Patient selection may reduce adverse neonatal outcomes among planned home births. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  11. Unnatural birth? : medical pain management technology and the naturalness of birth

    OpenAIRE

    Gihle, Marte

    2008-01-01

    The aim of this thesis is to explore how medical pain management technology affects the concept of natural birth.The relationship between medical pain management technology and natural birth is discussed in a structural framework in which medicalization, risk, and identity are acknowledged as important issues within the current childbirth paradigm. The analysis is based on thirteen in-depth interviews with Norwegian midwives and mothers on their perceptions of medical pain management technolo...

  12. Outcome of planned home births compared to hospital births in Sweden between 1992 and 2004. A population-based register study.

    Science.gov (United States)

    Lindgren, Helena E; Rådestad, Ingela J; Christensson, Kyllike; Hildingsson, Ingegerd M

    2008-01-01

    The aim of this population-based study was to measure the risk of adverse outcome for mother and child in planned home births in a Swedish population irrespective of where the birth actually occurred, at home or in hospital after transfer. A population-based study using data from the Swedish Medical Birth Register. Sweden 1992-2004. A total of 897 planned home births were compared with a randomly selected group of 11,341 planned hospital births. Prevalence of mortality and morbidity among mothers and children, emergency conditions, instrumental and operative delivery and perineal lacerations were compared. During this period in Sweden the neonatal mortality rate was 2.2 per thousand in the home birth group and 0.7 in the hospital group (RR 3.6, 95% CI 0.2-14.7). No cases of emergency complications were found in the home birth group. The risk of having a sphincter rupture was lower in the planned home birth group (RR 0.2, 95% CI 0.0-0.7). The risk of having a cesarean section (RR 0.4, 95% CI 0.2-0.7) or instrumental delivery (RR 0.3, 95% CI 0.2-0.5) was significantly lower in the planned home birth group. In Sweden, between 1992 and 2004, the intrapartum and neonatal mortality in planned home births was 2.2 per thousand. The proportion is higher compared to hospital births but no statistically significant difference was found. Women in the home birth group more often experienced a spontaneous birth without medical intervention and were less likely to sustain pelvic floor injuries.

  13. Birth Order and Psychopathology

    Directory of Open Access Journals (Sweden)

    Ajay Risal

    2012-01-01

    Full Text Available Context: Ordinal position the child holds within the sibling ranking of a family is related to intellectual functioning, personality, behavior, and development of psychopathology. Aim: To study the association between birth order and development of psychopathology in patients attending psychiatry services in a teaching hospital. Settings and Design: Hospital-based cross-sectional study. Materials and Methods: Retrospective file review of three groups of patients was carried out. Patient-related variables like age of onset, birth order, family type, and family history of mental illness were compared with psychiatry diagnosis (ICD-10 generated. Statistical Analysis: SPSS 13; descriptive statistics and one-way analysis of variance (ANOVA were used. Results: Mean age of onset of mental illness among the adult general psychiatry patients (group I, n = 527 was found to be 33.01 ± 15.073, while it was 11.68 ± 4.764 among the child cases (group II, n = 47 and 26.74 ± 7.529 among substance abuse cases (group III, n = 110. Among group I patients, commonest diagnosis was depression followed by anxiety and somatoform disorders irrespective of birth order. Dissociative disorders were most prevalent in the first born child (36.7% among group II patients. Among group III patients, alcohol dependence was maximum diagnosis in all birth orders. Conclusions: Depression and alcohol dependence was the commonest diagnosis in adult group irrespective of birth order.

  14. Geospatial association between adverse birth outcomes and arsenic in groundwater in New Hampshire, USA

    Science.gov (United States)

    Xun Shi,; Ayotte, Joseph; Akikazu Onda,; Stephanie Miller,; Judy Rees,; Diane Gilbert-Diamond,; Onega, Tracy L; Gui, Jiang; Karagas, Margaret R.; Moeschler, John B

    2015-01-01

    There is increasing evidence of the role of arsenic in the etiology of adverse human reproductive outcomes. Because drinking water can be a major source of arsenic to pregnant women, the effect of arsenic exposure through drinking water on human birth may be revealed by a geospatial association between arsenic concentration in groundwater and birth problems, particularly in a region where private wells substantially account for water supply, like New Hampshire, USA. We calculated town-level rates of preterm birth and term low birth weight (term LBW) for New Hampshire, by using data for 1997–2009 stratified by maternal age. We smoothed the rates by using a locally weighted averaging method to increase the statistical stability. The town-level groundwater arsenic probability values are from three GIS data layers generated by the US Geological Survey: probability of local groundwater arsenic concentration >1 µg/L, probability >5 µg/L, and probability >10 µg/L. We calculated Pearson’s correlation coefficients (r) between the reproductive outcomes (preterm birth and term LBW) and the arsenic probability values, at both state and county levels. For preterm birth, younger mothers (maternal age based on the data of probability >10 µg/L; for older mothers, r = 0.19 when the smoothing threshold = 3,500; a majority of county level r values are positive based on the arsenic data of probability >10 µg/L. For term LBW, younger mothers (maternal age based on the data of probability >1 µg/L; for older mothers, r = 0.14 when the rates are smoothed with a threshold = 1,000 births and also adjusted by town median household income in 1999, and the arsenic values are the town minimum based on probability >10 µg/L. At the county level for younger mothers, positive r values prevail, but for older mothers, it is a mix. For both birth problems, the several most populous counties—with 60–80% of the state’s population and clustering at the southwest

  15. Planned home births in Czech republic

    OpenAIRE

    Vlhová, Marína

    2007-01-01

    The aim of thesis is to describe general characteristic of women planned home birth in Czech republic. There are described also reasons and motivation to decide to this in thesis. Theoretical part of work is based on history of obstetrics in the world and Czech countries. This part of work analysis current models of birth care and explains humanization of obstetrics and inform about grant and acceptors of birth care. There is summary of places of birth and legal issues in Czech republic nowad...

  16. Does Birth Spacing Affect Personality?

    OpenAIRE

    Golsteyn, Bart H.H.; Magnée, Cécile A. J.

    2017-01-01

    This paper studies the causal effect of birth spacing (i.e., the age difference between siblings) on personality traits. We use longitudinal data from a large British cohort which has been followed from birth until age 42. Following earlier studies, we employ miscarriages between the first and second child as an instrument for birth spacing. The results show that a larger age gap between siblings negatively affects personality traits of the youngest child in two-child households. This result ...

  17. Birth Order, Schooling, and Earnings.

    OpenAIRE

    Behrman, Jere R; Taubman, Paul

    1986-01-01

    Birth-order effects are posited by many to affect earnings and schooling. The authors show how such effects can be interpreted to shift either the earnings possibility frontier for siblings or parental preferences. The authors find empirical evidence for birth- order effects on (age-adjusted) schooling and on earnings for young U.S. adults, though the latter is not robust for all specifications. The examination of intrahousehold allocations suggests that these birth-order differences occur, d...

  18. Birth order and post-traumatic stress disorder.

    Science.gov (United States)

    Green, Ben; Griffiths, Emily C

    2014-01-01

    To compare the birth order of patients with post-traumatic stress disorder (PTSD) and adjustment disorder (AD) with population norms. 83 PTSD patients and 104 AD control patients from a psychiatric trauma clinic were diagnosed according to DCR-10 guidelines. A family history was taken as to number of siblings, and their birth order. We compared the distribution of birth order for each patient group against birth order distributions expected by chance for the same years of birth using UK population-level birth order from the Office for National Statistics. Psychiatric patients with PTSD were more likely to be from a large family, specifically to be the fifth child or later (OR 4.78, p birth order between AD patients and the general population. People with PTSD are more likely to be the youngest children from large families than expected from a random sample of people born in the same years. This association with birth order was not found for another psychiatric diagnosis AD from the same clinic. We discuss possible psychosocial and biological causes, and implications for further research.

  19. Planned home births: the need for additional contraindications.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Arabin, Birgit; Chervenak, Frank A

    2017-04-01

    Planned home births in the United States are associated with fewer interventions but with increased adverse neonatal outcomes such as perinatal and neonatal deaths, neonatal seizures or serious neurologic dysfunction, and low 5-minute Apgar scores. The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice states that, to reduce perinatal death and to improve outcomes at planned home births, strict criteria are necessary to guide the selection of appropriate candidates for planned home birth. The committee lists 3 absolute contraindications for a planned home birth: fetal malpresentation, multiple gestations, and a history of cesarean delivery. The aim of this study was to evaluate whether there are risk factors that should be considered contraindications to planned home births in addition to the 3 that are listed by the American College of Obstetricians and Gynecologists. We conducted a population-based, retrospective cohort study of all term (≥37 weeks gestation), normal weight (≥2500 grams), singleton, nonanomalous births from 2009-2013 using the Centers for Disease Control and Prevention's period-linked birth-infant death files that allowed for identification of intended and unintended home births. We examined neonatal deaths (days 0-27 after birth) across 3 groups (hospital-attended births by certified nurse midwives, hospital-attended births by physicians, and planned home births) for 5 risk factors: 2 of the 3 absolute contraindications to home birth listed by the American College of Obstetricians and Gynecologists (breech presentation and previous cesarean delivery) and 3 additional risk factors (parity [nulliparous and multiparous], maternal age [women home births (12.1 neonatal death/10,000 deliveries; Pbirths by certified nurse midwives (3.08 neonatal death/10,000 deliveries) or physicians (5.09 neonatal death/10,000 deliveries). Neonatal mortality rates were increased significantly at planned home births, with the

  20. Male scarcity is associated with higher prevalence of premature gestation and low birth weight births across the United States.

    Science.gov (United States)

    Kruger, Daniel J; Clark, Jillian; Vanas, Sarah

    2013-01-01

    Modern adverse birth outcomes may partially result from mechanisms evolved to evaluate environmental conditions and regulate maternal investment trade-offs. Male scarcity in a population is associated with a cluster of characteristics related to higher mating effort and lower paternal investment. We predicted that modern populations with male scarcity would have shorter gestational times and lower birth weights on average. We compared US Centers for Disease Control and Prevention county-aggregated year 2000 birth records with US Decennial Census data. We combined these data in a path model with the degree of male scarcity and known socio-economic predictors of birth outcomes as exogenous predictors of prematurity and low birth weight, with single mother households as a proportion of families with children as a mediator (N = 450). Male scarcity was directly associated with higher rates of low birth weight. Male scarcity made significant indirect predictions of rates of prematurity and low birth weight, as mediated by the proportion of families headed by single mothers. Aggregate socio-economic status also indirectly predicted birth outcomes, as mediated by the proportion of families headed by single mothers, whereas the proportion African American retained both direct and indirect predictions of adverse birth outcomes. Male scarcity influences life history tradeoffs, with consequences for important social and public health issues such as adverse birth outcomes. Copyright © 2013 Wiley Periodicals, Inc.

  1. Birth weight in a large series of triplets

    Directory of Open Access Journals (Sweden)

    van Beijsterveldt Catharina EM

    2011-04-01

    Full Text Available Abstract Background Triplets are often born premature and with a low birth weight. Because the incidence of triplet births is rare, there are relatively few studies describing triplet birth weight characteristics. Earlier studies are often characterized by small sample sizes and lack information on important background variables such as zygosity. The objective of this study is to examine factors associated with birth weight in a large, population-based sample of triplets registered with the Netherlands Twin Register (NTR. Methods In a sample of 1230 triplets from 410 families, the effects of assisted reproductive techniques, zygosity, birth order, gestational age, sex, maternal smoking and alcohol consumption during pregnancy on birth weight were assessed. The resemblance among triplets for birth weight was estimated as a function of zygosity. Birth weight discordance within families was studied by the pair-wise difference between triplets, expressed as a percentage of the birth weight of the heaviest child. We compare data from triplets registered with the NTR with data from population records, which include live births, stillbirths and children that have deceased within days after birth. Results There was no effect of assisted reproductive techniques on triplet birth weight. At gestational age 24 to 40 weeks triplets gained on average 130 grams per week; boys weighed 110 grams more than girls and triplets of smoking mothers weighted 104 grams less than children of non-smoking mothers. Monozygotic triplets had lower birth weights than di- and trizygotic triplets and birth weight discordance was smaller in monozygotic triplets than in di- and trizygotic triplets. The correlation in birth weight among monozygotic and dizygotic triplets was 0.42 and 0.32, respectively. In nearly two-thirds of the families, the heaviest and the lightest triplet had a birth weight discordance over 15%. The NTR sample is representative for the Dutch triplet

  2. Forced Marriage and Birth Outcomes.

    Science.gov (United States)

    Becker, Charles M; Mirkasimov, Bakhrom; Steiner, Susan

    2017-08-01

    We study the impact of marriages resulting from bride kidnapping on infant birth weight. Bride kidnapping-a form of forced marriage-implies that women are abducted by men and have little choice other than to marry their kidnappers. Given this lack of choice over the spouse, we expect adverse consequences for women in such marriages. Remarkable survey data from the Central Asian nation of Kyrgyzstan enable exploration of differential birth outcomes for women in kidnap-based and other types of marriage using both OLS and IV estimation. We find that children born to mothers in kidnap-based marriages have lower birth weight compared with children born to other mothers. The largest difference is between kidnap-based and arranged marriages: the magnitude of the birth weight loss is in the range of 2 % to 6 % of average birth weight. Our finding is one of the first statistically sound estimates of the impact of forced marriage and implies not only adverse consequences for the women involved but potentially also for their children.

  3. Delivering information: a descriptive study of Australian women's information needs for decision-making about birth facility.

    Science.gov (United States)

    Thompson, Rachel; Wojcieszek, Aleena M

    2012-06-18

    Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women's recommendations about the facility, freedom to choose one's preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities.

  4. Low-birth-weight babies among hospital deliveries in Nepal: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Koirala AK

    2015-06-01

    Full Text Available Arun K Koirala,1 Dharma N Bhatta2,3 1Administrative Department, Helping Hands Community Hospital, Chabahil, Kathmandu, 2Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 3Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Background: Birth weight is an important indicator of a population’s health and is associated with numerous interrelated factors in the infant, mother, and physical environment. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a liveborn infant among the women in Morang, Nepal.Methods: A cross-sectional survey was carried out from December 2010 to March 2011 among 255 mothers who gave birth during the study period at the Koshi Zonal Hospital, Nepal. Data were collected using a structured questionnaire with face-to-face interviews. Data were analyzed through logistic regression and presented with crude and adjusted odds ratios (AORs with 95% confidence intervals (CIs.Results: The study showed that the prevalence of low-birth-weight babies was 23.1% (95% CI: 17.9–28.1. The mean (standard deviation age of mothers was 23.23 (4.18 years. The proportion of low birth weight of previous baby was 3.9% (95% CI: 0.1–7.9, and 15.7% (95% CI: 11.5–20.5 of the respondents had preterm delivery. Nearly one-third (36.1%; 95% CI: 26.4–45.6 of the respondents had >2 years’ gap after the previous delivery. Nonformal employment (AOR: 2.14; 95% CI: 0.523–8.74, vegetarian diet (AOR: 1.47; 95% CI: 0.23–9.36, and no rest during pregnancy (AOR: 1.38; 95% CI: 0.41–4.39 were factors more likely to determine low birth weight. However, none of the variables showed a significant association between low birth weight and other dependent variables.Conclusion: Low birth weight is an important factor for perinatal morbidity and mortality and is a common problem in the developing world. The

  5. Home versus hospital birth--process and outcome.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina

    2010-02-01

    A constant small, but clinically important, number of American women choose to deliver at home. Contradictory professional and public policies reflect the polarization and politicization of the controversy surrounding this birth option. Women opting for home birth seek and often attain their goals of a nonmedicalized experience in comfortable, familiar surroundings wherein they maintain situational control. However, home deliveries in developed Western nations are often associated with excess perinatal and neonatal mortality, particularly among nonanomalous term infants. On the other hand, current home birth practices are, especially when birth attendants are highly trained and fully integrated into comprehensive health care delivery systems, associated with fewer cesareans, operative vaginal deliveries, episiotomies, infections, and third and fourth degree lacerations. Newborn benefits include less meconium staining, assisted ventilation, low birth weight, prematurity, and intensive care admissions. Existing data suggest areas of future research regarding the safety of home birth in the United States. Obstetricians & Gynecologists, Family Physicians. After completion of this educational activity, the participant should be better able to assess perinatal outcomes described in the reported literature associated with home births in developed countries, list potential advantages and disadvantages of planned home births, and identify confounders in current literature that impact our thorough knowledge of home birth outcomes.

  6. Higher Prevalence of Left-Handedness in Twins? Not After Controlling Birth Time Confounders.

    Science.gov (United States)

    Heikkilä, Kauko; Vuoksimaa, Eero; Saari-Kemppainen, Aulikki; Kaprio, Jaakko; Rose, Richard J; Haukka, Jari; Pitkäniemi, Janne; Iivanainen, Matti

    2015-10-01

    Pregnancy- and birth-related factors may have an effect on handedness. Compared with singletons, twins have a lower birth weight, shorter gestational age, and are at higher risk for birth complications. We tested whether the prevalence of left-handedness is higher among twins than singletons, and if so, whether that difference is fully explained by pregnancy and birth-related differences between twins and singletons. We analyzed Finnish population-based datasets; included were 8,786 twins and 5,892 singletons with information on birth weight (n = 12,381), Apgar scores (n = 11,129), and gestational age (n = 11,811). Two twin cohorts were involved: FinnTwin12 included twins born during 1983-1987, and FinnTwin16 included twins born during 1974-1979. We had two comparison groups of singletons: 4,101 individuals born during 1986-1988 and enrolled in the Helsinki Ultrasound Trial, and 1,791 individuals who were partners of FinnTwin16 twins. We used logistic regression models with writing hand as the outcome for comparison and evaluating effects of covariates. Left-handedness was more common in twins (9.67%) than in singletons (8.27%; p = .004). However, Apgar scores were associated with handedness, and after controlling for covariates, we found no difference in the prevalence of left-handedness between twins and singletons. Increased left-handedness among twins, often reported by others, was evident in our data, but only among our older twin cohorts, and that association disappeared after removing effects of perinatal covariates.

  7. Department of Defense Birth and Infant Health Registry: select reproductive health outcomes, 2003-2014.

    Science.gov (United States)

    Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J

    2017-11-01

    Established following a 1998 directive, the Department of Defense Birth and Infant Health Registry (Registry) team conducts surveillance of select reproductive health outcomes among military families. Data are compiled from the Military Health System Data Repository and Defense Manpower Data Center to define the Registry cohort and outcomes of interest. Outcomes are defined using ICD-9/ICD-10 and Current Procedural Terminology codes, and include: pregnancy outcomes (e.g., live births, losses), birth defects, preterm births, and male:female infant sex ratio. This report includes data from 2003-2014 on 1,304,406 infants among military families and 258,332 pregnancies among active duty women. Rates of common adverse infant and pregnancy outcomes were comparable to or lower than those in the general US population. These observations, along with prior Registry analyses, provide reassurance that military service is not independently associated with increased risks for select adverse reproductive health outcomes. The Registry's diverse research portfolio demonstrates its unique capabilities to answer a wide range of questions related to reproductive health. These data provide the military community with information to identify successes and areas for improvement in prevention and care.

  8. Overview of Epidemiology, Genetics, Birth Defects, and Chromosome Abnormalities Associated With CDH

    Science.gov (United States)

    Pober, Barbara R.

    2010-01-01

    Congenital diaphragmatic hernia (CDH) is a common and well-studied birth defect. The etiology of most cases remains unknown but increasing evidence points to genetic causation. The data supporting genetic etiologies which are detailed below include the association of CDH with recurring chromosome abnormalities, the existence of CDH-multiplex families, and the co-occurrence of CDH with additional congenital malformations. PMID:17436298

  9. [Transition in the midwifery profession. 25. The prewar birth control movement and the concept of eugenics].

    Science.gov (United States)

    Obayashi, M

    1987-08-01

    The concept of eugenics played a significant role in the pre-war birth control movement. Some favored birth control from the standpoint of an individual's right to happiness, while others were against it from the standpoint of preservation of good stock for the nation. Yamamoto, Nobuharu (1889-1929), who translated Margaret Sanger's speech and her book in 1922, advocated birth control purely from a biologist's point of view. Birth control is necessary for the survival of strong healthy human beings capable of overcoming all the difficulties in their lives. Birth control is a form of natural selection consciously done to avoid overburdening and wasting individual lives. Nagai, Sen (1876-1957) was opposed to birth control from eugenicc' point of view. He became the 1st president of Japan Racial Hygiene Society in 1930 and founded Eugenics/Marriage Counseling Clinic in 1933. In his book on eugenics published in 1936 he stressed the importance of continuation of race by protecting good stock and eliminating poor stock by sterilization. Birth control was opposed because it will shorten the life of an ethnic group or a race. Furuya, Yoshio (1890-1974), also a racial hygiene major, supported population policies based on eugenics. He studied a trend in childbirth among women of different professions and geographical areas. Educated and cultured urban upper-middle class women showed a sudden decline in childbirth in their later years of marriage, suggesting the prevalence of birth control among them, while less educated low-income women continued to reproduce. He opposed to birth control but was in favor of sterilization for eliminating poor stock.

  10. Birth order and health of newborns

    DEFF Research Database (Denmark)

    Brenøe, Anne Ardila; Molitor, Ramona

    2017-01-01

    We examine birth order differences in health of newborns and follow the children throughout childhood using high-quality administrative data on individuals born in Denmark between 1981 and 2010. Family fixed effects models show a positive and robust effect of birth order on health at birth......; firstborn children are less healthy at birth. During earlier pregnancies, women are more likely to smoke, receive more prenatal care, and are more likely to suffer a medical pregnancy complication, suggesting worse maternal health. We further show that the health disadvantage of firstborns persists...

  11. Why babies die in unplanned out-of-institution births: an enquiry into perinatal deaths in Norway 1999-2013.

    Science.gov (United States)

    Gunnarsson, Björn; Fasting, Sigurd; Skogvoll, Eirik; Smárason, Alexander K; Salvesen, Kjell Å

    2017-03-01

    The aims were to describe causes of death associated with unplanned out-of-institution births, and to study whether they could be prevented. Retrospective population-based observational study based on data from the Medical Birth Registry of Norway and medical records. Between 1 January 1999 and 31 December 2013, 69 perinatal deaths among 6027 unplanned out-of-institution births, whether unplanned at home, during transportation, or unspecified, were selected for enquiry. Hospital records were investigated and cases classified according to Causes of Death and Associated Conditions. 63 cases were reviewed. There were 25 (40%) antepartum deaths, 10 (16%) intrapartum deaths, and 24 neonatal (38%) deaths. Four cases were in the unknown death category (6%). Both gestational age and birthweight followed a bimodal distribution with modes at 24 and 38 weeks and 750 and 3400 g, respectively. The most common main cause of death was infection (n = 14, 22%), neonatal (n = 14, 22%, nine due to extreme prematurity) and placental (n = 12, 19%, seven placental abruptions). There were 86 associated conditions, most commonly perinatal (n = 32), placental (n = 15) and maternal (n = 14). Further classification revealed that the largest subgroup was associated perinatal conditions/sub-optimal care, involving 25 cases (40%), most commonly due to sub-optimal maternal use of available care (n = 14, 22%). Infections, neonatal, and placental causes accounted for almost two-thirds of perinatal mortality associated with unplanned out-of-institution births in Norway. Sub-optimal maternal use of available care was found in more than one-fifth of cases. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

  12. Birth tourism: socio-demographic and statistical aspects

    Directory of Open Access Journals (Sweden)

    Anatoly V. Korotkov

    2016-01-01

    Full Text Available The purpose of the study is to research birth tourism issue. The article gives the socio-demographic and statistical aspects of research problems of birth inbound tourism in the Russian Federation. Following the literature analysis, the degree of study for birth tourism lags behind its actual size. Currently, the media has accumulated a significant amount of information on birth tourism in Russia, that requires processing, systematization and understanding that can and should become an independent area of study of sociologists and demographers to develop recommendations for the management of socio-demographic processes in birth tourism in our country. It is necessary to identify the problems that will inevitably arise. At present, this process is almost not regulated.These problems are complex, it requires the joint efforts of sociologists and demographers. However, it is impossible to obtain reliable results and to develop management decisions without attention to the statistical aspect of this problem. It is necessary to create methodological support for collecting and information processing and model development of the birth tourism. At the initial stage it is necessary to identify the direction and objectives of the analysis to determine the factors in the development of this process, to develop a hierarchical system of statistical indicators, to receive the information, needed for calculating of specific indicators.The complex research of the birth tourism issues should be based on the methodology of sociology, demography and statistics, including statistical observation, interviews with residents, structure analysis and birth tourism concentration in the country, the analysis of the dynamics, classification of factors and reasons, the grouping of regions for the development of the studied processes and, of course, the development of economic-statistical indicators.The article reveals the problem of the significant influence of the

  13. Methodology, Birth Order, Intelligence, and Personality.

    Science.gov (United States)

    Michalski, Richard L.; Shackelford, Todd K.

    2001-01-01

    Critiques recent research on the effects of birth order on intelligence and personality, which found that the between-family design revealed that birth order negatively related to intelligence, while the within-family design revealed that birth order was unrelated to intelligence. Suggests that it may not be intelligence that co-varies with birth…

  14. Risk factors for and perinatal outcomes of major depression during pregnancy

    DEFF Research Database (Denmark)

    Räisänen, Sari; Lehto, Soili M; Nielsen, Henriette Svarre

    2014-01-01

    was substantial to modest for small-for-gestational age newborn (care associated with major depression, whereas SES made only a minor contribution. CONCLUSIONS: Physician-diagnosed major depression......OBJECTIVES: To identify risk factors for and the consequences (several adverse perinatal outcomes) of physician-diagnosed major depression during pregnancy treated in specialised healthcare. DESIGN: A population-based cross-sectional study. SETTING: Data were gathered from Finnish health registers...... for 1996-2010. PARTICIPANTS: All singleton births (n=511,938) for 2002-2010 in Finland. PRIMARY OUTCOME MEASURES: Prevalence, risk factors and consequences of major depression during pregnancy. RESULTS: Among 511,938 women, 0.8% experienced major depression during pregnancy, of which 46.9% had a history...

  15. Separated before birth: pulsars B2020+28 and B2021+51 as the remnants of runaway stars

    OpenAIRE

    Gvaramadze, V. V.

    2007-01-01

    Astrometric data on the pulsars B2020+28 and B2021+51 suggest that they originated within several parsecs of each other in the direction of the Cyg OB2 association. It was proposed that the pulsars share their origin in a common massive binary and were separated at the birth of the second pulsar following the asymmetric supernova explosion. We consider a different scenario for the origin of the pulsar pair based on a possibility that the pulsars were separated before their birth and that they...

  16. The Danish national quality database for births

    DEFF Research Database (Denmark)

    Andersson, Charlotte Brix; Flems, Christina; Kesmodel, Ulrik Schiøler

    2016-01-01

    Aim of the database: The aim of the Danish National Quality Database for Births (DNQDB) is to measure the quality of the care provided during birth through specific indicators. Study population: The database includes all hospital births in Denmark. Main variables: Anesthesia/pain relief, continuous...... Medical Birth Registry. Registration to the Danish Medical Birth Registry is mandatory for all maternity units in Denmark. During the 5 years, performance has improved in the areas covered by the process indicators and for some of the outcome indicators. Conclusion: Measuring quality of care during...

  17. Hypnotherapy for birth.

    Science.gov (United States)

    Howell, Maggie

    2014-05-01

    There are many misunderstandings about hypnotherapy for birth and how best to support a woman who has chosen to use it. This article brings together experiences of midwives who have attended women in labour using hypnotherapy, and aims to help birth professionals understand a bit more about hypnotherapy and how they can best support women who are using it. It is a personal account from a hypnotherapy trainer reflecting on her encounters with midwives as they share experiences of observing hypnotherapy in action.

  18. Economic Conditions During Pregnancy and Adverse Birth Outcomes Among Singleton Live Births in the United States, 1990-2013.

    Science.gov (United States)

    Margerison-Zilko, Claire E; Li, Yu; Luo, Zhehui

    2017-11-15

    We know little about the relationship between the macroeconomy and birth outcomes, in part due to the methodological challenge of distinguishing effects of economic conditions on fetal health from effects of economic conditions on selection into live birth. We examined associations between state-level unemployment rates in the first 2 trimesters of pregnancy and adverse birth outcomes, using natality data on singleton live births in the United States during 1990-2013. We used fixed-effect logistic regression models and accounted for selection by adjusting for state-level unemployment before conception and maternal characteristics associated with both selection and birth outcomes. We also tested whether associations between macroeconomic conditions and birth outcomes differed during and after (compared with before) the Great Recession (2007-2009). Each 1-percentage-point increase in the first-trimester unemployment rate was associated with a 5% increase in odds of preterm birth, while second-trimester unemployment was associated with a 3% decrease in preterm birth odds. During the Great Recession, however, first-trimester unemployment was associated with a 16% increase in odds of preterm birth. These findings increase our understanding of the effects of the Great Recession on health and add to growing literature suggesting that macro-level social and economic factors contribute to perinatal health. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. The distribution of clinical phenotypes of preterm birth syndrome: implications for prevention.

    Science.gov (United States)

    Barros, Fernando C; Papageorghiou, Aris T; Victora, Cesar G; Noble, Julia A; Pang, Ruyan; Iams, Jay; Cheikh Ismail, Leila; Goldenberg, Robert L; Lambert, Ann; Kramer, Michael S; Carvalho, Maria; Conde-Agudelo, Agustin; Jaffer, Yasmin A; Bertino, Enrico; Gravett, Michael G; Altman, Doug G; Ohuma, Eric O; Purwar, Manorama; Frederick, Ihunnaya O; Bhutta, Zulfiqar A; Kennedy, Stephen H; Villar, José

    2015-03-01

    Preterm birth has been difficult to study and prevent because of its complex syndromic nature. To identify phenotypes of preterm delivery syndrome in the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. A population-based, multiethnic, cross-sectional study conducted at 8 geographically demarcated sites in Brazil, China, India, Italy, Kenya, Oman, the United Kingdom, and the United States. A total of 60,058 births over a 12-month fixed period between April 27, 2009, and March 2, 2014. Of these, 53,871 had an ultrasonography estimate of gestational age, among which 5828 were preterm births (10.8%). Pregnancies were prospectively studied using a standardized data collection and online data management system. Newborns had anthropometric and clinical examinations using standardized methods and identical equipment and were followed up until hospital discharge. The main study outcomes were clusters of preterm phenotypes and for each cluster, we analyzed signs of presentation at hospital admission, admission rates for neonatal intensive care for 7 days or more, and neonatal mortality rates. Twelve preterm birth clusters were identified using our conceptual framework. Eleven consisted of combinations of conditions known to be associated with preterm birth, 10 of which were dominated by a single condition. However, the most common single cluster (30.0% of the total preterm cases; n = 1747) was not associated with any severe maternal, fetal, or placental condition that was clinically detectable based on the information available; within this cluster, many cases were caregiver initiated. Only 22% (n = 1284) of all the preterm births occurred spontaneously without any of these severe conditions. Maternal presentation on hospital admission, newborn anthropometry, and risk for death before hospital discharge or admission for 7 or more days to a neonatal intensive care unit, none of which were used to construct the clusters, also differed according to the identified

  20. Differences in partnership and marital status at first birth by women’s and partners’ education: Evidence from Britain 1991-2012

    OpenAIRE

    Peri Rotem, Nitzan; Scott, J

    2017-01-01

    Non-marital childbearing, especially within cohabitation, has become increasingly common in Britain as in other Western countries. Nonetheless, births outside marriage occur more frequently among the relatively disadvantaged in terms of income potential. Building upon previous research in family formation patterns, we examine differences by education and employment status in the proportion of marital and non-marital first births among British women and couples over the past two decades. In pa...

  1. Elizabeth Belle's Birth Story.

    Science.gov (United States)

    Boro, Jessica; Boro, Samuel

    2014-01-01

    In this article, Jessica and Samuel Boro share the story of the birth of their daughter, Elizabeth Belle. With the physical and emotional support of her husband and her doula, this mother was able to cope with a long labor and have the natural birth she wanted. Her husband describes how important the doula was for him.

  2. Progesterone to prevent spontaneous preterm birth

    Science.gov (United States)

    Romero, Roberto; Yeo, Lami; Chaemsaithong, Piya; Chaiworapongsa, Tinnakorn; Hassan, Sonia

    2014-01-01

    Summary Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and its prevention is an important healthcare priority. Preterm parturition is one of the ‘great obstetrical syndromes’ and is caused by multiple etiologies. One of the mechanisms of disease is the untimely decline in progesterone action, which can be manifested by a sonographic short cervix in the midtrimester. The detection of a short cervix in the midtrimester is a powerful risk factor for preterm delivery. Vaginal progesterone can reduce the rate of preterm delivery by 45%, and the rate of neonatal morbidity (admission to neonatal intensive care unit, respiratory distress syndrome, need for mechanical ventilation, etc.). To prevent one case of spontaneous preterm birth birth in women with a short cervix both with and without a prior history of preterm birth. In patients with a prior history of preterm birth, vaginal progesterone is as effective as cervical cerclage to prevent preterm delivery. 17α-Hydroxyprogesterone caproate has not been shown to be effective in reducing the rate of spontaneous preterm birth in women with a short cervix. PMID:24315687

  3. BIRTH ORDER AMONG NORTHERN INDIAN MEDICAL STUDENTS

    Directory of Open Access Journals (Sweden)

    Vinay Agarwal

    2011-12-01

    Full Text Available Background: Birth order is claimed to be linked with academic achievement. However, many scientists do not accept it. Objective: To assess the association of birth order in North Indian medical students with number of attempts to cross the competition bar. Study design: Cross sectional study. Setting and participation: M.B.B.S. 1st year students of L.L.R.M. Medical College, Meerut. Statistical analysis used: Chi Square test. Methods: Enquiry of Birth order and number of attempts to crack the medical entrance examination from responded 360 medical students among 494 students admitted during 2005 – 2010. Results: The study revealed insignificant relationship between ages of entrance in medical college in both sexes. of 360 students responded 37% students were of first Birth order. Among those admitted in first attempt, 67% students were of first birth order and proportion of success in first attempt reduced with increasing birth order. Conclusion: Birth Order strongly influences academic achievements.

  4. Committee Opinion No. 697: Planned Home Birth.

    Science.gov (United States)

    2017-04-01

    In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse-midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives' Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

  5. Committee Opinion No. 669: Planned Home Birth.

    Science.gov (United States)

    2016-08-01

    In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse-midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives' Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

  6. Perinatal mortality in second- vs firstborn twins: a matter of birth size or birth order?

    Science.gov (United States)

    Luo, Zhong-Cheng; Ouyang, Fengxiu; Zhang, Jun; Klebanoff, Mark

    2014-08-01

    Second-born twins on average weigh less than first-born twins and have been reported at an elevated risk of perinatal mortality. Whether the risk differences depend on their relative birth size is unknown. The present study aimed to evaluate the association of birth order with perinatal mortality by birth order-specific weight difference in twin pregnancies. In a retrospective cohort study of 258,800 twin pregnancies without reported congenital anomalies using the US matched multiple birth data 1995-2000 (the available largest multiple birth dataset), conditional logistic regression was applied to estimate the odds ratio (OR) of perinatal death adjusted for fetus-specific characteristics (sex, presentation, and birthweight for gestational age). Comparing second vs first twins, the risks of perinatal death were similar if they had similar birthweights (within 5%) and were increasingly higher if second twins weighed progressively less (adjusted ORs were 1.37, 1.90, and 3.94 if weighed 5.0-14.9%, 15.0-24.9%, and ≥25.0% less, respectively), and progressively lower if they weighed increasingly more (adjusted ORs were 0.67, 0.63, and 0.36 if weighed 5.0-14.9%, 15.0-24.9%, and ≥25.0% more, respectively) (all P birth size. Vaginal delivery at term is associated with a substantially greater risk of perinatal mortality in second twins. Copyright © 2014 Mosby, Inc. All rights reserved.

  7. The impact of medically indicated and spontaneous preterm birth among hypertensive women.

    Science.gov (United States)

    Kase, Benjamin A; Carreno, Carlos A; Blackwell, Sean C; Sibai, Baha M

    2013-11-01

    To (1) describe the frequency of spontaneous preterm birth (SPTB) and medically indicated preterm birth (PTB) among women with chronic hypertension (CHTN) and (2) to evaluate differences in neonatal outcomes according to SPTB or medically indicated PTB. Retrospective analysis of a previously conducted multicenter randomized trial. Deliveries were categorized as SPTB or medically indicated and stratified by gestational ages (PTBs occurred in the late preterm period (n = 146). SGA was significantly more frequent among those with medically indicated PTB at 0.05). Nearly one-third of women with CHTN delivered preterm. The majority of PTBs were medically indicated and late preterm, but approximately one-third were due to SPTB. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Size at birth and preterm birth in women with lifetime eating disorders

    DEFF Research Database (Denmark)

    Micali, N.; Larsen, P. Stemann; Strandberg-Larsen, K.

    2016-01-01

    anorexia nervosa and lifetime anorexia + bulimia nervosa were prospectively associated with restricted fetal growth and higher odds of SGA [respectively, OR = 1.6 [95% CI 1.3-1.8] and OR = 1.5 [95% CI 1.2-1.9)] compared with unexposed women. Active anorexia nervosa was associated with lower birthweight......: Maternal anorexia nervosa (both active and past) is associated with lower size at birth and symmetric growth restriction, with evidence of worse outcomes in women with active disorder. Women with anorexia nervosa should be advised about achieving full recovery before conceiving. Similarly, targeting......OBJECTIVE: To investigate whether eating disorders are associated with lower size at birth, symmetric growth restriction, and preterm birth; and whether pregnancy smoking explains the association between anorexia nervosa and fetal growth. DESIGN: Longitudinal population-based cohort study. SETTING...

  9. Barriers to hospital births: why do many Bolivian women give birth at home?

    Directory of Open Access Journals (Sweden)

    Kelsey E. Otis

    2008-07-01

    Full Text Available OBJECTIVES: This study investigated the low rates of hospital/health center births recorded in Yapacaní, Bolivia, that persist despite the national maternal-infant insurance program designed to ensure equitable access to free center-based health care services for pregnant women. The purpose of this study was to identify the multilevel factors inhibiting access to and utilization of public health centers for labor and delivery. METHODS: Qualitative research methods were used, including participant observation, semistructured interviews of 62 community members, and key informant interviews with eight regional experts. Data were coded and analyzed using the grounded theory approach. RESULTS: From the semistructured interview data, five reasons for the low rate of institutional births and their frequency were identified: (1 fear or embarrassment related to receiving care at a public health care center (37%; (2 poor quality of care available at the health care centers (22%; (3 distance from or other geographic issues preventing timely travel to health care services (21%; (4 economic constraints preventing travel to or utilization of health care services (14%; and (5 the perception that health care services are not necessary due to the experience of "easy birth" (6%. CONCLUSIONS: The reasons for the low rate of births in public health centers exist within the context of deficient resources, politics, and cultural differences that all influence the experience of women and their partners at the time of birth. These large scale, contextual issues must be taken into account to improve access to quality health care services for all Bolivian women at the time of birth. Resources at the national level must be carefully targeted to ensure that governmental services will successfully instill confidence in Bolivian women and facilitate their overcoming the cultural, geographic, economic, and logistical barriers to accessing "free" services.

  10. Season of birth and multiple sclerosis in Tunisia.

    Science.gov (United States)

    Sidhom, Youssef; Kacem, Imen; Bayoudh, Lamia; Ben Djebara, Mouna; Hizem, Yosr; Ben Abdelfettah, Sami; Gargouri, Amina; Gouider, Riadh

    2015-11-01

    Recent studies on date of birth of multiple sclerosis (MS) patients showed an association between month of birth and the risk of developing MS. This association has not been investigated in an African country. We aimed to determine if the risk of MS is associated with month of birth in Tunisia. Data concerning date of birth for MS patients in Tunisia (n = 1912) was obtained. Birth rates of MS patients were compared with all births in Tunisia matched by year of birth (n = 11,615,912). We used a chi-squared analysis and the Hewitt's non-parametric test for seasonality. The distribution of births among MS patients compared with the control population was not different when tested by the chi-squared test. The Hewitt's test for seasonality showed an excess of births between May and October among MS patients (p = 0.03). The peak of Births of MS patients in Tunisia was in July and the nadir in December. Our data does support the seasonality hypothesis of month of birth as risk factor for MS in Tunisia. Low vitamin D levels during pregnancy could be a possible explanation that needs further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Physical activity during pregnancy and infant's birth weight: results from the 3D Birth Cohort.

    Science.gov (United States)

    Bisson, Michèle; Croteau, Jordie; Guinhouya, Benjamin C; Bujold, Emmanuel; Audibert, François; Fraser, William D; Marc, Isabelle

    2017-01-01

    To evaluate the association between maternal physical activity and infant's birth weight or risk of inappropriate weight for gestational age (GA), and whether this association differs by infant's sex, maternal body mass index (BMI) or pregnancy complications in a prospective cohort study. 1913 pregnant women from the 3D Birth Cohort (Québec, Canada) completed the Pregnancy Physical Activity Questionnaire at each trimester. Energy expenditure (metabolic equivalent of task (MET)*hours/week) for total activity, sports and exercise and vigorous intensity activities was calculated. The associations with birth weight and risk of inappropriate weight for GA were evaluated by regression modelling. Interactions were tested with infant's sex, maternal prepregnancy BMI, gestational diabetes, hypertensive disorders and prematurity. Each 1 MET/hours/week increase in sports and exercise in the first trimester was associated with a 2.5 g reduction in infant's birth weight (95% CI -4.8 to -0.3) but was not associated with the risk of small weight for GA. In contrast, although not significant, a 17% reduction in the risk of large weight for GA was observed with increasing sports and exercise. Furthermore, in women with subsequent pre-eclampsia (but not normotensive or hypertensive women), each 1 MET/hours/week increment spent in any vigorous exercise in the first trimester reduced the infant's birth weight by 19.8 g (95% CI -35.2 to -4.3). Pregnant women with higher sports and exercise levels in the first trimester delivered infants with a lower birth weight. The risk of reducing infant's birth weight with vigorous exercise in women who develop pre-eclampsia later in pregnancy requires evaluation.

  12. Born too soon: preterm birth matters.

    Science.gov (United States)

    Howson, Christopher P; Kinney, Mary V; McDougall, Lori; Lawn, Joy E

    2013-01-01

    Urgent action is needed to address preterm birth given that the fi rst country-level estimates show that globally 15 million babies are born too soon and rates are increasing in most countries with reliable time trend data. As the fi rst in a supplement entitled “Born Too Soon”, this paper focuses on the global policy context. Preterm birth is critical for progress on Millennium Development Goal 4 (MDG) for child survival by 2015 and beyond, and gives added value to maternal health (MDG 5) investments also linking to non-communicable diseases. For preterm babies who survive, the additional burden of prematurity-related disability may aff ect families and health systems. Prematurity is an explicit priority in many high-income settings; however, more attention is needed especially in low- and middle-income countries where the invisibility of preterm birth as well as its myths and misconceptions have slowed action on prevention and care. Recent global attention to preterm birth hit a tipping point in 2012, with the May 2 publication of Born Too Soon: The Global Action Report on Preterm Birth and with the 2nd annual World Prematurity Day on November 17 which mobilised the actions of partners in many countries to address preterm birth and newborn health. Interventions to strengthen preterm birth prevention and care span the continuum of care for reproductive, maternal, newborn and child health. Both prevention of preterm birth and implementation of care of premature babies require more research, as well as more policy attention and programmatic investment.

  13. Prevalence of atopic dermatitis in infants by domestic water hardness and season of birth

    DEFF Research Database (Denmark)

    Engebretsen, Kristiane A; Bager, Peter; Wohlfahrt, Jan

    2017-01-01

    BACKGROUND: Atopic dermatitis (AD) appears to be more common in regions with hard domestic water and in children with a fall/winter birth. However, it is unknown whether a synergistic effect exists. OBJECTIVE: We sought to evaluate the association between domestic water hardness and season of birth...... the Civil Registration System, and domestic water hardness data were obtained from the Geological Survey of Denmark and Greenland. The relative prevalence (RP) of AD was calculated by using log-linear binomial regression. RESULTS: The prevalence of AD was 15.0% (7,942/52,950). The RP of AD was 5% (RPtrend......, 1.05; 95% CI, 1.03-1.07) higher for each 5° increase in domestic water hardness (range, 6.60-35.90 German degrees of hardness [118-641 mg/L]). Although the RP of AD was higher in children with a fall (RP, 1.24; 95% CI, 1.17-1.31) or winter (RP, 1.18; 95% CI, 1.11-1.25) birth, no significant...

  14. High-risk of preterm birth and low birth weight after oocyte donation IVF: analysis of 133,785 live births.

    Science.gov (United States)

    Kamath, Mohan Shashikant; Antonisamy, Belavendra; Mascarenhas, Mariano; Sunkara, Sesh Kamal

    2017-09-01

    A higher risk of pregnancy complications occurs after assisted reproductive techniques compared with spontaneously conceived pregnancies. This is attributed to the underlying infertility and assisted reproduction technique procedures involved during treatment. It is a matter of interest whether use of donor oocytes affects perinatal outcomes compared with pregnancies after autologous IVF. Anonymized data were obtained from the Human Fertilization and Embryology Authority. The analysis included 5929 oocyte donation and 127,856 autologous IVF live births. Data from all women who underwent donor oocyte recipient or autologous IVF cycles, both followed with fresh embryo transfer, were analysed to compare perinatal outcomes of preterm birth (PTB) and low birthweight (LBW) after singleton and multiple live births. The risk of adverse perinatal outcomes after oocyte donation was increased: adjusted OR (aOR) 1.56, 99.5% CI 1.34 to 1.80 for PTB and aOR 1.43, 99.5% CI 1.24 to 1.66 for LBW were significantly higher after oocyte donation compared with autologous IVF singletons. The adjusted odds PTB (aOR 1.21, 99.5% CI 1.02 to 1.43) was significantly higher after oocyte donation compared with autologous IVF multiple births. Analysis of this large dataset suggests significantly higher risk of PTB and LBW after ooctye donation compared with autologous IVF pregnancies. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Teenage births to ethnic minority women.

    Science.gov (United States)

    Berthoud, R

    2001-01-01

    This article analyses British age-specific fertility rates by ethnic group, with a special interest in child-bearing by women below the age of 20. Birth statistics are not analysed by ethnic group, and teenage birth rates have been estimated from the dates of birth of mothers and children in the Labour Force Survey. The method appears to be robust. Caribbean, Pakistani and especially Bangladeshi women were much more likely to have been teenage mothers than white women, but Indian women were below the national average. Teenage birth rates have been falling in all three South Asian communities.

  16. Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study

    Directory of Open Access Journals (Sweden)

    Kyi Mar Wai

    2017-11-01

    Full Text Available Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR = 1.10; 95% confidence interval (CI: 1.01–1.21; p = 0.043, gestational age (adjusted OR = 0.83; 95% CI: 0.72–0.95; p = 0.009 and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31–13.65; p = 0.016 were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.

  17. Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study.

    Science.gov (United States)

    Wai, Kyi Mar; Mar, Ohn; Kosaka, Satoko; Umemura, Mitsutoshi; Watanabe, Chiho

    2017-11-03

    Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR) = 1.10; 95% confidence interval (CI): 1.01-1.21; p = 0.043), gestational age (adjusted OR = 0.83; 95% CI: 0.72-0.95; p = 0.009) and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31-13.65; p = 0.016) were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.

  18. Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Nøhr, Ellen Aagaard; Bech, Bodil Hammer; Vaeth, Michael

    2007-01-01

    The aim of the present study was to assess the impact of obesity and gestational weight gain on the risk of subtypes of preterm birth, because little is known about these associations. The study included 62 167 women within the Danish National Birth Cohort for whom self-reported information about...... prepregnancy body mass index (BMI) and gestational weight gain was available. Information about spontaneous preterm birth with or without preterm premature rupture of membranes (PPROM) and about induced preterm deliveries was obtained from national registers. Cox regression analyses were used to examine...... associations of prepregnancy BMI and gestational weight gain with subtypes of preterm birth. The crude risks of PPROM and of induced preterm deliveries were higher in obese women (BMI > or = 30) than in normal-weight women (18.5 gestation, when obese...

  19. Gamma-Gompertz life expectancy at birth

    Directory of Open Access Journals (Sweden)

    Trifon I. Missov

    2013-02-01

    Full Text Available BACKGROUND The gamma-Gompertz multiplicative frailty model is the most common parametric modelapplied to human mortality data at adult and old ages. The resulting life expectancy hasbeen calculated so far only numerically. OBJECTIVE Properties of the gamma-Gompertz distribution have not been thoroughly studied. The focusof the paper is to shed light onto its first moment or, demographically speaking, characterizelife expectancy resulting from a gamma-Gompertz force of mortality. The paperprovides an exact formula for gamma-Gompertz life expectancy at birth and a simplerhigh-accuracy approximation that can be used in practice for computational convenience.In addition, the article compares actual (life-table to model-based (gamma-Gompertzlife expectancy to assess on aggregate how many years of life expectancy are not captured(or overestimated by the gamma-Gompertz mortality mechanism. COMMENTS A closed-form expression for gamma-Gomeprtz life expectancy at birth contains a special(the hypergeometric function. It aids assessing the impact of gamma-Gompertz parameterson life expectancy values. The paper shows that a high-accuracy approximation canbe constructed by assuming an integer value for the shape parameter of the gamma distribution.A historical comparison between model-based and actual life expectancy forSwedish females reveals a gap that is decreasing to around 2 years from 1950 onwards.Looking at remaining life expectancies at ages 30 and 50, we see this gap almost disappearing.

  20. Twin birth order, birthweight and birthweight discordance: any relationship

    Directory of Open Access Journals (Sweden)

    Onyiriuka A.N.

    2010-12-01

    Full Text Available Background: It is widely believed that in twin pairs, at birth, the first-born weigh more than the second-born but this concept has been challenged. Objective: To assess the truthfulness of this common concept that first-born twins are usually heavier than their second-born siblings at birth. Methods: In a series of 104 sets of live-born twins, the birth weights of first-born twins were compared with those of their second-born siblings, after controlling for gender. Their intra-pair birthweight differences were determined and twin pairs whose birthweight difference was 15% or more were designated as discordant. Results: Twin I was heavier than Twin II in 61.5% of cases while Twin II was heavier than Twin I in 28.9% of cases. Twins I and II had equal birthweights in 9.6% of cases. Comparing the mean birthweight of the first-born-male twin with that of second-born- male twin, it was 2515+427g (95% Confidence Interval, CI=2402-2628 versus 2432 +435g (95% CI=2321-2543 p>0.05. The mean birthweight of first-born-female twin was 2326+445g (95% CI=2214-2439 while that of the second-born-female twin was 2325+501g (95% CI=2197-2453 p>0.05. When the birthweight difference exceeded 750g, the probability that Twin I will be heavier than Twin II was 83.3% (5 of 6. Conclusion: Although the first-born twin was more often heavier than their second-born siblings, either could weigh more or less at birth. The larger the birthweight difference between growth-discordant twin pair, the greater the probability that the heavier twin would be delivered first

  1. Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Dudenhausen, Joachim; Orosz, Brooke; Chervenak, Frank A

    2017-04-01

    The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US). A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams). Midwife-attended home births had the highest rate of neonatal deaths [122/95,657 neonatal mortality (NNM) 12.75/10,000; relative risk (RR): 3.6, 95% confidence interval (CI) 3-4.4], followed by hospital physician births (8695/14,447,355 NNM 6.02/10,000; RR: 1.7 95% CI 1.6-1.9) and hospital midwife births (480/1,363,199 NNM 3.52/10,000 RR: 1). Among midwife-assisted home births, underlying causes attributed to labor and delivery caused 39.3% (48/122) of neonatal deaths (RR: 13.4; 95% CI 9-19.9) followed by 29.5% due to congenital anomalies (RR: 2.5; 95% CI 1.8-3.6), and 12.3% due to infections (RR: 4.5; 95% CI 2.5-8.1). There are significantly increased risks of neonatal deaths among midwife-attended home births associated with three underlying causes: labor and delivery issues, infections, and fetal malformations. This analysis of the causes of neonatal death in planned home birth shows that it is consistently riskier for newborns to deliver at home than at the hospital. Physicians, midwives, and other health care providers have a professional responsibility to share information about the clinical benefits and risks of clinical management.

  2. Risk assessment and management to prevent preterm birth.

    Science.gov (United States)

    Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

    2016-04-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Neonatal mortality in Missouri home births, 1978-84.

    Science.gov (United States)

    Schramm, W F; Barnes, D E; Bakewell, J M

    1987-08-01

    A study was conducted of 4,054 Missouri home births occurring from 1978 through 1984. Of the 3,645 births whose planning status was identified, 3,067 (84 per cent) were planned to be at home. Neonatal mortality was elevated for both planned (17 observed deaths vs 8.59 expected deaths) and unplanned home births (45 observed vs 33.19 expected) compared with physician-attended hospital births. Nearly all of the mortality excess for planned home births occurred in association with lesser trained attendants (12 observed vs 4.42 expected), while for unplanned home births the excess was entirely among infants weighing 1500 grams or more (19 observed vs 3.50 expected). For planned home births attended by physicians, certified nurse-midwives, or Missouri Midwife Association recognized midwives, there was little difference between observed and expected deaths (5 observed vs 3.92 expected). There also was little difference in deaths for unplanned home births weighing less than 1500 grams (26 observed vs 29.69 expected) compared with hospital births. The study provides evidence of the importance of having skilled attendants present at planned home births.

  4. How Neighborhood Disadvantage Reduces Birth Weight

    Directory of Open Access Journals (Sweden)

    Emily Moiduddin

    2008-06-01

    Full Text Available In this analysis we connect structural neighborhood conditions to birth outcomes through their intermediate effects on mothers’ perceptions of neighborhood danger and their tendency to abuse substances during pregnancy. We hypothesize that neighborhood poverty and racial/ethnic concentration combine to produce environments that mothers perceive as unsafe, thereby increasing the likelihood of negative coping behaviors (substance abuse. We expect these behaviors, in turn, to produce lower birth weights. Using data from the Fragile Families and Child Wellbeing Study, a survey of a cohort of children born between 1998 and 2000 and their mothers in large cities in the United States, we find little evidence to suggest that neighborhood circumstances have strong, direct effects on birth weight. Living in a neighborhood with more foreigners had a positive effect on birth weight. To the extent that neighborhood conditions influence birth weight, the effect mainly occurs through an association with perceived neighborhood danger and subsequent negative coping behaviors. Poverty and racial/ethnic concentration increase a mother’s sense that her neighborhood is unsafe. The perception of an unsafe neighborhood, in turn, associates with a greater likelihood of smoking cigarettes and using illegal drugs, and these behaviors have strong and significant effects in reducing birth weight. However, demographic characteristics, rather than perceived danger or substance abuse, mediate the influence of neighborhood characteristics on birth weight.

  5. Reduced Disparities in Birth Rates Among Teens

    Science.gov (United States)

    ... Teens Winnable Battles Social Media at CDC Reduced Disparities in Birth Rates among Teens Aged 15–19 ... Pregnancy Prevention Community-Wide Initiative. National Rates and Disparities Nationally, the teen birth rate (number of births ...

  6. Cerebral palsy in eastern Denmark: declining birth prevalence but increasing numbers of unilateral cerebral palsy in birth year period 1986-1998

    DEFF Research Database (Denmark)

    Ravn, Susanne Holst; Flachs, Esben Meulengracht; Uldall, Peter

    2010-01-01

    The Cerebral Palsy Registry in eastern Denmark has been collecting cases using a uniform data sampling procedure since birth year 1979. Children are included by two child neurologists and an obstetrician. Information on pregnancy, birth, neonatal period, impairments and demographic data...... are registered. The total cerebral palsy birth prevalence has been significantly decreasing since the birth period 1983-1986 with 3.0 per 1000 live births until the period 1995-1998 with 2.1 per 1000 live births. The overall decrease was seen in preterm infants (...

  7. Mothers' marital adaptation following the birth of twins or singletons: empirical evidence and practical insights.

    Science.gov (United States)

    Taubman-Ben-Ari, Orit; Findler, Liora; Bendet, Chaya; Stanger, Varda; Ben-Shlomo, Shirley; Kuint, Jacob

    2008-08-01

    Parenting twins is typically portrayed as more stressful than is parenting single children and, therefore, more of a strain on the marital relationship. With this in mind, the present study examined the contribution of infant characteristics and mother's internal resources (attachment style) and external resources (maternal and paternal grandmothers' perceived support) to their marital adaptation during the first month following delivery, comparing mothers of twins (n = 88) with mothers of singletons (n = 82). The findings indicate that both internal and external resources contribute to the marital adaptation of the two groups, even beyond the contribution of specific circumstances. Thus, it seems that the birth of twins and the birth of a single child are normative life events that have more in common than previously acknowledged. The implications for the focus of social work interventions, particularly in the case of the birth of twins, are discussed.

  8. CDC Vital Signs: Preventing Repeat Teen Births

    Science.gov (United States)

    ... control after they have given birth. Although teen birth rates have been falling for the last two decades, ... effective forms of birth control. SOURCE: National Vital Statistics System, teens, ages 15–19, 2010 Larger image ...

  9. The New Rich and Their Unplanned Births: Stratified Reproduction under China's Birth-planning Policy.

    Science.gov (United States)

    Shi, Lihong

    2017-12-01

    This article explores the creation and ramifications of a stratified reproductive system under China's state control of reproduction. Within this system, an emerging group of "new rich" are able to circumvent birth regulations and have unplanned births because of their financial capabilities and social networks. While China's birth-planning policy is meant to be enforced equally for all couples, the unequal access to wealth and bureaucratic power as a result of China's widening social polarization has created disparate reproductive rights and experiences. This article identifies three ways in which reproductive privileges are created. It further explores how a stratified reproductive system under state population control reinforces social polarization. While many socially marginalized couples are unable to register their unplanned children for citizenship status and social benefits, the new rich are able to legitimate their births and transfer their privilege and status to their children, thus reproducing a new generation of elites. © 2016 by the American Anthropological Association.

  10. BIRTH ORDER, FAMILY SIZE, NEUROSIS

    Directory of Open Access Journals (Sweden)

    AHMAD JALILI

    1984-05-01

    Full Text Available In an attempt to investigate the relationship of birth rank and family size with the incidence of neurosis in an Iranian culture, case notes of 1029 schizophrenic patients as (497 males and 532 females referred to psychiatric clinic for insured workers were studied. The incidence of neurasis appeared to be significantly more frequent among the first-half position of birth  rders in The families of 5 children and over; this bei-ng more marked-in males than in females; and the first second births comprising the lighest incidence of the illness.

  11. Determination of sex-ratio by birth order in an urban community in Manipur.

    Science.gov (United States)

    Brogen, Akoijam S; Shantibala, K; Rajkumari, Bishwalata; Laishram, Jalina

    2009-01-01

    To determine the sex ratio by birth order and to assess the sex preference of the couples in an urban community. A cross sectional study, in an urban community in Manipur, was conducted among the currently married couples. Data on background characteristics of the couple, family pedigree chart (of the offspring) including history of abortion, stillbirth, death of child of the couple, sex preference and Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act [PNDT Act] were collected through a structured interview. Data were analyzed using descriptive and chi-square statistics. There were a total of 1777 births to the 855 couples interviewed. There were 900 females per 1000 males for the 1st birth order but the sex ratio was favorable towards females in the 2nd, 3rd and 4th birth orders. Among both the husbands and wives, being more educated was significantly associated (p<0.05) with preferring lesser number of children, using new technology for sex selection and having heard of the PNDT Act. Majority of those who wanted to use new