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Sample records for previous live birth

  1. Predicting live birth, preterm delivery, and low birth weight in infants born from in vitro fertilisation: a prospective study of 144,018 treatment cycles.

    Directory of Open Access Journals (Sweden)

    Scott M Nelson

    2011-01-01

    Full Text Available The extent to which baseline couple characteristics affect the probability of live birth and adverse perinatal outcomes after assisted conception is unknown.We utilised the Human Fertilisation and Embryology Authority database to examine the predictors of live birth in all in vitro fertilisation (IVF cycles undertaken in the UK between 2003 and 2007 (n = 144,018. We examined the potential clinical utility of a validated model that pre-dated the introduction of intracytoplasmic sperm injection (ICSI as compared to a novel model. For those treatment cycles that resulted in a live singleton birth (n = 24,226, we determined the associates of potential risk factors with preterm birth, low birth weight, and macrosomia. The overall rate of at least one live birth was 23.4 per 100 cycles (95% confidence interval [CI] 23.2-23.7. In multivariable models the odds of at least one live birth decreased with increasing maternal age, increasing duration of infertility, a greater number of previously unsuccessful IVF treatments, use of own oocytes, necessity for a second or third treatment cycle, or if it was not unexplained infertility. The association of own versus donor oocyte with reduced odds of live birth strengthened with increasing age of the mother. A previous IVF live birth increased the odds of future success (OR 1.58, 95% CI 1.46-1.71 more than that of a previous spontaneous live birth (OR 1.19, 95% CI 0.99-1.24; p-value for difference in estimate <0.001. Use of ICSI increased the odds of live birth, and male causes of infertility were associated with reduced odds of live birth only in couples who had not received ICSI. Prediction of live birth was feasible with moderate discrimination and excellent calibration; calibration was markedly improved in the novel compared to the established model. Preterm birth and low birth weight were increased if oocyte donation was required and ICSI was not used. Risk of macrosomia increased with advancing

  2. Subsequent childbirth after a previous traumatic birth.

    Science.gov (United States)

    Beck, Cheryl Tatano; Watson, Sue

    2010-01-01

    Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.

  3. 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.

  4. 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.

  5. The phenomenon of claimed memories of previous lives: possible interpretations and importance.

    Science.gov (United States)

    Stevenson, I

    2000-04-01

    Several disorders or abnormalities observed in medicine and psychology are not explicable (or not fully explicable) by genetics and environmental influences, either alone or together. These include phobias and philias observed in early infancy, unusual play in childhood, homosexuality, gender identity disorder, a child's idea of having parents other than its own, differences in temperament manifested soon after birth, unusual birthmarks and their correspondence with wounds on a deceased person, unusual birth defects, and differences (physical and behavioral) between monozygotic twins. The hypothesis of previous lives can contribute to the further understanding of these phenomena. Copyright 2000 Harcourt Publishers Ltd.

  6. [The influence of previous pregnancy terminations, miscarriages and still-births on the incidence of babies with low birth weight and premature births as well as a somatic classification of newborns].

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    Voigt, M; Olbertz, D; Fusch, C; Krafczyk, D; Briese, V; Schneider, K T M

    2008-02-01

    The influence of previous interruptions, miscarriages and IUFD on the IUGR and preterm rate as well as on the somatic staging (gestational age and birth weight) of the new born is a subject of controversial discussion in the literature. The present paper attempts to quantify these risks of the medical history. 2 282 412 singleton pregnancies of the period 1995 to 2000 were evaluated from the German Perinatal Database. For the analysis 1 065 202 pregnancies (46.7 %) of those mothers without any live birth in the medical history were assessed. To exclude any influence from previous abortions patients with previous miscarriages and IUFDs were excluded. The control collective were new borns whose mothers had suffered neither from miscarriages nor from abortions or IUFD. Previous interruptions, miscarriages and IUFD influence the rate of new borns with low birth weight and increase the rate of prematurity. With increasing numbers of isolated or combined risks in the medical history, the rate of newborns with a low birth weight or with prematurity is increased. The lowest risk was found after one interruption, the highest rate with two or more IUFDs. Interruptions, miscarriages or IUFD are not risk factors for IUGR or SGA. Previous interruptions, miscarriages and IUFD are relevant risk factors for prematurity and are related with low birth weight of the new borns. Pregnant women with such risk factors have to been considered as risk pregnancies and need intensive surveillance.

  7. Live Birth from Previously Vitrified Oocytes, after Trophectoderm Biopsy, Revitrification, and Transfer of a Euploid Blastocyst

    Directory of Open Access Journals (Sweden)

    Jamie A. Grifo

    2013-01-01

    Full Text Available Our objective is to describe a successful live birth from oocyte vitrification followed by thaw, fertilization, blastocyst culture, trophectoderm biopsy, vitrification, and subsequent thaw. Fifteen mature oocytes were frozen from a patient with uterine factor infertility. Thirteen oocytes survived the thaw, and five underwent trophectoderm biopsy and were refrozen. Three euploid embryos were obtained. A single euploid embryo was transferred in the second thaw cycle to a known recipient leading to the delivery of a normal male infant. This case report is proof of the concept that preimplantation screening and diagnosis is an option for fertility preservation patients.

  8. 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

  9. Live births profile, Maranguape – CE from 2000 to 2003

    OpenAIRE

    Nancy Costa de Oliveira; Escolástica Rejane Ferreira Moura; Cristiana Ferreira da Silva

    2012-01-01

    It was objectified to analyze the profile of the live births in Maranguape-CE registered in the Live Births Information System (SINASC) between January, 2000 and December, 2003.5.032 declarations of live births (DN) of resident mother were analyzed. The DN was included in the SINASC Software of the Health Ministry and the data were presented in tabular format. The maternal age between 21 and 30 was predominant, education between4 and 11 years of study, the increase in the percentage of single...

  10. Prognosis for live birth in women with recurrent miscarriage

    DEFF Research Database (Denmark)

    Lund, Marie; Kamper-Jørgensen, Mads; Nielsen, Henriette Svarre

    2012-01-01

    To establish a method of estimating the proportion of women with a subsequent live birth after a well-defined time period in an open cohort of women referred to a tertiary recurrent miscarriage clinic.......To establish a method of estimating the proportion of women with a subsequent live birth after a well-defined time period in an open cohort of women referred to a tertiary recurrent miscarriage clinic....

  11. Late preterm birth and previous cesarean section: a population-based cohort study.

    Science.gov (United States)

    Yasseen Iii, Abdool S; Bassil, Kate; Sprague, Ann; Urquia, Marcelo; Maguire, Jonathon L

    2018-02-21

    Late preterm birth (LPB) is increasingly common and associated with higher morbidity and mortality than term birth. Yet, little is known about the influence of previous cesarean section (PCS) and the occurrence of LPB in subsequent pregnancies. We aim to evaluate this association along with the potential mediation by cesarean sections in the current pregnancy. We use population-based birth registry data (2005-2012) to establish a cohort of live born singleton infants born between 34 and 41 gestational weeks to multiparous mothers. PCS was the primary exposure, LPB (34-36 weeks) was the primary outcome, and an unplanned or emergency cesarean section in the current pregnancy was the potential mediator. Associations were quantified using propensity weighted multivariable Poisson regression, and mediating associations were explored using the Baron-Kenny approach. The cohort included 481,531 births, 21,893 (4.5%) were LPB, and 119,983 (24.9%) were predated by at least one PCS. Among mothers with at least one PCS, 6307 (5.26%) were LPB. There was increased risk of LPB among women with at least one PCS (adjusted Relative Risk (aRR): 1.20 (95%CI [1.16, 1.23]). Unplanned or emergency cesarean section in the current pregnancy was identified as a strong mediator to this relationship (mediation ratio = 97%). PCS was associated with higher risk of LPB in subsequent pregnancies. This may be due to an increased risk of subsequent unplanned or emergency preterm cesarean sections. Efforts to minimize index cesarean sections may reduce the risk of LPB in subsequent pregnancies.

  12. [Live birth distribution by time and place from 1981 to 1998 in Japan].

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    Matsushima, Noriko; Morita, Noriko; Ogata, Nozomi; Saeki, Keigo; Matsuda, Ryozo; Kurumatani, Norio

    2003-01-01

    To investigate the diurnal rhythm of live births labored spontaneously, and the effects of obstetric intervention on birth time distributions. The data of live births tabulated by time (one-hour intervals), date and birthplace throughout Japan between 1981 and 1998 were obtained with permission from the former Ministry of Health and Welfare. Together with an investigation of hourly birth numbers by place in each year, an annual transition of hourly birth rates in medical institutions and the diurnal rhythm of birth numbers in maternity homes and at home were analyzed using regression analysis. In every calendar year studied the hourly live birth numbers at hospitals showed a single-peak distribution pattern with maximum values at 13:00-15:00. The annual transition of hourly birth rates showed a 10% (birth numbers base) decrease in the 11:00-13:00 period in 1998 as compared with that in 1981, while there was a corresponding increase of 8% in the 13:00-15:00 period. Hourly birth numbers at clinics showed a double-peak distribution pattern with maximum values during the 11:00-12:00 and 14:00-15:00 periods in early 1980, while a single-peak distribution with a maximum value during the 13:00-15:00 period appeared in 1989 and has remained thereafter. Hourly birth rates (birth numbers base) increased by over 6% in the 13:00-15:00 and 17:00-20:00 periods over the past 18 years, while they decreased by 10% in the 9:00-13:00 period. The results at maternity homes were clearly different from those at hospitals and clinics. The live birth numbers totaled for the 18 years showed a double-phase distribution with a maximum value in the 6:00-7:00 period and a minimum value in the 19:00-20:00 period. The best-fit regression model for the obtained data was a sine curve with a maximum value at 6:00 (coefficient of determination 0.97). Hourly distributions of live births at home also fitted best to a since curve with the maximum value again at 6:00 (coefficient of determination 0

  13. Predicting the chance of live birth for women undergoing IVF: a novel pretreatment counselling tool.

    Science.gov (United States)

    Dhillon, R K; McLernon, D J; Smith, P P; Fishel, S; Dowell, K; Deeks, J J; Bhattacharya, S; Coomarasamy, A

    2016-01-01

    Which pretreatment patient variables have an effect on live birth rates following assisted conception? The predictors in the final multivariate logistic regression model found to be significantly associated with reduced chances of IVF/ICSI success were increasing age (particularly above 36 years), tubal factor infertility, unexplained infertility and Asian or Black ethnicity. The two most widely recognized prediction models for live birth following IVF were developed on data from 1991 to 2007; pre-dating significant changes in clinical practice. These existing IVF outcome prediction models do not incorporate key pretreatment predictors, such as BMI, ethnicity and ovarian reserve, which are readily available now. In this cohort study a model to predict live birth was derived using data collected from 9915 women who underwent IVF/ICSI treatment at any CARE (Centres for Assisted Reproduction) clinic from 2008 to 2012. Model validation was performed on data collected from 2723 women who underwent treatment in 2013. The primary outcome for the model was live birth, which was defined as any birth event in which at least one baby was born alive and survived for more than 1 month. Data were collected from 12 fertility clinics within the CARE consortium in the UK. Multivariable logistic regression was used to develop the model. Discriminatory ability was assessed using the area under receiver operating characteristic (AUROC) curve, and calibration was assessed using calibration-in-the-large and the calibration slope test. The predictors in the final model were female age, BMI, ethnicity, antral follicle count (AFC), previous live birth, previous miscarriage, cause and duration of infertility. Upon assessing predictive ability, the AUROC curve for the final model and validation cohort was (0.62; 95% confidence interval (CI) 0.61-0.63) and (0.62; 95% CI 0.60-0.64) respectively. Calibration-in-the-large showed a systematic over-estimation of the predicted probability of live

  14. Congenital Microphthalmia, Anophthalmia and Coloboma among Live Births in Denmark.

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    Roos, Laura; Jensen, Hanne; Grønskov, Karen; Holst, René; Tümer, Zeynep

    2016-10-01

    This study aims to quantify the occurrence of the congenital eye malformations anophthalmia (AO), microphthalmia (MO) and coloboma among liveborn infants in Denmark, and to estimate the rate of chromosomal abnormalities in this group of patients. A cohort of patients born in 1995-2012 with diagnoses of MO/AO or coloboma was identified from the Danish National Patient Registry (DNPR), and their ocular and extra-ocular diagnoses were reviewed. In order to assess the occurrence of chromosomal abnormalities in the cohort, the data were cross-referenced with the Danish Cytogenetic Central Registry (DCCR). We identified 415 patients with MO/AO/coloboma in the DNPR. The total number of live births from 1995-2012 was 1,174,299, and the average birth prevalence of MO/AO/coloboma was 3.6/10,000 live births and of MO/AO was 1.2/10,000 live births. Extra-ocular abnormalities were observed in 32.1% of MO/AO cases and 21.7% of coloboma cases. Chromosome analysis was performed in 36.1% of the cohort, and 14.7% of cases had an abnormal karyotype. In 8.7% of the cohort, a chromosome microarray analysis was performed, and in 44.4% of cases, a possibly pathogenic copy number variation was observed. The birth prevalence of MO/AO/coloboma in Denmark has been steady at 3.6/10,000 live births during the last 17 years. The rate of syndromic cases was lower compared to other studies. A relatively high rate of pathogenic chromosomal aberrations was observed, suggesting an important role for cytogenetic analysis in this group of patients.

  15. Estimation of single-year-of-age counts of live births, fetal losses, abortions, and pregnant women for counties of Texas.

    Science.gov (United States)

    Singh, Bismark; Meyers, Lauren Ancel

    2017-05-08

    We provide a methodology for estimating counts of single-year-of-age live-births, fetal-losses, abortions, and pregnant women from aggregated age-group counts. As a case study, we estimate counts for the 254 counties of Texas for the year 2010. We use interpolation to estimate counts of live-births, fetal-losses, and abortions by women of each single-year-of-age for all Texas counties. We then use these counts to estimate the numbers of pregnant women for each single-year-of-age, which were previously available only in aggregate. To support public health policy and planning, we provide single-year-of-age estimates of live-births, fetal-losses, abortions, and pregnant women for all Texas counties in the year 2010, as well as the estimation method source code.

  16. Preimplantation Genetic Diagnosis and Natural Conception: A Comparison of Live Birth Rates in Patients with Recurrent Pregnancy Loss Associated with Translocation.

    Directory of Open Access Journals (Sweden)

    Shinichiro Ikuma

    Full Text Available Established causes of recurrent pregnancy loss (RPL include antiphospholipid syndrome, uterine anomalies, parental chromosomal abnormalities, particularly translocations, and abnormal embryonic karyotypes. The number of centers performing preimplantation genetic diagnosis (PGD for patients with translocations has steadily increased worldwide. The live birth rate with PGD was reported to be 27-54%. The live birth rate with natural conception was reported to be 37-63% on the first trial and 65-83% cumulatively. To date, however, there has been no cohort study comparing age and the number of previous miscarriages in matched patients undergoing or not undergoing PGD. Thus, we compared the live birth rate of patients with RPL associated with a translocation undergoing PGD with that of patients who chose natural conception.After genetic counseling, 52 patients who desired natural conception and 37 patients who chose PGD were matched for age and number of previous miscarriages and these comprised the subjects of our study. PGD was performed by means of fluorescence in situ hybridization analysis. The live birth rates on the first PGD trial and the first natural pregnancy after ascertainment of the carrier status were 37.8% and 53.8%, respectively (odds ratio 0.52, 95% confidence interval 0.22-1.23. Cumulative live birth rates were 67.6% and 65.4%, respectively, in the groups undergoing and not undergoing PGD. The time required to become pregnancy was similar in both groups. PGD was found to reduce the miscarriage rate significantly. The prevalence of twin pregnancies was significantly higher in the PGD group. The cost of PGD was $7,956 U.S. per patient.While PGD significantly prevented further miscarriages, there was no difference in the live birth rate. Couples should be fully informed of the similarity in the live birth rate, the similarity in time to become pregnancy, the advantages of PGD, such as the reduction in the miscarriage rate, as well as

  17. Association between ABO blood type and live-birth outcomes in single-embryo transfer cycles.

    Science.gov (United States)

    Pereira, Nigel; Patel, Hency H; Stone, Logan D; Christos, Paul J; Elias, Rony T; Spandorfer, Steven D; Rosenwaks, Zev

    2017-11-01

    To investigate the association between ABO blood type and live-birth outcomes in patients undergoing IVF with day 5 single-embryo transfer (SET). Retrospective cohort study. University-affiliated center. Normal responders, blood type and live birth, while controlling for confounders. Odds ratios (OR) with 95% confidence intervals (CI) for live birth were estimated. A total of 2,329 patients were included. The mean age of the study cohort was 34.6 ± 4.78 years. The distribution of blood types was as follows: A = 897 (38.5%); B = 397 (17.0%); AB = 120 (5.2%); and, O = 1,915 (39.3%) patients. There was no difference in the baseline demographics, ovarian stimulation, or embryo quality parameters between the blood types. The unadjusted ORs for live birth when comparing blood type A (referent) with blood types B, AB, and O were 0.96 (95% CI, 0.6-1.7), 0.72 (95% CI, 0.4-1.2), and 0.96 (95% CI. 0.6-1.7), respectively. The adjusted ORs for live birth remained not significant when comparing blood type A to blood types B, AB, and O individually. No difference in birth weight or gestational age at delivery was noted among the four blood types. Our findings suggest that ABO blood type is not associated with live-birth rate, birth weight, or gestational age at delivery in patients undergoing IVF with day 5 SET. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. 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

  19. 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.

  20. [Evaluation of data on live birth certificates from the Information System on Live Births (SINASC) in Campinas, São Paulo, 2009].

    Science.gov (United States)

    Gabriel, Guilherme Paiva; Chiquetto, Letícia; Morcillo, André Moreno; Ferreira, Maria do Carmo; Bazan, Ivan Gilberto M; Daolio, Luísa Dias; Lemos, Jéssica J Rocha; Carniel, Emília de Faria

    2014-09-01

    To assess the completeness and reliability of the Information System on Live Births (Sinasc) data. A cross-sectional analysis of the reliability and completeness of Sinasc's data was performed using a sample of Live Birth Certificate (LBC) from 2009, related to births from Campinas, Southeast Brazil. For data analysis, hospitals were grouped according to category of service (Unified National Health System, private or both), 600 LBCs were randomly selected and the data were collected in LBC-copies through mothers and newborns' hospital records and by telephone interviews. The completeness of LBCs was evaluated, calculating the percentage of blank fields, and the LBCs agreement comparing the originals with the copies was evaluated by Kappa and intraclass correlation coefficients. The percentage of completeness of LBCs ranged from 99.8%-100%. For the most items, the agreement was excellent. However, the agreement was acceptable for marital status, maternal education and newborn infants' race/color, low for prenatal visits and presence of birth defects, and very low for the number of deceased children. The results showed that the municipality Sinasc is reliable for most of the studied variables. Investments in training of the professionals are suggested in an attempt to improve system capacity to support planning and implementation of health activities for the benefit of maternal and child population. Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  1. 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.

  2. Live birth rate and number of blastomeres on day 2 transfer

    DEFF Research Database (Denmark)

    Azzarello, Antonino; Hoest, Thomas; Hay-Schmidt, Anders

    2016-01-01

    -lapse assessment, ACDs and/or recalculated fragmentation >25 % was recognized in 106/578 (18.3 %) of transferred embryos. None of them resulted in a live birth. After exclusion of these embryos, the number of blastomeres on the day of transfer did not have any impact on life birth rate. Conclusion Conventional...

  3. Living in violence: Neighborhood domestic violence and small for gestational age births.

    Science.gov (United States)

    Felker-Kantor, Erica; Wallace, Maeve; Theall, Katherine

    2017-07-01

    To determine the association between neighborhood domestic violence and small-for-gestational-age (SGA) birth and to examine if there is a differential impact of neighborhood domestic violence on SGA births by race in a high crime community. This analysis includes all birth records issued in New Orleans, Louisiana from 2011 to 2012 geocoded by census tract (N=177 census tracts, N=8322 women). Hierarchical modeling and ecologic spatial analysis were used to examine the area-effect of neighborhood domestic violence on SGA births, independent of individual-level predictors and accounting for the propensity to live in high domestic violence neighborhoods. Tests for spatial autocorrelation reveled area-level clustering and overlap of SGA and domestic violent rates. Pregnant women living in high domestic violence areas were more likely to give birth to an SGA infant compared to women in low-domestic violence areas (OR=1.04, 95%CI: 1.01, 1.08), net of the effects of individual-level factors and propensity scores. Neighborhood-level attributes including rates of domestic violence may increase women's risk for SGA birth, highlighting a policy-relevant and potentially amenable exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Predictors of Pregnancy and Live Birth in Couples with Unexplained or Male-factor Infertility after Insemination

    Science.gov (United States)

    Huang, Hao; Hansen, Karl R.; Factor-Litvak, Pamela; Carson, Sandra A.; Guzick, David S.; Santoro, Nanette; Diamond, Michael P.; Eisenberg, Esther; Zhang, Heping

    2012-01-01

    Objective To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination, with or without superovulation for unexplained or male-factor infertility. The treatment continued for four cycles unless pregnancy was achieved. Design Secondary analysis of data from a randomized superovulation and intrauterine insemination trial. Setting Academic medical centers. Intervention(s) None. Patients Out of 932 couples randomized to four treatment groups, 664 couples who had completed the lifestyle questionnaires were assessed for occurrence of pregnancy and live birth. Main outcome measure(s) pregnancy and live birth. Results The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past (past users) when compared to those who had never consumed coffee or tea (4.0, 1.6–10.2 for pregnancy; 3.1, 1.2–8.1 for live birth) or alcoholic beverages (1.9, 1.1–3.3 for pregnancy; 2.1, 1.2–3.7 for live birth) (data are adjusted odds ratio and 95% confidence interval). Past users also had significantly higher pregnancy and live birth rates than those who were currently consuming coffee or tea or alcoholic beverages. Demographic, occupational exposures and other lifestyle factors were not significant. Conclusion(s) Couples in which the female partners drank coffee, tea, or alcoholic beverages in the past had higher pregnancy and live birth rates when compared to never or current users. When discontinuing these habits, they might have made other lifestyle changes to improve the pregnancy outcome. PMID:22270557

  5. Effect of Embryo Banking on U.S. National Assisted Reproductive Technology Live Birth Rates.

    Directory of Open Access Journals (Sweden)

    Vitaly A Kushnir

    Full Text Available Assisted Reproductive Technology (ART reports generated by the Centers for Disease Control and Prevention (CDC exclude embryo banking cycles from outcome calculations.We examined data reported to the CDC in 2013 for the impact of embryo banking exclusion on national ART outcomes by recalculating autologous oocyte ART live birth rates. Inflation of reported fresh ART cycle live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births with reference to number of initiated fresh cycles (excluding embryo banking cycles, as typically reported by the CDC, and fresh cycle live births with reference to total initiated fresh ART cycles (including embryo banking cycles.During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7% involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women 44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P 44. The inflation of live birth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater.Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women.Exclusion of embryo banking cycles from US National Assisted Reproductive Technology outcome reports significantly inflates reported success rates especially in older women.

  6. Effect of Embryo Banking on U.S. National Assisted Reproductive Technology Live Birth Rates.

    Science.gov (United States)

    Kushnir, Vitaly A; Barad, David H; Albertini, David F; Darmon, Sarah K; Gleicher, Norbert

    2016-01-01

    Assisted Reproductive Technology (ART) reports generated by the Centers for Disease Control and Prevention (CDC) exclude embryo banking cycles from outcome calculations. We examined data reported to the CDC in 2013 for the impact of embryo banking exclusion on national ART outcomes by recalculating autologous oocyte ART live birth rates. Inflation of reported fresh ART cycle live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births with reference to number of initiated fresh cycles (excluding embryo banking cycles), as typically reported by the CDC, and fresh cycle live births with reference to total initiated fresh ART cycles (including embryo banking cycles). During 2013, out of 121,351 fresh non-donor ART cycles 27,564 (22.7%) involved embryo banking. The proportion of banking cycles increased with female age from 15.5% in women women >44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P women age >44. The inflation of live birth rates in thawed cycles could not be calculated from the publically available CDC data but appears to be even greater. Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women. Exclusion of embryo banking cycles from US National Assisted Reproductive Technology outcome reports significantly inflates reported success rates especially in older women.

  7. 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.

  8. Does age of the sperm donor influence live birth outcome in assisted reproduction?

    Science.gov (United States)

    Ghuman, N K; Mair, E; Pearce, K; Choudhary, M

    2016-03-01

    miscarriages per 100 women commencing treatment) was 1.3% in 18-34 year old women, 1.9% in 35-37 year old women and 1.9% in 38-50 year old women undergoing donor insemination treatment. In the sperm donation IVF/ICSI treatment group, these figures were 5.7, 8.4 and 6.8% respectively. The results were not suggestive of any unfavourable effect of advancing sperm donor age on the odds of miscarriage occurrence (P > 0.05). As sperm donors are a select population based on good semen indices, the generalization of results to the paternal population at large may not be possible. Although the study subgroups were controlled for female age, treatment modality and effect of previous treatment cycles, adjustments for certain potential compounding factors, such as smoking status, BMI of women and stimulation protocol used in IVF/ICSI treatment cycles, were not possible. Live birth and miscarriage occurrence following assisted reproduction weren't adversely affected by increasing sperm donor age up to 45 years. In view of the increasing demand for donor sperm, further studies may be required to ascertain the safe upper age limit for sperm donors. No funding was received from any individual or funding agency. NG was on a Commonwealth Scholarship for the duration of the study. The authors do not have any conflicts of interest to declare. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Risk of adverse birth outcomes in populations living near landfill sites

    Science.gov (United States)

    Elliott, Paul; Briggs, David; Morris, Sara; de Hoogh, Cornelis; Hurt, Christopher; Jensen, Tina Kold; Maitland, Ian; Richardson, Sylvia; Wakefield, Jon; Jarup, Lars

    2001-01-01

    Objective To investigate the risk of adverse birth outcomes associated with residence near landfill sites in Great Britain. Design Geographical study of risks of adverse birth outcomes in populations living within 2 km of 9565 landfill sites operational at some time between 1982 and 1997 (from a total of 19 196 sites) compared with those living further away. Setting Great Britain. Subjects Over 8.2 million live births, 43 471 stillbirths, and 124 597 congenital anomalies (including terminations). Main outcome measures All congenital anomalies combined, some specific anomalies, and prevalence of low and very low birth weight (<2500 g and <1500 g). Results For all anomalies combined, relative risk of residence near landfill sites (all waste types) was 0.92 (99% confidence interval 0.907 to 0.923) unadjusted, and 1.01 (1.005 to 1.023) adjusted for confounders. Adjusted risks were 1.05 (1.01 to 1.10) for neural tube defects, 0.96 (0.93 to 0.99) for cardiovascular defects, 1.07 (1.04 to 1.10) for hypospadias and epispadias (with no excess of surgical correction), 1.08 (1.01 to 1.15) for abdominal wall defects, 1.19 (1.05 to 1.34) for surgical correction of gastroschisis and exomphalos, and 1.05 (1.047 to 1.055) and 1.04 (1.03 to 1.05) for low and very low birth weight respectively. There was no excess risk of stillbirth. Findings for special (hazardous) waste sites did not differ systematically from those for non-special sites. For some specific anomalies, higher risks were found in the period before opening compared with after opening of a landfill site, especially hospital admissions for abdominal wall defects. Conclusions We found small excess risks of congenital anomalies and low and very low birth weight in populations living near landfill sites. No causal mechanisms are available to explain these findings, and alternative explanations include data artefacts and residual confounding. Further studies are needed to help differentiate between the various

  10. Sex ratios at birth after induced abortion.

    Science.gov (United States)

    Urquia, Marcelo L; Moineddin, Rahim; Jha, Prabhat; O'Campo, Patricia J; McKenzie, Kwame; Glazier, Richard H; Henry, David A; Ray, Joel G

    2016-06-14

    Skewed male:female ratios at birth have been observed among certain immigrant groups. Data on abortion practices that might help to explain these findings are lacking. We examined 1 220 933 births to women with up to 3 consecutive singleton live births between 1993 and 2012 in Ontario. Records of live births, and induced and spontaneous abortions were linked to Canadian immigration records. We determined associations of male:female infant ratios with maternal birthplace, sex of the previous living sibling(s) and prior spontaneous or induced abortions. Male:female infant ratios did not appreciably depart from the normal range among Canadian-born women and most women born outside of Canada, irrespective of the sex of previous children or the characteristics of prior abortions. However, among infants of women who immigrated from India and had previously given birth to 2 girls, the overall male:female ratio was 1.96 (95% confidence interval [CI] 1.75-2.21) for the third live birth. The male:female infant ratio after 2 girls was 1.77 (95% CI 1.26-2.47) times higher if the current birth was preceded by 1 induced abortion, 2.38 (95% CI 1.44-3.94) times higher if preceded by 2 or more induced abortions and 3.88 (95% CI 2.02-7.50) times higher if the induced abortion was performed at 15 weeks or more gestation relative to no preceding abortion. Spontaneous abortions were not associated with male-biased sex ratios in subsequent births. High male:female ratios observed among infants born to women who immigrated from India are associated with induced abortions, especially in the second trimester of pregnancy. © 2016 Canadian Medical Association or its licensors.

  11. 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...

  12. The long-term prognosis for live birth in couples initiating fertility treatments.

    Science.gov (United States)

    Malchau, S S; Henningsen, A A; Loft, A; Rasmussen, S; Forman, J; Nyboe Andersen, A; Pinborg, A

    2017-07-01

    What are the long-term chances of having a child for couples starting fertility treatments and how many conceive with ART, IUI and without treatment? Total 5-year live birthrates were strongly influenced by female age and ranged from 80% in women under 35-26% in women ≥40 years, overall, 14% of couples conceived naturally and one-third of couples starting treatments with intrauterine insemination delivered from that treatment. Few studies report success rates in fertility treatments across a couple's complete fertility treatment history, across clinics, evaluating live births after insemination, ART and natural conceptions. This register-based national cohort study from Denmark includes all women initiating fertility treatments in public and private clinics with homologous gametes in 2007-2010. Women were identified in the Danish ART Registry and were cross-linked with the Medical Birth Registry to identify live births. Subfertile couples were followed 2 years (N = 19 884), 3 years (N = 14 445) and 5 years (N = 5165), or until their first live birth. Cumulative live birthrates were estimated 2, 3 and 5 years from the first treatment cycle, in all women, including drop-outs. Birthrates were stratified by type of first treatment (ART/IUI), mode of conception (ART/IUI/natural conception) and female age. Within 5 years, in women aged years (N = 3553), 35-39 years (N = 1156) and ≥40 years (N = 451), a total of 64%, 49% and 16% had a live birth due to treatment, respectively. Additionally, in women aged years, 35-39 years and ≥40 years, 16%, 11% and 10% delivered after natural conception, yielding total 5-year birthrates of 80%, 60% and 26%. In women starting treatments with IUI (N = 3028), 35% delivered after IUI within 5 years, 24% delivered after shift to ART treatments and 17% delivered after natural conception. Within 5 years from starting treatments with ART (N = 2137), 53% delivered after ART, 11% delivered after natural conception and 0.6% delivered after

  13. Reproductive outcomes in adolescents who had a previous birth or an induced abortion compared to adolescents' first pregnancies

    Directory of Open Access Journals (Sweden)

    Wenzlaff Paul

    2008-01-01

    Full Text Available Abstract Background Recently, attention has been focused on subsequent pregnancies among teenage mothers. Previous studies that compared the reproductive outcomes of teenage nulliparae and multiparae often did not consider the adolescents' reproductive histories. Thus, the authors compared the risks for adverse reproductive outcomes of adolescent nulliparae to teenagers who either have had an induced abortion or a previous birth. Methods In this retrospective cohort study we used perinatal data prospectively collected by obstetricians and midwives from 1990–1999 (participation rate 87–98% of all hospitals in Lower Saxony, Germany. From the 9742 eligible births among adolescents, women with multiple births, >1 previous pregnancies, or a previous spontaneous miscarriage were deleted and 8857 women Results In bivariate logistic regression analyses, compared to nulliparous teenagers, adolescents with a previous birth had higher risks for perinatal [OR = 2.08, CI = 1.11,3.89] and neonatal [OR = 4.31, CI = 1.77,10.52] mortality and adolescents with a previous abortion had higher risks for stillbirths [OR = 3.31, CI = 1.01,10.88] and preterm births [OR = 2.21, CI = 1.07,4.58]. After adjusting for maternal nationality, partner status, smoking, prenatal care and pre-pregnancy BMI, adolescents with a previous birth were at higher risk for perinatal [OR = 2.35, CI = 1.14,4.86] and neonatal mortality [OR = 4.70, CI = 1.60,13.81] and adolescents with a previous abortion had a higher risk for very low birthweight infants [OR = 2.74, CI = 1.06,7.09] than nulliparous teenagers. Conclusion The results suggest that teenagers who give birth twice as adolescents have worse outcomes in their second pregnancy compared to those teenagers who are giving birth for the first time. The prevention of the second pregnancy during adolescence is an important public health objective and should be addressed by health care providers who attend the first birth or the abortion

  14. Cost of fertility treatment and live birth outcome in women of different ages and BMI.

    Science.gov (United States)

    Pandey, Shilpi; McLernon, David J; Scotland, Graham; Mollison, Jill; Wordsworth, Sarah; Bhattacharya, Siladitya

    2014-10-10

    What is the impact of different age and BMI groups on total investigation and treatment costs in women attending a secondary/tertiary care fertility clinic? Women in their early to mid-30s and women with normal BMI had higher cumulative investigation and treatment costs, but also higher probability of live birth. Female age and BMI have been used as criteria for rationing publically funded fertility treatments. Population-based data on the costs of investigating and treating infertility are lacking. A retrospective cohort study of 2463 women was conducted in a single secondary/tertiary care fertility clinic in Aberdeen, Scotland from 1998 to 2008. Participants included all women living in a defined geographical area referred from primary care to a specialized fertility clinic over an 11-year period. Women were followed up for 5 years or until live birth if this occurred sooner. Mean discounted cumulative National Health Service costs (expressed in 2010/2011 GBP) of fertility investigations, treatments (including all types of assisted reproduction), and pregnancy (including delivery episode) and neonatal admissions were calculated and summarized by age (≤ 30, 31-35, 36-40, >40 years) and BMI groupings (years, with 694 (55.1%) of these being natural conceptions. The live birth rate was highest among women in the youngest age group (64.3%), and lowest in those aged >40 years (13.4%). Overall live birth rates were generally lower in women with BMI >30 kg/m(2). The total costs of investigations were generally highest among women younger than 30 years (£491 in those with normal BMI), whilst treatment costs tended to be higher in 31-35 year olds (£1,840 in those with normal BMI). Multivariate modelling predicted a cost increase associated with treatment which was highest among women in the lowest BMI group (across all ages), and also highest among women aged 31-35 years. The increase in the predicted probability of live birth with exposure to treatment was consistent

  15. Sex ratio at birth in India, its relation to birth order, sex of previous children and use of indigenous medicine.

    Directory of Open Access Journals (Sweden)

    Samiksha Manchanda

    Full Text Available OBJECTIVE: Sex-ratio at birth in families with previous girls is worse than those with a boy. Our aim was to prospectively study in a large maternal and child unit sex-ratio against previous birth sex and use of traditional medicines for sex selection. MAIN OUTCOME MEASURES: Sex-ratio among mothers in families with a previous girl and in those with a previous boy, prevalence of indigenous medicine use and sex-ratio in those using medicines for sex selection. RESULTS: Overall there were 806 girls to 1000 boys. The sex-ratio was 720:1000 if there was one previous girl and 178:1000 if there were two previous girls. In second children of families with a previous boy 1017 girls were born per 1000 boys. Sex-ratio in those with one previous girl, who were taking traditional medicines for sex selection, was 928:1000. CONCLUSION: Evidence from the second children clearly shows the sex-ratio is being manipulated by human interventions. More mothers with previous girls tend to use traditional medicines for sex selection, in their subsequent pregnancies. Those taking such medication do not seem to be helped according to expectations. They seem to rely on this method and so are less likely use more definitive methods like sex selective abortions. This is the first such prospective investigation of sex ratio in second children looked at against the sex of previous children. More studies are needed to confirm the findings.

  16. Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil

    Directory of Open Access Journals (Sweden)

    Barbieri Marco A

    2000-01-01

    Full Text Available OBJECTIVE: To identify risk factors for low birth weight (LBW among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.

  17. Predictors of pregnancy and live birth after insemination in couples with unexplained or male-factor infertility.

    Science.gov (United States)

    Huang, Hao; Hansen, Karl R; Factor-Litvak, Pamela; Carson, Sandra A; Guzick, David S; Santoro, Nanette; Diamond, Michael P; Eisenberg, Esther; Zhang, Heping

    2012-04-01

    To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination, with or without superovulation for unexplained or male-factor infertility. Secondary analysis of data from a randomized superovulation and intrauterine insemination trial. Academic medical centers. Treatment continued for four cycles unless pregnancy was achieved. Out of 932 couples randomized to four treatment groups, 664 couples who had completed the lifestyle questionnaires were assessed for occurrence of pregnancy and live birth. Pregnancy and live birth. The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past (past users) compared with those who had never consumed coffee, tea, or alcoholic beverages. Past users also had significantly higher pregnancy and live birth rates than those currently consuming coffee or tea or alcoholic beverages. Demographic, occupational exposure, and other lifestyle factors were not significant. Couples in which the female partners drank coffee, tea, or alcoholic beverages in the past had higher pregnancy and live birth rates compared with never or current users. When discontinuing these habits, they might have made other lifestyle changes to improve the pregnancy outcome. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. No excess risk of adverse birth outcomes in populations living near special waste landfill sites in Scotland.

    Science.gov (United States)

    Morris, S E; Thomson, A O; Jarup, L; de Hoogh, C; Briggs, D J; Elliott, P

    2003-11-01

    A recent study showed small excess risks of low birth weight, very low birth weight and certain congenital anomalies in populations living near landfill sites in Great Britain. The objective of the current study was to investigate the risk of adverse birth outcomes associated with residence near special waste landfill sites in Scotland. We studied risks of adverse birth outcomes in populations living within 2 km of 61 Scottish special waste landfill sites operational at some time between 1982 and 1997 compared with those living further away. 324,167 live births, 1,849 stillbirths, and 11,138 congenital anomalies (including terminations) were included in the study. Relative risks were computed for all congenital anomalies combined, some specific anomalies and prevalence of stillbirth and low and very low birth weight (special waste landfill sites was 0.96 (99% confidence interval 0.89 to 1.02) adjusted for confounders. Adjusted risks were 0.71 (0.36 to 1.42) for neural tube defects, 1.03 (0.85 to 1.26) for cardiovascular defects, 0.84 (0.58 to 1.22) for hypospadias and epispadias (with no excess of surgical corrections), 0.78 (0.27 to 2.23) for abdominal wall defects (1.32 (0.42-4.17) for hospital admissions), 1.22 (0.28 to 5.38) for surgical correction of gastroschisis and exomphalos and 1.01 (0.96 to 1.07) and 1.01 (0.90 to 1.15) for low and very low birth weight respectively. There was no excess risk of stillbirth. In conclusion, we found no statistically significant excess risks of congenital anomalies or low birth weight in populations living near special waste landfill sites in Scotland.

  19. The spatial evaluation of neighborhood clusters of birth defects

    Energy Technology Data Exchange (ETDEWEB)

    Frisch, J.D.

    1990-04-16

    Spatial statistics have recently been applied in epidemiology to evaluate clusters of cancer and birth defects. Their use requires a comparison population, drawn from the population at risk for disease, that may not always be readily available. In this dissertation the plausibility of using data on all birth defects, available from birth defects registries, as a surrogate for the spatial distribution of all live births in the analysis of clusters is assessed. Three spatial statistics that have been applied in epidemiologic investigations of clusters, nearest neighbor distance, average interpoint distance, and average distance to a fixed point, were evaluated by computer simulation for their properties in a unit square, and in a zip code region. Comparison of spatial distributions of live births and birth defects was performed by drawing samples of live births and birth defects from Santa Clara County, determining the street address at birth, geocoding this address and evaluating the resultant maps using various statistical techniques. The proposed method was then demonstrated on a previously confirmed cluster of oral cleft cases. All live births for the neighborhood were geocoded, as were all birth defects. Evaluation of this cluster using the nearest neighbor and average interpoint distance statistics was performed using randomization techniques with both the live births population and the birth defect population as comparison groups. 113 refs., 36 figs., 16 tabs.

  20. Patterns of birth weight at a community level

    African Journals Online (AJOL)

    user

    identified a one-year live birth cohort of 8,273 in Jimma, Illubabor and Keffa ... METHODS: This was a community-based longitudinal study, which attempts to ... RESULTS: The results of the study found an estimated low birth weight rate ... mothers' experience of previous child deaths. ... births occur at home. ..... assessment.

  1. VAGINAL BIRTH AFTER A PREVIOUS CAESAREAN SECTION: CURRENT TRENDS AND OUTLOOK IN GHANA.

    Science.gov (United States)

    Seffah, J D; Adu-Bonsaffoh, K

    2014-01-01

    The optimal mode of subsequent delivery of women with prior caesarean birth remains a subject of intense research and debate in contemporary obstetric practice especially in low resource settings like West Africa where there are obvious systemic and management-related challenges associated with trial of scar. However, there is evidence that vaginal birth after caesarean section (VBAC) is safe in appropriately selected women in addition to adequate intrapartum monitoring and ready access to theatre when emergency CS is indicated. The primary objective of the study was to determine the current trends and performance of VBAC in Ghana after decades of practice of trial of labour after caesarean section (TOLAC) in the mist of inherent challenges in deciding the optimal mode of childbirth for women with a previous caesarean birth. The secondary objective was to relate evidence based practice of TOLAC to obstetric practice in low resource settings like Ghana and provide recommendations for improving maternal and newborn health among women with prior caesarean birth. This was a retrospective study of the records of patients who had had a prior caesarean delivery and who then proceeded to deliver the next babies at the Korle Bu Teaching Hospital (KBTH) between Jan 2010 and Dec 2014. The data on demography, antenatal care, labour and delivery and outcomes were collected from the Labour and Recovery wards and the Biostatistics unit of the Maternity unit of the Hospital. Excluded were women with a previous CS who had multiple pregnancies and those with incomplete notes as well as those whose delivery plans were not predetermined antenatally.. The data were analyzed using SPSS version 20. There were 53,581 deliveries during the study period. Vaginal delivery was obtained in 31,870 (59.5%) pregnancies and 21,711(40.5%) had CS. Also, 6261 (11.7%) had had a prior CS and 2472 (39.5%) of these were selected for TOLAC while 2119 (33.8) were scheduled for planned repeat CS. There was

  2. Acupuncture to improve live birth rates for women undergoing in vitro fertilization: a protocol for a randomized controlled trial

    Science.gov (United States)

    2012-01-01

    Background IVF is a costly treatment option for women, their partners, and the public. Therefore new therapies that improve reproductive and health outcomes are highly desirable. There is a growing body of research evaluating the effect of acupuncture administered during IVF, and specifically on the day of embryo transfer (ET). Many trials are heterogeneous and results inconsistent. There remains insufficient evidence to determine if acupuncture can enhance live birth rates when used as an adjunct to IVF treatment. The study will determine the clinical effectiveness of acupuncture with improving the proportion of women undergoing IVF having live births. Other objectives include: determination of the cost effectiveness of IVF with acupuncture; and examination of the personal and social context of acupuncture in IVF patients, and examining the reasons why the acupuncture may or may not have worked. Methods We will conduct a randomized controlled trial of acupuncture compared to placebo acupuncture. Inclusion criteria include: women aged less than 43 years; undergoing a fresh IVF or ICSI cycle; and restricted to women with the potential for a lower live birth rate defined as two or more previous unsuccessful ETs; and unsuccessful clinical pregnancies of quality embryos deemed by the embryologist to have been suitable for freezing by standard criteria. Women will be randomized to acupuncture or placebo acupuncture. Treatment is administered on days 6 to 8 of the stimulated cycle and two treatments on the day of ET. A non-randomized cohort of women not using acupuncture will be recruited to the study. The primary study outcome is the proportion of women reporting a live birth. Secondary outcomes include the proportion of women reporting a clinical pregnancy miscarriage prior to 12 weeks, quality of life, and self-efficacy. The sample size of the study is 1,168 women, with the aim of detecting a 7% difference in live births between groups (P = 0.05, 80% power

  3. Acupuncture to improve live birth rates for women undergoing in vitro fertilization: a protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Smith Caroline A

    2012-05-01

    Full Text Available Abstract Background IVF is a costly treatment option for women, their partners, and the public. Therefore new therapies that improve reproductive and health outcomes are highly desirable. There is a growing body of research evaluating the effect of acupuncture administered during IVF, and specifically on the day of embryo transfer (ET. Many trials are heterogeneous and results inconsistent. There remains insufficient evidence to determine if acupuncture can enhance live birth rates when used as an adjunct to IVF treatment. The study will determine the clinical effectiveness of acupuncture with improving the proportion of women undergoing IVF having live births. Other objectives include: determination of the cost effectiveness of IVF with acupuncture; and examination of the personal and social context of acupuncture in IVF patients, and examining the reasons why the acupuncture may or may not have worked. Methods We will conduct a randomized controlled trial of acupuncture compared to placebo acupuncture. Inclusion criteria include: women aged less than 43 years; undergoing a fresh IVF or ICSI cycle; and restricted to women with the potential for a lower live birth rate defined as two or more previous unsuccessful ETs; and unsuccessful clinical pregnancies of quality embryos deemed by the embryologist to have been suitable for freezing by standard criteria. Women will be randomized to acupuncture or placebo acupuncture. Treatment is administered on days 6 to 8 of the stimulated cycle and two treatments on the day of ET. A non-randomized cohort of women not using acupuncture will be recruited to the study. The primary study outcome is the proportion of women reporting a live birth. Secondary outcomes include the proportion of women reporting a clinical pregnancy miscarriage prior to 12 weeks, quality of life, and self-efficacy. The sample size of the study is 1,168 women, with the aim of detecting a 7% difference in live births between groups (P

  4. Live birth and adverse birth outcomes in women with ulcerative colitis and Crohn's disease receiving assisted reproduction

    DEFF Research Database (Denmark)

    Nørgård, Bente Mertz; Larsen, P V; Fedder, J

    2016-01-01

    , the OR of preterm birth was 5.29 (95% CI 2.41 to 11.63) in analyses including singletons and multiple births; restricted to singletons the OR was 1.80, 95% CI 0.49 to 6.62. CONCLUSIONS: Our results suggest that women with UC and CD receiving ART treatments cannot expect the same success for each embryo transfer......OBJECTIVE: To examine the chance of live births and adverse birth outcomes in women with ulcerative colitis (UC) and Crohn's disease (CD) compared with women without inflammatory bowel disease (IBD) who have undergone assisted reproductive technology (ART) treatments. METHODS: This was a nationwide...... cohort study based on Danish health registries, comprising all women with an embryo transfer during 1 January 1994 through 2013. The cohorts comprised 1360 ART treatments in 432 women with UC, 554 ART treatments in 182 women with CD and 148 540 treatments in 52 489 women without IBD. Our primary outcome...

  5. Congenital malformations among live births at arvand hospital, ahwaz, iran - a prospective study

    International Nuclear Information System (INIS)

    Ali, A.; Zahad, S.; Masoumeh, A.; Azar, A.

    2008-01-01

    The aim of the study was to determine the profile of congenital malformations (CM) among live births at Arvand hospital, in Ahwaz city. In this prospective study all of the neonates born at Arvand hospital in Ahwaz from 2004 to 2006 were registered. Stillbirths and those who died in a few hours after birth were excluded and finally 4660 newborns were enrolled. Of the 4660 live births 94 (20.2/1000) had at least a CM. The predominant systems involved were musculoskeletal (7.9/1000), followed by genitourinary (7.1/1000), central nervous (2.4 /1000), digestive (1.1/1000) and chromosomal anomalies (0.9/1000). Although the frequency of malformations in the study was approximately similar to other investigations, if we include abortions, stillbirths and if we used screening tests and genetic studies, this rate was more than 20.1/1000. (author)

  6. No. 155-Guidelines for Vaginal Birth After Previous Caesarean Birth.

    Science.gov (United States)

    Martel, Marie-Jocelyne; MacKinnon, Catherine Jane

    2018-03-01

    To provide evidence-based guidelines for the provision of a trial of labour (TOL) after Caesarean section. Fetal and maternal morbidity and mortality associated with vaginal birth after Caesarean (VBAC) and repeat Caesarean section. MEDLINE database was searched for articles published from January 1, 1995, to February 28, 2004, using the key words "vaginal birth after Caesarean (Cesarean) section." The quality of evidence is described using the Evaluation of Evidence criteria outlined in the Report of the Canadian Task Force on the Periodic Health Exam. VALIDATION: These guidelines were approved by the Clinical Practice Obstetrics and Executive Committees of the Society of Obstetricians and Gynaecologists of Canada. Copyright © 2018. Published by Elsevier Inc.

  7. Deciding on the mode of birth after a previous caesarean section - An online survey investigating women's preferences in Western Switzerland.

    Science.gov (United States)

    Bonzon, Magali; Gross, Mechthild M; Karch, André; Grylka-Baeschlin, Susanne

    2017-07-01

    promoting vaginal births after caesarean section (VBAC) for eligible women and increasing rates of successful VBACs are the best strategies to reduce the number of repeat caesarean sections (CS). Knowledge of factors that are associated with women's decision-making around mode of birth after CS is important when developing strategies to promote VBAC. This study assessed which factors are associated with women's preferences for VBAC versus elective repeat caesarean section (ERCS) in a new pregnancy after one previous caesarean in Switzerland. cross-sectional web-survey. Western Switzerland. French-speaking women living in Western Switzerland, with one previous CS who gave birth subsequently to a child after a complication-free pregnancy were eligible to participate in the survey. Of 393 women who started the survey in November/December 2014, 349 were included: 227 who planned a VBAC and 122 who planned an ERCS at term. univariable and multivariable analyses were conducted to describe and compare women who had planned a VBAC with women who had planned an ERCS in a pregnancy following a CS. Logistic regression modelling was used to investigate predictors that were associated with a preference for a VBAC at term. Analyses were performed with SPSS 22 and Stata 13. of the women planning a VBAC, 62.6% VBAC gave birth vaginally. Predictors which were significantly associated with increased odds of women choosing a VBAC: duration since previous birth in years (OR=1.11 95% CI [1.03-1.20], p=0.010), having had midwifery care during pregnancy (OR=2.09, 95% CI [1.08-4.05], p=0.029), being advised by their healthcare provider to attempt a VBAC (OR=4.20, 95% CI [1.75-10.09], p=0.001), preference for VBAC during the third trimester of their pregnancy (OR=3.98, 95% CI [1.77-8.93], p=0.001), and wishing to let the child choose the moment of birth (OR=1.46, 95% CI[1.22-1.74], p<0.001). The importance of safety for the mother decreased the odds of women preferring a VBAC (OR=0.74, 95

  8. Live birth and perinatal outcomes following stimulated and unstimulated IVF: analysis of over two decades of a nationwide data.

    Science.gov (United States)

    Sunkara, Sesh Kamal; LaMarca, Antonio; Polyzos, Nikolaos P; Seed, Paul T; Khalaf, Yakoub

    2016-10-01

    Does ovarian stimulation affect perinatal outcomes of preterm birth (PTB) and low birth weight (LBW) following IVF treatment. Despite no significant differences in the risks of PTB and LBW between stimulated and unstimulated IVF in the present study, the study cannot exclude the effect of ovarian stimulation on the perinatal outcomes following IVF. Pregnancies resulting from assisted reproductive treatments (ART) are associated with a higher risk of pregnancy complications compared to spontaneously conceived pregnancies attributed to the underlying infertility and the in vitro fertilization techniques. It is of interest to determine the effect size of ovarian stimulation use in achieving a live birth and whether ovarian stimulation that is routinely used in IVF, affects perinatal outcomes of birth weight and gestational age at delivery compared to unstimulated IVF. Anonymous data were obtained from the Human Fertilisation and Embryology Authority (HFEA), the statutory regulator of ART in the UK. The HFEA has collected data prospectively on all ART performed in the UK since 1991. Data from 1991 to 2011 comprising a total of 591 003 fresh IVF ± ICSI cycles involving 584 835 stimulated IVF cycles and 6168 unstimulated IVF cycles were analyzed. Data on all women undergoing either stimulated or unstimulated fresh IVF ± ICSI cycles during the period from 1991 to 2011 were analyzed to compare live birth rates, singleton live birth rates, perinatal outcomes of PTB, early PTB (IVF cycles and previous live birth. Analysis of the large nationwide data demonstrated 3.5 times (95% confidence interval (CI): 3.1-3.9) as many unstimulated IVF cycles being required to achieve one live birth compared to stimulated IVF and 2.9 times (95% CI: 2.6-3.2) as many unstimulated IVF cycles being required to achieve one singleton live birth compared to stimulated IVF. There was no significant difference in the unadjusted odds for PTB (odds ratio (OR) 1.27, 95% CI: 0.80-2.00) and LBW (OR 1

  9. Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis.

    Science.gov (United States)

    Maheux-Lacroix, S; Nesbitt-Hawes, E; Deans, R; Won, H; Budden, A; Adamson, D; Abbott, J A

    2017-11-01

    Can live birth be accurately predicted following surgical resection of moderate-severe (Stage III-IV) endometriosis? Live births can accurately be predicted with the endometriosis fertility index (EFI), with adnexal function being the most important factor to predict non-assisted reproductive technology (non-ART) fertility or the requirement for ART (www.endometriosisefi.com). Fertility prognosis is important to many women with severe endometriosis. Controversy persists regarding optimal post-operative management to achieve pregnancy and the counselling of patients regarding duration of conventional treatments before undergoing ART. The EFI is reported to correlate with expectant management pregnancy rate, although external validation has been performed without specifically addressing fertility in women with moderate and severe endometriosis. Retrospective cohort study of 279 women from September 2001 to June 2016. We included women undergoing laparoscopic resection of Stage III-IV endometriosis who attempted pregnancy post-operatively. The EFI was calculated based on detailed operative reports and surgical images. Fertility outcomes were obtained by direct patient contact. Kaplan-Meier model, log rank test and Cox regression were used for analyses. The follow-up rate was 84% with a mean duration of 4.1 years. A total of 147 women (63%) had a live birth following surgery, 94 of them (64%) without ART. The EFI was highly associated with live births (P years was 0% and steadily increased up to 91% with an EFI of 9-10, while the proportion of women who attempted ART and had a live birth, steadily increased from 38 to 71% among the same EFI strata (P = 0.1). A low least function score was the most significant predictor of failure (P = 0.003), followed by having had a previous resection (P = 0.019) or incomplete resection (P = 0.028), being older than 40 compared to years of age (P = 0.027), and having leiomyomas (P = 0.037). The main limitation of this study is its

  10. Age-specific cost and public funding of a live birth following assisted reproductive treatment in Japan.

    Science.gov (United States)

    Maeda, Eri; Ishihara, Osamu; Saito, Hidekazu; Kuwahara, Akira; Toyokawa, Satoshi; Kobayashi, Yasuki

    2014-05-01

    The aim of this study was to calculate and assess the cost of assisted reproductive technology (ART) treatment cycles and live-birth events in Japan in 2010. We performed a retrospective analysis of 238,185 ART cycles, registered with the national registry of assisted reproductive treatment during 2010. Costs were calculated, using a decision analysis model. The average cost per live birth was ¥1,974,000. This varied from ¥1,155,000 in women aged birth was ¥442,000. This was ¥6,118,000 in women aged ≥ 45, 15.4 times higher than that of the 35-39-year-old age group. The costs and public funding of a live birth after ART treatment rises with age due to the lower success rates in older women. It may provide economic background to improve the current subsidy system for ART and to provide practical knowledge about fertility for the general population. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  11. A cost per live birth comparison of HMG and rFSH randomized trials.

    Science.gov (United States)

    Connolly, Mark; De Vrieze, Kathleen; Ombelet, Willem; Schneider, Dirk; Currie, Craig

    2008-12-01

    To help inform healthcare treatment practices and funding decisions, an economic evaluation was conducted to compare the two leading gonadotrophins used for IVF in Belgium. Based on the results of a recently published meta-analysis, a simulated decision tree model was constructed with four states: (i) fresh cycle, (ii) cryopreserved cycle, (iii) live birth and (iv) treatment withdrawal. Gonadotrophin costs were based on highly purified human menopausal gonadotrophin (HP-HMG; Menopur) and recombinant FSH (rFSH) alpha (Gonal-F). After one fresh and one cryopreserved cycle the average treatment cost with HP-HMG was lower than with rFSH (HP-HMG euro3635; rFSH euro4103). The average cost saving per person started on HP-HMG when compared with rFSH was euro468. Additionally, the average costs per live birth of HP-HMG and rFSH were found to be significantly different: HP-HMG euro9996; rFSH euro13,009 (P cost-saving even after key parameters in the model were varied in the probabilistic sensitivity analysis. Treatment with HP-HMG was found to be the dominant treatment strategy in IVF because of improved live birth rates and lower costs. Within a fixed healthcare budget, the cost-savings achieved using HP-HMG would allow for the delivery of additional IVF cycles.

  12. Pre-stimulation parameters predicting live birth after IVF in the long GnRH agonist protocol

    DEFF Research Database (Denmark)

    Pettersson, Göran; Andersen, Anders Nyboe; Broberg, Per

    2010-01-01

    This retrospective study aimed to identify novel pre-stimulation parameters associated with live birth in IVF and to develop a model for prediction of the chances of live birth at an early phase of the treatment cycle. Data were collected from a randomized trial in couples with unexplained...... infertility, tubal factor, mild male factor or other reason for infertility. All women (n=731) had undergone an IVF cycle (no intracytoplasmic sperm injection) after stimulation with human menopausal gonadotrophin or follicle-stimulating hormone following the long gonadotrophin-releasing hormone agonist...

  13. Pre-stimulation parameters predicting live birth after IVF in the long GnRH agonist protocol

    DEFF Research Database (Denmark)

    Pettersson, Göran; Andersen, Anders Nyboe; Broberg, Per

    2010-01-01

    infertility, tubal factor, mild male factor or other reason for infertility. All women (n=731) had undergone an IVF cycle (no intracytoplasmic sperm injection) after stimulation with human menopausal gonadotrophin or follicle-stimulating hormone following the long gonadotrophin-releasing hormone agonist......This retrospective study aimed to identify novel pre-stimulation parameters associated with live birth in IVF and to develop a model for prediction of the chances of live birth at an early phase of the treatment cycle. Data were collected from a randomized trial in couples with unexplained...

  14. Combined advanced parental age has an additive negative effect on live birth rates-data from 4057 first IVF/ICSI cycles.

    Science.gov (United States)

    McPherson, Nicole O; Zander-Fox, Deirdre; Vincent, Andrew D; Lane, Michelle

    2018-02-01

    The purpose of this study is to determine if there is an additive effect of combined advanced maternal and paternal age on pregnancy and live birth rates. Retrospective data analysis of 4057 first cycles at a fertility centre between 2009 and 2013 was compiled. Donor, preimplantation genetic screening and double embryo transfer cycles were excluded. Main outcomes measured were clinical pregnancy, viable pregnancy, live birth and term birth. Logistic regression indicated strong negative associations for maternal ages exceeding 27 years with clinical pregnancies (p < 0.001), viable pregnancies (p < 0.001), live births (p < 0.001) and term births (p < 0.001). There was evidence of negative associations between paternal age and both viable pregnancies (p = 0.06) and live births (p = 0.04), such that the probability of pregnancy was 10% further reduced for women who were 35 years with a partner over 40 years vs. women aged 35 years with a partner under 30 years. There was evidence of an interaction between maternal age and the paternal age on term births (p = 0.02) such that advanced paternal age's effect on the probability of a term birth was only evident in couples where the maternal age ranged between ~27 and 35 years. There is an additive effect to pregnancy and live birth rates when both partners are of an advanced age, thus highlighting the need for pre-conception public health messaging and a combined approach to ART counselling assessing both parental ages in combination.

  15. Is there a link between blastomere contact surfaces of day 3 embryos and live birth rate?

    Directory of Open Access Journals (Sweden)

    Paternot Goedele

    2012-09-01

    Full Text Available Abstract Background Cell-cell communication and adhesion are essential for the compaction process of early stage embryos. The aim of this study was to develop a non-invasive objective calculation system of embryo compaction in order to test the hypothesis that embryos with a larger mean contact surface result in a higher live birth rate compared to embryos with a lower mean contact surface. Methods Multilevel images of 474 embryos transferred on day 3 were evaluated by the Cellify software. This software calculates the contact surfaces between the blastomeres. The primary outcome of this study was live birth. An ideal range of contact surface was determined and the positive and negative predictive value, the sensitivity, the specificity and the area under the curve for this new characteristic were calculated. Results In total, 115 (24% transferred embryos resulted in a live birth. Selection of an embryo for transfer on its mean contact surface could predict live birth with a high sensitivity (80% and high negative predicting value (83% but with a low positive predictive value (27%, a low specificity (31% and low area under the ROC curve (0.56. The mean contact surface of embryos cultured in a single medium was significantly higher compared to the mean contact surface of embryos cultured in a sequential medium (p = 0.0003. Conclusions Neither the mean contact surface nor the number of contact surfaces of a day 3 embryo had an additional value in the prediction of live birth. The type of culture medium, however, had an impact on the contact surface of an embryo. Embryos cultured in a single medium had a significant larger contact surface compared to embryos cultured in the sequential medium.

  16. Live birth sex ratios and father's geographic origins in Jerusalem, 1964-1976.

    Science.gov (United States)

    Groeger, J; Opler, M; Kleinhaus, K; Perrin, M C; Calderon-Margalit, R; Manor, O; Paltiel, O; Conley, D; Harlap, S; Malaspina, D

    2017-05-06

    To examine whether ancestry influenced sex ratios of offspring in a birth cohort before parental antenatal sex selection influenced offspring sex. We measured the sex ratio as the percent of males according to countries of birth of paternal and maternal grandfathers in 91,459 live births from 1964 to 1976 in the Jerusalem Perinatal Study. Confidence limits (CI) were computed based on an expected sex ratio of 1.05, which is 51.4% male. Of all live births recorded, 51.4% were male. Relative to Jewish ancestry (51.4% males), significantly more males (1,761) were born to Muslim ancestry (54.5, 95% CI = 52.1-56.8, P = 0.01). Among the former, sex ratios were not significantly associated with paternal or maternal age, education, or offspring's birth order. Consistent with a preference for male offspring, the sex ratio decreased despite increasing numbers of births over the 13-year period. Sex ratios were not affected by maternal or paternal origins in North Africa or Europe. However, the offspring whose paternal grandfathers were born in Western Asia included fewer males than expected (50.7, 50.1-51.3, P = 0.02), whether the father was born abroad (50.7) or in Israel (50.8). This was observed for descendents of paternal grandfathers born in Lebanon (47.6), Turkey (49.9), Yemen & Aden (50.2), Iraq (50.5), Afghanistan (50.5), Syria (50.6), and Cyprus (50.7); but not for those from India (51.5) or Iran (51.9). The West Asian group showed the strongest decline in sex ratios with increasing paternal family size. A decreased sex ratio associated with ancestry in Western Asia is consistent with reduced ability to bear sons by a subset of Jewish men in the Jerusalem cohort. Lower sex ratios may be because of pregnancy stress, which may be higher in this subgroup. Alternatively, a degrading Y chromosome haplogroup or other genetic or epigenetic differences on male germ lines could affect birth ratios, such as differential exposure to an environmental agent, dietary

  17. Pre-term birth and low birth weight following preimplantation genetic diagnosis: analysis of 88 010 singleton live births following PGD and IVF cycles.

    Science.gov (United States)

    Sunkara, Sesh Kamal; Antonisamy, Belavendra; Selliah, Hepsy Y; Kamath, Mohan S

    2017-02-01

    Is PGD associated with the risk of adverse perinatal outcomes such as pre-term birth (PTB) and low birth weight (LBW)? There was no increase in the risk of adverse perinatal outcomes of PTB, and LBW following PGD compared with autologous IVF. Pregnancies resulting from ART are associated with a higher risk of pregnancy complications compared with spontaneously conceived pregnancies. The possible reason of adverse obstetric outcomes following ART has been attributed to the underlying infertility itself and embryo specific epigenetic modifications due to the IVF techniques. It is of interest whether interventions such as embryo biopsy as performed in PGD affect perinatal outcomes. Anonymous data were obtained from the Human Fertilization and Embryology Authority (HFEA), the statutory regulator of ART in the UK. The HFEA has collected data prospectively on all ART performed in the UK since 1991. Data from 1996 to 2011 involving a total of 88 010 singleton live births were analysed including 87 571 following autologous stimulated IVF ± ICSI and 439 following PGD cycles. Data on all women undergoing either a stimulated fresh IVF ± ICSI treatment cycle or a PGD cycle during the period from 1996 to 2011 were analysed to compare perinatal outcomes of PTB and LBW among singleton live births. Logistic regression analysis was performed adjusting for female age category, year of treatment, previous IVF cycles, infertility diagnosis, number of oocytes retrieved, whether IVF or ICSI was used and day of embryo transfer. There was no increase in the risk of PTB and LBW following PGD versus autologous stimulated IVF ± ICSI treatment, unadjusted odds of PTB (odds ratio (OR) 0.68, 95% CI: 0.46-0.99) and LBW (OR 0.56, 95% CI: 0.37-0.85). After adjusting for the potential confounders, there was again no increase in the risk of the adverse perinatal outcomes following PGD: PTB (adjusted odds ratio (aOR) 0.66, 95% CI: 0.45-0.98) and LBW (aOR 0.58, 95% CI: 0.38-0.88). Although the

  18. Cretaceous choristoderan reptiles gave birth to live young

    Science.gov (United States)

    Ji, Qiang; Wu, Xiao-Chun; Cheng, Yen-Nien

    2010-04-01

    Viviparity (giving birth to live young) in fossil reptiles has been known only in a few marine groups: ichthyosaurs, pachypleurosaurs, and mosasaurs. Here, we report a pregnant specimen of the Early Cretaceous Hyphalosaurus baitaigouensis, a species of Choristodera, a diapsid group known from unequivocal fossil remains from the Middle Jurassic to the early Miocene (about 165 to 20 million years ago). This specimen provides the first evidence of viviparity in choristoderan reptiles and is also the sole record of viviparity in fossil reptiles which lived in freshwater ecosystems. This exquisitely preserved specimen contains up to 18 embryos arranged in pairs. Size comparison with small free-living individuals and the straight posture of the posterior-most pair suggest that those embryos were at term and had probably reached parturition. The posterior-most embryo on the left side has the head positioned toward the rear, contrary to normal position, suggesting a complication that may have contributed to the mother’s death. Viviparity would certainly have freed species of Hyphalosaurus from the need to return to land to deposit eggs; taking this advantage, they would have avoided intense competition with contemporaneous terrestrial carnivores such as dinosaurs.

  19. The Meaning of Giving Birth: Voices of Hmong Women Living in Vietnam.

    Science.gov (United States)

    Corbett, Cheryl A; Callister, Lynn Clark; Gettys, Jamie Peterson; Hickman, Jacob R

    Increasing knowledge about the sociocultural context of birth is essential to promote culturally sensitive nursing care. This qualitative study provides an ethnographic view of the perspectives on birthing of Hmong mothers living in the highlands of Vietnam. Unique cultural beliefs exist in Hmong culture about the spiritual and physical world as well as ritual practices associated with childbearing. This includes variations of ancestor worship, reincarnation, and healing practices by shamans. Traditionally, Hmong families take an active role in childbirth with birth frequently occurring in the home. Situated within a large collaborative anthropology project, a convenience sample of 8 Hmong women, who had recently given birth, were interviewed regarding the perinatal experience. In addition, ethnic traditional birth attendants (midwives) and other village women contributed perspectives providing richly descriptive data. This ethnographic study was conducted during 6 weeks of immersed participant observation with primary data collection carried out through fieldwork. Data were analyzed to derive cultural themes from interviews and observations. Significant themes included (1) valuing motherhood, (2) laboring and giving birth silently, (3) giving birth within the comfort of home and family, (4) feeling capable of birthing well, (5) feeling anxiety to provide for another child, and (6) embracing cultural traditions. Listening to the voices of Hmong women enhances understanding of the meaning of childbirth. Gaining greater understanding of Hmong cultural beliefs and practices can ensure childbearing women receive respectful, safe, and quality care.

  20. Anti-müllerian hormone levels are associated with live birth rates in ART, but the predictive ability of anti-müllerian hormone is modest.

    Science.gov (United States)

    Alson, Sara S E; Bungum, Leif J; Giwercman, Aleksander; Henic, Emir

    2018-06-01

    The aim was to evaluate the association between serum Anti-Müllerian Hormone (AMH) level and cumulative live birth rates (LBR) in patients undergoing their first in vitro fertilization (IVF) treatment cycle, and to compare serum AMH levels with Antral Follicle Count (AFC) and Ovarian Sensitivity Index (OSI) as predictors of live birth. A prospective cohort study of 454 patients under the age of 40 and with a regular menstrual cycle of 21-35 days, undergoing their first IVF treatment cycles between September 2010 and June 2015. Participants were divided into three groups based on their AMH level, (AMH ≤10, AMH 10-distribution between patients with or without live birth was analyzed using a Mann-Whitney-test, and live birth rates were compared between groups by a chi-squared test for linear trend. The ability of AMH, OSI and AFC as predictors of live birth was assessed by a receiver operating characteristics-analysis and the area under the curve (AUC) was calculated. Patients with live birth had a higher AMH, median (range) 26 [0-137] pmol/l, compared with patients without live birth, AMH 22 [0-154] pmol/l, p = 0.035. Mean live birth rate (SD) was 0.36 (0.48) in the total cohort, 0.26 (0.44) in AMH-group birth rates increased with 8% per AMH-group (95% CI: 0.02 -0.14, p = 0.015). The AUC for AFC was 0.56, for AMH 0.57 and for OSI 0.63, respectively. AMH concentration in serum is associated with live birth rates after IVF. Our results suggest that both AMH, AFC and OSI have an equal but modest predictive ability in relation to live birth rate. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. The associations between bridal pregnancy and obstetric outcomes among live births in Korea: population-based study.

    Directory of Open Access Journals (Sweden)

    Jung-Yun Lee

    Full Text Available OBJECTIVE: In East Asia the recently increased number of marriages in response to pregnancy is an important social issue. This study evaluated the association of marriage preceded by pregnancy (bridal pregnancy with obstetric outcomes among live births in Korea. METHODS: In this population-based study, 1,152,593 first singleton births were evaluated from data registered in the national birth registration database from 2004 to 2008 in Korea. In the study population, the pregnancy outcomes among live births from the bridal pregnancy group (N = 62,590 were compared with the outcomes of the post-marital pregnancy group (N = 564,749, composed of women who gave birth after 10 months but before 24 months of marriage. The variables preterm birth (PTB; <37 weeks gestation and low birth weight (LBW; <2.5 kg were used to determine the primary outcome. The adjusted odds ratios (aORs and 95% confidence intervals (CIs were calculated after controlling for socio-demographic factors. RESULTS: The socio-demographic factors among the bridal pregnancy group were associated with a social disadvantage and particular risk factors. In the subgroup analyses of maternal age, differences in adverse pregnancy outcomes from bridal pregnancy were identified between women in the following age group: (i ≤19, (ii 20-39, and (iii ≥40 years. After the multivariate analysis, the aORs for each age group were 1.47 (95% CI: 1.15-1.89, 1.76 (1.70-1.83, and 1.13 (0.77-1.66, respectively, for PTB and 0.92 (0.70-1.21, 1.60 (1.53-1.66, and 1.11 (0.71-1.74, respectively, for LBW. In the adjusted logistic regression models, bridal pregnancy was associated with PTB (1.76, 1.69-1.82 and LBW (1.53, 1.48-1.59. CONCLUSION: Pregnancy outcomes among live births from bridal pregnancies are associated with higher risks for PTB and LBW in Korea.

  2. Costs of achieving live birth from assisted reproductive technology: a comparison of sequential single and double embryo transfer approaches.

    Science.gov (United States)

    Crawford, Sara; Boulet, Sheree L; Mneimneh, Allison S; Perkins, Kiran M; Jamieson, Denise J; Zhang, Yujia; Kissin, Dmitry M

    2016-02-01

    To assess treatment and pregnancy/infant-associated medical costs and birth outcomes for assisted reproductive technology (ART) cycles in a subset of patients using elective double embryo (ET) and to project the difference in costs and outcomes had the cycles instead been sequential single ETs (fresh followed by frozen if the fresh ET did not result in live birth). Retrospective cohort study using 2012 and 2013 data from the National ART Surveillance System. Infertility treatment centers. Fresh, autologous double ETs performed in 2012 among ART patients younger than 35 years of age with no prior ART use who cryopreserved at least one embryo. Sequential single and double ETs. Actual live birth rates and estimated ART treatment and pregnancy/infant-associated medical costs for double ET cycles started in 2012 and projected ART treatment and pregnancy/infant-associated medical costs if the double ET cycles had been performed as sequential single ETs. The estimated total ART treatment and pregnancy/infant-associated medical costs were $580.9 million for 10,001 double ETs started in 2012. If performed as sequential single ETs, estimated costs would have decreased by $195.0 million to $386.0 million, and live birth rates would have increased from 57.7%-68.0%. Sequential single ETs, when clinically appropriate, can reduce total ART treatment and pregnancy/infant-associated medical costs by reducing multiple births without lowering live birth rates. Published by Elsevier Inc.

  3. Male and female alcohol consumption and live birth after assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Vittrup, Ida; Petersen, Gitte Lindved; Kamper-Jørgensen, Mads

    2017-01-01

    The objective was to assess the potential association between female and male alcohol consumption and probability of achieving a live birth after assisted reproductive treatment. From a nationwide Danish register-based cohort information on alcohol consumption at assisted reproductive treatment i...

  4. 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

  5. Effect of simultaneously started clomiphene citrate and gonadotropins in antagonist regimes, on cumulative live births, fresh-cycle live births and cost of stimulation in IVF cycles.

    Science.gov (United States)

    Satwik, Ruma; Kochhar, Mohinder

    2018-04-11

    The aim of the study was to compare simultaneously started clomiphene citrate (CC) and gonadotropins (Gn) with gonadotropins alone in conventional antagonist regimes with respect to fresh-cycle live births, cumulative live births and cost of ovarian stimulation per started cycle. This was a single-center prospective cohort study conducted over 1 year. Women undergoing autologous in vitro fertilization (IVF) treatment in antagonist protocols and who consented to participate in the study were divided into two cohorts. The CC cohort (n = 86) received 50 mg CC for 5 days and individualized Gn daily until the hCG trigger, both starting from day 2 and antagonist daily from day 8 of menstrual cycle. The Gn-only cohort (n = 349) received individualized Gn from day 2 and the antagonist from day 7 of menstrual cycle. IVF outcomes and cost of stimulation were compared between two cohorts across expected ovarian response categories. The CC cohort used a mean lower dose of Gn (1741.38 ± 604.46 vs 1980.54 ± 686.42; MD = -239.16; 95%CI = -348.03 to -189.24; P = 0.003) over fewer days (8.54 ± 1.86 vs 9.25 ± 1.97; MD =-0.71;95% CI = -1.17 to -0.25; P = 0.0026) to achieve similar retrieved oocytes, (9.19 ± 5.92 vs 9.36 ± 6.96; MD = -0.17; 95%CI -1.77 to + 1.43; P = 0.83), positive bhCG rates (40% vs 29.6%, MD = 10.4%; OR = 1.65, 95%CI = 0.95-2.86; P = 0.078) and live births in fresh cycles (32.31% vs 21.30%; MD = 11.01%; OR = 1.76; 95%CI = 0.97-3.19; P = 0.06) and cumulative live births per initiated cycle (30.23% vs 20.34%; MD = 9.89%; OR = 1.697; 95%CI = 0.99-2.88; P = 0.0501). The dose lowering achieved a 28-40% reduction in the cost of stimulation, which was most noticeable in the hyper-responder category for both hMG cycles, (Rs.11 602.3 ± 3365.9 vs 19615 ± 2677.1; MD = -8012.7; %age reduction: 40.8%; P = 0.0007) and recombinant FSH cycles (Rs. 22

  6. The Impact of ART on Live Birth Outcomes: Differing Experiences across Three States.

    Science.gov (United States)

    Luke, Sabrina; Sappenfield, William M; Kirby, Russell S; McKane, Patricia; Bernson, Dana; Zhang, Yujia; Chuong, Farah; Cohen, Bruce; Boulet, Sheree L; Kissin, Dmitry M

    2016-05-01

    Research has shown an association between assisted reproductive technology (ART) and adverse birth outcomes. We identified whether birth outcomes of ART-conceived pregnancies vary across states with different maternal characteristics, insurance coverage for ART services, and type of ART services provided. CDC's National ART Surveillance System data were linked to Massachusetts, Florida, and Michigan vital records from 2000 through 2006. Maternal characteristics in ART- and non-ART-conceived live births were compared between states using chi-square tests. We performed multivariable logistic regression analyses and calculated adjusted odds ratios (aOR) to assess associations between ART use and singleton preterm delivery (birth. ART use in Massachusetts was associated with significantly lower odds of twins as well as triplets and higher order births compared to Florida and Michigan (aOR 22.6 vs. 30.0 and 26.3, and aOR 37.6 vs. 92.8 and 99.2, respectively; Pinteraction order gestations per cycle was lower in Massachusetts, which may be due to the availability of insurance coverage for ART in Massachusetts. © 2016 John Wiley & Sons Ltd.

  7. Does a Caesarean section increase the time to a second live birth? A register-based cohort study.

    Science.gov (United States)

    O'Neill, Sinéad M; Khashan, Ali S; Henriksen, Tine B; Kenny, Louise C; Kearney, Patricia M; Mortensen, Preben B; Greene, Richard A; Agerbo, Esben

    2014-11-01

    Does a primary Caesarean section influence the rate of, and time to, subsequent live birth compared with vaginal delivery? Caesarean section was associated with a reduction in the rate of subsequent live birth, particularly among elective and maternal-requested Caesareans indicating maternal choice plays a role. Several studies have examined the relationship between Caesarean section and subsequent birth rate with conflicting results primarily due to poor epidemiological methods. This Danish population register-based cohort study covered the period from 1982 to 2010 (N = 832 996). All women with index live births were followed until their subsequent live birth or censored (maternal death, emigration or study end) using Cox regression models. In all 577 830 (69%) women had a subsequent live birth. Women with any type of Caesarean had a reduced rate of subsequent live birth (hazard ratio [HR] 0.86, 95% confidence intervals [CI] 0.85, 0.87) compared with spontaneous vaginal delivery. This effect was consistent when analyses were stratified by type of Caesarean: emergency (HR 0.87, 95% CI 0.86, 0.88), elective (HR 0.83, 95% CI 0.82, 0.84) and maternal-requested (HR 0.61, 95% CI 0.57, 0.66) and in the extensive sub-analyses performed. Lack of biological data to measure a woman's fertility is a major limitation of the current study. Unmeasured confounding and limited availability of data (maternal BMI, smoking, access to fertility services and maternal-requested Caesarean section) as well as changes in maternity care over time may also influence the findings. This is the largest study to date and shows that Caesarean section is most likely not causally related to a reduction in fertility. Maternal choice to delay or avoid childbirth is the most plausible explanation. Our findings are generalizable to other middle- to high-income countries; however, cross country variations in Caesarean section rates and social or cultural differences are acknowledged. Funding was

  8. The influence of female and male body mass index on live births after assisted reproductive technology treatment

    DEFF Research Database (Denmark)

    Petersen, Gitte Lindved; Schmidt, Lone; Pinborg, Anja

    2013-01-01

    OBJECTIVE: To investigate the independent and combined associations between female and male body mass index (BMI) on the probability of achieving a live birth after treatments with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) under adjustment for relevant covariates....... DESIGN: Population-based cohort study. SETTING: Danish national registers. PATIENT(S): Patients with permanent residence in Denmark receiving IVF or ICSI treatment with use of autologous oocytes from January 1, 2006, to September 30, 2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live birth...

  9. Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment.

    Science.gov (United States)

    Li, Hang Wun Raymond; Lee, Vivian Chi Yan; Lau, Estella Yee Lan; Yeung, William Shu Biu; Ho, Pak Chung; Ng, Ernest Hung Yu

    2014-02-01

    This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment. We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers combined after the same stimulation cycle. Women in both the PCOS (n = 104) and isolated PCO groups (n = 184) had higher ovarian response parameters compared to age-matched controls (n = 576), and higher rates of withholding fresh embryo transfer for risk of ovarian hyperstimulation syndrome (OHSS). The actual incidence of moderate to severe OHSS was significantly higher in the PCOS (11.5 %) but not the isolated PCO group (8.2%) compared to controls (4.9%). The live birth rates in the fresh cycle were comparable among the 3 groups, but the PCOS group had a significantly higher miscarriage rate compared to the other 2 groups. Cumulative live birth rate was significantly higher in the isolated PCO group (60.3%), but not the PCOS group (50.0%), compared to controls (47.5%). Women in the isolated PCO group, but not the PCOS group, had a significantly higher cumulative live birth rate compared to controls. This could be explained by the quantitative effect of the higher number of transferable embryos obtained per stimulation cycle, which is uncompromised by the unfavourable embryo competence otherwise observed in PCOS.

  10. Preconceptional antithyroid peroxidase antibodies, but not thyroid-stimulating hormone, are associated with decreased live birth rates in infertile women.

    Science.gov (United States)

    Seungdamrong, Aimee; Steiner, Anne Z; Gracia, Clarisa R; Legro, Richard S; Diamond, Michael P; Coutifaris, Christos; Schlaff, William D; Casson, Peter; Christman, Gregory M; Robinson, Randal D; Huang, Hao; Alvero, Ruben; Hansen, Karl R; Jin, Susan; Eisenberg, Esther; Zhang, Heping; Santoro, Nanette

    2017-10-25

    To study whether preconceptual thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) antibodies are associated with poor reproductive outcomes in infertile women. Secondary analysis of data from two multicenter, randomized, controlled trials conducted by the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Multivariable logistic regression analyses were performed to assess the association between preconceptual TSH levels and anti-TPO antibodies. Not applicable. Serum samples from 1,468 infertile women were utilized. None. Cumulative conception, clinical pregnancy, miscarriage, and live birth rates were calculated. Conception, clinical pregnancy, miscarriage, and live birth rates did not differ between patients with TSH ≥2.5 mIU/L vs. TSH < 2.5 mIU/L. Women with anti-TPO antibodies had similar conception rates (33.3% vs. 36.3%) but higher miscarriage rates (43.9% vs. 25.3%) and lower live birth rates (17.1% vs. 25.4%) than those without anti-TPO antibodies. Adjusted, multivariable logistic regression models confirmed elevated odds of miscarriage (odds ratio 2.17, 95% confidence interval 1.12-4.22) and lower odds of live birth (oddr ratio 0.58, 95% confidence interval 0.35-0.96) in patients with anti-TPO antibodies. In infertile women, preconceptional TSH ≥2.5 mIU/L is not associated with adverse reproductive outcomes; however, anti-TPO antibodies are associated with increased risk of miscarriage and decreased probability of live birth. PPCOS II NCT00719186; AMIGOS NCT01044862. Copyright © 2017. Published by Elsevier Inc.

  11. Cortisol production patterns in young children living with birth parents vs children placed in foster care following involvement of Child Protective Services.

    Science.gov (United States)

    Bernard, Kristin; Butzin-Dozier, Zachary; Rittenhouse, Joseph; Dozier, Mary

    2010-05-01

    To examine differences in waking to bedtime cortisol production between children who remained with birth parents vs children placed in foster care following involvement of Child Protective Services (CPS). Between-subject comparison of cortisol patterns among 2 groups of children. Children referred from the child welfare system. Three hundred thirty-nine children aged 2.9 to 31.4 months who were living with birth parents (n = 155) or placed in foster care (n = 184) following CPS involvement as well as 96 unmatched children from low-risk environments. Main Exposures Involvement by CPS and foster care. Main Outcome Measure Salivary cortisol samples obtained at waking and bedtime for children on 2 days. Child Protective Services-involved children who continued to live with birth parents and CPS-involved children placed in foster care differed in cortisol production, with children living with their birth parents showing flatter slopes in waking to bedtime values. Continuing to live with birth parents following involvement of CPS is associated with greater perturbation to the diurnal pattern of cortisol production than living with foster parents. Foster care may have a regulating influence on children's cortisol among children who have experienced maltreatment.

  12. Prevalence of hospitalized live births affected by alcohol and drugs and parturient women diagnosed with substance abuse at liveborn delivery: United States, 1999-2008.

    Science.gov (United States)

    Pan, I-Jen; Yi, Hsiao-ye

    2013-05-01

    To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births.

  13. Triassic marine reptiles gave birth to live young.

    Science.gov (United States)

    Cheng, Yen-Nien; Wu, Xiao-Chun; Ji, Qiang

    2004-11-18

    Sauropterygians form the largest and most diverse group of ancient marine reptiles that lived throughout nearly the entire Mesozoic era (from 250 to 65 million years ago). Although thousands of specimens of this group have been collected around the world since the description of the first plesiosaur in 1821 (ref. 3), no direct evidence has been found to determine whether any sauropterygians came on shore to lay eggs (oviparity) like sea turtles, or gave birth in the water to live young (viviparity) as ichthyosaurs and mosasauroids (marine lizards) did. Viviparity has been proposed for plesiosaur, pachypleurosaur and nothosaur sauropterygians, but until now no concrete evidence has been advanced. Here we report two gravid specimens of Keichousaurus hui Young from the Middle Triassic of China. These exquisitely preserved specimens not only provide the first unequivocal evidence of reproductive mode and sexual dimorphism in sauropterygians, but also indicate that viviparity could have been expedited by the evolution of a movable pelvis in pachypleurosaurs. By extension, this has implications for the reproductive pattern of other sauropterygians and Mesozoic marine reptiles that possessed a movable pelvis.

  14. The first successful live birth following preimplantation genetic diagnosis using PCR for type 1 citrullinemia

    Science.gov (United States)

    Cho, Jae-Hyun; Lee, Kyung-Hee; Jeon, Il-Kyung; Kim, Jae-Min; Kang, Byung-Moon

    2014-01-01

    Type 1 citrullinemia (CTLN1) is an autosomal recessive inherited metabolic disorder caused by anargininosuccinicnate synthetase deficiency. The patient was a 38-year-old Korean woman who is a carrier for CTLN1 and her first baby was diagnosed with CTLN1. Preimplantation genetic diagnosis (PGD) for CTLN1 in day 3 embryos using polymerase chain reaction was performed for live birth of healthy baby who is no affected with CTLN1. One unaffected blastocyst was transferred. This resulted in a clinical pregnancy and the live birth of healthy male twin. They were confirmed to be unaffected with CTNL1 by post natal diagnosis. This is the first case report of the use of PGD for CTNL1. PMID:24883299

  15. Live birth sex ratios and father’s geographic origins in Jerusalem, 1964–1976

    Science.gov (United States)

    Groeger, J; Opler, M; Kleinhaus, K; Perrin, MC; Calderon-Margalit, R; Manor, O; Paltiel, O; Conley, D; Harlap, S; Malaspina, D

    2016-01-01

    Objective To examine whether ancestry influenced sex ratios of offspring in a birth cohort before parental antenatal sex selection influenced offspring sex. Methods We measured the sex ratio as the percent of males according to countries of birth of paternal and maternal grandfathers in 91,459 live births from 1964 to 1976 in the Jerusalem Perinatal Study. Confidence limits (CI) were computed based on an expected sex ratio of 1.05, which is 51.4% male. Results Of all live births recorded, 51.4% were male. Relative to Jewish ancestry (51.4% males), significantly more males (1,761) were born to Muslim ancestry (54.5, 95% CI=52.1–56.8, p=.01). Among the former, sex ratios were not significantly associated with paternal or maternal age, education, or offspring’s birth order. Consistent with a preference for male offspring, the sex ratio decreased despite increasing numbers of births over the 13-year period. Sex ratios were not affected by maternal or paternal origins in North Africa or Europe. However, the offspring whose paternal grandfathers were born in Western Asia included fewer males than expected (50.7, 50.1–51.3, p=.02), whether the father was born abroad (50.7) or in Israel (50.8). This was observed for descendents of paternal grandfathers born in Lebanon (47.6), Turkey (49.9), Yemen & Aden (50.2), Iraq (50.5), Afghanistan (50.5), Syria (50.6), and Cyprus (50.7); but not for those from India (51.5) or Iran (51.9). The West Asian group showed the strongest decline in sex ratios with increasing paternal family size. Conclusions A decreased sex ratio associated with ancestry in Western Asia is consistent with reduced ability to bear sons by a subset of Jewish men in the Jerusalem cohort. Lower sex ratios may be due to pregnancy stress, which may be higher in this subgroup. Alternatively, a degrading Y chromosome haplogroup or other genetic or epigenetic differences on male germ lines could affect birth ratios, such as differential exposure to an

  16. Institutional racism, neighborhood factors, stress, and preterm birth.

    Science.gov (United States)

    Mendez, Dara D; Hogan, Vijaya K; Culhane, Jennifer F

    2014-01-01

    Racial/ethnic disparities in the risk of preterm birth may be explained by various factors, and previous studies are limited in examining the role of institutional racism. This study focused on the following questions: what is the association between preterm birth and institutional racism as measured by residential racial segregation (geographic separation by race) and redlining (black-white disparity in mortgage loan denial); and what is the association between preterm birth and reported stress, discrimination, and neighborhood quality. We used data from a clinic-based sample of pregnant women (n = 3462) participating in a stress and pregnancy study conducted from 1999 to 2004 in Philadelphia, PA (USA). We linked data from the 2000 US Census and Home Mortgage Disclosure Act (HMDA) data from 1999 to 2004 and developed measures of residential redlining and segregation. Among the entire population, there was an increased risk for preterm birth among women who were older, unmarried, tobacco users, higher number of previous births, high levels of experiences of everyday discrimination, owned their homes, lived in nonredlined areas, and areas with high levels of segregation measured by the isolation index. Among black women, living in a redlined area (where blacks were more likely to be denied mortgage loans compared to whites) was moderately associated with a decreased risk of preterm birth (aRR = 0.8, 95% CI: 0.6, 0.99). Residential redlining as a form institutional racism and neighborhood characteristic may be important for understanding racial/ethnic disparities in pregnancy and preterm birth.

  17. The influence on birthweight of maternal living conditions a decade prior to giving birth

    Directory of Open Access Journals (Sweden)

    John Singhammer

    2009-10-01

    Full Text Available The study’s aim was to correlate measures of mothers’ socio-economic status, a decade prior to giving birth, with their children’s birthweight. As part of a larger study, information on birth characteristics from 706 babies born 1970-73 were linked with census data obtained from their mothers near the time of birth as well as one decade earlier. The 706 individuals were selected at random from two national surveys in 1998 and 2000 and traced back to the time of birth in the period 1970-73. Information on birth characteristics was linked to census data obtained from the mothers in 1960 and 1970. Included was information on parent’s living conditions (e.g. income, type of dwelling, indoor plumbing, telephone, number of people in the household. Information on mother’s health during pregnancy, a decade before childbirth and near childbirth, and data on mothers’ and the infants’ health at birth was obtained from the Medical Birth Registry of Norway. In analysis that included both early and current socio-economic conditions maternal education and rural residency at the time of giving birth were observed as statistical significant predictors of birthweight. Results were adjusted for maternal age, parity, plurality, gender and diagnoses before and during pregnancy, all factors observed to attenuate birthweight. Indicators of women’s socio-economic conditions a decade prior to giving birth were not significantly associated with birthweight. These findings do not clearly support suggestions in the literature that an infant’s vitality may be influenced by the family’s socio-economic conditions years before birth.

  18. Prevalence of Hospitalized Live Births Affected by Alcohol and Drugs and Parturient Women Diagnosed with Substance Abuse at Liveborn Delivery: United States, 1999–2008

    Science.gov (United States)

    Pan, I-Jen; Yi, Hsiao-ye

    2015-01-01

    Objective To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. Methods This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. Results From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. Conclusions The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births. PMID:22688539

  19. Women's decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study.

    Science.gov (United States)

    Chen, Shu-Wen; Hutchinson, Alison M; Nagle, Cate; Bucknall, Tracey K

    2018-01-17

    Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women's decision-making processes and the influences on their mode of birth following a previous CS. A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks' gestation. Stage II involved interviews with pregnant women at 35-37 weeks' gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis. Ensuring the safety of mother and baby was the focus of women's decisions. Women's decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians' recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians' professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions. The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women's interactions with obstetricians regarding birth choices

  20. 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

  1. 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

  2. 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

  3. 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

  4. Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics.

    Science.gov (United States)

    Lalli, Marek; Ruysen, Harriet; Blencowe, Hannah; Yee, Kristen; Clune, Karen; DeSilva, Mary; Leffler, Marissa; Hillman, Emily; El-Noush, Haitham; Mulligan, Jo; Murray, Jeffrey C; Silver, Karlee; Lawn, Joy E

    2018-01-29

    Grand Challenges for international health and development initiatives have received substantial funding to tackle unsolved problems; however, evidence of their effectiveness in achieving change is lacking. A theory of change may provide a useful tool to track progress towards desired outcomes. The Saving Lives at Birth partnership aims to address inequities in maternal-newborn survival through the provision of strategic investments for the development, testing and transition-to-scale of ground-breaking prevention and treatment approaches with the potential to leapfrog conventional healthcare approaches in low resource settings. We aimed to develop a theory of change and impact framework with prioritised metrics to map the initiative's contribution towards overall goals, and to measure progress towards improved outcomes around the time of birth. A theory of change and impact framework was developed retrospectively, drawing on expertise across the partnership and stakeholders. This included a document and literature review, and wide consultation, with feedback from stakeholders at all stages. Possible indicators were reviewed from global maternal-newborn health-related partner initiatives, priority indicator lists, and project indicators from current innovators. These indicators were scored across five domains to prioritise those most relevant and feasible for Saving Lives at Birth. These results informed the identification of the prioritised metrics for the initiative. The pathway to scale through Saving Lives at Birth is articulated through a theory of change and impact framework, which also highlight the roles of different actors involved in the programme. A prioritised metrics toolkit, including ten core impact indicators and five additional process indicators, complement the theory of change. The retrospective nature of this development enabled structured reflection of the program mechanics, allowing for inclusion of learning from the first four rounds of the

  5. 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

  6. The Role of Birth/Previously Adopted Children in Families Choosing to Adopt Children with Special Needs.

    Science.gov (United States)

    Mullin, Ellen Steele; Johnson, LeAnne

    1999-01-01

    Notes that successful child placement depends on engaging birth or previously adopted children during the adoption process, yet other children are often overlooked when parents are adopting a special-needs child. Presents a model which recognizes dynamics of strength and vulnerability and applies that model to preparing and supporting the adoptive…

  7. Live birth potential of good morphology and vitrified blastocysts presenting abnormal cell divisions

    DEFF Research Database (Denmark)

    Azzarello, Antonino; Høst, Thomas; Hay-Schmidt, Anders

    2017-01-01

    a lower live birth rate (17.0%) than blastocyst with solely regular cell divisions (29.3%). ACDs could occur at more than one cell division in the same good morphology blastocyst. Reported as independent events, we observed ACDs occurring more frequently at the later cell cycles (1st: 1.3%; 2nd: 8.0%; 3rd...

  8. Antimüllerian hormone levels and antral follicle count as prognostic indicators in a personalized prediction model of live birth.

    Science.gov (United States)

    Nelson, Scott M; Fleming, Richard; Gaudoin, Marco; Choi, Bokyung; Santo-Domingo, Kenny; Yao, Mylene

    2015-08-01

    To compare antimüllerian hormone (AMH) and antral follicle count (AFC) separately and in combination with clinical characteristics for the prediction of live birth after controlled ovarian stimulation. Retrospective development and temporal external validation of prediction model. Outpatient IVF clinic. We applied the boosted tree method to develop three prediction models incorporating clinical characteristics plus AMH or AFC or the combination on 2,124 linked IVF cycles from 2006 to 2010 and temporally externally validated predicted live-birth probabilities with an independent data set comprising 1,121 cycles from 2011 to 2012. None. Predictive power (posterior log of odds ratio compared to age, or PLORA), reclassification, receiver operator characteristic analysis, calibration, dynamic range. Predictive power, was highest for the AMH model (PLORA = 29.1), followed by the AMH-AFC model (PLORA = 28.3) and AFC model (PLORA = 22.5). The prediction errors were 1% to models, except for the predicted live-birth probabilities of model, where the prediction error was 8%. The improvement in predictive power was highest for the AMH model: 76.2% improvement over age alone relative to 59% improvement for AFC and 73.3% for the combined model. Receiver operating characteristic analysis demonstrated that the AMH and the combined model had comparable discrimination (area under the curve = 0.716) and similar prediction error for high and low strata of live-birth prediction, with an improvement of 6.3% over age alone. The validated prediction model confirmed that AMH when combined with clinical characteristics can accurately identify the likelihood of live birth with a low prediction error. AFC provided no added predictive value beyond AMH. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. 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....

  10. Differences in rates and short-term outcome of live births before 32 weeks of gestation in Europe in 2003: results from the MOSAIC cohort

    DEFF Research Database (Denmark)

    Zeitlin, Jennifer; Draper, Elizabeth S; Kollée, Louis

    2008-01-01

    ,000 total live births were discharged from the hospital alive with a range from 64.1 to 117.1; the range was 10 to 31 per 10,000 live births for infants discharged with a diagnosis of neurologic or respiratory morbidity. CONCLUSIONS: Very preterm mortality and morbidity differed between European regions...

  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. Live birth rates after MESA or TESE in men with obstructive azoospermia: is there a difference?

    NARCIS (Netherlands)

    van Wely, Madelon; Barbey, Natalie; Meissner, Andreas; Repping, Sjoerd; Silber, Sherman J.

    2015-01-01

    How do live birth rates compare after intracytoplasmic sperm injection (ICSI) for men with obstructive azoospermia when using sperm derived from testicular sperm extraction (TESE) versus microsurgical epididymal sperm aspiration (MESA)? Our study suggests that proximal epididymal sperm (from MESA)

  13. Coffee Consumption During Pregnancy and Birth Weight

    DEFF Research Database (Denmark)

    Bech, Bodil Hammer; Frydenberg, Morten; Henriksen, Tine Brink

    2015-01-01

    weight and whether it was modified by the mothers' smoking habits. Methods: In the Danish National Birth Cohort, coffee intake and smoking during pregnancy were recorded prospectively in 89,539 pregnancies that ended with live born singletons. Information on birth weight was obtained from the Danish......Background: A previous randomized trial demonstrated an association between coffee intake and birth weight in smokers only. This could be a chance finding or because smoking interferes with caffeine metabolism. This study assessed the association between coffee intake during pregnancy and birth....../cup/day). Compared to non-coffee drinkers, intake of eight or more cups of coffee per day was associated with an adjusted birth weight difference of −65 g [95% confidence interval (CI) −92 to −39] for non-smokers and −79 g [95% CI −124 to −34] for women smoking more than 10 cigarettes per day. Women drinking eight...

  14. Effect of Different Concentrations of Melatonin on Live Births Resulting from the Transfer of Two-Cell Embryos of NMRI Mice

    Directory of Open Access Journals (Sweden)

    Mahdi Saadati

    2014-12-01

    Full Text Available Background & objectives : Infertility is a global problem affecting millions of men and women in developed and developing countries. In this regard, in-vitro fertilization (IVF plays an important role in improving the quality of life in infertile patients. However, studies have shown that the implantation failure in IVF is the main challenge of this procedure. Melatonin can increase the survival rate of embryos and IVF success rate through eliminating free radicals and removing reactive oxygen species. So, this study is conducted to investigate the effects of different concentrations of melatonin on the rate of newborns of mice following transfer oftwo-cell embryos .   Methods : In this study, female mice with average age of six to eight weeks were superovulated by administering pregnant mares serum gonadotropin (PMSG intraperitoneally (7.5 IU. ip, and followed after 48h by human chorionic gonadotropin (hCG (7.5 IU. ip. Two-cell mouse embryos were obtained from female mice oviduct after 48 h. The embryos transferred bilaterally into pseudopregnant mice of the same strain through surgical procedure and 8-14 embryos were transferred to each tube. The study included 4 treatment groups and one control group (6 mice in each group. The treatment groups were exposed to subcutaneous injection of concentrations of 100 µm , 10 µm , 1 µm and 100 nm of melatonin. After the cesarean on 18th day of pregnancy, the percentage of live births was assessed. The outcomes of the live birth rate were as­sessed using the chi-square test and statistical analyses were carried out using SPSS version 16.0. Percentage of live birth was calculated and compared with the control group.   Results: A total of 701 two-cell mouse embryos were transferred into one control group and four experimental groups. The number and percentage of live births at concentrations of 100 µm and 10 µm of melatonin and the control groups were 21 (15.55%, 13 (9.15% and 9 (6

  15. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study)

    DEFF Research Database (Denmark)

    Vissenberg, R; van Dijk, M M; Fliers, E

    2015-01-01

    . The analysis will be performed according to the intention to treat principle. We need to randomize 240 women (120 per group) to demonstrate an improvement in live birth rate from 55% in the placebo group to 75% in the levothyroxine treatment group. This trial is a registered trial (NTR 3364, March 2012). Here......BACKGROUND: Thyroid peroxidase antibodies (TPO-Ab) in euthyroid women are associated with recurrent miscarriage (RM) and other pregnancy complications such as preterm birth. It is unclear if treatment with levothyroxine improves pregnancy outcome. Aim To determine the effect of levothyroxine...... administration on live birth rate in euthyroid TPO-Ab positive women with recurrent miscarriage. METHODS: /Design We will perform a multicenter, placebo controlled randomized trial in euthyroid women with recurrent miscarriage and TPO-Ab. Recurrent miscarriage is defined as two or more miscarriages before the 20...

  16. [Prevalence of Down syndrome using certificates of live births and fetal deaths in México 2008-2011].

    Science.gov (United States)

    Sierra Romero, María Del Carmen; Navarrete Hernández, Eduardo; Canún Serrano, Sonia; Reyes Pablo, Aldelmo E; Valdés Hernández, Javier

    Down syndrome (DS) or trisomy 21 is the most common genetic cause of mental retardation with the clinical presentation of a series of well-defined characteristics. Advanced maternal age has been associated with DS. The databases of all the certificates of live births and fetal deaths in Mexico were combined. Codes based on the International Classification of Diseases 10 th Revision (ICD-10) in Chapter XVII "Congenital malformations, deformations and chromosomal abnormalities" were selected. A database of 8,250,375 births during the period 2008-2011 was constructed: 99.2% were live births with 0.8% of fetal deaths and 3,076 cases diagnosed with DS. The importance of this report is to initiate an epidemiological surveillance of newborn cases of DS nationwide and by state using census information systems available in the country since 2008. An increased risk has been observed for having a child with DS since the mother is ≥ 35 years, as has been reported in other studies. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  17. Live Births from Domestic Dog (Canis familiaris Embryos Produced by In Vitro Fertilization.

    Directory of Open Access Journals (Sweden)

    Jennifer B Nagashima

    Full Text Available Development of assisted reproductive technologies (ART in the dog has resisted progress for decades, due to their unique reproductive physiology. This lack of progress is remarkable given the critical role ART could play in conserving endangered canid species or eradicating heritable disease through gene-editing technologies-an approach that would also advance the dog as a biomedical model. Over 350 heritable disorders/traits in dogs are homologous with human conditions, almost twice the number of any other species. Here we report the first live births from in vitro fertilized embryos in the dog. Adding to the practical significance, these embryos had also been cryopreserved. Changes in handling of both gametes enabled this progress. The medium previously used to capacitate sperm excluded magnesium because it delayed spontaneous acrosome exocytosis. We found that magnesium significantly enhanced sperm hyperactivation and ability to undergo physiologically-induced acrosome exocytosis, two functions essential to fertilize an egg. Unlike other mammals, dogs ovulate a primary oocyte, which reaches metaphase II on Days 4-5 after the luteinizing hormone (LH surge. We found that only on Day 6 are oocytes consistently able to be fertilized. In vitro fertilization of Day 6 oocytes with sperm capacitated in medium supplemented with magnesium resulted in high rates of embryo development (78.8%, n = 146. Intra-oviductal transfer of nineteen cryopreserved, in vitro fertilization (IVF-derived embryos resulted in seven live, healthy puppies. Development of IVF enables modern genetic approaches to be applied more efficiently in dogs, and for gamete rescue to conserve endangered canid species.

  18. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis.

    Science.gov (United States)

    Kirby, E Will; Wiener, Laura Elizabeth; Rajanahally, Saneal; Crowell, Karen; Coward, Robert M

    2016-11-01

    To evaluate how varicocele repair (VR) impacts pregnancy (PRs) and live birth rates in infertile couples undergoing assisted reproduction wherein the male partner has oligospermia or azoospermia and a history of varicocele. Systematic review and meta-analysis. Not applicable. Azoospermic and oligospermic males with varicoceles and in couples undergoing assisted reproductive technology (ART) with IUI, IVF, or testicular sperm extraction (TESE) with IVF and intracytoplasmic sperm injection (ICSI). Measurement of PRs, live birth, and sperm extraction rates. Odds ratios for the impact of VR on PRs, live birth, and sperm extraction rates for couples undergoing ART. Seven articles involving a total of 1,241 patients were included. Meta-analysis showed that VR improved live birth rates for the oligospermic (odds ratio [OR] = 1.699) and combined oligospermic/azoospermic groups (OR = 1.761). Pregnancy rates were higher in the azoospermic group (OR = 2.336) and combined oligospermic/azoospermic groups (OR = 1.760). Live birth rates were higher for patients undergoing IUI after VR (OR = 8.360). Sperm retrieval rates were higher in persistently azoospermic men after VR (OR = 2.509). Oligospermic and azoospermic patients with clinical varicocele who undergo VR experience improved live birth rates and PRs with IVF or IVF/ICSI. For persistently azoospermic men after VR requiring TESE for IVF/ICSI, VR improves sperm retrieval rates. Therefore, VR should be considered to have substantial benefits for couples with a clinical varicocele even if oligospermia or azoospermia persists after repair and ART is required. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. 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. ...

  20. Cumulative live birth rates after IVF in patients with polycystic ovaries: phenotype matters.

    Science.gov (United States)

    De Vos, Michel; Pareyn, Stéphanie; Drakopoulos, Panagiotis; Raimundo, José M; Anckaert, Ellen; Santos-Ribeiro, Samuel; Polyzos, Nikolaos P; Tournaye, Herman; Blockeel, Christophe

    2018-05-07

    Do cumulative live birth rates (CLBR) vary among women with different polycystic ovary syndrome (PCOS) phenotypes who undergo IVF/intracytoplasmic sperm injection (ICSI) treatment? In this retrospective cohort study, data from 567 patients undergoing an assisted reproductive technology (ART) cycle between January 2010 and December 2015 were collected. Demographical traits, cycle characteristics and clinical and laboratory data were analysed. After conventional ovarian stimulation using a gonadotrophin-releasing hormone antagonist protocol, the median number of oocytes retrieved ranged between 11 and 13.5 and did not differ significantly among the studied groups. Live birth rate (LBR) after fresh embryo transfer and CLBR after transfer of all fresh and vitrified embryos were significantly lower in women with hyperandrogenic PCOS phenotypes A (LBR 16.7%, CLBR 25.8%) and C (LBR 18.5%, CLBR 27.8%) compared with women with normoandrogenic PCOS phenotype D (LBR 33.7%, CLBR 48%) (P-value for LBR 0.01 and 0.03, respectively; P-value for CLBR 0.002 and 0.01, respectively) and controls with a polycystic ovarian morphology (LBR 37.1%, CLBR 53.3%) (P-value for LBR 0.002 and 0.01, respectively; P-value for CLBR counselling and tailored approaches when treating PCOS patients with hyperandrogenism who require ART. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  1. The long-term prognosis for live birth in couples initiating fertility treatments

    DEFF Research Database (Denmark)

    Malchau, S. S.; Henningsen, A. A.; Loft, A.

    2017-01-01

    -26% in women ≥40 years, overall, 14% of couples conceived naturally and one-third of couples starting treatments with intrauterine insemination delivered from that treatment. WHAT IS KNOWN ALREADY: Few studies report success rates in fertility treatments across a couple's complete fertility treatment history......STUDY QUESTION: What are the long-term chances of having a child for couples starting fertility treatments and how many conceive with ART, IUI and without treatment? SUMMARY ANSWER: Total 5-year live birthrates were strongly influenced by female age and ranged from 80% in women under 35...... years (N = 3553), 35-39 years (N = 1156) and ≥40 years (N = 451), a total of 64%, 49% and 16% had a live birth due to treatment, respectively. Additionally, in women aged years, 35-39 years and ≥40 years, 16%, 11% and 10% delivered after natural conception, yielding total 5-year birthrates of 80...

  2. Waiting time distribution for the first conception leading to a live birth

    International Nuclear Information System (INIS)

    Shrestha, G.; Biswas, S.

    1985-01-01

    An attempt has been made in this paper to obtain probability model describing the distribution of the waiting time from marriage to first conception based on the data from marriage to first live birth. The speciality of this present approach lies in assuming the marital exposure to be finite which was assumed to be infinite by most of the earlier investigators for mathematical simplicity. Illustration of the applicability of the model on the data pertaining to first order of conception and monthly probability of conception for women married at different age groups have been illustrated in this paper. (author)

  3. [CHALLENGING THE OPTIMAL NUMBER OF RETRIEVED OOCYTES AND ITS IMPACT ON PREGNANCY AND LIVE BIRTH RATES IN IVF/ICSI CYCLES].

    Science.gov (United States)

    Blais, Idit; Lahav-Baratz, Shirly; Koifman, Mara; Wiener-Megnazi, Zofnat; Auslender, Ron; Dirnfeld, Martha

    2015-06-01

    Large numbers of retrieved oocytes are associated with higher chances of having cryopreservation of embryos. However, the process entailed exposes women to increased risk for ovarian hyperstimulation syndrome. Furthermore, mild ovary stimulation protocols are more patient-friendly and with less adverse effects. Only limited reports exist on the significance of the number of retrieved oocytes achieved in a single stimulation cycle. To investigate the optimal number of retrieved oocytes to achieve pregnancy and live birth. This retrospective analysis included 1590 IVF cycles. Oocytes maturation, fertilization, cleavage, as well as pregnancy and live birth rates were analyzed according to the number of retrieved oocytes. Oocyte maturation, fertilization and cleavage rates were lower in cycles with more than 10 retrieved oocytes compared with other groups. Live birth rates were highest when the number of retrieved oocytes was 11-15. Retrieval of more than 15 oocytes was not associated with a significant increase in chances of conception and birth. The better oocyte quality with 10 or less oocytes retrieved could be the result of a possible interference with the natural selection, or the minimized exposure of growing follicles to the potentially negative effects of ovarian stimulation. Although the average number of available embryos was higher when more than 10 oocytes were retrieved, achievement of more than 15 oocytes did not improve IVF outcome in terms of pregnancy and delivery rates. Analysis of 1590 IVF cycles including the frozen-thawed transfers shows that the best outcomes were achieved with an optimal number of 11-15 oocytes.

  4. 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 ...

  5. Perinatal Risks in "Late Motherhood" Defined Based On Parity and Preterm Birth Rate - an Analysis of the German Perinatal Survey (20th Communication).

    Science.gov (United States)

    Schure, V; Voigt, M; Schild, R L; Hesse, V; Carstensen, M; Schneider, K T M; Straube, S

    2012-01-01

    Aim: "Late motherhood" is associated with greater perinatal risks but the term lacks precise definition. We present an approach to determine what "late motherhood" associated with "high risk" is, based on parity and preterm birth rate. Materials and Methods: Using data from the German Perinatal Survey of 1998-2000 we analysed preterm birth rates in women with zero, one, or two previous live births. We compared groups of "late" mothers (with high preterm birth rates) with "control" groups of younger women (with relatively low preterm birth rates). Data of 208 342 women were analysed. For women with zero (one; two) previous live births, the "control" group included women aged 22-26 (27-31; 29-33) years. Women in the "late motherhood" group were aged > 33 (> 35; > 38) years. Results: The "late motherhood" groups defined in this way were also at higher risk of adverse perinatal events other than preterm birth. For women with zero (one; two) previous live births, normal cephalic presentation occurred in 89 % (92.7 %; 93.3 %) in the "control" group, but only in 84.5 % (90 %; 90.4 %) in the "late motherhood" group. The mode of delivery was spontaneous or at most requiring manual help in 71.3 % (83.4 %; 85.8 %) in the "control" group, but only in 51.4 % (72.2 %; 76.4 %) in the "late motherhood" group. Five-minute APGAR scores were likewise worse for neonates of "late" mothers and the proportion with a birth weight ≤ 2499 g was greater. Conclusion: "Late motherhood" that is associated with greater perinatal risks can be defined based on parity and preterm birth rate.

  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. Disproportion in the falling birth rate.

    Science.gov (United States)

    Gordon, R R

    1977-10-08

    Since 1962 there has been a disproportionately greater fall in the number of small (less than 1000 g) live births than total live births: this has applied to Sheffield and to England and Wales but more to the former. This may have affected falling neonatal mortality rates.

  8. First birth Caesarean section and subsequent fertility: a population-based study in the USA, 2000-2008.

    Science.gov (United States)

    Kjerulff, K H; Zhu, J; Weisman, C S; Ananth, C V

    2013-12-01

    for the pregnancy and childbirth complications had little effect on the RR of not having a subsequent live birth (RR = 1.15, 95% CI: 1.11-1.19). We were unable to distinguish between women who did not have a subsequent live birth and those who moved out of the state, which may have introduced a selection bias if those who had Caesarean births were more likely to emigrate than those who delivered vaginally. In addition we were unable to measure pre-pregnancy body mass index, weight gain during pregnancy and prior infertility, which would have been helpful in our efforts to reduce selection bias. The results of this study provide further corroboration of previous studies that have reported reduced fertility subsequent to Caesarean section in comparison with vaginal delivery. This study was funded by the US National Institute of Child Health and Human Development (NICHD, R01-HD052990). No competing interests are declared.

  9. Birth prevalence of Prader-Willi syndrome in Australia.

    Science.gov (United States)

    Smith, A; Egan, J; Ridley, G; Haan, E; Montgomery, P; Williams, K; Elliott, E

    2003-03-01

    This is the first population based study to estimate the birth prevalence of DNA proven Prader-Willi syndrome. Thirty infants were reported to the Australian Paediatric Surveillance Unit between 1998 and 2000, a prevalence of 4 per 100,000 live births or approximately 1/25,000 live births per annum.

  10. Development of Autoimmune Overt Hypothyroidism Is Highly Associated With Live Births and Induced Abortions but Only in Premenopausal Women

    DEFF Research Database (Denmark)

    Carle, Allan; Pedersen, Inge Buelow; Knudsen, Nils

    2014-01-01

    : In conditional multivariate logistic regression models, we analyzed the associations between the development of autoimmune hypothyroidism and age at menarche/menopause, years of menstruations, pregnancies, spontaneous and induced abortions, live births, and years on oral contraceptives and postmenopausal hormone...

  11. Estimates of live birth prevalence of children with Down syndrome in the period 1991-2015 in the Netherlands

    NARCIS (Netherlands)

    de Graaf, G.; Engelen, J. J. M.; Gijsbers, A. C. J.; Hochstenbach, R.; Hoffer, M. J. V.; Kooper, A. J. A.; Sikkema-Raddatz, B.; Srebniak, M. I.; van der Kevie-Kersemaekers, A. M. F.; van Zutven, L. J. C. M.; Voorhoeve, E.

    2017-01-01

    In Western countries, increasing maternal age has led to more pregnancies with a child with Down syndrome (DS). However, prenatal screening programs, diagnostic testing and termination of pregnancy influence the actual DS live birth (LB) prevalence as well. The aim of this study is to examine these

  12. Perinatal Risks in “Late Motherhood” Defined Based On Parity and Preterm Birth Rate – an Analysis of the German Perinatal Survey (20th Communication)

    Science.gov (United States)

    Schure, V.; Voigt, M.; Schild, R. L.; Hesse, V.; Carstensen, M.; Schneider, K. T. M.; Straube, S.

    2012-01-01

    Aim: “Late motherhood” is associated with greater perinatal risks but the term lacks precise definition. We present an approach to determine what “late motherhood” associated with “high risk” is, based on parity and preterm birth rate. Materials and Methods: Using data from the German Perinatal Survey of 1998–2000 we analysed preterm birth rates in women with zero, one, or two previous live births. We compared groups of “late” mothers (with high preterm birth rates) with “control” groups of younger women (with relatively low preterm birth rates). Data of 208 342 women were analysed. For women with zero (one; two) previous live births, the “control” group included women aged 22–26 (27–31; 29–33) years. Women in the “late motherhood” group were aged > 33 (> 35; > 38) years. Results: The “late motherhood” groups defined in this way were also at higher risk of adverse perinatal events other than preterm birth. For women with zero (one; two) previous live births, normal cephalic presentation occurred in 89 % (92.7 %; 93.3 %) in the “control” group, but only in 84.5 % (90 %; 90.4 %) in the “late motherhood” group. The mode of delivery was spontaneous or at most requiring manual help in 71.3 % (83.4 %; 85.8 %) in the “control” group, but only in 51.4 % (72.2 %; 76.4 %) in the “late motherhood” group. Five-minute APGAR scores were likewise worse for neonates of “late” mothers and the proportion with a birth weight ≤ 2499 g was greater. Conclusion: “Late motherhood” that is associated with greater perinatal risks can be defined based on parity and preterm birth rate. PMID:25253904

  13. Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178,898 women.

    Science.gov (United States)

    McLernon, David J; Maheshwari, Abha; Lee, Amanda J; Bhattacharya, Siladitya

    2016-03-01

    What is the chance of a live birth following one or more linked complete cycles of IVF (including ICSI)? The chance of a live birth after three complete cycles of IVF was 42.3% for treatment commencing from 1999 to 2007. IVF success has generally been reported on the basis of live birth rates after a single episode of treatment resulting in the transfer of a fresh embryo. This fails to capture the real chance of having a baby after a number of complete cycles-each involving the replacement of fresh as well as frozen-thawed embryos. Population-based observational cohort study of 178 898 women between 1992 and 2007. Participants included all women who commenced IVF treatment at a licenced clinic in the UK as recorded in the Human Fertilisation and Embryology Authority (HFEA) national database. Exclusion criteria included women whose treatment involved donor insemination, egg donation, surrogacy and the transfer of more than three embryos. Cumulative rates of live birth, term (>37 weeks) singleton live birth, and multiple pregnancy were estimated for two time-periods, 1992-1998 and 1999-2007. Conservative estimates assumed that women who did not return for IVF would not have the outcome of interest while optimal estimates assumed that these women would have similar outcome rates to those who continued IVF. A total of 71 551 women commenced IVF treatment during 1992-1998 and an additional 107 347 during 1999-2007. After the third complete IVF cycle (defined as three fresh IVF treatments-including replacement of any surplus frozen-thawed embryos), the conservative CLBR in women who commenced IVF during 1992-1998 was 30.8% increasing to 42.3% during 1999-2007. The optimal CLBRs were 44.6 and 57.1%, respectively. After eight complete cycles the optimal CLBR was 82.4% in the latter time period. The conservative rate for multiple pregnancy per pregnant woman fell from 31.9% during the earlier time period to 26.2% during the latter. Linkage of all IVF treatments to

  14. Birth order has no effect on intelligence: a reply and extension of previous findings.

    Science.gov (United States)

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

    2007-09-01

    We address points raised by Zajonc and Sulloway, who reject findings showing that birth order has no effect on intelligence. Many objections to findings of null birth-order results seem to stem from a misunderstanding of the difference between study designs where birth order is confounded with true causal influences on intelligence across families and designs that control for some of these influences. We discuss some of the consequences of not appreciating the nature of this difference. When between-family confounds are controlled using appropriate study designs and techniques such as multilevel modeling, birth order is shown not to influence intelligence. We conclude with an empirical investigation of the replicability and generalizability of this approach.

  15. A multicenter prospective study to assess the effect of early cleavage on embryo quality, implantation, and live-birth rate.

    Science.gov (United States)

    de los Santos, Maria José; Arroyo, Gemma; Busquet, Ana; Calderón, Gloria; Cuadros, Jorge; Hurtado de Mendoza, Maria Victoria; Moragas, Marta; Herrer, Raquel; Ortiz, Agueda; Pons, Carme; Ten, Jorge; Vilches, Miguel Angel; Figueroa, Maria José

    2014-04-01

    To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Prospective cross-sectional study. Multicenter study. Seven hundred embryo transfers and 1,028 early-stage human embryos. None. Implantation according to the presence of EC and embryo quality. The presence of EC is associated with embryo quality, especially in cycles with autologous oocytes. However, the use of EC as an additional criterion for selecting an embryo for transfer does not appear to significantly improve likelihood of implantation. Furthermore, embryos that presented EC had live-birth rates per implanted embryo similar to those that did not show any sign of cleavage. At least for conventional embryo culture and morphologic evaluations, the additional evaluation of EC in embryos may not be valuable to improve embryo implantation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Estimating the net effect of progesterone elevation on the day of hCG on live birth rates after IVF: a cohort analysis of 3296 IVF cycles.

    Science.gov (United States)

    Venetis, Christos A; Kolibianakis, Efstratios M; Bosdou, Julia K; Lainas, George T; Sfontouris, Ioannis A; Tarlatzis, Basil C; Lainas, Tryfon G

    2015-03-01

    What is the proper way of assessing the effect of progesterone elevation (PE) on the day of hCG on live birth in women undergoing fresh embryo transfer after in vitro fertilization (IVF) using GnRH analogues and gonadotrophins? This study indicates that a multivariable approach, where the effect of the most important confounders is controlled for, can lead to markedly different results regarding the association between PE on the day of hCG and live birth rates after IVF when compared with the bivariate analysis that has been typically used in the relevant literature up to date. PE on the day of hCG is associated with decreased pregnancy rates in fresh IVF cycles. Evidence for this comes from observational studies that mostly failed to control for potential confounders. This is a retrospective analysis of a cohort of fresh IVF/intracytoplasmic sperm injection cycles (n = 3296) performed in a single IVF centre during the period 2001-2013. Patients in whom ovarian stimulation was performed with gonadotrophins and GnRH analogues. Natural cycles and cycles where stimulation involved the administration of clomiphene were excluded. In order to reflect routine clinical practice, no other exclusion criteria were imposed on this dataset. The primary outcome measure for this study was live birth defined as the delivery of a live infant after 24 weeks of gestation. We compared the association between PE on the day of hCG (defined as P > 1.5 ng/ml) and live birth rates calculated by simple bivariate analyses with that derived from multivariable logistic regression. The multivariable analysis controlled for female age, number of oocytes retrieved, number of embryos transferred, developmental stage of embryos at transfer (cleavage versus blastocyst), whether at least one good-quality embryo was transferred, the woman's body mass index, the total dose of FSH administered during ovarian stimulation and the type of GnRH analogues used (agonists versus antagonists) during ovarian

  17. New Option in the Lives Saved Tool (LiST) Allows for the Conversion of Prevalence of Small-for-Gestational-Age and Preterm Births to Prevalence of Low Birth Weight.

    Science.gov (United States)

    Kozuki, Naoko; Katz, Joanne; Clermont, Adrienne; Walker, Neff

    2017-11-01

    Background: The Lives Saved Tool (LiST) is a software model that estimates the health impact of scaling up interventions on maternal and child health. One of the outputs of the model is an estimation of births by fetal size [appropriate-for-gestational-age (AGA) or small-for-gestational-age (SGA)] and by length of gestation (term or preterm), both of which influence birth weight. LiST uses prevalence estimates of births in these categories rather than of birth weight categories, because the causes and health consequences differ between SGA and preterm birth. The World Health Assembly nutrition plan, however, has set the prevalence of low birth weight (LBW) as a key indicator, with a specific goal of a 30% reduction in LBW prevalence by 2025. Objective: The objective of the study is to develop an algorithm that will allow LiST users to estimate changes in prevalence of LBW on the basis of changes in coverage of interventions and the resulting impact on prevalence estimates of SGA and preterm births. Methods: The study used 13 prospective cohort data sets from low- and middle-income countries (LMICs; 4 from sub-Saharan Africa, 5 from Asia, and 4 from Latin America), with reliable measures of gestational age and birth weight. By calculating the proportion of LBW births among SGA and preterm births in each data set and meta-analyzing those estimates, we calculated region-specific pooled rates of LBW among SGA and preterm births. Results: In Africa, 0.4% of term-AGA, 36.7% of term-SGA, 49.3% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. In Asia, 1.0% of term-SGA, 47.0% of term-SGA, 36.7% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. In Latin America, 0.4% of term-AGA, 34.4% of term-SGA, 32.3% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. Conclusions: The simple conversion factor proposed here allows for the estimation of LBW within LiST for most LMICs. This will allow LiST users to approximate the impact of their health programs on

  18. 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 ...

  19. Cost-effectiveness of a mild compared with a standard strategy for IVF: a randomized comparison using cumulative term live birth as the primary endpoint.

    Science.gov (United States)

    Polinder, S; Heijnen, E M E W; Macklon, N S; Habbema, J D F; Fauser, B J C M; Eijkemans, M J C

    2008-02-01

    BACKGROUND Conventional ovarian stimulation and the transfer of two embryos in IVF exhibits an inherent high probability of multiple pregnancies, resulting in high costs. We evaluated the cost-effectiveness of a mild compared with a conventional strategy for IVF. METHODS Four hundred and four patients were randomly assigned to undergo either mild ovarian stimulation/GnRH antagonist co-treatment combined with single embryo transfer, or standard stimulation/GnRH agonist long protocol and the transfer of two embryos. The main outcome measures are total costs of treatment within a 12 months period after randomization, and the relationship between total costs and proportion of cumulative pregnancies resulting in term live birth within 1 year of randomization. RESULTS Despite a significantly increased average number of IVF cycles (2.3 versus 1.7; P costs over a 12-month period (8333 versus euro10 745; P = 0.006) were observed using the mild strategy. This was mainly due to higher costs of the obstetric and post-natal period for the standard strategy, related to multiple pregnancies. The costs per pregnancy leading to term live birth were euro19 156 in the mild strategy and euro24 038 in the standard. The incremental cost-effectiveness ratio of the standard strategy compared with the mild strategy was euro185 000 per extra pregnancy leading to term live birth. CONCLUSIONS Despite an increased mean number of IVF cycles within 1 year, from an economic perspective, the mild treatment strategy is more advantageous per term live birth. It is unlikely, over a wide range of society's willingness-to-pay, that the standard treatment strategy is cost-effective, compared with the mild strategy.

  20. [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.

  1. Trial of labour and vaginal birth after previous caesarean section: A population based study of Eastern African immigrants in Victoria, Australia.

    Science.gov (United States)

    Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

    2017-03-01

    Variations in caesarean section (CS) between some immigrant groups and receiving country populations have been widely reported. Often, African immigrant women are at higher risk of CS than the receiving population in developed countries. However, evidence about subsequent mode of birth following CS for African women post-migration is lacking. The objective of this study was to examine differences in attempted and successful vaginal birth after previous caesarean (VBAC) for Eastern African immigrants (Eritrea, Ethiopia, Somalia and Sudan) compared with Australian-born women. A population-based observational study was conducted using the Victorian Perinatal Data Collection. Pearson's chi-square test and logistic regression analysis were performed to generate adjusted odds ratios for attempted and successful VBAC. Victoria, Australia. 554 Eastern African immigrants and 24,587 Australian-born eligible women with previous CS having singleton births in public care. 41.5% of Eastern African immigrant women and 26.1% Australian-born women attempted a VBAC with 50.9% of Eastern African immigrants and 60.5% of Australian-born women being successful. After adjusting for maternal demographic characteristics and available clinical confounding factors, Eastern African immigrants were more likely to attempt (OR adj 1.94, 95% CI 1.57-2.47) but less likely to succeed (OR adj 0.54 95% CI 0.41-0.71) in having a VBAC. There are disparities in attempted and successful VBAC between Eastern African origin and Australian-born women. Unsuccessful VBAC attempt is more common among Eastern African immigrants, suggesting the need for improved strategies to select and support potential candidates for vaginal birth among these immigrants to enhance success and reduce potential complications associated with failed VBAC attempt. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  2. 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.

  3. Residential green space and birth outcomes in a coastal setting.

    Science.gov (United States)

    Glazer, Kimberly B; Eliot, Melissa N; Danilack, Valery A; Carlson, Lynn; Phipps, Maureen G; Dadvand, Payam; Savitz, David A; Wellenius, Gregory A

    2018-05-01

    Residential green space may improve birth outcomes, with prior studies reporting higher birthweight among infants of women living in greener areas. However, results from studies evaluating associations between green space and preterm birth have been mixed. Further, the potential influence of residential proximity to water, or 'blue space', on health has not previously been evaluated. To evaluate associations between green and blue space and birth outcomes in a coastal area of the northeastern United States. Using residential surrounding greenness (measured by Normalized Difference Vegetation Index [NDVI]) and proximity to recreational facilities, coastline, and freshwater as measures of green and blue space, we examined associations with preterm birth (PTB), term birthweight, and term small for gestational age (SGA) among 61,640 births in Rhode Island. We evaluated incremental adjustment for socioeconomic and environmental metrics. In models adjusted for individual - and neighborhood-level markers of socioeconomic status (SES), an interquartile range (IQR) increase in NDVI was associated with a 12% higher (95% CI: 4, 20%) odds of PTB and, conversely, living within 500 m of a recreational facility was associated with a 7% lower (95% CI: 1, 13%) odds of PTB. These associations were eliminated after further adjustment for town of residence. NDVI was associated with higher birthweight (7.4 g, 95% CI: 0.4-14.4 g) and lower odds of SGA (OR = 0.92, 95% CI: 0.87-0.98) when adjusted for individual-level markers of SES, but not when further adjusted for neighborhood SES or town. Living within 500 m of a freshwater body was associated with a higher birthweight of 10.1 g (95% CI: 2.0, 18.2) in fully adjusted models. Findings from this study do not support the hypothesis that residential green space is associated with reduced risk of preterm birth or higher birthweight after adjustment for individual and contextual socioeconomic factors, but variation in results with

  4. Effect of clomiphene citrate on endometrial thickness, ovulation, pregnancy and live birth in anovulatory women: systematic review and meta-analysis

    NARCIS (Netherlands)

    Gadalla, M. A.; Huang, S.; Wang, R.; Norman, R. J.; Abdullah, S. A.; El Saman, A. M.; Ismail, A. M.; van Wely, M.; Mol, B. W. J.

    2018-01-01

    To compare the impact of clomiphene citrate (CC) vs other drug regimens on mid-cycle endometrial thickness (EMT), ovulation, pregnancy and live birth rates in women with World Health Organization (WHO) group II ovulatory disorders. We searched MEDLINE, EMBASE, Scopus, Web of Science, The Cochrane

  5. Antral follicle counts are strongly associated with live-birth rates after assisted reproduction, with superior treatment outcome in women with polycystic ovaries.

    Science.gov (United States)

    Holte, Jan; Brodin, Thomas; Berglund, Lars; Hadziosmanovic, Nermin; Olovsson, Matts; Bergh, Torbjörn

    2011-09-01

    To evaluate the association of antral follicle count (AFC) with in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) outcome in a large unselected cohort of patients covering the entire range of AFC. Prospective observational study. University-affiliated private infertility center. 2,092 women undergoing 4,308 IVF-ICSI cycles. AFC analyzed for associations with treatment outcome and statistically adjusted for repeated treatments and age. Pregnancy rate, live-birth rate, and stimulation outcome parameters. The AFC was log-normally distributed. Pregnancy rates and live-birth rates were positively associated with AFC in a log-linear way, leveling out above AFC ∼30. Treatment outcome was superior among women with polycystic ovaries, independent from ovulatory status. The findings were significant also after adjustment for age and number of oocytes retrieved. Pregnancy and live-birth rates are log-linearly related to AFC. Polycystic ovaries, most often excluded from studies on ovarian reserve, fit as one extreme in the spectrum of AFC; a low count constitutes the other extreme, with the lowest ovarian reserve and poor treatment outcome. The findings remained statistically significant also after adjustment for the number of oocytes retrieved, suggesting this measure of ovarian reserve comprises information on oocyte quality and not only quantity. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. The changing trends in live birth statistics in Korea, 1970 to 2010

    Directory of Open Access Journals (Sweden)

    Jae Woo Lim

    2011-11-01

    Full Text Available Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, the number of congenital anomalies is expected to increase due to the advanced maternal age. In addition, the number of interracial children is expected to increase due to the rise in the number of international marriages. However, the maternal education level is high, single-mother birth rate is low, and the gender imbalance has lessened. The number of overweight babies has been decreased, as more pregnant women are receiving adequate prenatal care. Compared to the Asian average birth weight, the average birth weight is the highest in Asia. Moreover, the rate of low birth weight infants is low, and infant mortality is similarly low across Asia. Using birth data from Statistics Korea and studies of birth outcomes in Korea and abroad, this study aimed to assess the changes in maternal and infant characteristics associated with birth outcomes during the past four decades and identify necessary information infrastructures to study countermeasures the decrease in birth rate and increase in low birth weight infants in Korea.

  7. The changing trends in live birth statistics in Korea, 1970 to 2010.

    Science.gov (United States)

    Lim, Jae Woo

    2011-11-01

    Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, the number of congenital anomalies is expected to increase due to the advanced maternal age. In addition, the number of interracial children is expected to increase due to the rise in the number of international marriages. However, the maternal education level is high, single-mother birth rate is low, and the gender imbalance has lessened. The number of overweight babies has been decreased, as more pregnant women are receiving adequate prenatal care. Compared to the Asian average birth weight, the average birth weight is the highest in Asia. Moreover, the rate of low birth weight infants is low, and infant mortality is similarly low across Asia. Using birth data from Statistics Korea and studies of birth outcomes in Korea and abroad, this study aimed to assess the changes in maternal and infant characteristics associated with birth outcomes during the past four decades and identify necessary information infrastructures to study countermeasures the decrease in birth rate and increase in low birth weight infants in Korea.

  8. 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.

  9. [Estimating child mortality using the previous child technique, with data from health centers and household surveys: methodological aspects].

    Science.gov (United States)

    Aguirre, A; Hill, A G

    1988-01-01

    2 trials of the previous child or preceding birth technique in Bamako, Mali, and Lima, Peru, gave very promising results for measurement of infant and early child mortality using data on survivorship of the 2 most recent births. In the Peruvian study, another technique was tested in which each woman was asked about her last 3 births. The preceding birth technique described by Brass and Macrae has rapidly been adopted as a simple means of estimating recent trends in early childhood mortality. The questions formulated and the analysis of results are direct when the mothers are visited at the time of birth or soon after. Several technical aspects of the method believed to introduce unforeseen biases have now been studied and found to be relatively unimportant. But the problems arising when the data come from a nonrepresentative fraction of the total fertile-aged population have not been resolved. The analysis based on data from 5 maternity centers including 1 hospital in Bamako, Mali, indicated some practical problems and the information obtained showed the kinds of subtle biases that can result from the effects of selection. The study in Lima tested 2 abbreviated methods for obtaining recent early childhood mortality estimates in countries with deficient vital registration. The basic idea was that a few simple questions added to household surveys on immunization or diarrheal disease control for example could produce improved child mortality estimates. The mortality estimates in Peru were based on 2 distinct sources of information in the questionnaire. All women were asked their total number of live born children and the number still alive at the time of the interview. The proportion of deaths was converted into a measure of child survival using a life table. Then each woman was asked for a brief history of the 3 most recent live births. Dates of birth and death were noted in month and year of occurrence. The interviews took only slightly longer than the basic survey

  10. [Relationship between air pollution exposure during pregnancy and birth weight of term singleton live-birth newborns].

    Science.gov (United States)

    Guo, L Q; Zhang, Q; Zhao, D D; Wang, L L; Chen, Y; Mi, B B; Dang, S N; Yan, H

    2017-10-10

    Objective: This study explored the association between air pollution exposure and birth weight by using the multilevel linear model, after controlling related meteorological factors and individual differences of both mothers and babies. Methods: Women of childbearing age who were pregnant in Xi'an from 2010 to 2013, were selected as objects of this study. Multistage random sampling method was used to select 4 631 subjects followed by a self-designed questionnaire survey. Data related to quality of air and meteorology were gathered from routine monitoring system. Gestational age and date of birth, together with the average levels of air pollution were calculated for each trimester on each mother, and then the impact of air pollution on birth weight was assessed. A multilevel linear model was employed to investigate the association between the levels of exposure to air pollution by birth weight. Confounding factors were under control. We established three models in this study: Model 1 which involving the variable of air pollution exposure. Model 2 was adjusted for variables in Model 1 plus some other individual differences of both mother and baby. Model 3 was adjusted for variables in Model 2 plus meteorological factors. Results: There were significant differences seen in birth weight within the subgroups of gender, gestational age, mother's reproductive age, maternal education, residential areas and family incomes ( P 0.05). Data from Model 3 indicated that a decrease of 13.3 g(10.9 g in Model 2) and 6.6 g (5.9 g in Model 2) in birth weight that were associated with an increase of 10 μg/m(3) in the average level of NO(2) and PM(10) during the second trimester; A decrease of 13.7 g (9.8 g in Model 2) in birth weight was associated with an increase of 10 μg/m(3) in the average level of NO(2) during the third trimester. Conclusion: After controlling for meteorological factors, the levels of exposure to NO(2) and PM(10) during the second trimester and NO(2) during the

  11. Ovarian response and cumulative live birth rate of women undergoing in-vitro fertilisation who had discordant anti-Mullerian hormone and antral follicle count measurements: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Hang Wun Raymond Li

    Full Text Available OBJECTIVE: To evaluate ovarian response and cumulative live birth rate of women undergoing in-vitro fertilization (IVF treatment who had discordant baseline serum anti-Mullerian hormone (AMH level and antral follicle count (AFC. METHODS: This is a retrospective cohort study on 1,046 women undergoing the first IVF cycle in Queen Mary Hospital, Hong Kong. Subjects receiving standard IVF treatment with the GnRH agonist long protocol were classified according to their quartiles of baseline AMH and AFC measurements after GnRH agonist down-regulation and before commencing ovarian stimulation. The number of retrieved oocytes, ovarian sensitivity index (OSI and cumulative live-birth rate for each classification category were compared. RESULTS: Among our studied subjects, 32.2% were discordant in their AMH and AFC quartiles. Among them, those having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate. Subjects discordant in AMH and AFC had intermediate OSI which differed significantly compared to those concordant in AMH and AFC on either end. OSI of those discordant in AMH and AFC did not differ significantly whether either AMH or AFC quartile was higher than the other. CONCLUSIONS: When AMH and AFC are discordant, the ovarian responsiveness is intermediate between that when both are concordant on either end. Women having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate.

  12. H-Y antibody titers are increased in unexplained secondary recurrent miscarriage patients and associated with low male : female ratio in subsequent live births

    DEFF Research Database (Denmark)

    Nielsen, H S; Wu, F; Aghai, Z

    2010-01-01

    The birth of a boy is significantly more common than a girl prior to secondary recurrent miscarriage (SRM) and is associated with a poorer chance of a subsequent live birth. Children born after SRM are more likely to be girls. High-titer antisera specific for male antigens (H-Y) have been shown t...... to arrest development of male bovine embryos efficiently. We consequently questioned the role of H-Y antibodies in women with SRM....

  13. Acupuncture and Clomiphene Citrate for Live Birth in Polycystic Ovary Syndrome: Study Design of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Hongying Kuang

    2013-01-01

    Full Text Available Acupuncture is an alternative therapy to induce ovulation in women with polycystic ovary syndrome (PCOS, but there is no study reporting the live birth rate following ovulation induction by acupuncture or its potential as an adjuvant treatment to clomiphene citrate (CC. We assess the efficacy of acupuncture with or without CC in achieving live births among 1000 PCOS women in Mainland China. This paper reports the methodology of an ongoing multicenter randomized controlled trial. The randomization scheme is coordinated through the central mechanism and stratified by the participating sites. Participants will be randomized into one of the four treatment arms: (A true acupuncture and CC, (B control acupuncture and CC, (C true acupuncture and placebo CC, and (D control acupuncture and placebo CC. To ensure the quality and integrity of the trial we have developed a unique multinational team of investigators and Data and Safety Monitoring Board. Up to the end of April 2013, 326 subjects were recruited. In conclusion, the success of this trial will allow us to evaluate the additional benefit of acupuncture beyond the first line medicine for fertility treatment in PCOS women in an unbiased manner.

  14. 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

  15. Projecting the potential impact of the Cap-Score™ on clinical pregnancy, live births, and medical costs in couples with unexplained infertility.

    Science.gov (United States)

    Babigumira, Joseph B; Sharara, Fady I; Garrison, Louis P

    2018-01-01

    The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles. We developed and parameterized a decision-analytic model of management of unexplained infertility for women based on data from the published literature. We calculated the clinical pregnancy rates, live birth rates, and medical costs comparing CS-TI and SOC. We used Monte Carlo simulation to quantify uncertainty in projected estimates and performed univariate sensitivity analysis. Compared to SOC, CS-TI was projected to increase the pregnancy rate by 1-26%, marginally reduce live birth rates by 1-3% in couples with women below 40 years, increase live birth rates by 3-7% in couples with women over 40 years, reduce mean medical costs by $4000-$19,200, reduce IUI costs by $600-$1370, and reduce IVF costs by $3400-$17,800, depending on the woman's age. The Cap-Score™ is a potentially valuable clinical tool for management of unexplained infertility because it is projected to improve clinical pregnancy rates, save money, and, depending on the price of the test, increase access to treatment for infertility.

  16. Births: Final Data for 2001.

    Science.gov (United States)

    Martin, Joyce A.; Hamilton, Brady E.; Ventura, Stephanie J.; Menacker, Fay; Park, Melissa M.; Sutton, Paul D.

    2002-01-01

    This report presents 2001 data on U.S. births according to maternal demographics (age, live-birth order, marital status, race, Hispanic origin, and educational attainment); maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); pregnant women's medical care utilization (prenatal care, obstetric procedures,…

  17. Live birth following serial vitrification of embryos and PGD for fragile X syndrome in a patient with the premutation and decreased ovarian reserve.

    Science.gov (United States)

    Nayot, Dan; Chung, Jin Tae; Son, Weon-Young; Ao, Assangla; Hughes, Mark; Dahan, Michael H

    2013-11-01

    To present a live birth resulting from serial vitrification of embryos and pre-implantation genetic diagnosis (PGD). A 31-year-old with primary infertility, fragile-X premutation, and decreased ovarian reserve (DOR) (baseline FSH level 33 IU/L), presented after failing to stimulate to follicle diameters >10 mm with three cycles of invitro fertilization (IVF). After counseling, the couple opted for serial in-vitro maturation (IVM), embryo vitrification, and genetic testing using array comparative genomic hybridization (aCGH) and PGD. Embryos were vitrified 2 days after intra-cytoplasmic sperm injection (ICSI). Thawed embryos were biopsied on day-three and transferred on day-five. The couple underwent 20 cycles of assisted reproductive technology. A total of 23 in-vivo mature and five immature oocytes were retrieved, of which one matured in-vitro. Of 24 embryos, 17/24 (71 %) developed to day two and 11/24 (46 %) survived to blastocyst stage with a biopsy result available. Four blastocysts had normal PGD and aCGH results. Both single embryo transfers resulted in a successful implantation, one a blighted ovum and the other in a live birth. Young patients with DOR have potential for live birth as long as oocytes can be obtained and embryos created. Serial vitrification may be the mechanism of choice in these patients when PGD is needed.

  18. Triggering of final oocyte maturation with gonadotropin-releasing hormone agonist or human chorionic gonadotropin. Live birth after frozen-thawed embryo replacement cycles

    DEFF Research Database (Denmark)

    Griesinger, Georg; Kolibianakis, E M; Papanikolaou, E G

    2007-01-01

    OBJECTIVE: To report the outcome of frozen-thawed embryo replacement cycles after GnRH-agonist triggering of final oocyte maturation in the collecting cycle with GnRH-antagonist. DESIGN: Prospective, observational, multicentric clinical study. SETTING: Tertiary university-affiliated IVF centers...... a total of 228 participants. Surplus embryos or oocytes at the pronuclear stage were cryopreserved in 53 patients after hCG administration and 32 patients after GnRH-agonist administration on the basis of patient choice, pronuclear/embryo availability, and local laws. INTERVENTION(S): Transfer of frozen......-thawed embryos. MAIN OUTCOME MEASURE(S): Live birth rate. RESULT(S): Thirty-one and 23 patients after administration of hCG and GnRH-agonist, respectively, started a frozen-embryo replacement cycle by September 2005, with 25 and 16 patients eventually undergoing at least one frozen-thawed ET. Live birth rate per...

  19. Normal live births after intracytoplasmic sperm injection in a man with the rare condition of Eagle-Barrett syndrome (prune-belly syndrome).

    Science.gov (United States)

    Fleming, Steven D; Varughese, Elizabeth; Hua, Vi-Khiem; Robertson, Amanda; Dalzell, Fiona; Boothroyd, Clare V

    2013-12-01

    To report the first live births of male infants resulting from intracytoplasmic sperm injection (ICSI) using spermatozoa from a man with Eagle-Barrett syndrome (EBS). Case report. Assisted conception unit within a private hospital. An infertile couple. An infertile couple received repeated treatment with ICSI. Clinical pregnancy and a normal live birth. In 2008, after microinjection of ten oocytes, the transfer of a single expanded blastocyst led to the premature birth of a morphologically normal male infant at 18 weeks' gestation. This outcome followed preterm rupture of membranes and possible cervical incompetence. In 2009, after microinjection of six oocytes, transfer of a single 5-cell embryo led to a singleton pregnancy, with emergency cervical cerclage being performed at 21 weeks. A healthy male infant was born at 30 weeks, with no evidence of EBS, by lower-segment cesarean section for breech presentation and premature labor. In 2012, after elective laparoscopic placement of cervical suture, microinjection of ten oocytes and transfer of a single 4-cell embryo led to a singleton pregnancy with a healthy male infant, with no evidence of EBS, being born by cesarean section at 38 weeks. This report suggests that EBS is not transmitted to male offspring via ICSI. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  20. 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.

  1. Association of previous severe low birth weight with adverse perinatal outcomes in a subsequent pregnancy among HIV-prevalent urban African women.

    Science.gov (United States)

    Smid, Marcela C; Ahmed, Yusuf; Stoner, Marie C D; Vwalika, Bellington; Stringer, Elizabeth M; Stringer, Jeffrey S A

    2017-02-01

    To evaluate the association between severity of prior low birth weight (LBW) delivery and adverse perinatal outcomes in the subsequent delivery among an HIV-prevalent urban African population. A retrospective cohort study was conducted among 41 109 women who had undergone two deliveries in Lusaka, Zambia, between February 1, 2006, and May 31, 2013. The relationship between prior LBW delivery (<2500 g) and a composite measure of adverse perinatal outcome in the second pregnancy was assessed using multivariate logistic regression. Women with prior LBW delivery (n=4259) had an increased risk of LBW in the second delivery versus those without prior LBW delivery (n=37 642). Such risk correlated with the severity of first delivery LBW. The adjusted odds ratio (AOR) was 2.89 (95% confidence interval [CI] 2.05-4.09) for a birth weight of 1000-1499 g, 3.05 (95% CI 2.42-3.86) for a birth weight of 1500-1999 g, and 2.02 (95% CI 1.81-2.27) for a birth weight of 2000-2499 g. Previous LBW delivery also increased the risk of adverse perinatal outcome, with an AOR of 1.4 (95% CI 1.2-1.7). Severe prior LBW delivery conferred substantial risk for adverse perinatal outcomes in a subsequent pregnancy. © 2016 International Federation of Gynecology and Obstetrics.

  2. The changing trends in live birth statistics in Korea, 1970 to 2010

    OpenAIRE

    Jae Woo Lim

    2011-01-01

    Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, ...

  3. Adjustment of a Population of South African Children of Mothers Living With/and Without HIV Through Three Years Post-Birth.

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Tomlinson, Mark; Scheffler, Aaron; Harris, Danielle M; Nelson, Sandahl

    2017-06-01

    Mothers living with HIV (MLH) and their children are typically studied to ensure that perinatal HIV transmission is blocked. Yet, HIV impacts MLH and their children lifelong. We examine child outcomes from pregnancy to 3 years post-birth among a peri-urban population of pregnant MLH and mothers without HIV (MWOH). Almost all pregnant women in 12 neighborhoods (98 %; N = 584) in Cape Town, South Africa were recruited and repeatedly assessed within 2 weeks of birth (92 %), at 6 months (88 %), 18 months (84 %), and 3 years post-birth (86 %). There were 186 MLH and 398 MWOH. Controlling for neighborhood and repeated measures, child and maternal outcomes were contrasted over time using longitudinal random effects regression analyses. For measures collected only at 3 years, outcomes were analyzed using multiple regressions. Compared to MWOH, MLH had less income, more informal housing and food insecurity, used alcohol more often during pregnancy, and were more depressed during pregnancy and over time. Only 4.8 % of MLH's children were seropositive; seropositive children were excluded from additional analyses. Children of MLH tended to have significantly lower weights (p rates (8.5 %) and were similar in social and behavioral adjustment, vocabulary, and executive functioning at 3 years post-birth. Despite living in households with fewer resources and having more depressed mothers, only the physical health of children of MLH is compromised, compared to children of MWOH. In township neighborhoods with extreme poverty, social, behavioral, language, and cognitive functioning appear similar over the first three years of life between children of MLH and MWOH.

  4. Births: Final Data for 1998.

    Science.gov (United States)

    Ventura, Stephanie J.; Martin, Joyce A.; Curtin, Sally C.; Matthews, T. J.; Park, Melissa M.

    2000-01-01

    This report presents 1998 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics, including: (1) age, live-birth order, race, Hispanic origin, marital status, and educational attainment; (2) maternal lifestyle and health characteristics, such as medical risk factors, weight…

  5. Prevalence of Autism in Children of Somali Origin Living in Stockholm: Brief Report of an At-Risk Population

    Science.gov (United States)

    Barnevik-Olsson, Martina; Gillberg, Christopher; Fernell, Elisabeth

    2010-01-01

    This work was a follow-up study (birth years 1999-2003) of the prevalence of autism in children of Somali background living in the county of Stockholm, Sweden. In a previous study (birth years 1988-98), the prevalence of autism associated with learning disability was found to be three to four times higher among Somali children compared with other…

  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. Maternal residential exposure to agricultural pesticides and birth defects in a 2003 to 2005 North Carolina birth cohort.

    Science.gov (United States)

    Rappazzo, Kristen M; Warren, Joshua L; Meyer, Robert E; Herring, Amy H; Sanders, Alison P; Brownstein, Naomi C; Luben, Thomas J

    2016-04-01

    Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects. We conducted a case-control study to estimate the associations between a residence-based metric of agricultural pesticide exposure and birth defects. We linked singleton live birth records for 2003 to 2005 from the North Carolina (NC) State Center for Health Statistics to data from the NC Birth Defects Monitoring Program. Included women had residence at delivery inside NC and infants with gestational ages from 20 to 44 weeks (n = 304,906). Pesticide exposure was assigned using a previously constructed metric, estimating total chemical exposure (pounds of active ingredient) based on crops within 500 meters of maternal residence, specific dates of pregnancy, and chemical application dates based on the planting/harvesting dates of each crop. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals for four categories of exposure (90(th) percentiles) compared with unexposed. Models were adjusted for maternal race, age at delivery, education, marital status, and smoking status. We observed elevated ORs for congenital heart defects and certain structural defects affecting the gastrointestinal, genitourinary and musculoskeletal systems (e.g., OR [95% confidence interval] [highest exposure vs. unexposed] for tracheal esophageal fistula/esophageal atresia = 1.98 [0.69, 5.66], and OR for atrial septal defects: 1.70 [1.34, 2.14]). Our results provide some evidence of associations between residential exposure to agricultural pesticides and several birth defects phenotypes. Birth Defects Research (Part A) 106:240-249, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. 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.

  9. Antimüllerian hormone as a predictor of live birth following assisted reproduction: an analysis of 85,062 fresh and thawed cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013.

    Science.gov (United States)

    Tal, Reshef; Seifer, David B; Wantman, Ethan; Baker, Valerie; Tal, Oded

    2018-02-01

    To determine if serum antimüllerian hormone (AMH) is associated with and/or predictive of live birth assisted reproductive technology (ART) outcomes. Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database from 2012 to 2013. Not applicable. A total of 69,336 (81.8%) fresh and 15,458 (18.2%) frozen embryo transfer (FET) cycles with AMH values. None. Live birth. A total of 85,062 out of 259,499 (32.7%) fresh and frozen-thawed autologous non-preimplantation genetic diagnosis cycles had AMH reported for cycles over this 2-year period. Of those, 70,565 cycles which had embryo transfers were included in the analysis. Serum AMH was significantly associated with live birth outcome per transfer in both fresh and FET cycles. Multiple logistic regression demonstrated that AMH is an independent predictor of live birth in fresh transfer cycles and FET cycles when controlling for age, body mass index, race, day of transfer, and number of embryos transferred. Receiver operating characteristic (ROC) curves demonstrated that the areas under the curve (AUC) for AMH as predictors of live birth in fresh cycles and thawed cycles were 0.631 and 0.540, respectively, suggesting that AMH alone is a weak independent predictor of live birth after ART. Similar ROC curves were obtained also when elective single-embryo transfer (eSET) cycles were analyzed separately in either fresh (AUC 0.655) or FET (AUC 0.533) cycles, although AMH was not found to be an independent predictor in eSET cycles. AMH is a poor independent predictor of live birth outcome in either fresh or frozen embryo transfer for both eSET and non-SET transfers. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Vital signs: Repeat births among teens - United States, 2007-2010.

    Science.gov (United States)

    2013-04-05

    Teen childbearing has potential negative health, economic, and social consequences for mother and child. Repeat teen childbearing further constrains the mother's education and employment possibilities. Rates of preterm and low birth weight are higher in teens with a repeat birth, compared with first births. To assess patterns of repeat childbearing and postpartum contraceptive use among teens, CDC analyzed natality data from the National Vital Statistics System (NVSS) and the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2007-2010. Based on 2010 NVSS data from all 50 states and the District of Columbia, of more than 367,000 births to teens aged 15-19 years, 18.3% were repeat births. The percentage of teen births that represented repeat births decreased by 6.2% between 2007 and 2010. Disparities in repeat teen births exist by race/ethnicity, with the highest percentages found among American Indian/Alaska Natives (21.6%), Hispanics (20.9%), and non-Hispanic blacks (20.4%) and lowest among non-Hispanic whites (14.8%). Wide geographic disparities in the percentage of teen births that were repeat births also exist, ranging from 22% in Texas to 10% in New Hampshire. PRAMS data from 16 reporting areas (15 states and New York City) indicate that 91.2% of teen mothers used a contraceptive method 2-6 months after giving birth, but only 22.4% of teen mothers used the most effective methods. Teens with a previous live birth were significantly more likely to use the most effective methods postpartum compared with those with no prior live birth (29.6% versus 20.9%, respectively). Non-Hispanic white and Hispanic teens were significantly more likely to use the most effective methods than non-Hispanic black teens (24.6% and 27.9% versus 14.3%, respectively). The percentage of teens reporting postpartum use of the most effective methods varied greatly geographically across the PRAMS reporting areas, ranging from 50.3% in Colorado to 7.2% in New York State. Although the

  11. Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study.

    Science.gov (United States)

    La Marca, Antonio; Grisendi, Valentina; Giulini, Simone; Sighinolfi, Giovanna; Tirelli, Alessandra; Argento, Cindy; Re, Claudia; Tagliasacchi, Daniela; Marsella, Tiziana; Sunkara, Sesh Kamal

    2015-06-01

    to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.

  12. Race, Ethnicity, Concentrated Poverty, and Low Birth Weight Disparities

    OpenAIRE

    Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

    2008-01-01

    This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in ne...

  13. Birth asphyxia in a mission hospital in Benin City, Nigeria | Onyiriuka ...

    African Journals Online (AJOL)

    Methods: In this descriptive (cross-sectional) study at St Philomena Catholic Hospital, the one-and-five-minute Apgar scores of 2,208 live-births were recorded. Those with low Apgar scores (6 at one minute) were studied and their data analyzed. Results: Birth asphyxia occurred in 83.8 per 1000 live-births with preterm and ...

  14. Is the fertile window extended in women with polycystic ovary syndrome? Utilizing the Society for Assisted Reproductive Technology registry to assess the impact of reproductive aging on live-birth rate.

    Science.gov (United States)

    Kalra, Suleena Kansal; Ratcliffe, Sarah J; Dokras, Anuja

    2013-07-01

    To assess whether women with polycystic ovary syndrome (PCOS) follow the same age-related decline in IVF outcomes as women with tubal factor infertility over the reproductive life span. PCOS is characterized by increased ovarian reserve as assessed by antral follicle counts and anti-Müllerian hormone levels. It is unclear whether these surrogate markers of ovarian reserve reflect a true lengthening of the reproductive window. Retrospective cohort. Not applicable. Women with PCOS and tubal factor infertility (42,286 cycles). IVF. Pregnancy and live-birth rates. The mean number of oocytes retrieved was higher in women with PCOS compared with in women with tubal factor (16.4 vs. 12.8; odds ratio [OR], 1.27; 95% confidence interval [CI], 1.25-1.29). The clinical pregnancy (42.5% vs. 35.8%; OR, 1.32; 95% CI, 1.27-1.38) and live-birth rates were also increased in women with PCOS (34.8% vs. 29.1%; OR, 1.30; 95% CI, 1.24-1.35). A similar rate of decline in clinical pregnancy and live-birth rates was noted in both groups (20-44 years). The implantation, clinical pregnancy, miscarriage, and live-birth rates were not significantly different for each year after age 40 in the two groups. Despite a higher oocyte yield in all age groups, women with PCOS over age 40 had similar clinical pregnancy and live-birth rates compared with women with tubal factor infertility. These findings suggest that the reproductive window may not be extended in PCOS and that patients with infertility should be treated in a timely manner despite indicators of high ovarian reserve. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. 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 

  16. FastStats: Birth Defects or Congenital Anomalies

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Birth Defects or Congenital Anomalies Recommend on Facebook Tweet ... 4,825 Infant deaths per 100,000 live births: 121.3 Cause of infant death rank: 1 ...

  17. The value of Anti-Mullerian hormone in low and extremely low ovarian reserve in relation to live birth after in vitro fertilization

    NARCIS (Netherlands)

    Reijnders, I.F.; Nelen, W.L.D.M.; Hout, J. in't; Herwaarden, A.E. van; Braat, D.D.M.; Fleischer, K.

    2016-01-01

    OBJECTIVE: To determine the relation of Anti-Mullerian hormone (AMH) with live birth after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in women with (extremely) low ovarian reserve. STUDY DESIGN: This study was a retrospective cohort study in a Dutch tertiary fertility

  18. Day 4 good morula embryo transfer provided compatible live birth rate with day 5 blastocyst embryo in fresh IVF/ET cycles.

    Science.gov (United States)

    Li, Ryh-Sheng; Hwu, Yuh-Ming; Lee, Robert Kuo-Kuang; Li, Sheng-Hsiang; Lin, Ming-Huei

    2018-02-01

    Embryo transfers during cleavage stage (day 2 or day 3) and blastocyst stages (day 5 or day 6) are common in current daily practice in fresh IVF/ET cycles. Data regarding transferring day 4 embryos, morula/compact stage, is still restricted and the grading system is also inconsistent, as between IVF clinics. This study provided a new detailed classification system for morula/compact stage embryos and compared successes rates between day 4 and day 5 ET. This was a retrospective study. A review of medical records from January 1st, 2013, to December 31st 2015, performed for all conventional insemination and ICSI cycles with a GnRH-antagonist protocol at the Infertility Division of MacKay Memorial Hospital in Taipei City, Taiwan. There were 427 cycles included in our study, 107 in study group (day 4 MET) and 320 in control group (day 5 BET). Pregnancy rates and live birth rate were compatible, as between morula embryo transfer (MET) and blastocyst embryo transfer (BET). The implantation rate (36.3% vs. 39.6%, respectively, p = 0.500), clinical pregnancy rate (49.5% vs. 51.9%, respectively, p = 0.737), and live birth rate (42.1% vs. 45.6%, respectively, p = 0.574) were statistically insignificant between groups. The term birth rate was statistically higher in the MET group than in the BET group (95.7% vs. 79.5%, respectively, p = 0.006). When the clinical outcomes between day 4 good MET and day 5 good BET were compared, the results were compatible. The implantation rate (48.8% vs. 41.1%, respectively, p = 0.335), clinical pregnancy rate (55.0% vs. 53.2%, respectively, p = 0.867), and live birth rate (47.5% vs. 47.1%, respectively, p = 1.000) showed no significant difference. The term birth rate was also higher in day 4 good MET group than in day 5 good BET group (100% vs. 78.3%, respectively, p = 0.025). In this study, we performed day 4 MET avoid BET on Sunday. The grading system we provided was more detailed for embryo selection and it was easier to

  19. 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

  20. Maternal anthropometric characteristics in pregnancy and blood pressure among adolescents: 1993 live birth cohort, Pelotas, southern Brazil

    Directory of Open Access Journals (Sweden)

    Hallal Pedro C

    2010-07-01

    Full Text Available Abstract Background We investigated the association between maternal anthropometric measurements in prepregnancy and at the end of pregnancy and their children's systolic (SBP and diastolic (DBP blood pressure at 11 years of age, in a prospective cohort study. Methods All hospital births which took place in 1993 in the city of Pelotas - Brazil, were identified (5,249 live births. In 2004, the overall proportion of follow-up was 85% and we obtained arterial blood pressure measurements of 4,452 adolescents. Results Independent variables analyzed included maternal prepregnancy weight and body mass index (BMI and maternal weight, and height at the end of pregnancy. Multiple linear regression analysis controlling for the following confounders were carried out: adolescent's skin color, family income at birth, smoking, alcohol intake during pregnancy, and gestational arterial hypertension. Mean SBP and DBP were 101.9 mmHg (SD 12.3 and 63.4 mmHg (SD 9.9, respectively. Maternal prepregnancy weight and BMI, and weight at the end of pregnancy were positively associated with both SBP and DBP in adolescent subjects of both sexes; maternal height was positively associated with SBP only among males. Conclusions Adequate evaluation of maternal anthropometric characteristics during pregnancy may prevent high levels of blood pressure among adolescent children.

  1. Exposure to Traffic-related Air Pollution During Pregnancy and Term Low Birth Weight: Estimation of Causal Associations in a Semiparametric Model

    Science.gov (United States)

    Padula, Amy M.; Mortimer, Kathleen; Hubbard, Alan; Lurmann, Frederick; Jerrett, Michael; Tager, Ira B.

    2012-01-01

    Traffic-related air pollution is recognized as an important contributor to health problems. Epidemiologic analyses suggest that prenatal exposure to traffic-related air pollutants may be associated with adverse birth outcomes; however, there is insufficient evidence to conclude that the relation is causal. The Study of Air Pollution, Genetics and Early Life Events comprises all births to women living in 4 counties in California's San Joaquin Valley during the years 2000–2006. The probability of low birth weight among full-term infants in the population was estimated using machine learning and targeted maximum likelihood estimation for each quartile of traffic exposure during pregnancy. If everyone lived near high-volume freeways (approximated as the fourth quartile of traffic density), the estimated probability of term low birth weight would be 2.27% (95% confidence interval: 2.16, 2.38) as compared with 2.02% (95% confidence interval: 1.90, 2.12) if everyone lived near smaller local roads (first quartile of traffic density). Assessment of potentially causal associations, in the absence of arbitrary model assumptions applied to the data, should result in relatively unbiased estimates. The current results support findings from previous studies that prenatal exposure to traffic-related air pollution may adversely affect birth weight among full-term infants. PMID:23045474

  2. [Evaluation of maternal parameters as risk factors for premature birth (individual and combined effects)].

    Science.gov (United States)

    Voigt, M; Briese, V; Pietzner, V; Kirchengast, S; Schneider, K T M; Straube, S; Jorch, G

    2009-08-01

    We aimed to examine the individual and combined effects of nine maternal parameters (biological, medical, and social) on rates of prematurity. Our objective was to provide obstetricians with a way of screening women for likely premature deliveries. We conducted a retrospective analysis on the data of about 2.3 million pregnancies taken from the German perinatal statistics of 1995-2000. Rates of prematurity were calculated with single and multi-dimensional analyses on the basis of nine maternal parameters (age, weight, height, number of previous live births, stillbirths, miscarriages and terminations of pregnancy, smoking status, previous premature delivery). The following combinations of parameters were investigated in particular: rates of prematurity according to the number of previous stillbirths, miscarriages, and terminations; rates of prematurity according to the number of previous live births and maternal age, height and weight. We also included daily cigarette consumption and previous premature deliveries in our analyses. The rate of prematurity (premature deliveries (32-36 weeks) was 5.9%, and the rate of very early premature deliveries (prematurity (prematurity of 27.5% in women with the following combination of parameters: > or =1 stillbirth, > or =2 terminations of pregnancy and > or =2 miscarriages. A rather high risk of premature delivery (>11%) was also found for elderly (> or =40 years) grand multiparous women as well as small (premature deliveries (>10%). The risk table that we present here may assist in predicting premature delivery. Georg Thieme Verlag KG Stuttgart.New York.

  3. Using new satellite based exposure methods to study the association between pregnancy PM₂.₅ exposure, premature birth and birth weight in Massachusetts.

    Science.gov (United States)

    Kloog, Itai; Melly, Steven J; Ridgway, William L; Coull, Brent A; Schwartz, Joel

    2012-06-18

    Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM₂.₅) levels during pregnancy in Massachusetts for a 9-year period (2000-2008). Building on a novel method we developed for predicting daily PM₂.₅ at the spatial resolution of a 10x10 km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM₂.₅ exposure and birth weight (among full term births) and PM₂.₅ exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Birth weight was negatively associated with PM₂.₅ across all tested periods. For example, a 10 μg/m³ increase of PM₂.₅ exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = -21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01-1.13) for each 10 μg/m3 increase of PM₂.₅ exposure during the entire pregnancy period. The presented study suggests that exposure to PM₂.₅ during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants.

  4. Live birth rates in the first complete IVF cycle among 20 687 women using a freeze-all strategy.

    Science.gov (United States)

    Zhu, Qianqian; Chen, Qiuju; Wang, Li; Lu, Xuefeng; Lyu, Qifeng; Wang, Yun; Kuang, Yanping

    2018-05-01

    What is the chance of having a child following one complete IVF cycle for patients using a freeze-all strategy? The chance of having a child after the first complete IVF cycle was 50.74% with the freeze-all strategy. Several studies have reported on live birth rates (LBRs) based on only the fresh embryo transfer cycle or fresh and frozen-thawed embryo transfer cycles. However, the LBR using a freeze-all strategy in IVF is unknown. This retrospective cohort study included 20 687 women who started their first IVF cycles using a freeze-all strategy during the period from 1 January 2007, through 31 March 2016, in China. Data on 20 687 women undergoing their first complete cycles using a freeze-all strategy from 2007 to 2016 were analyzed to estimate LBRs. The LBR in a complete cycle was defined as the chance of a live birth from an ovarian stimulation cycle including all subsequent frozen embryo transfers from this stimulation. The relationship between LBR and number of oocyte was explored. The LBR for the first complete cycle was 50.74% for patients using a freeze-all strategy. By age group, the LBR declined from 63.81% for women under 31 years old to 4.71% for women over 40 years old after the first complete cycle. The LBRs improved as the number of oocytes retrieved increased up to 25 in the freeze-all strategy. This was a retrospective study without a control group. Data on BMI and smoking status were not collected in this database. Our results showed that 50.74% of patients could achieve a live birth after the first complete cycle via a freeze-all strategy. In addition, the LBRs were positively correlated with the number of oocytes retrieved via the freeze-all strategy. These findings are critical for patients and clinicians in making an informed decision to embark on IVF treatment. This work was supported by grants from the National Natural Science Foundation of China (NSFC) (31770989 to Y.W.) and the Shanghai Ninth People's Hospital Foundation of China (JYLJ030

  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. Recent trends in the incidence of multiple births and its consequences on perinatal problems in Korea.

    Science.gov (United States)

    Choi, Sun Hee; Park, Young Sil; Shim, Kye Shik; Choi, Yong Sung; Chang, Ji Young; Hahn, Won Ho; Bae, Chong-Woo

    2010-08-01

    The aim of this study was to survey multiple birth data and to analyze the recent trends of multiple births and its consequences on perinatal problems in Korea from 1991 to 2008. Data were obtained from the Korean Statistical Information Service. The total number of multiple births showed increasing trends. The multiple birth rate was maintained within less than 10.0 for the decade from 1981 to 1990. However, it increased gradually to reach 27.5 in 2008. The maternal age for multiple births was higher than for total live births. The mean birth weight of the total live births was 3.23 kg; for the multiple births it was 2.40 kg in 2008. The incidence of low birth weight infants (LBWI) among total live births was 3.8% in 2000 and 4.9% in 2008. For multiple births it was 49.2% and 53.0% during the same years. The incidence of preterm births among total live births was 3.8% in 2000 and 5.5% in 2008; for the multiple births it was 38.3% and 51.5% during the same years. The incidence of multiple births and its consequences on perinatal problems (preterm, LBWI, and advanced-maternal age) have been increased steadily over the last two decades in Korea.

  7. SECULAR TRENDS AND LATITUDE GRADIENTS IN SEX RATIOS AT BIRTH IN THE FORMER SOVIET REPUBLICS

    Directory of Open Access Journals (Sweden)

    Victor Grech

    2013-01-01

    Full Text Available Background: The male-female ratio at birth (M/F: male births divided by total births, which is anticipated to approximate 0.515, has been shown to exhibit latitude gradients and secular trends. Methods: Annual national data for male and female live births for the 15 countries that comprise the former Soviet Union were obtained from the World Health Organisation for the period 1980–2009 (115,167,569 total live births and analysed with contingency tables. Spearman correlation was also carried out to compare percentage annual gross domestic product growth (GDP% – downloaded from the World Bank and M/F. In this context, GDP% is used as a measure for economic hardship or wellbeing within the populace. Results: There have been overall highly significant secular increases in M/F (p < 0.0001 in the countries and regions investigated. M/F is significantly lower in the three more northern regions (Russian Federation, Baltic States and Central Asia. M/F 0.51324, 0.51335-0.51314 than the two more southern regions (Southern Caucasus and Eastern Europe. M/F 0.51654, 0.51635-0.51672. There was a male excess of 113,818 live births.There was a significant positive correlation between GDP% and M/F for Armenia, Azerbaijan and Uzbekistan. There was a significant negative correlation in Estonia. Conclusion: Previous studies have shown that improving socioeconomic conditions increase M/F, and the converse has also been demonstrated. This is a potential influence in this geographical area since this region has relatively recently emerged from communist rule and experienced an overall economic upturn, but is only partially supported using GDP%. Another factor may be the selective termination of female pregnancies. The latitude gradient parallels that of neighbouring Europe but no theory has been put forward to convincingly explain this finding to date.

  8. Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF success.

    Science.gov (United States)

    Garrido, Nicolás; Bellver, José; Remohí, José; Simón, Carlos; Pellicer, Antonio

    2011-07-01

    To report the use of cumulative live-birth rates (CLBRs) per ovarian stimulation cycle to measure the success of IVF is proving to be the most accurate method for advising couples who failed to conceive, although the accuracy yielded is relatively low, and cycle outcome is highly dependent on the number of embryos replaced. Our aim with this work is to report the CLBRs of IVF as a function of the number of embryos required to reach a live birth (EmbR), considering age, day of ET, and infertility etiology. Survival curves and Kaplan-Meier methods to analyze CLBR in a retrospective cohort with respect to the number of EmbR. University-affiliated infertility center. Infertile couples undergoing IVF using own oocytes. None. CLBR per embryo transferred. CLBRs increase rapidly between 1 and 5 EmbR, moderately between 5 and 15, and slowly thereafter. Live-birth rates rise more slowly when embryos are transferred on days 2-3 rather than on days 5-6, with comparable long-term results. Women's age is a negative factor from 35 to 37 years old, with a dramatic decrease in live-birth rates beyond age 40 years. In addition, there are significant worse results in endometriosis patients. The relationship between CLBR and number of EmbR provides realistic and precise information regarding IVF success and can be used to guide couples and practitioners. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. The President Kennedy assassination and the male to female birth ratio.

    Science.gov (United States)

    Grech, Victor; Zammit, Dorota

    2016-12-01

    Male live births occur slightly in excess of female. This ratio is expressed as M/F. Terrorist attacks induce stress which transiently lowers M/F three to five months later due to increased male foetal losses. A previous study had shown that the assassination of President John F. Kennedy in November 1963 was associated with a significant dip in M/F in the United States for 1964 due to a dip confined to March 1964. This study was carried out in order to ascertain whether the assassination influenced M/F in the rest of the world. Annual male and female live births were obtained from a World Health Organisation Mortality database for all countries reporting. Comparisons were made between 1964, the year after the assassination, and the preceding five years (1959-1963) and following five years (1965-1969). Monthly data was only available for Malta, for the period 1958-1968. There were 159,339,564 live births (82,066,005 males, 77,273,559 females, M/F 0.5150; 95% CI 0.5150-0.5151). No dip was present for 1964 for any country, nor for the amalgamation of European countries, for the Far East, the North American continent, or for the amalgamation of the total. Data for Malta showed a significant decline in March 1964 (M/F 0.4661, p=0.0175), translating to a loss of 56 boys (estimated at 6.3/1000 births). These findings replicate the findings for the United States following the assassination of President Kennedy. The March M/F dip transiently exceeded the modern expected rate for perinatal mortality, making terrorist attacks Public Health issues. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. 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.

  11. Distinct differences in global gene expression profiles in non-implanted blastocysts and blastocysts resulting in live birth

    DEFF Research Database (Denmark)

    Kirkegaard, Kirstine Kjær; Fredsted, Palle Villesen; Jensen, Jacob Malte

    2015-01-01

    Results from animal models points towards the existence of a gene expression profile that is distinguishably different in viable embryos compared with non-viable embryos. Knowledge of human embryo transcripts is however limited, in particular with regard to how gene expression is related...... to clinical outcome. The purpose of the present study was therefore to determine the global gene expression profiles of human blastocysts. Next Generation Sequencing was used to identify genes that were differentially expressed in non-implanted embryos and embryos resulting in live birth. Three trophectoderm...

  12. 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...

  13. Live birth of twins after IVF of oocytes that were cryopreserved almost 12 years before.

    Science.gov (United States)

    Quintans, Carlos J; Donaldson, Monica J; Urquiza, M Fernanda; Carretero, Inés; Pasqualini, R Agustín; Horton, Marcos; Pasqualini, R Sergio

    2012-12-01

    A 45-year-old woman received embryos from IVF by intracytoplasmic sperm injection (ICSI) with her own oocytes that were cryopreserved (slow freezing in a low-sodium medium) 11 years and 7 and a half months before, when she was 33 years old. From seven metaphase-II oocytes thawed, five survived, four were fertilized after ICSI and two cleaving embryos were transferred on day 3. A diamniotic dichorionic term pregnancy was achieved, ending with the delivery of two healthy girls. As far as is known, this case represents, to date, the longest storage period of cryopreserved human oocytes resulting in a live birth. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Pregnant Women's Infant Oral Health Knowledge and Beliefs: Influence of Having Given Birth and of Having a Child in the Home.

    Science.gov (United States)

    Baker, Suzanne D; Quiñonez, Rocio B; Boggess, Kim; Phillips, Ceib

    2016-06-01

    Introduction Prenatal oral health interventions can positively impact maternal and child oral health, yet limited information exists concerning how to best educate pregnant women about infant oral health. Our objective was to examine the influence of having given birth on pregnant women's infant oral health knowledge and beliefs. Methods We conducted a secondary analysis of data collected from a cross-sectional survey of pregnant women ≥18 years old attending UNC's Ultrasound Clinic. Four binomial items were categorized as infant knowledge (IK) and five rated on a Likert scale (1-5) as infant belief (IB). Overall IK and IB scores were calculated, averaging the items within each construct. Respondents were categorized into two groups: multiparous (N = 268), women having at least one previous live birth and a child between 2 and 6 years old, or nulliparous (N = 186), women with no previous live births or a child between 2 and 6 years old. Regression models for IK and IB were conducted using SAS 9.2 with maternal demographic characteristics, dental utilization, and birth history as explanatory variables (p ≤ 0.05). Results IK was affected by race (p = 0.04), mother's oral health self-rating (p = 0.0002), and birth history (p birth, adjusting for explanatory variables. IB was influenced by maternal oral health beliefs (p = 0.002) and history of access to dental care (p = 0.0002). IB did not differ based on birth history (p = 0.17). Discussion The influence of birth history on pregnant women's infant oral health knowledge and beliefs can be considered in future intervention designs to maximize available resources.

  15. THE LIVED EXPERIENCES OF BLACK AFRICAN MOTHERS FOLLOWING THE BIRTH OF A CHILD WITH DOWN SYNDROME: IMPLICATIONS FOR INDIGENISATION OF SOCIAL WORK

    Directory of Open Access Journals (Sweden)

    Mathebane, Mbazima

    2016-08-01

    Full Text Available The article discusses the lived experiences of black African mothers following the birth of a child with Down syndrome and implications of this for the indigenisation of social work practice in South Africa. A retrospective qualitative study following a phenomenological design was undertaken. Findings indicated that giving birth to a child with Down syndrome evokes intense psychological and social reactions from the mother, family and community. The cultural norms and values of black African people, including principles of ubuntu and their belief in collectivism, provide important opportunities, support systems and resources that could be pooled for efficient and effective helping intervention.

  16. Birth interval and its predictors among married women in Dabat ...

    African Journals Online (AJOL)

    2008-12-30

    Birth intervals (time between two successive live births) if short are associated with diverse complications. We assessed birth interval and its predictors among 613 married women who gave birth from January 1 to December 30, 2008. Data were collected in April 2012. Life table and Kaplan-Meier curve were used to ...

  17. Open Adoption Placement by Birth Mothers in Their Twenties.

    Science.gov (United States)

    Clutter, Lynn B

    The purpose of this study was to summarize birth mothers' descriptions of unplanned pregnancy experienced in their twenties and how open adoption influenced their lives. Naturalistic inquiry was used with purposive sampling from one agency and telephone interviews of women who experienced unplanned pregnancy in their twenties and relinquishment through open adoption. Recorded, transcribed, and deidentified interviews were analyzed for qualitative themes. Fifteen participants judiciously weighed the open adoption decision. Over half parented other children prior to placement. Most knew they could not have parented this child due to life stressors. Placement was a hard decision, but ongoing contact with birth child and adoptive family was valued. Open adoption processes made them stronger by being happy that their child experienced family life with greater opportunities than birth mothers could offer at the time. Summarized themes used the acronym COMMITTED: C-care deeply about what is best for the child, O-ongoing open adoption: good and hard, M-meeting together regularly, M-moving on in personal growth, accomplishments, and milestones, I-independence from previous stressors or crises, T-transitions, T-therapeutic support, E-emotions, D-depression giving way to deepened strength and personal direction. Open adoption is reinforced as a positive resolution of unintended pregnancy for birth mothers in their twenties.

  18. 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.

  19. Perinatal and infant mortality rates and place of birth in Italy, 1980.

    Science.gov (United States)

    Parazzini, F; La Vecchia, C

    1988-06-01

    In 1980, the ratio of home birth to public hospital perinatal and neonatal mortality rates decreased from Northern to Southern Italy, being inversely related to the proportion of home deliveries and probably reflecting the effect of planned versus unplanned home births. The post neonatal mortality rate in Southern Italy was about four times as high in children born at home (9.5/1,000 live births) than in those delivered in public hospitals (2.6/1,000 live births), probably reflecting differences in the socioeconomic status according to the birthplace selection in various regions.

  20. Association of light-to-moderate alcohol drinking in pregnancy with preterm birth and birth weight

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Katrine; Poulsen, Gry; Bech, Bodil Hammer

    2017-01-01

    Women who drink light-to-moderately during pregnancy have been observed to have lower risk of unfavourable pregnancy outcomes than abstainers. This has been suggested to be a result of bias. In a pooled sample, including 193 747 live-born singletons from nine European cohorts, we examined...... alcohol. This decreased to 39% in 2000–2004, and 14% in 2005–2011. Before 2000, every additional drink was associated with reduced mean birth weight, whereas in 2005–2011, the mean birth weight increased with increasing intake. The period-specific associations between low-to-moderate drinking and birth...

  1. Risk factors for maternal anaemia and low birth weight in pregnant women living in rural India: a prospective cohort study.

    Science.gov (United States)

    Ahankari, A S; Myles, P R; Dixit, J V; Tata, L J; Fogarty, A W

    2017-10-01

    The aim of this prospective study was to estimate the prevalence and risk factors for maternal anaemia and low birth weight (LBW) in pregnant women living in Maharashtra state, India. This is a prospective study. Women between 3 and 5 months of pregnancy were recruited from 34 villages based in Maharashtra state. Baseline data collection, anthropometric measurements and blood investigations were performed. Participants were followed-up to record birth weight. In total, 303 women were eligible, and 287 (95%) provided data. 77% were anaemic, defined as haemoglobin less than 11.0 g/dl at the time of recruitment, with a mean corpuscular volume of 80.5 fl/cell (standard deviation: 7.22, range: 53.4-93.8). The increased risk of anaemia was seen in women with consanguineous marriages (odds ratio [OR]: 2.41, 95% confidence interval [CI]: 1.16-5.01, P = 0.01) after adjustment for potential confounding factors. Postdelivery data from full-term singleton live births demonstrated a 7% prevalence of LBW. Consanguineous marriage was a major risk factor for LBW (OR: 4.10, 95% CI: 1.25-13.41, P = 0.02). The presence of maternal anaemia during 3-5 months of pregnancy was associated with lower risk of LBW (unadjusted OR: 0.34, 95% CI: 0.13-0.92, P = 0.03). About 30% of our study participants were in a consanguineous marriage, which was identified as a potentially avoidable risk factor for both anaemia and LBW. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. Factors associated with low birth weight in Goiás State

    Directory of Open Access Journals (Sweden)

    Ruth Minamisava

    2006-12-01

    Full Text Available ABSTRACT: Low birth weight (LBW is public health problem, because they are associated with increased risk of morbidity and mortality. No previous studies on factors associated with LBW carried out in central Brazil were found in the literature. The main aims of this study were to determine the prevalence and the factors associated with LBW in children born alive in the State of Goiás, Brazil. A cross-sectional analysis was performed using data from the Live Births Information System from the Brazilian Health Ministry. All 92.745 singleton births in the State of Goiás during the year of 2000 were examined. Logistic regression analysis was used to examine the factors associated with LBW (< 2500 g. In Goiás, the prevalence of LBW was 5.96% and the most important factors associated with LBW were: prematurity, young and older mothers, unmarried women, mother illiteracy, mothers who had less than seven prenatal care visits, non-hospital delivery, and female infants. Local public health actions are necessary to reduce inequalities in infant and maternal care. KEYWORDS: newborn, birth weight, prenatal care.

  3. Drug Improves Birth Rates for Women with Ovary Disorder

    Science.gov (United States)

    ... NIH Research Matters July 21, 2014 Drug Improves Birth Rates for Women with Ovary Disorder At a ... more effective than standard therapy in increasing live births for women with polycystic ovary syndrome. Letrozole could ...

  4. Decreased live births among women of Middle Eastern/North African ethnicity compared to Caucasian women.

    Science.gov (United States)

    Salem, W H; Abdullah, A; Abuzeid, O; Bendikson, K; Sharara, F I; Abuzeid, M

    2017-05-01

    The objective of this study is to determine if IVF outcome disparities exist among MENA women in the USA in comparison to a control group of Caucasian women. A retrospective cohort study comparing MENA (N = 190) and Caucasian (N = 200) women undergoing their first IVF cycle between 5/2006 and 5/2014 was carried out at an academically affiliated fertility practice. All MENA cycles during that time period undergoing IVF/ICSI using autologous embryos and blastocyst transfers were compared to a control group of Caucasian women. MENA women were significantly younger (32.9 vs 34.5, P Middle Eastern/North African women have worse IVF outcomes with decreased live birth rates per blastocyst transfer and increased miscarriage rates compared to Caucasian women.

  5. THE ENIGMA OF ETHIOPIAN SEX RATIOS AT BIRTH.

    Science.gov (United States)

    Garenne, Michel

    2017-09-01

    This study analysed sex ratios at birth (defined as the number of male births per 100 female births) using data on children ever-born from three censuses conducted in Ethiopia in 1984, 1994 and 2007. The results showed very high values by any standard, with an average of 108.4 for a sample of some 8.2 million births, with somewhat lower values in urban areas. Analysis of socioeconomic correlates revealed that the sex ratio varied very much by household wealth, from about 110 for very poor women to about 102 for wealthier women. The high value of the sex ratio at birth in Ethiopia could be explained by poverty, used as a proxy for poor nutritional status. In multivariate analysis, the effects of living in urban areas and of maternal education were less important than household wealth. Among the many ethno-linguistic groups, the Nilotic family had higher sex ratios than other groups. The results were confirmed using data from DHS surveys conducted in the country, and by the analysis of children still living at time of census.

  6. Does local endometrial injury in the nontransfer cycle improve the IVF-ET outcome in the subsequent cycle in patients with previous unsuccessful IVF? A randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Sachin A Narvekar

    2010-01-01

    Full Text Available Background: Management of repeated implantation failure despite transfer of good-quality embryos still remains a dilemma for ART specialists. Scrapping of endometrium in the nontransfer cycle has been shown to improve the pregnancy rate in the subsequent IVF/ET cycle in recent studies. Aim: The objective of this randomized controlled trial (RCT was to determine whether endometrial injury caused by Pipelle sampling in the nontransfer cycle could improve the probability of pregnancy in the subsequent IVF cycle in patients who had previous failed IVF outcome. Setting: Tertiary assisted conception center. Design: Randomized controlled study. Materials and Methods: 100 eligible patients with previous failed IVF despite transfer of good-quality embryos were randomly allocated to the intervention group and control groups. In the intervention group, Pipelle endometrial sampling was done twice: One in the follicular phase and again in the luteal phase in the cycle preceding the embryo transfer cycle. Outcome Measure: The primary outcome measure was live birth rate. The secondary outcome measures were implantation and clinical pregnancy rates. Results: The live birth rate was significantly higher in the intervention group compared to control group (22.4% and 9.8% P = 0.04. The clinical pregnancy rate in the intervention group was 32.7%, while that in the control group was 13.7%, which was also statistically significant ( P = 0.01. The implantation rate was significantly higher in the intervention group as compared to controls (13.07% vs 7.1% P = 0.04. Conclusions: Endometrial injury in nontransfer cycle improves the live birth rate,clinical pregnancy and implantation rates in the subsequent IVF-ET cycle in patients with previous unsuccessful IVF cycles.

  7. Using new satellite based exposure methods to study the association between pregnancy pm2.5 exposure, premature birth and birth weight in Massachusetts

    Science.gov (United States)

    2012-01-01

    Background Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. Methods We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM2.5) levels during pregnancy in Massachusetts for a 9-year period (2000–2008). Building on a novel method we developed for predicting daily PM2.5 at the spatial resolution of a 10x10km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM2.5 exposure and birth weight (among full term births) and PM2.5 exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Results Birth weight was negatively associated with PM2.5 across all tested periods. For example, a 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = −21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01–1.13) for each 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy period. Conclusions The presented study suggests that exposure to PM2.5 during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants. PMID:22709681

  8. Using new satellite based exposure methods to study the association between pregnancy pm2.5 exposure, premature birth and birth weight in Massachusetts

    Directory of Open Access Journals (Sweden)

    Kloog Itai

    2012-06-01

    Full Text Available Abstract Background Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. Methods We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM2.5 levels during pregnancy in Massachusetts for a 9-year period (2000–2008. Building on a novel method we developed for predicting daily PM2.5 at the spatial resolution of a 10x10km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM2.5 exposure and birth weight (among full term births and PM2.5 exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Results Birth weight was negatively associated with PM2.5 across all tested periods. For example, a 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI = −21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI = 1.01–1.13 for each 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy period. Conclusions The presented study suggests that exposure to PM2.5 during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in

  9. Single blastocyst transfer: The key to reduce multiple pregnancy rates without compromising the live birth rate

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    Uma M Sundhararaj

    2017-01-01

    Full Text Available Background: Historically, to achieve higher pregnancy rates, multiple embryos were transferred after an in-vitro fertilisation (IVF. However, this practice is being reassessed, because it leads to multiple pregnancies that is known to cause adverse maternal and fetal outcomes. Aim: To compare the pregnancy outcomes in fresh IVF or intracytoplasmic sperm injection (ICSI cycles among women undergoing elective single blastocyst transfer (eSBT vs. those undergoing double blastocyst transfer (DBT. Settings and Design: It is a retrospective data analysis of 582 patients undergoing fresh IVF/ICSI cycles performed from January 2012 to June 2015. Materials and Methods: Patients, who underwent IVF/ICSI and developed more than one blastocyst, were included in the study. Donor cycles were excluded from the study. All the embryos were cultured to blastocyst stage in sequential media followed by transfer of two blastocysts (DBT or eSBT and cryopreservation of the remaining. Statistical Analysis: Statistical analysis was performed using chi square test. Results: Out of 582 patients, in 149 patients one blastocyst was transferred and in 433 patients two blastocysts were transferred. There was no statistical difference in the biochemical pregnancy rate, clinical pregnancy rate and live birth rate in both the groups. Statistics demonstrated a significant drop in miscarriage rate in eSBT group. There was no incidence of twins in eSBT group, whereas twin birth rate per clinical pregnancy was 29.02% in DBT group. Conclusion: Single blastocyst transfer is an effective method to reduce the risk of multiple births without compromising the pregnancy outcomes. Given the promising potential of vitrification; the remaining blastocyst can be cryopreserved.

  10. International variations in the gestational age distribution of births

    DEFF Research Database (Denmark)

    Delnord, Marie; Mortensen, Laust; Hindori-mohangoo, Ashna D.

    2018-01-01

    -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. Results: 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 correlated overall (adjusted-r = 0.55, P

  11. 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.

  12. Low Birth Weight And Maternal Risk Factors

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    Secma Nigam

    2003-06-01

    Full Text Available Objectives : To study tile socio-economic and maternal risk factors associated with low birth weight babies and to measure the strength of association. Study Design : Hospital based case-control study. Setting : Shri Sayajirao General Hospital, Vadodara. Sample size : 312 cases and 312 controls. Participants : Cases Mothers who delivered single, live baby less than 2500 gms i.e. low birth weight. Controls:- Mothers who delivered single live baby more than 2500 gms. Study Variable : Maternal age, literacy, anaemia, outcome of last pregnancy. Statistical Analysis : Chi-square test and odd’s ratio. Result : Among cases, 14.5% mothers had age less titan 20 yrs as compared to 7.3% mothers in control group. 68.6% mothers amongst cases were illiterate against 46.5% mothers in control group. 53.8% mothers had haemoglobin level 10gm% or less amongst cases and no statistically significant difference was found between low birth weight and outcome of last pregnancy Conclusion : The maternal risk factors associated with low birth weight in mothers attending S.S.G. hospital age maternal anaemia (OR 2.66, illiteracy (OR 2.51, maternal age less than 20 yrs. (OR 2.OS. No association was found between low birth rate and outcome of last pregnancy

  13. In vitro fertilization outcome in women with endometriosis & previous ovarian surgery

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    Sonja Pop-Trajkovic

    2014-01-01

    Full Text Available Background & objectives: Women with endometriosis often need in vitro fertilization (IVF to concieve. There are conflicting data on the results of IVF in patients with endometriosis. This study was undertaken to elucidate the influence of endometriosis on IVF outcome to give the best counselling for infertile patient with this problem. Methods: The outcome measures in 78 patients with surgically confirmed endometriosis were compared with 157 patients with tubal factor infertility, all of whom have undergone IVF. The groups were matched for age and follicle stimulating hormone (FSH levels. Outcome measures included number of follicles, number of ocytes, peak oestradiol (E2 concentrations and mean number of ampoules of gonadotropins. Cumulative pregnancy, miscarriage and live birth rates were calculated in both the groups. Results: Higher cancelation rates, higher total gonadotropin requirements, lower peak E2 levels and lower oocyte yield were found in women with endometriosis and previous surgery compared with those with tubal factor infertility. However, no differences were found in fertilization, implantation, pregnancy, miscarriage, multiple births and delivery rates between the endometriosis and tubal factor infertility groups. Interpretation & conclusions: The present findings showed that women with endometriosis and previous surgery responded less well to gonadotropins during ovarian stimulation and hence the cost of treatment to achieve pregnancy was higher in this group compared with those with tubal factor infertility. However, the outcome of IVF treatment in patients with endometriosis was as good as in women with tubal factor infertility.

  14. Elevated serum estradiol levels in artificial autologous frozen embryo transfer cycles negatively impact ongoing pregnancy and live birth rates.

    Science.gov (United States)

    Fritz, Rani; Jindal, Sangita; Feil, Heather; Buyuk, Erkan

    2017-12-01

    The aim of this study is to evaluate the correlation between serum estradiol (E 2 ) levels during artificial autologous frozen embryo transfer (FET) cycles and ongoing pregnancy/live birth rates (OP/LB). A historical cohort study was conducted in an academic setting in order to correlate peak and average estradiol levels with ongoing pregnancy/live birth rates for all autologous artificial frozen embryo transfer cycles performed from 1/2011 to 12/2014. Average and peak E 2 levels from 110 autologous artificial FET cycles from 95 patients were analyzed. Average E 2 levels were significantly lower in cycles resulting in OP/LB compared to those that did not (234.1 ± 16.6 pg/ml vs. 315 ± 24.8 pg/ml, respectively, p = 0.04). Although peak E 2 levels were not significantly different between cycles resulting in OP/LB compared with those that did not (366.9 ± 27.7 pg/ml vs. 459.1 ± 32.3 pg/ml, respectively, p = 0.19), correlation analysis revealed a statistically significant (p = 0.02) downward trend in OP/LB rates with increasing peak E 2 levels. This study suggests that elevated E 2 levels in artificial autologous FET cycles are associated with lower OP/LB rates. Estradiol levels should be monitored during artificial FET cycles.

  15. 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.

  16. Birth order and mortality in two ethno-linguistic groups: Register-based evidence from Finland.

    Science.gov (United States)

    Saarela, Jan; Cederström, Agneta; Rostila, Mikael

    2016-06-01

    Previous research has documented an association between birth order and suicide, although no study has examined whether it depends on the cultural context. Our aim was to study the association between birth order and cause-specific mortality in Finland, and whether it varies by ethno-linguistic affiliation. We used data from the Finnish population register, representing a 5% random sample of all Finnish speakers and a 20% random sample of Swedish speakers, who lived in Finland in any year 1987-2011. For each person, there was a link to all children who were alive in 1987. In total, there were 254,059 siblings in 96,387 sibling groups, and 9797 deaths. We used Cox regressions stratified by each siblings group and estimated all-cause and cause-specific mortality risks during the period 1987-2011. In line with previous research from Sweden, deaths from suicide were significantly associated with birth order. As compared to first-born, second-born had a suicide risk of 1.27, third-born of 1.35, and fourth- or higher-born of 1.72, while other causes of death did not display an evident and consistent birth-order pattern. Results for the Finnish-speaking siblings groups were almost identical to those based on both ethno-linguistic groups. In the Swedish-speaking siblings groups, there was no increase in the suicide risk by birth order, but a statistically not significant tendency towards an association with other external causes of death and deaths from cardiovascular diseases. Our findings provided evidence for an association between birth order and suicide among Finnish speakers in Finland, while no such association was found for Swedish speakers, suggesting that the birth order effect might depend on the cultural context. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. 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.

  18. Perfil dos nascidos vivos no Município de Belo Horizonte, 1992-1994 Profile of live births in Belo Horizonte, 1992-1994

    Directory of Open Access Journals (Sweden)

    Celeste de Souza Rodrigues

    1997-01-01

    Full Text Available O Sistema de Informações sobre Nascidos Vivos ­ Sinasc ­ foi desenvolvido pelo Ministério da Saúde, objetivando a melhoria da qualidade das informações sobre estas crianças, no Brasil, e vem sendo usado no Município de Belo Horizonte, efetivamente, desde 1992. Com o objetivo de caracterizar as crianças nascidas vivas e permitir a utilização dos dados para subsidiar o planejamento, organização e avaliação de ações de saúde desenvolvidas, foi analisada a distribuição destas, através de todas as Declarações de Nascidos Vivos ­ DN, de mães residentes em Belo Horizonte, 1992/94, segundo características relativas ao parto,à gravidez e à mãe. Concluiu-se haver necessidade de estudos que aprofundem a análise da morbi-mortalidade materna e infantil e os custos das internações por partos operatórios, por uma atenção especial às adolescentes, além de acompanhamento pré-natal de boa qualidade para todas as gestantes. O Sinasc é um instrumento poderoso de informações rotineiras, devendo ser aprimorado e o seu uso difundido, incluindo a possibilidade não só de cruzamento de dados com os de outros sistemas, especialmente o SIM (Sistema de Informação sobre Mortalidade e o banco de dados de AIH (Autorização para Internação Hospitalar, como também de sua utilização para intervenções específicas e diferenciadas em determinados grupos populacionais e microáreas de risco.The Information System on Live Births - SINASC - was developed by the Health Ministry and designed to improve quality of information on live births in Brazil. It has been effectively used in Belo Horizonte since 1992. The distribution of live births was analysed in order to characterise them and to allow use of existing data to support planning, organisation and evaluation of the health activities developed. It was conducted by using Declarations of Live Births of newborns of mothers resident in Belo Horizonte, in the period 1992-1994, in

  19. Race, ethnicity, concentrated poverty, and low birth weight disparities.

    Science.gov (United States)

    Sims, Mario; Sims, Tammy L; Bruce, Marino A

    2008-07-01

    This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group.

  20. 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.

  1. 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.

  2. The close relation between birth, abortion and employment rates in Sweden from 1980 to 2004.

    Science.gov (United States)

    Rahmqvist, Mikael

    2006-09-01

    Birth and abortion rates in Sweden have fluctuated since 1980 while the proportion between the rates are the same at the beginning and end of the period. An increase in birth rates in the late 1980s resulted in a peak in 1991 and 1992, with 124,000 live births each year. Thereafter followed a steady decline in the rate until 2000, when the number of live births was about 90,000. At that point, the trend changed to an increase. The aim of this analysis was to investigate any relation between employment rates and the number of live births among women aged 20-34, and at the same time to explore the trend for abortion rates compared to the trend for live births. The relation between employment status and live birth rate is statistically more significant for women than men, and the rates have a higher correlation for the period after 1986. Young adults in this age group are vulnerable to economic cycles that can explain this covariation but the decline in birth rates in economically developed societies has multidimensional aspects and many other possible explanations. Much has been done in recent years in Sweden to decrease household inequality for families with children to avoid the risk of relative poverty, but the fact that there is no explicit health policy to reduce the abortion level that remain unchanged since the early 1980s may appear as a notable lack of strategy in a country with many other health-related goals.

  3. 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).

  4. Birth spacing, sibling rivalry and child mortality in India.

    Science.gov (United States)

    Whitworth, Alison; Stephenson, Rob

    2002-12-01

    The detrimental impact of short preceding birth intervals on infant and early childhood mortality is well documented in demographic literature, although the pathways of influence within the relationship remain an area of debate. This paper examines the impact of the length of the preceding birth interval on under-two mortality in India, and examines the pathways through which short preceding birth intervals may lead to an increased risk of mortality. Three mortality periods are examined: neonatal, early post neonatal and late post-neonatal and toddler, using the 1992 Indian National Family Health Survey. A multilevel modelling approach is used to account for the hierarchical nature of the data. The determinants of infants following a short or long birth interval are also examined. The results show that short preceding birth intervals (sibling rivalry is a pathway through which short birth intervals influence mortality, with the death of the previous sibling removing the competition for scarce resources, and resulting in lower risks of mortality than if the previous sibling was still alive. The greatest risks of an infant following a short birth interval are among those whose previous sibling died, high parities, those with young mothers, and those whose previous sibling was breastfed for a short duration. Copyright 2002 Elsevier Science Ltd.

  5. Perceptions of giving birth and adherence to cultural practices in Chinese women.

    Science.gov (United States)

    Callister, Lynn Clark; Eads, Megan Nicole; Yeung Diehl, Jenny Pui See

    2011-01-01

    To compare the childbirth experiences of Chinese women living in varied sociocultural contexts. Qualitative study of 34 Chinese women who had given birth in their country of origin (the People's Republic of China [PRC] or Taiwan) and Chinese women who immigrated to the United States. This research provides insights into the perspectives of mothers living in varied sociocultural contexts. Themes included expecting a child and defining birth expectations, experiencing giving birth, adhering to cultural beliefs and practices, and framing birth within sociocultural context. There are cultural beliefs and practices associated with giving birth in all cultures, and because there is such rich cultural diversity in the United States, it is important for nurses caring for childbearing women to understand Chinese cultural beliefs and practices in order to provide culturally competent care.

  6. 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.

  7. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Science.gov (United States)

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  8. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Leal

    Full Text Available A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk.This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services.Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8% when compared to the ones receiving public services (rate of 2.4%, regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6 for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3 for women of high obstetric risk.The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  9. The Great Recession of 2007 in the United States and the male: female ratio at birth

    OpenAIRE

    Grech, Victor

    2015-01-01

    OBJECTIVE: Male live births slightly exceed female live births by approximately 3%. The ratio of male to total live births is conventionally represented as M/F. Many factors have been shown to affect M/F, mainly privation, toxins, and stress, all of which reduce M/F. Population stress may be engendered by natural phenomena such as earthquakes and man-made events such as short wars, terrorist attacks, and contracting economies. This study was conducted to ascertain whether the onset of the "Gr...

  10. VBAC Scoring: Successful vaginal delivery in previous one caesarean section in induced labour

    International Nuclear Information System (INIS)

    Raja, J.F.; Bangash, K.T.; Mahmud, G.

    2013-01-01

    Objective: To develop a scoring system for the prediction of successful vaginal birth after caesarean section, following induction of labour with intra-vaginal E2 gel (Glandin). Methods: The cross-sectional study was conducted from January 2010 to August 2011, at the Pakistan Institute of Medical Sciences in Islamabad. Trial of labour in previous one caesarean section, undergoing induction with intra-vaginal E2 gel, was attempted in 100 women. They were scored according to six variables; maternal age; gestation; indications of previous caesarean; history of vaginal birth either before or after the previous caesarean; Bishop score and body mass index. Multivariate and univariate logistic regression analysis was used to develop the scoring system. Results: Of the total, 67 (67%) women delivered vaginally, while 33 (33%) ended in repeat caesarean delivery. Among the subjects, 55 (55%) women had no history of vaginal delivery either before or after previous caesarean section; 15 (15%) had history of vaginal births both before and after the previous caesarean; while 30 (30%) had vaginal delivery only after the previous caesarean section. Rates of successful vaginal birth after caesarean increased from 38% in women having a score of 0-3 to 58% in patients scoring 4-6. Among those having a score of 7-9 and 10-12, the success rates were 71% and 86% respectively. Conclusion: Increasing scores correlated with the increasing probability of vaginal birth after caesarean undergoing induction of labour. The admission VBAC scoring system is useful in counselling women with previous caesarean for the option of induction of labour or repeat caesarean delivery. (author)

  11. Reference birthweight range for multiple birth neonates in Japan

    Directory of Open Access Journals (Sweden)

    Kato Noriko

    2004-02-01

    Full Text Available Abstract Background A reference range for the birthweight of multiple births neonates is necessary for the assessment for intrauterine growth. Methods Pairs of multiple births were identified by birthplace, the ages of the parents, gestational age, and the year and month of birth. We studied a total of 32,232 livebirth-livebirth pairs of twins, 1894 triplet live births, and 206 quadruplet live births. Results The median birthweight of males, taking gestational age into account, was ca. 0.05 kg–0.1 kg heavier than that of females. Compared to singleton neonates, the median birthweight of twins was ca. 0.15 kg smaller at the gestational age of 34 weeks, increasing to ca. 0.5 kg at 42 weeks of gestation. As for birth order, the mean birthweight of the first-born twin was heavier than that of the second-born. The standard deviation of birthweight was larger for second-born twins. The birthweight of twins from multiparous mothers was greater than those from primiparous mothers. The median birthweight according to gestational age was found to be the greatest in twins, lower in triplets and the lowest in quadruplets. In triplets, the 50th percentile was 0.08 kg heavier in boys than for girls. Conclusion Our results can be used for assessment of birthweight of multiple births in Japan.

  12. Births: Final Data for 1999. National Vital Statistics Reports, Volume 49, Number 1.

    Science.gov (United States)

    Ventura, Stephanie J.; Martin, Joyce A.; Curtin, Sally C.; Menacker, Fay; Hamilton, Brady E.

    This report presents data on U.S. births using information from the birth certificates of the 3.96 million births in 1999. Data are presented for maternal demographics (age, live-birth order, race, Hispanic origin, marital status, and educational attainment); maternal characteristics (medical risk factors, weight gain, tobacco use, and alcohol…

  13. Periodicity and time trends in the prevalence of total births and conceptions with congenital malformations among Jews and Muslims in Israel, 1999-2006: a time series study of 823,966 births.

    Science.gov (United States)

    Agay-Shay, Keren; Friger, Michael; Linn, Shai; Peled, Ammatzia; Amitai, Yona; Peretz, Chava

    2012-06-01

    BACKGROUND Congenital malformations (CMs) are a leading cause of infant disability. Geophysical patterns such as 2-year, yearly, half-year, 3-month, and lunar cycles regulate much of the temporal biology of all life on Earth and may affect birth and birth outcomes in humans. Therefore, the aim of this study was to evaluate and compare trends and periodicity in total births and CM conceptions in two Israeli populations. METHODS Poisson nonlinear models (polynomial) were applied to study and compare trends and geophysical periodicity cycles of weekly births and weekly prevalence rate of CM (CMPR), in a time-series design of conception date within and between Jews and Muslims. The population included all live births and stillbirths (n = 823,966) and CM (three anatomic systems, eight CM groups [n = 2193]) in Israel during 2000 to 2006. Data were obtained from the Ministry of Health. RESULTS We describe the trend and periodicity cycles for total birth conceptions. Of eight groups of CM, periodicity cycles were statistically significant in four CM groups for either Jews or Muslims. Lunar month and biennial periodicity cycles not previously investigated in the literature were found to be statistically significant. Biennial cycle was significant in total births (Jews and Muslims) and syndactyly (Muslims), whereas lunar month cycle was significant in total births (Muslims) and atresia of small intestine (Jews). CONCLUSION We encourage others to use the method we describe as an important tool to investigate the effects of different geophysical cycles on human health and pregnancy outcomes, especially CM, and to compare between populations. Copyright © 2012 Wiley Periodicals, Inc.

  14. Previous treatment, sputum-smear nonconversion, and suburban living: The risk factors of multidrugresistant tuberculosis among Malaysians

    Directory of Open Access Journals (Sweden)

    Noorsuzana Mohd Shariff

    2016-01-01

    Full Text Available The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese (odds ratio 3.17, 95% confidence interval 1.04–9.68; and odds ratio 6.23, 95% confidence interval 2.24–17.35, respectively, unmarried (odds ratio 2.58, 95% confidence interval 1.09–6.09, living in suburban areas (odds ratio 2.58, 95% confidence interval 1.08–6.19, are noncompliant (odds ratio 4.50, 95% confidence interval 1.71–11.82, were treated previously (odds ratio 8.91, 95% confidence interval 3.66–21.67, and showed positive sputum smears at the 2nd (odds ratio 7.00, 95% confidence interval 2.46–19.89 and 6th months of treatment (odds ratio 17.96, 95% confidence interval 3.51–91.99. Living in suburban areas, positive sputum smears in the 2nd month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment

  15. Avaliação de preditores do óbito neonatal em uma série histórica de nascidos vivos no Nordeste brasileiro An evaluation of the predictors of neonatal death in a time series of live births in the Northeast Region of Brazil

    Directory of Open Access Journals (Sweden)

    Lygia Carmen de Moraes Vanderlei

    2010-12-01

    Full Text Available OBJETIVOS: avaliar tendência dos preditores do óbito neonatal entre os nascidos vivos e qualidade do preenchimento do Sistema de Informações para Nascidos Vivos (Sinasc institucional. MÉTODOS: série histórica do Sinasc do Instituto de Medicina Integral Prof. Fernando Figueira (1995-2006 em Recife, Pernambuco, Brasil. Foram avaliadas: completitude de preenchimento das variáveis e tendência dos indicadores de risco para mortalidade infantil (baixo peso ao nascer; anóxia; prematuridade; cesariana; ausência de pré-natal; mãe adolescente; analfabetismo e nenhum filho nascido vivo e morto. Significância estatística para teste t de Student foi de 5% em um modelo de regressão linear. RESULTADOS: 58.689 nascidos vivos com contínuo incremento a partir de 2002; baixo peso ao nascer, 22,8%; Apgar OBJECTVES: to evaluate predictors of neonatal death among live births and the quality of use of the institutional Live Birth Information System register (Sinasc. METHODS: a time serie based on data from the Sinasc of the Instituto de Medicina Integral Prof. Fernando Figueira (1995-2006 in the city Recife, Pernambuco, Brazil. The following were evaluated: the completeness of the forms and the tendency regarding risk factors for infant mortality (low birth weight; anoxia; premature birth; caesarian birth; lack of prenatal care; adolescent pregnancy; illiteracy; and having had no live or still born child. Statistical significance was tested using Student's t test with p<0.05 in a linear regression model. RESULTS: 58,689 live births occurred with a continued rise from 2002 onwards; low birth weight, 22.8%; Apgar <7 1º minute 15.3%; premature 22.4%; Caesarian birth 38,2%; adolescent mothers 27.2%; illiteracy 2.7% and 89% with no live or still born child. One percent of variables were not recorded. The following variables increased (p<0.05: Apgar in the 1st minute, low birth weight, premature birth and caesarian birth; and the following decreased (p<0

  16. Utilitarian population ethics and births timing

    OpenAIRE

    Ponthière, Grégory

    2015-01-01

    Births postponement is a key demographic trend of the last decades. To examine its social desirability, we study how utilitarian criteria rank histories equal on all dimensions except the age at which individuals give birth to their children. We develop a T-period dynamic overlapping generations economy with a fixed living space, where individual welfare is increasing in the available space per head, and where agents have children in one out of two fertility periods. When comparing finite his...

  17. 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.

  18. Time-lapse culture with morphokinetic embryo selection improves pregnancy and live birth chances and reduces early pregnancy loss: a meta-analysis.

    Science.gov (United States)

    Pribenszky, Csaba; Nilselid, Anna-Maria; Montag, Markus

    2017-11-01

    Embryo evaluation and selection is fundamental in clinical IVF. Time-lapse follow-up of embryo development comprises undisturbed culture and the application of the visual information to support embryo evaluation. A meta-analysis of randomized controlled trials was carried out to study whether time-lapse monitoring with the prospective use of a morphokinetic algorithm for selection of embryos improves overall clinical outcome (pregnancy, early pregnancy loss, stillbirth and live birth rate) compared with embryo selection based on single time-point morphology in IVF cycles. The meta-analysis of five randomized controlled trials (n = 1637) showed that the application of time-lapse monitoring was associated with a significantly higher ongoing clinical pregnancy rate (51.0% versus 39.9%), with a pooled odds ratio of 1.542 (P loss (15.3% versus 21.3%; OR: 0.662; P = 0.019) and a significantly increased live birth rate (44.2% versus 31.3%; OR 1.668; P = 0.009). Difference in stillbirth was not significant between groups (4.7% versus 2.4%). Quality of the evidence was moderate to low owing to inconsistencies across the studies. Selective application and variability were also limitations. Although time-lapse is shown to significantly improve overall clinical outcome, further high-quality evidence is needed before universal conclusions can be drawn. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  19. 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.

  20. Endometrial scratching in women with implantation failure after a first IVF/ICSI cycle; does it lead to a higher live birth rate? The SCRaTCH study: a randomized controlled trial (NTR 5342).

    Science.gov (United States)

    van Hoogenhuijze, N E; Torrance, H L; Mol, F; Laven, J S E; Scheenjes, E; Traas, M A F; Janssen, C; Cohlen, B; Teklenburg, G; de Bruin, J P; van Oppenraaij, R; Maas, J W M; Moll, E; Fleischer, K; van Hooff, M H; de Koning, C; Cantineau, A; Lambalk, C B; Verberg, M; Nijs, M; Manger, A P; van Rumste, M; van der Voet, L F; Preys-Bosman, A; Visser, J; Brinkhuis, E; den Hartog, J E; Sluijmer, A; Jansen, F W; Hermes, W; Bandell, M L; Pelinck, M J; van Disseldorp, J; van Wely, M; Smeenk, J; Pieterse, Q D; Boxmeer, J C; Groenewoud, E R; Eijkemans, M J C; Kasius, J C; Broekmans, F J M

    2017-07-21

    Success rates of assisted reproductive techniques (ART) are approximately 30%, with the most important limiting factor being embryo implantation. Mechanical endometrial injury, also called 'scratching', has been proposed to positively affect the chance of implantation after embryo transfer, but the currently available evidence is not yet conclusive. The primary aim of this study is to determine the effect of endometrial scratching prior to a second fresh in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle on live birth rates in women with a failed first IVF/ICSI cycle. Multicenter randomized controlled trial in Dutch academic and non-academic hospitals. A total of 900 women will be included of whom half will undergo an endometrial scratch in the luteal phase of the cycle prior to controlled ovarian hyperstimulation using an endometrial biopsy catheter. The primary endpoint is the live birth rate after the 2 nd fresh IVF/ICSI cycle. Secondary endpoints are costs, cumulative live birth rate (after the full 2 nd IVF/ICSI cycle and over 12 months of follow-up); clinical and ongoing pregnancy rate; multiple pregnancy rate; miscarriage rate and endometrial tissue parameters associated with implantation failure. Multiple studies have been performed to investigate the effect of endometrial scratching on live birth rates in women undergoing IVF/ICSI cycles. Due to heterogeneity in both the method and population being scratched, it remains unclear which group of women will benefit from the procedure. The SCRaTCH trial proposed here aims to investigate the effect of endometrial scratching prior to controlled ovarian hyperstimulation in a large group of women undergoing a second IVF/ICSI cycle. NTR 5342 , registered July 31 st , 2015. Version 4.10, January 4th, 2017.

  1. Births: Preliminary Data for 2011. National Vital Statistics Reports. Volume 61, Number 5

    Science.gov (United States)

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

    2012-01-01

    Objectives: This report presents preliminary data for 2011 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 are also presented. Methods: Data in this report are based on approximately 100…

  2. Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011.

    Science.gov (United States)

    Liang, Fu-Wen; Chou, Hung-Chieh; Chiou, Shu-Ti; Chen, Li-Hua; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Lu, Tsung-Hsueh

    2018-06-01

    A yearly increase in the proportion of very low birth weight (VLBW) live births has resulted in the slowdown of decreasing trends in crude infant mortality rates (IMRs). In this study, we examined the trends in birth weight-specific as well as birth weight-adjusted IMRs in Taiwan. We linked three nationwide datasets, namely the National Birth Reporting Database, National Birth Certification Registry, and National Death Certification Registry databases, to calculate the IMRs according to the birth weight category. Trend tests and mortality rate ratios in the periods 2010-2011 and 2004-2005 were used to examine the extent of reduction in birth weight-specific and birth weight-adjusted IMRs. The proportion of VLBW (births increased from 0.78% in 2004-2005 to 0.89% in 2010-2011, thus exhibiting a 15% increase. The extents of the decreases in birth weight-specific IMRs in the 500-999, 1000-1499, 1500-1999, 2000-2499, and 2500-2999 g birth weight categories were 15%, 33%, 43%, 30%, and 28%, respectively, from 2004-2005 to 2010-2011. The reduction in IMR in each birth weight category was larger than the reduction in the crude IMR (13%). By contrast, the IMR in the birth weight category exhibited a 56% increase during the study period. The IMRs were calculated by excluding all live births with a birth weight of birth weight-adjusted IMRs, which were calculated using a standard birth weight distribution structure for adjustment, exhibited similar extent reductions. In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs. Copyright © 2017. Published by Elsevier B.V.

  3. BIRTH WEIGHT : A COMMUNITY PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    J P SRIVASTAVA

    2003-06-01

    Full Text Available India has a dubious distinction of belonging to the top bracket of countries with a very high under-5 Mortality Rate (U5MR of above 96/1000 live births. The U5MR considered the single most significant basic indicator of health status of a community, is proportional to the Infant Mortality Rate (IMR which in turn is contributed to directly and indirectly by the incidence of low Birth Weight (LB W.About 25 million LB W are born each year consisting 17% of all live births,nearly 95% of them in developing countries. About 26% of newborns are LBW in India, and indeed over 16% in those countries with very high U5MR.Both preterm and small-for-dates almost equally make up this category of vulnerable infants predisposed to asphyxia, feeding problems, anemia and growth failure. Considering the close relationship of birth weight with perinatal and infant morbidity as well as mortality, it is crucial to identify the liigh risk groups of low birth weight babies as early as possible.Unfortunately, in a community where 80% of newborns never get to have their weight measured, this itself is a tall order. In our society, the cry of the newborn is greeted with anxious queries about the sex of the baby and not his well­being and potential for healthy survival. The basic concept of the importance of birth weight is missing even among educated families. Indeed, it is as if the weighing machine has no place in the requirements at childbirth. In the absence of this basic facility, field workers and TBAs must report to other means to identify babies at risk. Mid-arm circumference, thigh circumference, foot length, and skin-fold thickness etc. are measurements that have been correlated satisfactorily with the baby’s weight. Simple tools like coloured strips have been developed and these show promise of applicability in field situation for identification of LB W by TBAs for early referral.

  4. BIRTH WEIGHT : A COMMUNITY PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    J P SRIVASTAVA

    2003-06-01

    Full Text Available India has a dubious distinction of belonging to the top bracket of countries with a very high under-5 Mortality Rate (U5MR of above 96/1000 live births. The U5MR considered the single most significant basic indicator of health status of a community, is proportional to the Infant Mortality Rate (IMR which in turn is contributed to directly and indirectly by the incidence of low Birth Weight (LB W.About 25 million LB W are born each year consisting 17% of all live births,nearly 95% of them in developing countries. About 26% of newborns are LBW in India, and indeed over 16% in those countries with very high U5MR.Both preterm and small-for-dates almost equally make up this category of vulnerable infants predisposed to asphyxia, feeding problems, anemia and growth failure.Considering the close relationship of birth weight with perinatal and infant morbidity as well as mortality, it is crucial to identify the liigh risk groups of low birth weight babies as early as possible.Unfortunately, in a community where 80% of newborns never get to have their weight measured, this itself is a tall order. In our society, the cry of the newborn is greeted with anxious queries about the sex of the baby and not his well­being and potential for healthy survival. The basic concept of the importance of birth weight is missing even among educated families. Indeed, it is as if the weighing machine has no place in the requirements at childbirth. In the absence of this basic facility, field workers and TBAs must report to other means to identify babies at risk. Mid-arm circumference, thigh circumference, foot length, and skin-fold thickness etc. are measurements that have been correlated satisfactorily with the baby’s weight. Simple tools like coloured strips have been developed and these show promise of applicability in field situation for identification of LB W by TBAs for early referral.

  5. Community Context, Land Use and First Birth.

    Science.gov (United States)

    Ghimire, Dirgha J; Axinn, William G

    2010-09-01

    This paper examines the influence of community context and land use on the monthly odds of first birth in a society in the midst of dramatic fertility transition. The theoretical framework guiding our work predicts that proximity to non-family services should delay first births by creating opportunities for competing non-family activities and spreading new ideas that change expectations about family life. On the other hand, living in agricultural settings that provide opportunities for higher returns to the child labor should speed first births. We use a longitudinal, multilevel, mixed-method data from the Nepalese Himalayas to test these predictions. The empirical results reveal that non-family services during childhood and during early adulthood both have important independent influences on the odds of first birth. Also, as predicted, a high density of agricultural land use affects the odds of first births in the opposite direction, speeding first births. This clear pattern of contrasting effects provides important new evidence of the contextual dynamics that produce watershed changes in post-marital birth timing.

  6. 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...

  7. 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.

  8. Rate of new HIV diagnoses among Latinos living in Florida: disparities by country/region of birth.

    Science.gov (United States)

    Sheehan, Diana M; Trepka, Mary Jo; Fennie, Kristopher P; Maddox, Lorene M

    2015-01-01

    HIV incidence in the USA is three times higher for Latinos than for non-Latino whites. Latinos differ in educational attainment, poverty, insurance coverage, and health-care access, factors that affect HIV knowledge, risk behaviors, and testing. The purpose of this study was to identify differences in demographics, risk factors, and rate of new HIV diagnoses by birth country/region among Latinos in Florida to guide the targeting of primary and secondary prevention programs. Using Florida HIV/AIDS surveillance data from 2007 to 2011 and the American Community Survey, we compared demographic and risk factors, and calculated annual and five-year age-adjusted rates of new HIV diagnoses for 5801 Latinos by birth country/region. Compared to US-born Latinos, those born in Cuba and South America were significantly more likely to report the HIV transmission mode of MSM; those born in the Dominican Republic (DR) heterosexual transmission; and those born in Puerto Rico injection drug use. Mexican- and Central American-born Latinos were more likely to be diagnosed with AIDS within a month of HIV diagnosis. The rate of new HIV diagnoses among Latinos declined 33% from 2007 to 2011. HIV diagnoses over time decreased significantly for Latinos born in Mexico and increased nonsignificantly for those born in the DR. Although this study was limited to Latinos living in Florida, results suggest that tailoring HIV primary prevention and testing initiatives to specific Latino groups may be warranted.

  9. 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.

  10. Maternal Age at Child Birth, Birth Order, and Suicide at a Young Age: A Sibling Comparison

    OpenAIRE

    Bjørngaard, Johan Håkon; Bjerkeset, Ottar; Vatten, Lars Johan; Janszky, Imre; Gunnell, David; Romundstad, Pål Richard

    2013-01-01

    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 wit...

  11. Time trends and risk factor associated with premature birth and infants deaths due to prematurity in Hubei Province, China from 2001 to 2012.

    Science.gov (United States)

    Xu, Haiqing; Dai, Qiong; Xu, Yusong; Gong, Zhengtao; Dai, Guohong; Ding, Ming; Duggan, Christopher; Hu, Zubin; Hu, Frank B

    2015-12-10

    The nutrition and epidemiologic transition has been associated with an increasing incidence of preterm birth in developing countries, but data from large observational studies in China have been limited. Our study was to describe the trends and factors associated with the incidence of preterm birth and infant mortality due to prematurity in Hubei Province, China. We conducted a population-based survey through the Maternal and Child Health Care Network in Hubei Province from January 2001 to December 2012. We used data from 16 monitoring sites to examine the trend and risk factors for premature birth as well as infant mortality associated with prematurity. A total of 818,481 live births were documented, including 76,923 preterm infants (94 preterm infants per 1,000 live births) and 2,248 deaths due to prematurity (2.75 preterm deaths per 1,000 live births). From 2001 to 2012, the incidence of preterm birth increased from 56.7 to 105.2 per 1,000 live births (P for trend prematurity declined from 95.0 to 13.4 per 1,000 live births (P for trend prematurity were observed in Hubei Province from 2001 to 2012. Our results provide important information for areas of improvements in reducing incidence and mortality of premature birth.

  12. Effects of vitamin D supplementation on semen quality, reproductive hormones and live birth rate

    DEFF Research Database (Denmark)

    Blomberg Jensen, Martin; Lawaetz, Jacob Gerner; Petersen, Jørgen Holm

    2018-01-01

    Context: Animal models and cross-sectional cohort studies have suggested a beneficial role for vitamin D in male reproduction. Objective: Determine the effect of vitamin D and calcium supplementation on semen quality in infertile men with serum 25-hydroxyvitamin-D (25OHD)≤ 50 nmol/l. Design: A si...... of vitamin D supplementation on live birth rate and serum inhibin B in oligozoospermic and vitamin D deficient men may be of clinical importance and warrant verification by others. Trial ID: NCT01304927.......Context: Animal models and cross-sectional cohort studies have suggested a beneficial role for vitamin D in male reproduction. Objective: Determine the effect of vitamin D and calcium supplementation on semen quality in infertile men with serum 25-hydroxyvitamin-D (25OHD)≤ 50 nmol/l. Design...... calcium daily for 150 days, while the other group received placebo. Results: Serum concentrations of 25-OHD and 1,25OH2D3 were significantly higher in men treated with vitamin D + calcium for 150 days compared with placebo. Vitamin D supplementation was not associated with changes in semen parameters...

  13. Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda

    Directory of Open Access Journals (Sweden)

    Joharifard Shahrzad

    2012-12-01

    Full Text Available Abstract Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839], possessing health insurance (OR = 3.812 [1.795 - 8.097], managing household finances (OR = 1.897 [1.046 - 3.439], attending more antenatal care visits (OR = 1.567 [1.163 - 2.112], delivering more recently (OR = 1.438 [1.120 - 1.847] annually, and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a

  14. Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial

    OpenAIRE

    I G. A. P. Eka Pratiwi; Soetjiningsih Soetjiningsih; I Made Kardana

    2009-01-01

    Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn. Objective To evaluate the differences of...

  15. Respiratory symptoms in the first 7 years of life and birth weight at term - The PIAMA birth cohort

    NARCIS (Netherlands)

    Caudri, Daan; Wijga, Alet; Gehring, Ulrike; Smit, Henriette A.; Brunekreef, Bert; Kerkhof, Marjan; Hoekstra, Maarten; Gerritsen, Jorrit; de Jongste, Johan C.

    2007-01-01

    Rationale: The relation between birth weight and respiratory symptoms and asthma in children remains unclear. Previous studies focused on a relation at separate ages. A longitudinal analysis may lead to a better understanding. Objectives: To estimate the effect of birth weight on the development and

  16. 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.

  17. RECENT TRENDS IN GENDER RATIO AT BIRTH IN HANGZHOU, CHINA.

    Science.gov (United States)

    Tang, L; Qiu, L Q; Yau, Kkw; Hui, Y V; Binns, C W; Lee, A H

    2015-12-01

    Higher than normal sex ratios at birth in China have been reported since the early 1980's. This study aimed to investigate recent trends in sex ratio at birth in Hangzhou, capital of Zhejiang Province in southeast China. Information on selected maternal and birth-related characteristics was extracted from the Hangzhou Birth Information Database for all pregnant women who delivered live births during 2005-2014. The sex ratios at birth were calculated after excluding infants with missing data on gender and those born with ambiguous genitalia. A total of 478,192 male births and 430,852 female births were recorded giving an overall ratio of 111.0. The sex ratio at birth was almost constant at around 110.7 during the period 2005-2008, followed by an increase to the peak at 113.1 in 2010 and then declined back to 109.6 in 2014. The gender ratio at birth in Hangzhou remained unbalanced for the past decade.

  18. Previous treatment, sputum-smear nonconversion, and suburban living: The risk factors of multidrug-resistant tuberculosis among Malaysians.

    Science.gov (United States)

    Mohd Shariff, Noorsuzana; Shah, Shamsul Azhar; Kamaludin, Fadzilah

    2016-03-01

    The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese (odds ratio 3.17, 95% confidence interval 1.04-9.68; and odds ratio 6.23, 95% confidence interval 2.24-17.35, respectively), unmarried (odds ratio 2.58, 95% confidence interval 1.09-6.09), living in suburban areas (odds ratio 2.58, 95% confidence interval 1.08-6.19), are noncompliant (odds ratio 4.50, 95% confidence interval 1.71-11.82), were treated previously (odds ratio 8.91, 95% confidence interval 3.66-21.67), and showed positive sputum smears at the 2nd (odds ratio 7.00, 95% confidence interval 2.46-19.89) and 6th months of treatment (odds ratio 17.96, 95% confidence interval 3.51-91.99). Living in suburban areas, positive sputum smears in the 2nd month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment, have a history of previous

  19. Neonatal and Infant Mortality in Korea, Japan, and the U.S.: Effect of Birth Weight Distribution and Birth Weight-Specific Mortality Rates

    OpenAIRE

    Kim, Do-Hyun; Jeon, Jihyun; Park, Chang Gi; Sriram, Sudhir; Lee, Kwang-sun

    2016-01-01

    Difference in crude neonatal and infant mortality rates (NMR and IMR) among different countries is due to the differences in its two determinants: birth weight distribution (BWD) and birth weight-specific mortality rates (BW-SMRs). We aimed to determine impact of BWD and BW-SMRs on differences in crude NMR and IMR among Korea, Japan, and the U.S. Our study used the live birth data of the period 2009 through 2010. Crude NMR/IMR are the lowest in Japan, 1.1/2.1, compared to 1.8/3.2, in Korea, a...

  20. Preterm birth time trends in Europe: A study of 19 countries

    NARCIS (Netherlands)

    Zeitlin, J.; Szamotulska, K.; Drewniak, N.; Mohangoo, A.D.; Chalmers, J.; Sakkeus, L.; Irgens, L.; Gatt, M.; Gissler, M.; Blondel, B.

    2013-01-01

    Objective To investigate time trends in preterm birth in Europe by multiplicity, gestational age, and onset of delivery. Design Analysis of aggregate data from routine sources. Setting Nineteen European countries. Population Live births in 1996, 2000, 2004, and 2008. Methods Annual risk ratios of

  1. How the integration of traditional birth attendants with formal health systems can increase skilled birth attendance.

    Science.gov (United States)

    Byrne, Abbey; Morgan, Alison

    2011-11-01

    Forty years of safe motherhood programming has demonstrated that isolated interventions will not reduce maternal mortality sufficiently to achieve MDG 5. Although skilled birth attendants (SBAs) can intervene to save lives, traditional birth attendants (TBAs) are often preferred by communities. Considering the value of both TBAs and SBAs, it is important to review strategies for maximizing their respective strengths. To describe mechanisms to integrate TBAs with the health system to increase skilled birth attendance and examine the components of successful integration. A systematic review of interventions linking TBAs and formal health workers, measuring outcomes of skilled birth attendance, referrals, and facility deliveries. Thirty-three articles met the selection criteria. Mechanisms used for integration included training and supervision of TBAs, collaboration skills for health workers, inclusion of TBAs at health facilities, communication systems, and clear definition of roles. Impact on skilled birth attendance depended on selection of TBAs, community participation, and addressing barriers to access. Successful approaches were context-specific. The integration of TBAs with formal health systems increases skilled birth attendance. The greatest impact is seen when TBA integration is combined with complementary actions to overcome context-specific barriers to contact among SBAs, TBAs, and women. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. 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...

  3. Trends in low birth weight: a comparison of two birth cohorts separated by a 15-year interval in Ribeirão Preto, Brazil.

    OpenAIRE

    Silva, A. A.; Barbieri, M. A.; Gomes, U. A.; Bettiol, H.

    1998-01-01

    The incidence and some determinants of low birth weight (LBW) were studied in two population-based cohorts of singletons born live to families in Ribeirão Preto, São Paulo State, Brazil. The first cohort comprised infants born between June 1978 and May 1979 (6750 births--population survey) and the second, infants born between May and August 1994 (2990 births--sample survey). The incidence of LBW was 7.2% in 1978-79 and 10.6% in 1994. After adjustment for confounding factors, the following det...

  4. CDC-reported assisted reproductive technology live-birth rates may mislead the public.

    Science.gov (United States)

    Kushnir, Vitaly A; Choi, Jennifer; Darmon, Sarah K; Albertini, David F; Barad, David H; Gleicher, Norbert

    2017-08-01

    The Centre for Disease Control and Prevention (CDC) publicly reports assisted reproductive technology live-birth rates (LBR) for each US fertility clinic under legal mandate. The 2014 CDC report excluded 35,406 of 184,527 (19.2%) autologous assisted reproductive technology cycles that involved embryo or oocyte banking from LBR calculations. This study calculated 2014 total clinic LBR for all patients utilizing autologous oocytes two ways: including all initiated assisted reproductive technology cycles or excluding banking cycles, as done by the CDC. The main limitation of this analysis is the CDC report did not differentiate between cycles involving long-term banking of embryos or oocytes for fertility preservation from cycles involving short-term embryo banking. Twenty-seven of 458 (6%) clinics reported over 40% of autologous cycles involved banking, collectively performing 12% of all US assisted reproductive technology cycles. LBR in these outlier clinics calculated by the CDC method, was higher than the other 94% of clinics (33.1% versus 31.1%). However, recalculated LBR including banking cycles in the outlier clinics was lower than the other 94% of clinics (15.5% versus 26.6%). LBR calculated by the two methods increasingly diverged based on proportion of banking cycles performed by each clinic reaching 4.5-fold, thereby, potentially misleading the public. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Replacing single frozen-thawed euploid embryos in a natural cycle in ovulatory women may increase live birth rates compared to medicated cycles in anovulatory women.

    Science.gov (United States)

    Melnick, Alexis P; Setton, Robert; Stone, Logan D; Pereira, Nigel; Xu, Kangpu; Rosenwaks, Zev; Spandorfer, Steven D

    2017-10-01

    The goal of this study was to compare pregnancy outcomes between natural frozen embryo transfer (FET) cycles in ovulatory women and programmed FET cycles in anovulatory women after undergoing in vitro fertilization with preimplantation genetic screening (IVF-PGS). This was a retrospective cohort study performed at an academic medical center. Patients undergoing single FET IVF-PGS cycles between October 2011 and December 2014 were included. Patients were stratified by type of endometrial replacement: programmed cycles with estrogen/progesterone replacement and natural cycles. IVF-PGS with 24-chromosome screening was performed on all included patients. Those patients with euploid embryos had single embryo transfer in a subsequent FET. The primary study outcome was live birth/ongoing pregnancy rate. Secondary outcomes included implantation, biochemical pregnancy, and miscarriage rates. One hundred thirteen cycles met inclusion criteria: 65 natural cycles and 48 programmed cycles. The programmed FET group was younger (35.9 ± 4.5 vs. 37.5 ± 3.7, P = 0.03) and had a higher AMH (3.95 ± 4.2 vs. 2.37 ± 2.4, P = 0.045). The groups were similar for BMI, gravidity, parity, history of uterine surgery, and incidence of Asherman's syndrome. There was also no difference in embryo grade at biopsy or transfer, and proportion of day 5 and day 6 transfers. Implantation rates were higher in the natural FET group (0.66 ± 0.48 vs. 0.44 ± 0.50, P = 0.02). There was no difference in the rates of biochemical pregnancy or miscarriage. After controlling for age, live birth/ongoing pregnancy rate was higher in natural FETs with an adjusted odds ratio of 2.68 (95% CI 1.22-5.87). Natural FET in ovulatory women after IVF-PGS is associated with increased implantation and live birth rates compared to programmed FET in anovulatory women. Further investigation is needed to determine whether these findings hold true in other patient cohorts.

  6. 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

  7. Adult outcomes of teen mothers across birth cohorts

    Directory of Open Access Journals (Sweden)

    Anne Driscoll

    2014-04-01

    Full Text Available Background: Teen and young adult mothers have lower socioeconomic status than older mothers. Objective: This study analyzes the socioeconomic status (SES of teen, young adult, and older adult mothers across four five-year birth cohorts from 1956 to 1975 who were teens from 1971 to 1994. Methods: Data were pooled from the 1995, 2002, and 2006-2010 National Survey of Family Growth (NSFG. Mothers were categorized by age at first birth and by their birth cohorts. The SES (education, single motherhood, poverty, employment of teen, young adult, and older mothers was compared across cohorts and within cohorts. Results: Among teen mothers, the odds of fulltime employment improved across birth cohorts and the odds of educational attainment beyond high school did not vary. Their odds of single motherhood and living in poverty increased across cohorts. The odds of higher education and single motherhood increased across birth cohorts for young adult mothers as did the odds of living in poverty, even if working fulltime. Among older adult mothers, educational attainment and the odds of single motherhood rose for recent cohorts. Conclusions: Comparisons between teen mothers and both young adult and all adult mothers within cohorts suggest that gaps in single motherhood and poverty between teen and adult mothers have widened over time, to the detriment of teen mothers. Teen mothers have become more likely to be single and poor than in the past and compared to older mothers.

  8. 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.

  9. Liberalization of Birth Control and the Unmarried Share of Births

    DEFF Research Database (Denmark)

    Kennes, John; Knowles, John

    Half of unmarried births are to women who are already mothers, and a quarter to women who were previously married. We develop a model of equilibrium matching and fertility to replicate these facts. We use the model to revisit the hypothesis that liberalization of the Pill and abortion caused...

  10. Do attitudes of families concerned influence features of children who claim to remember previous lives?

    Science.gov (United States)

    Pasricha, Satwant K

    2011-01-01

    Reported cases of nearly 2600 children (subjects) who claim to remember previous lives have been investigated in cultures with and without belief in reincarnation. The authenticity in most cases has been established. To study the influence of attitudes of parents of the subjects, families of the deceased person with whom they are identified and attention paid by others on the features of the cases. The study is based on field investigations. Data is derived from analysis of a larger series of an ongoing project. Information on initial and subsequent attitudes of subjects' mothers was available for 292 and 136 cases, respectively; attitudes of 227 families of deceased person (previous personality) with whom he is identified, and the extent of attention received from outsiders for 252 cases. Observations and interviews with multiple firsthand informants on both sides of the case as well as some neutral informants supplemented by examination of objective data were the chief methods of investigation. The initial attitude of mothers varied from encouragement (21%) to neutral or tolerance (51%) to discouragement (28%). However, it changed significantly from neutrality to taking measures to induce amnesia in their children for previous life memories due to various psychosocial pressures and prevalent beliefs. Families of the previous personalities, once convinced, showed complete acceptance in a majority of cases. Outside attention was received in 58% cases. The positive attitude of parents might facilitate expression of memories but subsequently attitudes of persons concerned do not seem to alter features of the cases.

  11. Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42 880 women treated with ART

    DEFF Research Database (Denmark)

    Sejbaek, C S; Hageman, I; Pinborg, A

    2013-01-01

    differing in fertility status (both mothers and childless women). WIDER IMPLICATIONS OF THE FINDINGS: Fewer women in the ART cohort developed depression over time compared with the age-matched background population, which might reflect a healthy patient effect of the women seeking ART treatment. Women......STUDY QUESTION: Does prior depression in women treated with assisted reproduction technology (ART) influence the number of treatment cycles and ART live births? SUMMARY ANSWER: Women with a depression diagnosis prior to ART treatment initiated statistically significantly fewer ART treatment cycles...... and had a lower mean number of ART live births compared with women with no history of depression. WHAT IS KNOWN ALREADY: Previous studies have shown an increased prevalence of depressive symptoms in fertility patients than in the comparison groups. STUDY DESIGN, SIZE, DURATION: A register-based national...

  12. Reproductive health and rights in East Jerusalem: the effects of militarisation and biopolitics on the experiences of pregnancy and birth of Palestinians living in the Kufr 'Aqab neighbourhood.

    Science.gov (United States)

    Hamayel, Layaly; Hammoudeh, Doaa; Welchman, Lynn

    2017-10-01

    Research with marginalised communities points to the need to understand political determinants of reproductive health. For residents of Kufr 'Aqab neighbourhood, Israeli biopolitics in East Jerusalem can be barriers to access to maternal health. This is manifested in women having to cross military checkpoints to give birth in hospitals located in Jerusalem to make their children eligible for "permanent residency", a document required for Palestinians to live in Jerusalem. A basic qualitative design is utilised, and semi-structured in-depth interviews with 27 women and 20 men were conducted and thematic analysis was used to extract themes and subthemes. Women reported exposure to risky conditions during pregnancy and worries of giving birth at checkpoints. Social support was restricted for some women due to inability of the husband/family to reach the hospital at the time of birth. Men reported distress related to inability to attend birth. Giving birth in a Jerusalem hospital, as part of passing residency to children, was perceived as reaffirming Palestinian presence in the City and transforming sites of suffering to sites of resistance. Israeli residency policies and segregation of Jerusalem affect Kufr 'Aqab residents' pregnancy and birth on physical, social and psychological levels. Results indicate the importance of incorporating political determinants of access to maternal care and safe pregnancy in the conceptualisation of reproductive rights.

  13. Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women

    DEFF Research Database (Denmark)

    Toftager, M; Bogstad, J; Løssl, K

    2017-01-01

    birth increases. There are no previous randomized controlled trials (RCTs) comparing CLBRs in GnRH-antagonist versus GnRH-agonist protocols. Previous studies on CLBR are either retrospective cohort studies including multiple fresh cycles or RCTs comparing single embryo transfer (SET) with double embryo...... transfer (DET). STUDY DESIGN, SIZE, DURATION: CLBR was a secondary outcome in a Phase IV, dual-center, open-label, RCT including 1050 women allocated to a short GnRH-antagonist or a long GnRH-agonist protocol in a 1:1 ratio over a 5-year period using a web-based concealed randomization code. The minimum...... follow-up time from the first IVF cycle was 2 years. The aim was to compare CLBR between the two groups following utilization of all fresh and frozen embryos from the first ART cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS: All women referred for their first ART cycle at two public fertility clinics...

  14. Sperm-storage defects and live birth in Drosophila females lacking spermathecal secretory cells.

    Directory of Open Access Journals (Sweden)

    Sandra L Schnakenberg

    2011-11-01

    Full Text Available Male Drosophila flies secrete seminal-fluid proteins that mediate proper sperm storage and fertilization, and that induce changes in female behavior. Females also produce reproductive-tract secretions, yet their contributions to postmating physiology are poorly understood. Large secretory cells line the female's spermathecae, a pair of sperm-storage organs. We identified the regulatory regions controlling transcription of two genes exclusively expressed in these spermathecal secretory cells (SSC: Spermathecal endopeptidase 1 (Send1, which is expressed in both unmated and mated females, and Spermathecal endopeptidase 2 (Send2, which is induced by mating. We used these regulatory sequences to perform precise genetic ablations of the SSC at distinct time points relative to mating. We show that the SSC are required for recruiting sperm to the spermathecae, but not for retaining sperm there. The SSC also act at a distance in the reproductive tract, in that their ablation: (1 reduces sperm motility in the female's other sperm-storage organ, the seminal receptacle; and (2 causes ovoviviparity--the retention and internal development of fertilized eggs. These results establish the reproductive functions of the SSC, shed light on the evolution of live birth, and open new avenues for studying and manipulating female fertility in insects.

  15. Reproduction in female copperhead snakes (Agkistrodon contortrix): plasma steroid profiles during gestation and post-birth periods.

    Science.gov (United States)

    Smith, Charles F; Schuett, Gordon W; Hoss, Shannon K

    2012-04-01

    We investigated levels of plasma progesterone (P4), 17β-estradiol (E2), testosterone (T), and corticosterone (CORT) during gestation and post-birth periods in wild-collected female copperhead snakes (Viperidae; Agkistrodon contortrix). We also sought to determine whether CORT levels at (or near) birth dramatically increase and were correlated with duration of labor and litter size. Specifically, pregnant subjects (N = 14) were collected during early- to mid-gestation, held in the laboratory, and repeatedly bled to obtain plasma for steroid analyses. Progesterone showed significant changes during gestation, with the highest levels at the onset of sampling (circa 50 days prior to birth); P4 progressively declined up to parturition, and basal levels were observed thereafter. At the onset of sampling, E2 was at peak levels and fell sharply at circa 30 days prior to birth, a trend observed throughout the post-birth sampling period. Throughout the entire sampling period, T was undetectable. Although CORT showed no significant changes during gestation and several days following parturition, there was a highly significant peak at the time of birth. Our findings mirror the results of previous studies on pregnancy and steroid hormones of other live-bearing snakes, lizards, and mammals. As expected, there was a significant relationship between duration of labor and litter size; however, although levels of CORT did not achieve significance, there was a positive trend with litter size. We suggest that elevation of CORT at birth is involved in the mobilization and regulation of energy stores necessary for the physiological process of parturition and as a possible mechanism to trigger birth.

  16. Socioeconomic factors affecting marriage, divorce and birth rates in a Japanese population.

    Science.gov (United States)

    Uchida, E; Araki, S; Murata, K

    1993-10-01

    The effects of low income, urbanisation and young age population on age-adjusted rates of first marriage, divorce and live birth among the Japanese population in 46 prefectures were analysed by stepwise regression for 1970 and for 1975. During this period, Japanese society experienced a drastic change from long-lasting economic growth to serious recession in 1973. In both 1970 and 1975, the first marriage rate for females was inversely related to low income and the divorce rates for both males and females were positively related to low income. The live birth rate was significantly related to low income, urbanisation and young age population only in 1975. The first marriage rate for females and the divorce rates for both sexes increased significantly but the first marriage rate for males and live birth rate significantly decreased between 1970 and 1975. These findings suggest that low income was the essential factor affecting first marriage for females and divorce for males and females.

  17. Changes in birth weight between 2002 and 2012 in Guangzhou, China.

    Directory of Open Access Journals (Sweden)

    Yong Guo

    Full Text Available Recent surveillance data suggest that mean birth weight has begun to decline in several developed countries. The aim of this study is to examine the changes in birth weight among singleton live births from 2002 to 2012 in Guangzhou, one of the most rapidly developed cities in China.We used data from the Guangzhou Perinatal Health Care and Delivery Surveillance System for 34108 and 54575 singleton live births with 28-41 weeks of gestation, who were born to local mothers, in 2002 and 2012, respectively. The trends in birth weight, small (SGA and large (LGA for gestational age and gestational length were explored in the overall population and gestational age subgroups.The mean birth weight decreased from 3162 g in 2002 to 3137 g in 2012 (crude mean difference, -25 g; 95% CI, -30 to -19. The adjusted change in mean birth weight appeared to be slight (-6 g from 2002 to 2012 after controlling for maternal age, gestational age, educational level, parity, newborn's gender and delivery mode. The percentages of SGA and LGA in 2012 were 0.6% and 1.5% lower than those in 2002, respectively. The mean gestational age dropped from 39.2 weeks in 2002 to 38.9 weeks in 2012. In the stratified analysis, we observed the changes in birth weight differed among gestational age groups. The mean birth weight decreased among very preterm births (28-31 weeks, while remained relatively stable among other gestational age subcategories.Among local population in Guangzhou from 2002 to 2012, birth weight appeared to slightly decrease. The percentage of SGA and LGA also simultaneously dropped, indicating that newborns might gain a healthier weight for gestational age.

  18. Frequency of marriage and live birth among survivors prenatally exposed to the atomic bomb

    International Nuclear Information System (INIS)

    Blot, W.J.; Shimizu, Y.; Kato, H.; Miller, R.W.

    1975-01-01

    Frequency of marriage and birth as of January 1973 was determined for persons exposed in utero to the atomic bombs in 1945 and for controls. The marriage rate was lower in persons heavily exposed in utero than in the non-exposed or lightly exposed. This difference is attributed partly to the lesser marriageability of persons with mental retardation who are significantly more numerous among the heavily exposed, and partly to unmeasured variables, possibly including social discrimination against survivors of the atomic bomb. No consistent relation was observed between radiation exposure and three reproductive indices: childless marriages, number of births, and interval between marriage and first birth

  19. 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.

  20. Postpartum Care Services and Birth Features of The Women Who Gave Birth in Burdur in 2009

    Directory of Open Access Journals (Sweden)

    Binali Catak

    2011-10-01

    Full Text Available AIM: In the study, it is aimed to evaluate postpartum care services and the delivery characteristics of the women who gave birth in Burdur in 2009. MATERIAL AND METHODS: In the study, the data is used about \\\\\\"Birth and Postpartum Care\\\\\\" of the research \\\\\\" Birth, Postpartum Care Services, and Nutritional Status of Children of the women who are giving birth in Burdur in 2009 \\\\\\". The population of the planned cross-sectional study are women who gave birth in Burdur in 2009. For the determination of the population, a list of women who gave birth in 2009 were used which was requested from family physicians. The reported number of women was 2318. The sample size representing the population to be reached was calculated as 1179. The data were collected using face-to-face interviews and were analyzed using SPSS package program. RESULTS: The mean age of the women was 27.1 (± 5.5 with an average size of households 4.3 (± 1.2. 22.1% of the women live with large families and 64.4% live in the village. 8.0% of the women were relatives with their husbands, 52.8% have arranged marriage and 1.3% have no official marriage. 1 in every 4 women is housewive, 1.8% have no formal education, 76.4% have no available social and 7.1% have no available health insurance. The average number of pregnancies of women is 2.1 (± 1.2 and number of children is 1.8 (± 0.8. Spontaneous abortion, induced abortion, stillbirth and death rate of children under 5 years of age are respectively 16.4%, 6.6%, 2.7%, 3.4%. 99.8% of the women have given birth in hospital, % 67.3 had medical supervision, 62.8% had cesarean birth. The average days of hospital stay after birth is 1.9 (± 3.1. 4.8% of the women after being discharged from the hospital have not received Postpartum Care (DSB. Of the women who have received DSB service, 2.2% had taken this service at home by family physician / family health stuff, 33.9% by obstetrician in practice. 92.2% of the women 1 time, 15

  1. Maternal Eating Disorders Influence Sex Ratio at Birth

    OpenAIRE

    Bulik, Cynthia M; Von Holle, Ann; Gendall, Kelly; Kveim Lie, Kari; Hoffman, Elizabeth; Mo, Xiaofei; Torgersen, Leila; Reichborn-Kjennerud, Ted

    2008-01-01

    We explored sex ratio at birth, defined as the proportion of male live births, in women with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified-purging type (EDNOS-P) relative to a referent group in a large population based sample of 38,340 pregnant women in Norway. Poisson regressions were adjusted for mother’s age, pre-pregnancy BMI, lifetime smoking status, maternal education, income, marital status, gestational age, and parity. Lower pro...

  2. 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

    alternative estimates by outcome. Fewer than 1 in 10 women in the United States with a previous cesarean delivery delivered by vaginal birth after cesarean delivery in any setting, and increasing proportions of these women delivered in an out-of-hospital setting. Adverse outcomes were more frequent for neonates who were born in an out-of-hospital setting, with risk concentrated among women birthing their second child and women without a history of vaginal birth. This information urgently signals the need to increase availability of in-hospital vaginal birth after cesarean delivery and suggests that there may be benefit associated with increasing options that support physiologic birth and may prevent primary cesarean delivery safely. Results may inform evidence-based recommendations for birthplace among women who seek vaginal birth after cesarean delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Integrated approaches to improve birth outcomes: perinatal periods of risk, infant mortality review, and the Los Angeles Mommy and Baby Project.

    Science.gov (United States)

    Chao, Shin Margaret; Donatoni, Giannina; Bemis, Cathleen; Donovan, Kevin; Harding, Cynthia; Davenport, Deborah; Gilbert, Carol; Kasehagen, Laurin; Peck, Magda G

    2010-11-01

    This article provides an example of how Perinatal Periods of Risk (PPOR) can provide a framework and offer analytic methods that move communities to productive action to address infant mortality. Between 1999 and 2002, the infant mortality rate in the Antelope Valley region of Los Angeles County increased from 5.0 to 10.6 per 1,000 live births. Of particular concern, infant mortality among African Americans in the Antelope Valley rose from 11.0 per 1,000 live births (7 cases) in 1999 to 32.7 per 1,000 live births (27 cases) in 2002. In response, the Los Angeles County Department of Public Health, Maternal, Child, and Adolescent Health Programs partnered with a community task force to develop an action plan to address the issue. Three stages of the PPOR approach were used: (1) Assuring Readiness; (2) Data and Assessment, which included: (a) Using 2002 vital records to identify areas with the highest excess rates of feto-infant mortality (Phase 1 PPOR), and (b) Implementing Infant Mortality Review (IMR) and the Los Angeles Mommy and Baby (LAMB) Project, a population-based study to identify potential factors associated with adverse birth outcomes. (Phase 2 PPOR); and (3) Strategy and Planning, to develop strategic actions for targeted prevention. A description of stakeholders' commitments to improve birth outcomes and monitor infant mortality is also given. The Antelope Valley community was engaged and ready to investigate the local rise in infant mortality. Phase 1 PPOR analysis identified Maternal Health/Prematurity and Infant Health as the most important periods of risk for further investigation and potential intervention. During the Phase 2 PPOR analyses, IMR found a significant proportion of mothers with previous fetal loss (45%) or low birth weight/preterm (LBW/PT) birth, late prenatal care (39%), maternal infections (47%), and infant safety issues (21%). After adjusting for potential confounders (maternal age, race, education level, and marital status), the

  4. Gentrification and preterm birth in New York City, 2008–2010.

    Science.gov (United States)

    Huynh, M; Maroko, A R

    2014-02-01

    Adverse birth outcomes have been linked to neighborhood level socioeconomic status. However, little work has examined the influence of social and economic change over time (i.e., gentrification) on health. This study aims to assess the association between gentrification and preterm birth (PTB) while examining the modifying effect of maternal race/ethnicity and educational attainment. New York City births, 2008–2010, (n=126,165) were linked to a measure of gentrification at the community district level (n=59). The gentrification measure was calculated using percent change in education level, poverty level, and median household income (MHI) between the 2005–2009 American Community Survey and the 1990 Census. PTB was defined as clinical gestational age less than 37 weeks. Generalized estimating equations were utilized to examine the association. Gentrification (i.e., increase in residents with a college education, increase in MHI, and decrease in residents living below the poverty line) was not associated with PTB. However, among Non-Hispanic Blacks, very high gentrification was adversely associated with PTB (AOR, 1.16; 95 % CI, 1.01–1.33) as compared to those who lived in a very low gentrified neighborhood. Among non- Hispanic Whites, living in a very high gentrified neighborhood was protective as compared to living in a very low gentrified neighborhood (AOR, 0.78; 95 % CI, 0.64– 0.94). Although there is a need to develop a more nuanced measure of gentrification, these results indicate that changes in the economic character of a neighborhood may have a significant influence on birth outcomes.

  5. Factors associated with delaying birth of first child: A Case Study of 15- 49 years old married women lived in Meybod town

    Directory of Open Access Journals (Sweden)

    R Zare Mehrjardi

    2016-09-01

    Full Text Available Introduction: The purpose of this paper is to examine the impact of demographic, social, economic and cultural factors on delaying the Birth of the first child in Meybod town. Spacing between marriage and the birth of the first child is a crucial factor in demographic planning. Methods: The survey was research method and Information collected by the structured questionnaire. The study population was married women 15 to 49 years old in the city Meybod, and the sample population included 379 such women were selected with using of multi stage cluster random sampling. Results: The results of the study show that there are a meaningful relationship between the variables of women’s tendency to pregnancy, kind of family, women’s age and duration of marriage, Education of women and their husbands, geographic origin of women, occupational status of women, and their type of marriage with the dependent variable the length of period from marriage to first child birth. Also, Results of multivariate regression shows that the Use of contraceptive, women’s marriage age, women’s geographic origin, Duration of marriage, Gender Equality and kind of family, Respectively, Have a major role in determining this spacing, and able to predict 34% of the variance in the dependent variable. Conclusion: The results of this study and previous studies shows that in recent years, the space between marriage and birth of first child has increased and from the intensity of fertility is reduced. Overall, from the findings can be concluded that impact of demographic, social and cultural Condition on increase in delaying of the first child birth, and therefore the fertility decline of society is far more than economic conditions. So, to reduce the space between marriage and the birth of first child in the planning, should pay more attention to demographic and social-cultural Factors.

  6. Caring for women wanting a vaginal birth after previous caesarean section: A qualitative study of the experiences of midwives and obstetricians.

    Science.gov (United States)

    Foureur, Maralyn; Turkmani, Sabera; Clack, Danielle C; Davis, Deborah L; Mollart, Lyndall; Leiser, Bernadette; Homer, Caroline S E

    2017-02-01

    One of the greatest contributors to the overall caesarean section rate is elective repeat caesarean section. Decisions around mode of birth are often complex for women and influenced by the views of the doctors and midwives who care for and counsel women. Women may be more likely to choose a repeat elective caesarean section (CS) if their health care providers lack skills and confidence in supporting vaginal birth after caesarean section (VBAC). To explore the views and experiences of providers in caring for women considering VBAC, in particular the decision-making processes and the communication of risk and safety to women. A descriptive interpretive method was utilised. Four focus groups with doctors and midwives were conducted. The central themes were: 'developing trust', 'navigating the system' and 'optimising support'. The impact of past professional experiences; the critical importance of continuity of carer and positive relationships; the ability to weigh up risks versus benefits; and the language used were all important elements. The role of policy and guidelines on providing standardised care for women who had a previous CS was also highlighted. Midwives and doctors in this study were positively oriented towards assisting and supporting women to attempt a VBAC. Care providers considered that women who have experienced a prior CS need access to midwifery continuity of care with a focus on support, information-sharing and effective communication. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  7. Different Risk Factors for Very Low Birth Weight, Term-Small-for-Gestational-Age, or Preterm Birth in Japan

    Directory of Open Access Journals (Sweden)

    Naomi Tamura

    2018-02-01

    Full Text Available From 1985 to 2013, the mean birth weight of infants in Japan decreased from 3120 g to 3000 g, and the low-birth-weight rate among live births increased from 6.3% to 9.6%. No prospective study has elucidated the risk factors for poor fetal growth and preterm birth in recent Japanese parents, such as increased parental age, maternal body figure, assisted reproductive technology (ART, and socioeconomic status. Participants were mother–infant pairs (n = 18,059 enrolled in a prospective birth cohort in Hokkaido, Japan from 2002 to 2013. Parental characteristics were obtained via self-reported questionnaires during pregnancy. Medical records helped identify very-low-birth-weight (VLBW; <1500g, term-small-for-gestational-age (term-SGA, and preterm-birth (PTB; <37 weeks infants. We calculated relative risks (RRs for PTB, VLBW, and term-SGA birth based on parental characteristics. The prevalence of PTB, VLBW, and term-SGA was 4.5%, 0.4%, and 6.5%, respectively. Aged parents and ART were risk factors for PTB and VLBW. Maternal alcohol drinking during pregnancy increased the risk; a parental educational level of ≥16 years reduced risk of term-SGA. Maternal pre-pregnancy BMI of <18.5 kg/m2 increased the risk of PTB and term-SGA. The RR for low BMI was highest among mothers who have low educational level. Among various factors, appropriate nutritional education to maintain normal BMI is important to prevent PTB and term-SGA in Japan.

  8. 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.

  9. 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.

  10. Secular Trends and Latitude Gradients in Sex Ratios at Birth in Czechoslovakia and the Post-Czechoslovakian States

    Directory of Open Access Journals (Sweden)

    Victor Grech

    2012-01-01

    Full Text Available Latitude gradients and secular trends in Europe and North America have been found in the male-female ratio at birth (M/F: male births divided by total births which is expected to be 0.515. Annual national data for Czechoslovakia and the post-Czechoslovakian (Czech Republic and Slovakia countries for male and female live births were obtained from the World Health Organisation and analysed with contingency tables. This study analysed 13,123,538 live births. An overall decreasing trend in M/F was found (p < 00001. No latitude gradient was noted. There was an overall deficit of 15,232 male births based on an M/F of 0.515. M/F is declining in this region, despite well developing economies that have resisted the worldwide slowdown. An interplay of several poorly understood factors is likely.

  11. Impact of police-reported intimate partner violence during pregnancy on birth outcomes.

    Science.gov (United States)

    Lipsky, Sherry; Holt, Victoria L; Easterling, Thomas R; Critchlow, Cathy W

    2003-09-01

    To examine the relationship of police-reported intimate partner violence during pregnancy and adverse birth outcomes. We conducted a population-based, retrospective, cohort study in Seattle, Washington, using Seattle police data and Washington State birth certificate files from January 1995 through September 1999. Exposed subjects were women with an intimate partner violence incident reported to police during pregnancy and who subsequently had a singleton live birth or fetal death registered in the state of Washington. Unexposed subjects were randomly selected Seattle residents with a singleton live birth or fetal death in the same time period and who did not report an incident. The main outcome measures were low birth weight (LBW less than 2500 g), very LBW (VLBW less than 1500 g), preterm birth (20-36 weeks' gestation), very preterm birth (20-31 weeks), and neonatal death (before discharge). Women reporting any partner violence during pregnancy were significantly more likely to have a LBW infant (adjusted odds ratio [aOR] 1.70; 95% confidence interval [CI] 1.20, 2.40), a VLBW infant (aOR 2.54; 95% CI 1.32, 4.91), a preterm birth (aOR 1.61; 95% CI 1.14, 2.28), a very preterm birth (aOR 3.71; 95% CI 1.80, 7.63), and a neonatal death (aOR 3.49; 95% CI 1.43, 8.50). Police-reported partner violence during pregnancy is significantly associated with an increased risk of adverse birth outcomes. There is a critical need to identify pregnancy among women with reported incidents and to provide women health and social service information and referrals, particularly referrals to high-risk pregnancy programs.

  12. Impact of GnRH agonist triggering and intensive luteal steroid support on live-birth rates and ovarian hyperstimulation syndrome

    DEFF Research Database (Denmark)

    Iliodromiti, Stamatina; Lan, Vuong Thi Ngoc; Tuong, Ho Manh

    2013-01-01

    Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory implanta......Conventional luteal support packages are inadequate to facilitate a fresh transfer after GnRH agonist (GnRHa) trigger in patients at high risk of developing ovarian hyperstimulation syndrome (OHSS). By providing intensive luteal-phase support with oestradiol and progesterone satisfactory...... implantation rates can be sustained. The objective of this study was to assess the live-birth rate and incidence of OHSS after GnRHa trigger and intensive luteal steroid support compared to traditional hCG trigger and conventional luteal support in OHSS high risk Asian patients....

  13. 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.

  14. Variability in the management and outcomes of extremely preterm births across five European countries

    DEFF Research Database (Denmark)

    Smith, Lucy K; Blondel, Beatrice; Van Reempts, Patrick

    2017-01-01

    OBJECTIVE: To explore international variations in the management and survival of extremely low gestational age and birthweight births. DESIGN: Area-based prospective cohort of births SETTING: 12 regions across Belgium, France, Italy, Portugal and the UK PARTICIPANTS: 1449 live births and fetal de...... and for those weighing under 500 g suggest little impact of intervention and support the inclusion of birth weight along with gestational age in ethical decision-making guidelines....

  15. 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.

  16. Stress, Pregnancy, and Motherhood: Implications for Birth Weights in the Borderlands of Texas.

    Science.gov (United States)

    Fleuriet, K Jill; Sunil, T S

    2017-03-01

    We argue that changes over time in how ideas of stress are incorporated into understandings of pregnancy and motherhood among Mexican immigrant women living in the United States may affect the documented increase of low birth weight infants born to those women. Stress has consistently been linked to low birth weight, and pregnant Mexican American and Mexican immigrant women differ in levels of perceived social stress. What is lacking is an explanation for these differences. We utilize a subset of 36 ethnographic interviews with pregnant immigrant women from northern Mexico and Mexican Americans living in south Texas to demonstrate how meanings of pregnancy and motherhood increasingly integrate notions of stress the longer immigrant Mexican women live in the United States. We situate our results within anthropological and sociological research on motherhood in the United States and Mexico, anthropological research in the U.S.-Mexico borderlands, and interdisciplinary research on Hispanic rates of low birth weight. © 2016 by the American Anthropological Association.

  17. Prevalence of birth defects and risk-factor analysis from a population-based survey in Inner Mongolia, China

    Directory of Open Access Journals (Sweden)

    Zhang Xingguang

    2012-08-01

    Full Text Available Abstract Background Birth Defects are a series of diseases that seriously affect children's health. Birth defects are generally caused by several interrelated factors. The aims of the article is to estimate the prevalence rate and types of birth defects in Inner Mongolia, China, to compare socio-demographic characteristics among the children with birth defects and to analyze the association between risk factors and birth defects. Methods Data used in this study were obtained through baseline survey of Inner Mongolia Birth Defects Program, a population-based survey conducted from 2005 to 2008. The survey used cluster sampling method in all 12 administrative districts of Inner Mongolia. Sampling size is calculated according to local population size at a certain percentage. All live births, stillbirths and abortions born from October 2005 to September 2008, whose families lived in Inner Mongolia at least one year, were included. The cases of birth defects were diagnosed by the clinical doctors according to their experiences with further laboratory tests if needed. The inclusion criteria of the cases that had already dead were decided according to death records available at local cites. We calculated prevalence rate and 95% confidence intervals of different groups. Outcome variable was the occurrence of birth defects and associations between risk factors and birth defects were analyzed by using Poisson regression analysis. Results 976 children with birth defects were diagnosed. The prevalence rate of birth defects was 156.1 per 10000 births (95%CI: 146.3-165.8. The prevalence rate of neural tube defect (20.1 per 10000 births including anencephaly(6.9 per 10000, spina bifida (10.6 per 10000, and encephalocele (2.7 per 10000 was the highest, followed by congenital heart disease (17.1 per 10000. The relative risk (RR for maternal age less than 25 was 2.22 (95%CI: 2.05, 2.41. The RR of the ethnic Mongols was lower than Han Chinese (RR: 0.84; 95%CI: 0

  18. Adult birth mothers who made open infant adoption placements after adolescent unplanned pregnancy.

    Science.gov (United States)

    Clutter, Lynn B

    2014-01-01

    To summarize birth mothers' descriptions of how their adolescent or young adult unplanned pregnancies and decision for open infant adoption placement influenced their lives. Naturalistic inquiry using unstructured interviews. One to 2-hour telephone interviews with participants in their home settings were recorded and transcribed. Deidentified transcripts were analyzed for qualitative content themes. Fifteen women who had experienced unplanned adolescent or young adult pregnancy and relinquished their infants through open adoption were interviewed. Birth mothers who had been members of an agency support group were identified by an agency representative as having been typical of open adoption and were purposively recruited for study participation. Participants described the open adoption decision as "one of the most difficult but best" choices of their lives. Themes were summarized using the acronym AFRESH: A--adoption accomplishments, F--fresh start, R--relationship changes, E--emotions, S--support, H--healing. Findings indicated that benefits of open adoption outweighed challenges of pregnancy, birth, and emotional transitions. Birth children were perceived as thriving with adoptive families who were cherished like extended family. Birth mothers perceived themselves as being better people with better lives than before the unintended pregnancy. Growth with improved life direction was seen as a result of personal maturation from the experience. Open adoption is reinforced as a positive resolution of adolescent unintended pregnancy. Birth mothers believed teens who feel "stuck" with a pregnancy should consider open adoption; nurses should provide support and uphold the process. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  19. A Study Of Risk Factors For Low Birth Weight

    Directory of Open Access Journals (Sweden)

    Deswal B S

    1999-01-01

    Full Text Available Research question: What is the extent of low weight babies born in hospitals and its association with some maternal factors? Objectives: 1. To find an overall prevalence of low birth weight babies amongst hospital births in Meerut city. 2. To identify and quantify the effects of some risk factors for low birth weight. Setting: District women Hospital of Meerut city of western U.P. Study Design: Hospital based matched case-control study. Sample size: 491 low birth weight babies as ‘cases’ and an equal number of babies of normal birth weight in ‘control’ group matched for maternal age, sex of baby, birth order and institution of delivery. Study variables: Socio-economic Status: maternal biological factors including obstetric history: antenatal factors: nutritional factors: history of abortion: toxaemia of pregnancy etc. Results: Overall proportion of low birth weight babies was found to be 21.8% amongst hospital live births and 30.9% born to mothers aged below 30 years of age. Low maternal weight, under nutrition, lack of antenatal care, short inter-pregnancy interval, toxacmia of pregnancy were independent factors increasing the risk of low birth weight significantly. Conclusions: The study suggested that a substantial proportion of low birth weight babies can be averted by improving maternal nutritional status including anemic condition, birth spacing and proper antenatal care.

  20. Adherence to traditional Indian customs surrounding birth ...

    African Journals Online (AJOL)

    Customs traditionally followed by Indian women during pregnancy, birth and early parenthood have been documented. An exploratory investigation of the extent to which some of these traditional beliefs, customs and practices are currently adhered to was undertaken by interviewing Indian mothers living in Johannesburg ...

  1. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study

    Directory of Open Access Journals (Sweden)

    Claire Leppold

    2017-05-01

    Full Text Available Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (<2500 g at birth and preterm births (<37 weeks gestation at birth were compared pre- and post-disaster, and regression models were conducted to assess for associations between these outcomes and evacuation and food avoidance. A total of 1101 live singleton births were included. There were no increased proportions of low birthweight or preterm births in any year after the disaster (merged post-disaster risk ratio of low birthweight birth: 0.98, 95% confidence interval (CI: 0.64–1.51; and preterm birth: 0.68, 95% CI: 0.38–1.21. No significant associations between birth outcomes and residential area or food purchasing patterns were identified, after adjustment for covariates. In conclusion, no changes in birth outcomes were found in this institution-based investigation after the Fukushima disaster. Further research is needed on the pathways that may exacerbate or reduce disaster effects on maternal and perinatal health.

  2. Income inequality, parental socioeconomic status, and birth outcomes in Japan.

    Science.gov (United States)

    Fujiwara, Takeo; Ito, Jun; Kawachi, Ichiro

    2013-05-15

    The purpose of this study was to investigate the impact of income inequality and parental socioeconomic status on several birth outcomes in Japan. Data were collected on birth outcomes and parental socioeconomic status by questionnaire from Japanese parents nationwide (n = 41,499) and then linked to Gini coefficients at the prefectural level in 2001. In multilevel analysis, z scores of birth weight for gestational age decreased by 0.018 (95% confidence interval (CI): -0.029, -0.006) per 1-standard-deviation (0.018-unit) increase in the Gini coefficient, while gestational age at delivery was not associated with the Gini coefficient. For dichotomous outcomes, mothers living in prefectures with middle and high Gini coefficients were 1.24 (95% CI: 1.05, 1.47) and 1.23 (95% CI: 1.02, 1.48) times more likely, respectively, to deliver a small-for-gestational-age infant than mothers living in more egalitarian prefectures (low Gini coefficients), although preterm births were not significantly associated with income distribution. Parental educational level, but not household income, was significantly associated with the z score of birth weight for gestational age and small-for-gestational-age status. Higher income inequality at the prefectural level and parental educational level, rather than household income, were associated with intrauterine growth but not with shorter gestational age at delivery.

  3. [The effect of birth weight on the early postnatal vitality of piglets].

    Science.gov (United States)

    Hoy, S; Lutter, C; Wähner, M; Puppe, B

    1994-10-01

    Investigations with 1248 newborn piglets in 7 farms showed a high significant influence of birth weight on parameters of early postnatal vitality. The duration between birth and first standing up was by two times, the time between birth and first udder contact by 3.5 times and the duration between birth and first colostrum intake was by 4 times longer in piglets with a low birth weight ( 2200 g). The drop in rectal temperature up to 30 minutes after birth reached 4.5 Kelvin in lightweight piglets, whereas their litter mates with a high body weight at birth had a value of 0.85 K (p vitality of newborn piglets and has a high prognostic value in relation to the risk of losses and the live weight development of neonates.

  4. Two new prediction rules for spontaneous pregnancy leading to live birth among subfertile couples, based on the synthesis of three previous models.

    NARCIS (Netherlands)

    C.C. Hunault; J.D.F. Habbema (Dik); M.J.C. Eijkemans (René); J.A. Collins (John); J.L.H. Evers (Johannes); E.R. te Velde (Egbert)

    2004-01-01

    textabstractBACKGROUND: Several models have been published for the prediction of spontaneous pregnancy among subfertile patients. The aim of this study was to broaden the empirical basis for these predictions by making a synthesis of three previously published models. METHODS:

  5. Smoking ban and health at birth: Evidence from Hungary.

    Science.gov (United States)

    Hajdu, Tamás; Hajdu, Gábor

    2018-06-13

    In 2012, smoking restrictions were extended to hospitality venues in Hungary. Women working in bars and restaurants were primarily affected by the intervention. In this research, we analyze the effect of this smoking ban on the outcomes of their pregnancies. Using individual live birth, fetal loss, and infant mortality registry data, we examine the probability of live birth, indicators of health at birth, and the probability of death in the first year of life. We apply a difference-in-differences framework and show that the smoking ban has improved health at birth. We observed birth weight to increase by 56 g (95% CI: 4.2 to 106.8) and gestation length by 0.19 weeks (95% CI: 0.02 to 0.36). Due to the ban, the probability of being born with very low and low birth weight has decreased by 1.2 and 2.2 percentage points, respectively (95% CI: -0.2 to -2.2 and 0.06 to -4.4), and we see a 0.9 percentage points reduction in the chance of being born very preterm (95% CI: -0.03 to -1.9). We also observe a decrease in the probability of being born with a low Ponderal index (decrease of 4.1 percentage points, 95% CI: -0.7 to -7.5). Performing a series of robustness and placebo tests, we provide evidence that supports the causal interpretation of our results. We also show that the ban was more beneficial for newborns of parents with low educational attainment and at the bottom of the fetal health endowment distribution. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Placental share and hemoglobin level in relation to birth weight in twin anemia-polycythemia sequence.

    Science.gov (United States)

    Zhao, D; Slaghekke, F; Middeldorp, J M; Duan, T; Oepkes, D; Lopriore, E

    2014-12-01

    Twin anemia-polycythemia sequence (TAPS) is a newly described form of chronic twin transfusion. Previous observational studies noted a discordance between birth weight and individual placental share in TAPS. The purpose of this study was to investigate if fetal growth in monochorionic (MC) twins with TAPS is determined by placental share or by the net inter-twin blood transfusion. All consecutive MC twin placentas of live-born twin pairs with and without TAPS examined at our center between June 2002 and February 2014 were included in this study. Hemoglobin (Hb) levels and individual placental share were evaluated at birth and correlated with birth weight share. We excluded MC twin pregnancies with twin-twin transfusion syndrome. A total of 270 MC twin pregnancies (TAPS group, n = 20; control group without TAPS, n = 250) were included in this study. Donors with TAPS had a lower birth weight than recipients in 90% (18/20) of cases, but a larger placental share in 65% (13/20) of cases. In the TAPS group, birth weight share was positively correlated with Hb share at birth (P < 0.01) but not with placental share (P = 0.54). In the control group without TAPS, birth weight share was strongly correlated with placental share (P < 0.01) but not with Hb share (P = 0.14). A relatively larger placental share may enable the survival of the anemic twin in TAPS. In contrast with uncomplicated MC twins, fetal growth in MC twins with TAPS is determined primarily by the net inter-twin blood transfusion instead of placental share. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. The Great Recession of 2007 in the United States and the male: female ratio at birth.

    Science.gov (United States)

    Grech, Victor

    2015-01-01

    Male live births slightly exceed female live births by approximately 3%. The ratio of male to total live births is conventionally represented as M/F. Many factors have been shown to affect M/F, mainly privation, toxins, and stress, all of which reduce M/F. Population stress may be engendered by natural phenomena such as earthquakes and man-made events such as short wars, terrorist attacks, and contracting economies. This study was conducted to ascertain whether the onset of the "Great Recession" (2007) was associated with changes in M/F in the United States (US). Annual monthly live births by gender for January 2006 to December 2008 were obtained from United States Centres for Disease Control and Prevention. In 2007, there were 4316233 live births [M/F: 0.51157; 95% confidence intervals: 0.51110-0.51205). M/F rose between January and June, and then fell sharply between August and December. M/F was statistically significantly lower in the second half of 2007 (p=0.007). The dip in M/F from June to July was also significant (p=0.02). These findings were not replicated in the amalgamated data for 2006 and 2008. The United States housing boom of the mid-2000s was fueled by rising house prices and cheap mortgages given to credit-poor buyers. A halt in rising house prices resulted in defaults and foreclosures, triggering the worst financial crisis since the Great Depression. The associated stress appears to have decreased M/F in the US.

  8. Genomics of Preterm Birth

    Science.gov (United States)

    Swaggart, Kayleigh A.; Pavlicev, Mihaela; Muglia, Louis J.

    2015-01-01

    The molecular mechanisms controlling human birth timing at term, or resulting in preterm birth, have been the focus of considerable investigation, but limited insights have been gained over the past 50 years. In part, these processes have remained elusive because of divergence in reproductive strategies and physiology shown by model organisms, making extrapolation to humans uncertain. Here, we summarize the evolution of progesterone signaling and variation in pregnancy maintenance and termination. We use this comparative physiology to support the hypothesis that selective pressure on genomic loci involved in the timing of parturition have shaped human birth timing, and that these loci can be identified with comparative genomic strategies. Previous limitations imposed by divergence of mechanisms provide an important new opportunity to elucidate fundamental pathways of parturition control through increasing availability of sequenced genomes and associated reproductive physiology characteristics across diverse organisms. PMID:25646385

  9. 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.

  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. 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. Ecological analysis of secular trends in low birth weight births and adult height in Japan.

    Science.gov (United States)

    Morisaki, Naho; Urayama, Kevin Yuji; Yoshii, Keisuke; Subramanian, S V; Yokoya, Susumu

    2017-10-01

    Japan, which currently maintains the highest life expectancy in the world and has experienced an impressive gain in adult height over the past century, has suffered a dramatic twofold increase in low birth weight (LBW) births since the 1970s. We observed secular trends in birth characteristics using 64 115 249 live births included the vital statistics (1969-2014), as well as trends in average height among 3 145 521 adults born between 1969 and 1996, included in 79 surveys conducted among a national, subnational or community population in Japan. LBW rates exhibited a U-shaped pattern showing reductions until 1978-1979 (5.5%), after which it increased. Conversely, average adult height peaked for those born during the same period (men, 171.5 cm; women, 158.5 cm), followed by a reduction over the next 20 years. LBW rate and adult height showed a strong inverse correlation (men, r=-0.98; women, r=-0.88). A prediction model based on birth and economical characteristics estimated the national average of adult height would continue to decline, to 170.0cm (95% CI 169.6 to 170.3) for men and 157.9cm (95% CI 157.5 to 158.3) for women among those born in 2014. Adult height in Japan has started to decline for those born after 1980, a trend that may be attributed to increases in LBW births over time. Considering the known association between shorter adult height and adverse health outcomes, evidence of population-level decline in adult health due to long-term consequences of increasing LBW births in Japan is anticipated. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. 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.

  14. The Zulu traditional birth attendant

    African Journals Online (AJOL)

    Some of the important practices of Zulu traditional birth attendants ... the people as regards pregnancy and labour. This article docu- .... into account previous perinatal deaths. ... They were either widows or married to husbands unable to work.

  15. Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011

    Directory of Open Access Journals (Sweden)

    Fu-Wen Liang

    2018-06-01

    Conclusion: In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs.

  16. No seasonality of birth in BMI at 7 years of age

    DEFF Research Database (Denmark)

    Jensen, Camilla Bjørn; Sørensen, Thorkild I.A.; Heitmann, Berit

    2016-01-01

    Seasonal variation in birth weight was found in a previous Danish study. In the present study we investigated if the seasonality in birth weight tracked into BMI at 7 years of age, but found no seasonality of birth in either BMI, overweight, or obesity. © 2016 Elsevier Ireland Ltd...

  17. Sex ratio at birth: scenario from normal- and high-level natural radiation areas of Kerala coast in south-west India

    International Nuclear Information System (INIS)

    Koya, P.K.M.; Jaikrishan, G.; Sudheer, K.R.; Madhusoodhanan, M.; Jagadeesan, C.K.; Das, Birajalaxmi; Andrews, V.J.

    2015-01-01

    Newborns were monitored for congenital malformations in four government hospitals located in high-level (ambient dose >1.5 mGy/year) and normal-level (≤1.5 mGy/year) natural radiation areas of Kerala, India, from August 1995 to December 2012. Sex ratio at birth (SRB) among live singleton newborns and among previous children, if any, of their mothers without history of any abortion, stillbirth or twins is reported here. In the absence of environmental stress or selective abortion of females, global average of SRB is about 1050 males to 1000 females. A total of 151,478 singleton, 1031 twins, 12 triplets and 1 quadruplet deliveries were monitored during the study period. Sex ratio among live singleton newborns was 1046 males (95 % CI 1036-1057) for 1000 females (77,153 males:73,730 females) and was comparable to the global average. It was similar in high-level and normal-level radiation areas of Kerala with SRB of 1050 and 1041, respectively. It was consistently more than 1000 and had no association with background radiation levels, maternal and paternal age at birth, parental age difference, gravida status, ethnicity, consanguinity or year of birth. Analysis of SRB of the children of 139,556 women whose reproductive histories were available suggested that couples having male child were likely to opt for more children and this, together with enhanced rate of males at all birth order, was skewing the overall SRB in favour of male children. Though preference for male child was apparent, extreme steps of sex-selective abortion or infanticide were not prevalent. (orig.)

  18. Sex ratio at birth: scenario from normal- and high-level natural radiation areas of Kerala coast in south-west India

    Energy Technology Data Exchange (ETDEWEB)

    Koya, P.K.M.; Jaikrishan, G.; Sudheer, K.R. [Bhabha Atomic Research Centre, Low Level Radiation Research Laboratory, Low Level Radiation Research Section, Radiation Biology and Health Sciences Division, Bio-Science Group, Kollam (India); Madhusoodhanan, M. [Victoria Hospital, Department of Paediatrics, Kollam (India); Jagadeesan, C.K. [Directorate of Health Services, Thiruvananthapuram (India); Das, Birajalaxmi [Bhabha Atomic Research Centre, Low Level Radiation Research Section, Radiation Biology and Health Sciences Division, Bio-Science Group, Mumbai (India); Andrews, V.J.

    2015-11-15

    Newborns were monitored for congenital malformations in four government hospitals located in high-level (ambient dose >1.5 mGy/year) and normal-level (≤1.5 mGy/year) natural radiation areas of Kerala, India, from August 1995 to December 2012. Sex ratio at birth (SRB) among live singleton newborns and among previous children, if any, of their mothers without history of any abortion, stillbirth or twins is reported here. In the absence of environmental stress or selective abortion of females, global average of SRB is about 1050 males to 1000 females. A total of 151,478 singleton, 1031 twins, 12 triplets and 1 quadruplet deliveries were monitored during the study period. Sex ratio among live singleton newborns was 1046 males (95 % CI 1036-1057) for 1000 females (77,153 males:73,730 females) and was comparable to the global average. It was similar in high-level and normal-level radiation areas of Kerala with SRB of 1050 and 1041, respectively. It was consistently more than 1000 and had no association with background radiation levels, maternal and paternal age at birth, parental age difference, gravida status, ethnicity, consanguinity or year of birth. Analysis of SRB of the children of 139,556 women whose reproductive histories were available suggested that couples having male child were likely to opt for more children and this, together with enhanced rate of males at all birth order, was skewing the overall SRB in favour of male children. Though preference for male child was apparent, extreme steps of sex-selective abortion or infanticide were not prevalent. (orig.)

  19. A review of terrorism and its reduction of the gender ratio at birth after seasonal adjustment.

    Science.gov (United States)

    Grech, Victor; Zammit, Dorota

    2017-12-01

    Males are born in excess of females, a ratio expressed as M/T (males:total births). The ratio exhibits seasonal variation. Furthermore, acute stressful events may result in a transient dip in male births due to excess foetal losses, reducing M/T. This study was carried out in order to identify significant M/T dips after adjusting for seasonality. Live births by gender and month were sought for acute stressful events. After seasonal correction (where appropriate), M/T dips were sought. Live births. M/T dips. This paper studied 112,226,306 live births. The following events showed dips ≤5th percentile 3-5months after these acute episodes: the Brooklyn Bridge protests, Katrina Hurricane for all 4 states and for each individual state (Alabama, Florida, Louisiana, Mississippi), the Battle in Seattle, the London bombings, The Madrid bombings (for Madrid and for Spain), the Breivik shooting, the Oklahoma City bombing and the Sandy Hook Elementary School shooting. The Virginia Polytechnic Institute and State University shooting the Fukushima Daiichi nuclear disaster also showed dips albeit slightly later. Seasonal adjustments should be taken into consideration in order to avoid Type 1 or 2 error pitfalls. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Trends and predictors of cesarean birth in Singapore, 2005-2014: A population-based cohort study.

    Science.gov (United States)

    Chi, Claudia; Pang, Deanette; Aris, Izzuddin M; Teo, Wei Ting; Li, Sarah Weiling; Biswas, Arijit; Yong, Eu Leong; Chong, Yap Seng; Tan, Kelvin; Kramer, Michael S

    2018-02-17

    Rates of cesarean birth have continued to rise in many high-income countries. We examined the temporal trends and predictors of cesarean birth in Singapore. Linked hospitalization and Birth Registry data were used to examine all live births to Singaporean citizens and permanent residents between January 1, 2005 and December 31, 2014 (n = 342 932 births). We calculated cesarean rates and age-adjusted average annual percent change (AAPC) in those rates and used sequential multivariable regression modeling to assess the contribution of changes in predictors to the change in cesarean rates over time. The overall cesarean rate in Singapore rose from 32.2% in 2005 to 37.4% in 2014. Among singleton, cephalic, term pregnancies, the two major predictions of cesarean were nulliparity and previous cesarean, each accounting for just over one-third of all cesareans. Higher AAPC was observed in nulliparous women of Indian ethnicity (0.74% [95% confidence interval 0.68-0.80]) compared with Chinese (0.62% [0.60-0.65]) or Malay women (0.63% [0.59-0.68]), and in women who delivered in private hospitals (0.62% [0.60-0.64]) compared with those delivered under subsidized care in public hospitals (0.58% [0.52-0.63]). Parity and education had the largest influences on cesarean birth trend (attenuation of AAPC from 0.62% [0.59-0.66] to 0.39% [0.38-0.40] after adjustment). Cesarean birth has continued to rise at a steady rate in Singapore. Strategies to curb this temporal increase include avoidance of medically unnecessary primary cesarean and attempts at trial of labor and vaginal delivery among women with a history of prior cesarean. © 2018 Wiley Periodicals, Inc.

  1. [Birth and matrimony of foreign citizens in Italy].

    Science.gov (United States)

    Manese, G

    1986-01-01

    A group of 1,030 children of foreign women living in or around Rome, Italy, are classified according to place of birth (public institution or private dwelling) and legitimacy and by parents' educational level, economic and professional status, citizenship, residence, and age at marriage.

  2. Levels and correlates of non-adherence to WHO recommended inter-birth intervals in Rufiji, Tanzania

    Directory of Open Access Journals (Sweden)

    Exavery Amon

    2012-12-01

    Full Text Available Abstract Background Poorly spaced pregnancies have been documented worldwide to result in adverse maternal and child health outcomes. The World Health Organization (WHO recommends a minimum inter-birth interval of 33 months between two consecutive live births in order to reduce the risk of adverse maternal and child health outcomes. However, birth spacing practices in many developing countries, including Tanzania, remain scantly addressed. Methods Longitudinal data collected in the Rufiji Health and Demographic Surveillance System (HDSS from January 1999 to December 2010 were analyzed to investigate birth spacing practices among women of childbearing age. The outcome variable, non-adherence to the minimum inter-birth interval, constituted all inter-birth intervals Results A total of 15,373 inter-birth intervals were recorded from 8,980 women aged 15–49 years in Rufiji district over the follow-up period of 11 years. The median inter-birth interval was 33.4 months. Of the 15,373 inter-birth intervals, 48.4% were below the WHO recommended minimum length of 33 months between two live births. Non-adherence was associated with younger maternal age, low maternal education, multiple births from the preceding pregnancy, non-health facility delivery of the preceding birth, being an in-migrant resident, multi-parity and being married. Conclusion Generally, one in every two inter-birth intervals among 15–49 year-old women in Rufiji district is poorly spaced, with significant variations by socio-demographic and behavioral characteristics of mothers and newborns. Maternal, newborn and child health services should be improved with a special emphasis on community- and health facility-based optimum birth spacing education in order to enhance health outcomes of mothers and their babies, especially in rural settings.

  3. Characteristics of planned and unplanned home births in 19 States.

    Science.gov (United States)

    Declercq, Eugene; Macdorman, Marian F; Menacker, Fay; Stotland, Naomi

    2010-07-01

    To estimate the differences in the characteristics of mothers having planned and unplanned home births that occurred at home in a 19-state reporting area in the United States in 2006. Data are from the 2006 U.S. vital statistics natality file. Information on whether a home birth was planned or unplanned was available from 19 states, representing 49% of all home births nationally. Data were examined by maternal age, race or ethnicity, education, marital status, live birth order, birthplace of mother, gestational age, prenatal care, smoking status, state, population of county of residence, and birth attendant. We could not identify planned home births that resulted in a transfer to the hospital. Of the 11,787 home births with planning status recorded in the 19 states studied here, 9,810 (83.2%) were identified as planned home births. The proportion of all births that occurred at home that were planned varied from 54% to 98% across states. Unplanned home births are more likely to involve mothers who are non-white, younger, unmarried, foreign-born, smokers, not college-educated, and with no prenatal care. Unplanned home births are also more likely to be preterm and to be attended by someone who is neither a doctor nor a midwife and is listed as either "other" or "unknown." Planned and unplanned home births differ substantially in characteristics, and distinctions need to be drawn between the two in subsequent analyses. III.

  4. Defeitos congênitos no Município do Rio de Janeiro, Brasil: uma avaliação através do SINASC (2000-2004 Birth defects in Rio de Janeiro, Brazil: an evaluation through birth certificates (2000-2004

    Directory of Open Access Journals (Sweden)

    Fernando Antônio Ramos Guerra

    2008-01-01

    Full Text Available Avaliou-se a ocorrência de defeitos congênitos em nascidos vivos no Município do Rio de Janeiro, Brasil, com base no Sistema de Informações sobre Nascidos Vivos (SINASC, no período de 1º de janeiro de 2000 a 31 de dezembro de 2004. Através de um estudo seccional e descritivo, estudaram-se as variáveis relativas aos defeitos congênitos (presença e aparelho ou sistema acometido, aos serviços de saúde, às mães, às gestações, aos recém-natos e aos partos. Constatou-se uma prevalência de defeitos congênitos de 83/10 mil nascidos vivos. Os sistemas orgânicos mais afetados foram o osteomuscular, nervoso central, genital, as fendas lábio-palatinas e as anomalias cromossômicas. A maioria dos casos nasceu nas maternidades municipais e na rede privada, e maior prevalência de defeitos congênitos ocorreu no Instituto Fernandes Figueira da Fundação Oswaldo Cruz. Os defeitos congênitos foram mais prevalentes entre os filhos de mulheres mais velhas e menos instruídas. O percentual de casos ignorados foi alto, chegando a 21% em algumas maternidades. Uma maior divulgação das informações do SINASC sobre defeitos congênitos deveria ser estimulada. Estudos de confiabilidade são recomendados para melhor aproveitamento das informações.To evaluate the occurrence of birth defects in the city of Rio de Janeiro, Brazil, using the Live Birth Information System (SINASC, we performed a cross-sectional study on all live newborns with birth defects from January 1, 2000, to December 31, 2004. The variables referred to birth defects (presence and system affected, type of health service, mothers, gestations, live births, and deliveries. Prevalence of birth defects was 83/10,000 live births. The most frequent birth defects involved the musculoskeletal system, central nervous system, cleft lip and palate, and chromosomal anomalies. The majority of cases were born in public (municipal and private maternity hospitals, with the highest prevalence

  5. Inclusion of non-viable neonates in the birth record and its impact on infant mortality rates in Shelby County, Tennessee, USA

    Directory of Open Access Journals (Sweden)

    Bryan Lee Williams

    2010-02-01

    Full Text Available Rates of infant death are one of the most common indicators of a population’s overall health status. Infant mortality rates (IMRs are used to make broad inferences about the quality of health care, effects of health policies and even environmental quality. The purpose of our study was threefold: i to examine the characteristics of births in the area in relation to gestational age and birthweight; ii to estimate infant mortality using variable gestational age and/or birthweight criteria for live birth, and iii to calculate proportional mortality ratios for each cause of death using variable gestational age and/or birthweight criteria for live birth. We conducted a retrospective analysis of all Shelby County resident-linked birth and infant death certificates during the years 1999 to 2004. Descriptive test statistics were used to examine infant mortality rates in relation to specific maternal and infant risk factors. Through careful examination of 1999-2004 resident-linked birth and infant death data sets, we observed a disproportionate number of non-viable live births (≤20 weeks gestation or ≤350 grams in Shelby County. Issuance of birth certificates to these non-viable neonates is a factor that contributes to an inflated IMR. Our study demonstrates the complexity and the appropriateness of comparing infant mortality rates in smaller geographic units, given the unique characteristics of live births in Shelby County. The disproportionate number of pre-viable infants born in Shelby County greatly obfuscates neonatal mortality and de-emphasizes the importance of post-neonatal mortality.

  6. Selected perinatal outcomes associated with planned home births in the United States.

    Science.gov (United States)

    Cheng, Yvonne W; Snowden, Jonathan M; King, Tekoa L; Caughey, Aaron B

    2013-10-01

    More women are planning home birth in the United States, although safety remains unclear. We examined outcomes that were associated with planned home compared with hospital births. We conducted a retrospective cohort study of term singleton live births in 2008 in the United States. Deliveries were categorized by location: hospitals or intended home births. Neonatal outcomes were compared with the use of the χ(2) test and multivariable logistic regression. There were 2,081,753 births that met the study criteria. Of these, 12,039 births (0.58%) were planned home births. More planned home births had 5-minute Apgar score births (0.24%; adjusted odds ratio, 1.87; 95% confidence interval, 1.36-2.58) and neonatal seizure (0.06% vs 0.02%, respectively; adjusted odds ratio, 3.08; 95% confidence interval, 1.44-6.58). Women with planned home birth had fewer interventions, including operative vaginal delivery and labor induction/augmentation. Planned home births were associated with increased neonatal complications but fewer obstetric interventions. The trade-off between maternal preferences and neonatal outcomes should be weighed thoughtfully. Copyright © 2013 Mosby, Inc. All rights reserved.

  7. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants

    OpenAIRE

    Gr?nebaum, Amos; McCullough, Laurence B.; Arabin, Birgit; Brent, Robert L.; Levene, Malcolm I.; Chervenak, Frank A.

    2016-01-01

    Introduction 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. Purpose The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of...

  8. 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.

  9. Modeling of live-birth rates and cost-effectiveness of oocyte cryopreservation for cancer patients prior to high- and low-risk gonadotoxic chemotherapy.

    Science.gov (United States)

    Lyttle Schumacher, B; Grover, N; Mesen, T; Steiner, A; Mersereau, J

    2017-10-01

    What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC). The decision to undergo FP prior to treatment is multifactorial and can be costly and delay treatment. Not all treatments carry the same gonadotoxicity and patients may choose to undergo FP-OC based on the probability of premature ovarian insufficiency, predicted outcomes and cost. A comprehensive model that incorporates age at diagnosis and toxicity of treatment to help guide patients in the decision to undergo FP-OC does not yet exist. This study used a Decision Analysis Model to estimate effectiveness and cost of FP for cancer patients. Age-based estimates of LBR and cost per live birth were calculated for ages 25-40 years based on gonadotoxicity of treatment. A decision analysis model was constructed using Treeage Pro 2015 with case base probabilities derived from national registries, practice guidelines and medical records from a national network of infertility practices (IntegraMed). Compared to no FP-OC, FP-OC improved LBRs for women of all ages undergoing either low-risk chemotherapy (LRC) or HRC; however, it was most cost effective for women undergoing LRC at older ages or HRC at younger ages. Although FP-OC results in higher LBRs, it was always more costly. Using donor oocyte IVF can be a successful alternative to autologous FP-OC. Decision tree results reflect probabilities of certain events and are compiled from multiple reputable sources but are not directly derived from a recruited cohort of patients. Outcomes are based on United States estimates and should be

  10. Inter-birth interval in zebras is longer following the birth of male foals than after female foals

    Science.gov (United States)

    Barnier, Florian; Grange, Sophie; Ganswindt, Andre; Ncube, Hlengisizwe; Duncan, Patrick

    2012-07-01

    Mammalian reproductive rates vary among individuals for physiological and environmental reasons. This study aims to determine reproductive rates from an individually monitored population of wild Plains zebras Equus quagga, and to assess the sources of variability in inter-birth intervals. The animals were monitored, where possible, every six months from 2004 to 2011. Thirty nine intervals corresponding to 65 births in 26 mares were identified, using direct observations and faecal steroid monitoring. Mean foaling rate of the population is 0.74 foal/year, and comparable with the literature. There was no significant effect of mother's age, nor of the season of previous birth on the length of inter-birth intervals. Inter-birth interval was significantly longer when the first foal was a male. This finding indicates that additional costs of having a son may delay future reproduction and thus reduce the total number of offspring a mare can have during her lifetime. Individually-based data provide critical information on the determinants of reproductive rates, and are therefore a key to understanding the causes of variations in life-history traits.

  11. Improving activities of daily living in danish centenarians--but only in women: A comparative study of two birth cohorts born in 1895 and 1905

    DEFF Research Database (Denmark)

    Engberg, Henriette; Christensen, Kaare; Andersen-Ranberg, Karen

    2008-01-01

    ) and Physical Activities of Daily Living (PADLs) were assessed in both cohorts. RESULTS: The 1905 cohort displayed better self-reported ADLs than the 1895 cohort did. Stratified by gender, this apparent cohort advantage was due to women in the 1905 cohort performing significantly better than their female......BACKGROUND: The number of centenarians has increased rapidly since the 1950s. In Denmark, 42% more of the 1905 birth cohort made it to 100 years of age compared to the 1895 cohort. We tested whether this increased survival proportion has resulted in an increased disability level in the more recent...... included all individuals born in Denmark in 1905. At baseline in 1998, a total of 2262 persons participated in the intake survey (63%). In total, 225 of 364 persons (62%) who reached their 100th birthday in the cohort participated in the most recent 2005 wave. Basic Activities of Daily Living (BADLs...

  12. Births: preliminary data for 2000.

    Science.gov (United States)

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

    2001-07-24

    rise in the rate of primary cesarean deliveries and a decline in the rate of vaginal births after previous cesarean delivery.

  13. 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

  14. The partial-birth stratagem.

    Science.gov (United States)

    1998-06-01

    In Wisconsin, physicians stopped performing abortions when a Federal District Court Judge refused to issue a temporary restraining order against the state's newly enacted "partial birth" abortion ban that was couched in such vague language it actually covered all abortions. While ostensibly attempting to ban late-term "intact dilation and extraction," the language of the law did not refer to that procedure or to late terms. Instead, it prohibited all abortions in which a physician "partially vaginally delivers a living child, causes the death of the partially delivered child with the intent to kill the child and then completes the delivery of the child." The law also defined "child" as "a human being from the time of fertilization" until birth. It is clear that this abortion ban is unconstitutional under Row v. Wade, and this unconstitutionality is compounded by the fact that the law allowed no exception to protect a woman's health, which is required by Roe for abortion bans after fetal viability. Wisconsin is only one of about 28 states that have enacted similar laws, and only two have restricted the ban to postviability abortions. Many of these laws have been struck down in court, and President Clinton has continued to veto the Federal partial-birth bill. The Wisconsin Judge acknowledged that opponents of the ban will likely prevail when the case is heard, but his action in denying the temporary injunction means that many women in Wisconsin will not receive timely medical care. The partial birth strategy is really only another anti-abortion strategy.

  15. Rates of preterm birth following antenatal exposure to severe life events: A population-based cohort study

    DEFF Research Database (Denmark)

    Khashan, Ali; McNamee, R.; Abel, Kathryn

    2009-01-01

    BACKGROUND: Preterm birth and other pregnancy complications have been linked to maternal stress during pregnancy. We investigated the association between maternal exposure to severe life events and risk of preterm birth. METHODS: Mothers of all singleton live births (n = 1.35 million births...... to estimate the effect of exposure on preterm birth, very preterm birth and extremely preterm birth. RESULTS: There were 58 626 (4.34%) preterm births (births and 3288 (0.24%) extremely preterm births in the study cohort. Severe life events in close relatives in the 6...... months before conception increased the risk of preterm birth by 16% (relative risk, RR = 1.16, [95% CI: 1.08-1.23]). Severe life events in older children in the 6 months before conception increased the risk of preterm birth by 23% (RR = 1.23, [95% CI: 1.02-1.49]) and the risk of very preterm birth by 59...

  16. Use of ICSI in IVF cycles in women with tubal ligation does not improve pregnancy or live birth rates.

    Science.gov (United States)

    Grimstad, F W; Nangia, Ajay K; Luke, B; Stern, J E; Mak, W

    2016-12-01

    Does ICSI improve outcomes in ART cycles without male factor, specifically in couples with a history of tubal ligation as their infertility diagnosis? The use of ICSI showed no significant improvement in fertilization rate and resulted in lower pregnancy and live birth (LB) rates for women with the diagnosis of tubal ligation and no male factor. Prior studies have suggested that ICSI use does not improve fertilization, pregnancy or LB rates in couples with non-male factor infertility. However, it is unknown whether couples with tubal ligation only diagnosis and therefore iatrogenic infertility could benefit from the use of ICSI during their ART cycles. Longitudinal cohort of nationally reported cycles in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) of ART cycles performed in the USA between 2004 and 2012. There was a total of 8102 first autologous fresh ART cycles from women with the diagnosis of tubal ligation only and no reported male factor in the SART database. Of these, 957 were canceled cycles and were excluded from the final analysis. The remaining cycles were categorized by the use of conventional IVF (IVF, n = 3956 cycles) or ICSI (n = 3189 cycles). The odds of fertilization, clinical intrauterine gestation (CIG) and LB were calculated by logistic regression modeling, and the adjusted odds ratios (AORs) with 95% confidence intervals were calculated by adjusting for the confounders of year of treatment, maternal age, race and ethnicity, gravidity, number of oocytes retrieved, day of embryo transfer and number of embryos transferred. The main outcome measures of the study were odds of fertilization (2PN/total oocytes), clinical intrauterine gestation (CIG/cycle) and live birth (LB/cycle). The fertilization rate was higher in the ICSI versus IVF group (57.5% vs 49.1%); however, after adjustment this trend was no longer significant (AOR 1.14, 0.97-1.35). Interestingly, both odds of CIG (AOR 0.78, 0

  17. Periventricular-intraventricular haemorrhage in low-birth-weight ...

    African Journals Online (AJOL)

    The prevalence of periventricular-intraventricular haemorrhage (PV-IVH) aInong very-low-birthweight infants at Baragwanath Hospital has not been well docwnented. In this prospective study, a total of 282 live-born infants with birth weights of 1 000 - 1 749 g were studied over a 41/2-month period. Every infant had at least ...

  18. The inner state differences of preterm birth rates in Brazil: a time series study.

    Science.gov (United States)

    de Oliveira, Rosana Rosseto; Melo, Emiliana Cristina; Fujimori, Elizabeth; Mathias, Thais Aidar de Freitas

    2016-05-17

    Preterm birth is a serious public health problem, as it is linked to high rates of neonatal and child morbidity and mortality. The prevalence of premature births has increased worldwide, with regional differences. The objective of this study was to analyze the trend of preterm births in the state of Paraná, Brazil, according to Macro-regional and Regional Health Offices (RHOs). This is an ecological time series study using preterm births records from the national live birth registry system of Brazil's National Health Service - Live Birth Information System (Sinasc), for residents of the state of Paraná, Brazil, between 2000 and 2013. The preterm birth rates was calculated on a yearly basis and grouped into three-year periods (2000-2002, 2003-2005, 2006-2008, 2009-2011) and one two-year period (2012-2013), according to gestational age and mother's Regional Health Office of residence. The polynomial regression model was used for trend analysis. The predominance of preterm birth rate increased from 6.8 % in 2000 to 10.5 % in 2013, with an average increase of 0.20 % per year (r(2) = 0.89), and a greater share of moderate preterm births (32 to rate of prematurity and average annual growth during that period (7.55 % and 0.35 %, respectively). The trend analysis of preterm birth rates according to RHO showed a growing trend for almost all RHOs - except for the 7(th) RHO where a declining trend was observed (-0.95 a year); and in the 20(th), 21(st) and 22(nd) RHOs which remained unchanged. In the last three-year of the study period (2011-2013), no RHO showed preterm birth rates below 7.3 % or prevalence of moderate preterm birth below 9.4 %. The results show an increase in preterm births with differences among Macro-regional and RHOs, which indicate the need to improve actions during the prenatal period according to the specificities of each region.

  19. Systematic review of progesterone for the prevention of preterm birth in singleton pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Langhoff-Roos, Jens; Andersson, Charlotte

    2009-01-01

    . SEARCH STRATEGY: A search in the PubMed, Embase, and Cochrane database was performed using the keywords: pregnancy, progesterone, preterm birth/preterm delivery, preterm labor, controlled trial, and randomized controlled trial. SELECTION CRITERIA: Studies on singleton pregnancies. DATA COLLECTION...... AND ANALYSIS: A meta-analysis was performed on randomized trials including singleton pregnancies with previous preterm birth. MAIN RESULTS: Two new randomized controlled trials of women with previous preterm birth were added to the four analyzed in the Cochrane review, and the meta-analysis of all six studies......BACKGROUND: A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. OBJECTIVE: To provide an update on the preventive effect of progesterone on preterm birth in singleton pregnancies...

  20. 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.

  1. Birth Order and Injury-Related Infant Mortality in the U.S.

    Science.gov (United States)

    Ahrens, Katherine A; Rossen, Lauren M; Thoma, Marie E; Warner, Margaret; Simon, Alan E

    2017-10-01

    The purpose of this study was to evaluate the risk of death during the first year of life due to injury, such as unintentional injury and homicide, by birth order in the U.S. Using national birth cohort-linked birth-infant death data (births, 2000-2010; deaths, 2000-2011), risks of infant mortality due to injury in second-, third-, fourth-, and fifth or later-born singleton infants were compared with first-born singleton infants. Risk ratios were estimated using log-binomial models adjusted for maternal age, marital status, race/ethnicity, and education. The statistical analyses were conducted in 2016. Approximately 40%, 32%, 16%, 7%, and 4% of singleton live births were first, second, third, fourth, and fifth or later born, respectively. From 2000 to 2011, a total of 15,866 infants died as a result of injury (approximately 1,442 deaths per year). Compared with first-born infants (2.9 deaths per 10,000 live births), second or later-born infants were at increased risk of infant mortality due to injury (second, 3.6 deaths; third, 4.2 deaths; fourth, 4.8 deaths; fifth or later, 6.4 deaths). The corresponding adjusted risk ratios were as follows: second, 1.84 (95% CI=1.76, 1.91); third, 2.42 (95% CI=2.30, 2.54); fourth, 2.96 (95% CI=2.77, 3.16); and fifth or later, 4.26 (95% CI=3.96, 4.57). Singleton infants born second or later were at increased risk of mortality due to injury during their first year of life in the U.S. This study's findings highlight the importance of investigating underlying mechanisms behind this increased risk. Published by Elsevier Inc.

  2. Tritium releases, birth defects and infant deaths

    International Nuclear Information System (INIS)

    1991-01-01

    The AECB has published a report 'Tritium releases from the Pickering Nuclear Generating Station and Birth Defects and Infant Mortality in Nearby Communities 1971-1988' (report number INFO-0401). This presents the results of a detailed analysis of deaths and birth defects occurring in infants born to mothers living in the area (25 Km radius) of the Pickering nuclear power plant, over an 18-year period. The analysis looked at the frequency of these defects and deaths in comparison to the general rate for Ontario, and also in relation to airborne and waterborne releases of tritium from the power plant. The overall conclusion was that the rates of infant death and birth defects were generally not higher in the study population than in all of Ontario. There was no prevalent relationship between these deaths and defects and tritium releases measured either at the power plant or by ground monitoring stations t some distance from the facility

  3. Navajo birth outcomes in the Shiprock uranium mining area

    International Nuclear Information System (INIS)

    Shields, L.M.; Wiese, W.H.; Skipper, B.J.; Charley, B.; Benally, L.

    1992-01-01

    The role of environmental radiation in the etiology of birth defects, stillbirths, and other adverse outcomes of pregnancy was evaluated for 13,329 Navajos born at the Public Health Service/Indian Health Service Hospital in the Shiprock, NM, uranium mining area (1964-1981). More than 320 kinds of defective congenital conditions were abstracted from hospital records. Using a nested case-control design, families of 266 pairs of index and control births were interviewed. The only statistically significant association between uranium operations and unfavorable birth outcome was identified with the mother living near tailings or mine dumps. Among the fathers who worked in the mines, those of the index cases had histories of more years of work exposure but not necessarily greater gonadal dosage of radiation. Also, birth defects increased significantly when either parent worked in the Shiprock electronics assembly plant. Overall, the associations between adverse pregnancy outcome and exposure to radiation were weak and must be interpreted with caution with respect to implying a biogenetic basis

  4. Preterm birth rates in Japan from 1979 to 2014: Analysis of national vital statistics.

    Science.gov (United States)

    Sakata, Soyoko; Konishi, Shoko; Ng, Chris Fook Sheng; Watanabe, Chiho

    2018-03-01

    Secular trends of preterm birth in Japan between 1979 and 2014 were examined to determine whether changes could be explained by a shift in the distribution of maternal age at delivery and parity and/or by changes in age-specific preterm birth rates. Live birth data for 1979 to 2014 were obtained from the Japanese Ministry of Health, Labour and Welfare. Analyses were limited to singleton children born in Japan (n = 43 632 786). Preterm birth was defined using two cut-offs at rates of preterm birth were calculated for firstborn and later-born singletons by maternal age at delivery for specific time periods. Throughout the study period, the rates of preterm birth (both at rates of preterm birth at rates of preterm birth showed a secular increase for preterm births at rates of preterm birth among mothers aged in their 20s and early 30s increased between 1979 and 2014, which contributed to the secular increase in rates of preterm birth at < 37 weeks. © 2017 Japan Society of Obstetrics and Gynecology.

  5. Birth weight, breast cancer and the potential mediating hormonal environment.

    LENUS (Irish Health Repository)

    Bukowski, Radek

    2012-01-01

    Previous studies have shown that woman\\'s risk of breast cancer in later life is associated with her infants birth weights. The objective of this study was to determine if this association is independent of breast cancer risk factors, mother\\'s own birth weight and to evaluate association between infants birth weight and hormonal environment during pregnancy. Independent association would have implications for understanding the mechanism, but also for prediction and prevention of breast cancer.

  6. Risk of preterm birth by subtype among Medi-Cal participants with mental illness.

    Science.gov (United States)

    Baer, Rebecca J; Chambers, Christina D; Bandoli, Gretchen; Jelliffe-Pawlowski, Laura L

    2016-10-01

    Previous studies have demonstrated an association between mental illness and preterm birth (before 37 weeks). However, these investigations have not simultaneously considered gestation of preterm birth, the indication (eg, spontaneous or medically indicated), and specific mental illness classifications. The objective of the study was to examine the likelihood of preterm birth across gestational lengths and indications among Medi-Cal (California's Medicaid program) participants with a diagnostic code for mental illness. Mental illnesses were studied by specific illness classification. The study population was drawn from singleton live births in California from 2007 through 2011 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes birth certificate and hospital discharge records. The sample was restricted to women with Medi-Cal coverage for prenatal care. Women with mental illness were identified using International Classification of Diseases, ninth revision, codes from their hospital discharge record. Women without a mental illness International Classification of Diseases, ninth revision, code were randomly selected at a 4:1 ratio. Adjusting for maternal characteristics and obstetric complications, relative risks and 95% confidence intervals were calculated for preterm birth comparing women with a mental illness diagnostic code with women without such a code. We identified 6198 women with a mental illness diagnostic code and selected 24,792 women with no such code. The risk of preterm birth in women with a mental illness were 1.2 times higher than women without a mental illness (adjusted relative risk, 1.2, 95% confidence interval, 1.1-1.3). Among the specific mental illnesses, schizophrenia, major depression, and personality disorders had the strongest associations with preterm birth (adjusted relative risks, 2.0, 2.0 and 3.3, respectively). Women receiving prenatal care through California's low

  7. [Chinese neonatal birth weight curve for different gestational age].

    Science.gov (United States)

    Zhu, Li; Zhang, Rong; Zhang, Shulian; Shi, Wenjing; Yan, Weili; Wang, Xiaoli; Lyu, Qin; Liu, Ling; Zhou, Qin; Qiu, Quanfang; Li, Xiaoying; He, Haiying; Wang, Jimei; Li, Ruichun; Lu, Jiarong; Yin, Zhaoqing; Su, Ping; Lin, Xinzhu; Guo, Fang; Zhang, Hui; Li, Shujun; Xin, Hua; Han, Yanqing; Wang, Hongyun; Chen, Dongmei; Li, Zhankui; Wang, Huiqin; Qiu, Yinping; Liu, Huayan; Yang, Jie; Yang, Xiaoli; Li, Mingxia; Li, Wenjing; Han, Shuping; Cao, Bei; Yi, Bin; Zhang, Yihui; Chen, Chao

    2015-02-01

    Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve. A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system. the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1. A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method. Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

  8. Age, time period, and birth cohort differences in self-esteem: Reexamining a cohort-sequential longitudinal study.

    Science.gov (United States)

    Twenge, Jean M; Carter, Nathan T; Campbell, W Keith

    2017-05-01

    Orth, Trzesniewski, and Robins (2010) concluded that the nationally representative Americans' Changing Lives (ACL) cohort-sequential study demonstrated moderate to large age differences in self-esteem, and no birth cohort (generational) differences in the age trajectory. In a reanalysis of these data using 2 different statistical techniques, we find significant increases in self-esteem that could be attributed to birth cohort or time period. First, hierarchical linear modeling analyses with birth cohort as a continuous variable (vs. the multiple group formulation used by Orth et al.) find that birth cohort has a measurable influence on self-esteem through its interaction with age. Participants born in later years (e.g., 1960) were higher in self-esteem and were more likely to increase in self-esteem as they aged than participants born in earlier years (e.g., 1920). However, the estimated age trajectory up to age 60 is similar in Orth et al.'s results and in the results from our analyses including cohort. Second, comparing ACL respondents of the same age in 1986 versus 2002 (a time-lag design) yields significant birth cohort differences in self-esteem, with 2002 participants of the same age higher in self-esteem than those in 1986. Combined with some previous studies finding significant increases in self-esteem and positive self-views over time, these results suggest that cultural change in the form of cohort and time period cannot be ignored as influences in cross-sectional and longitudinal studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection - 15 States and U.S. Territories, 2016.

    Science.gov (United States)

    Delaney, Augustina; Mai, Cara; Smoots, Ashley; Cragan, Janet; Ellington, Sascha; Langlois, Peter; Breidenbach, Rebecca; Fornoff, Jane; Dunn, Julie; Yazdy, Mahsa; Scotto-Rosato, Nancy; Sweatlock, Joseph; Fox, Deborah; Palacios, Jessica; Forestieri, Nina; Leedom, Vinita; Smiley, Mary; Nance, Amy; Lake-Burger, Heather; Romitti, Paul; Fall, Carrie; Prado, Miguel Valencia; Barton, Jerusha; Bryan, J Michael; Arias, William; Brown, Samara Viner; Kimura, Jonathan; Mann, Sylvia; Martin, Brennan; Orantes, Lucia; Taylor, Amber; Nahabedian, John; Akosa, Amanda; Song, Ziwei; Martin, Stacey; Ramlal, Roshan; Shapiro-Mendoza, Carrie; Isenburg, Jennifer; Moore, Cynthia A; Gilboa, Suzanne; Honein, Margaret A

    2018-01-26

    Zika virus infection during pregnancy can cause serious birth defects, including microcephaly and brain abnormalities (1). Population-based birth defects surveillance systems are critical to monitor all infants and fetuses with birth defects potentially related to Zika virus infection, regardless of known exposure or laboratory evidence of Zika virus infection during pregnancy. CDC analyzed data from 15 U.S. jurisdictions conducting population-based surveillance for birth defects potentially related to Zika virus infection.* Jurisdictions were stratified into the following three groups: those with 1) documented local transmission of Zika virus during 2016; 2) one or more cases of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents; and 3) less than one case of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents. A total of 2,962 infants and fetuses (3.0 per 1,000 live births; 95% confidence interval [CI] = 2.9-3.2) (2) met the case definition. † In areas with local transmission there was a non-statistically significant increase in total birth defects potentially related to Zika virus infection from 2.8 cases per 1,000 live births in the first half of 2016 to 3.0 cases in the second half (p = 0.10). However, when neural tube defects and other early brain malformations (NTDs) § were excluded, the prevalence of birth defects strongly linked to congenital Zika virus infection increased significantly, from 2.0 cases per 1,000 live births in the first half of 2016 to 2.4 cases in the second half, an increase of 29 more cases than expected (p = 0.009). These findings underscore the importance of surveillance for birth defects potentially related to Zika virus infection and the need for continued monitoring in areas at risk for Zika.

  10. Improvement in Activities of Daily Living among Danish Centenarians?

    DEFF Research Database (Denmark)

    Rasmussen, Signe Høi; Thinggaard, Mikael; Højgaard, Majken Boris

    2018-01-01

    at investigating if the later born cohort had better functioning in terms of activities of daily living (ADL). Methods: Identification, methodology and assessment instruments were identical in the 1895-West and 1915-West Birth Cohort Studies: All persons living in the western part of Denmark and turning 100 years...

  11. 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.

  12. 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...

  13. Ordered delinquency: the "effects" of birth order on delinquency.

    Science.gov (United States)

    Cundiff, Patrick R

    2013-08-01

    Juvenile delinquency has long been associated with birth order in popular culture. While images of the middle child acting out for attention or the rebellious youngest child readily spring to mind, little research has attempted to explain why. Drawing from Adlerian birth order theory and Sulloway's born-to-rebel hypothesis, I examine the relationship between birth order and a variety of delinquent outcomes during adolescence. Following some recent research on birth order and intelligence, I use new methods that allow for the examination of between-individual and within-family differences to better address the potential spurious relationship. My findings suggest that contrary to popular belief, the relationship between birth order and delinquency is spurious. Specifically, I find that birth order effects on delinquency are spurious and largely products of the analytic methods used in previous tests of the relationship. The implications of this finding are discussed.

  14. 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

  15. 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

  16. 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

  17. National screening guidelines and developments in prenatal diagnoses and live births of Down syndrome in 1973–2016 in Denmark

    DEFF Research Database (Denmark)

    Lou, Stina; Petersen, Olav B.; Jørgensen, Finn Stener

    2018-01-01

    INTRODUCTION: Denmark was the first country in the world to implement a national, free-for-all offer of prenatal screening for Down syndrome to all pregnant women. It has a high uptake (> 90%) compared to other countries. Thus, Denmark offers an interesting case for investigating the consequences...... of implementing a comprehensive, national prenatal screening guideline. The aim of this study was to describe the historical developments in invasive procedures, pre-/postnatal diagnoses of Down syndrome and Down syndrome live births in the period 1973-2016 in Denmark MATERIAL AND METHODS: Data on invasive...... procedures, pre- and postnatal Down syndrome diagnoses were retrieved from the Danish Cytogenetic Central Registry RESULTS: From 1973-1993 screening based on maternal age and high-risk indications resulted in a constant increase in invasive procedures. After the introduction of the triple test in 1994...

  18. Brothers and reduction of the birth weight of later-born siblings

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Mortensen, Laust; Nygaard, Ulrikka

    2008-01-01

    It has been speculated whether maternal immune responses against male-specific minor histocompatibility (H-Y) antigens affect pregnancies negatively. This study explores, on a population level, whether previous births of boys compared with girls are associated with a decrease in birth weight...... of later-born siblings. The population was identified in the Danish Birth Registry and consisted of all Danish women who gave birth to their first-born singleton from 1980 to 1998. The women were followed until 2004, and their subsequent births were recorded. A total of 545,839 second- to fourth......-born children were identified. The authors used linear regression to analyze the association between sex of preceding children and birth weight of subsequent siblings. Brothers compared with sisters reduced the birth weight of later-born siblings. One or two brothers, respectively, reduced the mean birth weight...

  19. Variation in rates of postterm birth in Europe: reality or artefact?

    Science.gov (United States)

    Zeitlin, J; Blondel, B; Alexander, S; Bréart, G

    2007-09-01

    To compare rates of postterm birth in Europe. Analysis of data from vital statistics, birth registers, and national birth samples collected for the PERISTAT project. Thirteen European countries. All live births or representative samples of births for the year 2000 or most recent year available. Comparison of national and regional rates of postterm birth. Other indicators (birthweight, deliveries with a non-spontaneous onset and mortality) were used to assess the validity of postterm rates. The proportion of births at 42 completed weeks of gestation or later. Postterm rates varied greatly, from 0.4% (Austria, Belgium) to over 7% (Denmark, Sweden) of births. Higher postterm rates were associated with a greater proportion of babies with birthweight 4500 g or more. Fetal and early neonatal mortality rates were higher among postterm births than among births at 40 weeks. Countries with higher proportions of births with a nonspontaneous onset of labour had lower postterm birth rates. The shapes of the gestational-age distributions at term varied. In some countries, there was a sharp cutoff in deliveries at 40 weeks, while elsewhere this occurred at 41 weeks. These results suggest that practices for managing pregnancies continuing beyond term differ in Europe and raise questions about the health and other impacts in countries with markedly high or low postterm rates. Some variability in these rates may also be due to methods for determining gestational age, which has broader implications for international comparisons of gestational age, including rates of postterm and preterm births and small-for-gestational-age newborns.

  20. Audit of Childbirth Emergency Referrals by Trained Traditional Birth Attendants in Enugu, Southeast, Nigeria.

    Science.gov (United States)

    Okafor, I I; Arinze-Onyia, S U; Ohayi, Sar; Onyekpa, J I; Ugwu, E O

    2015-01-01

    The essence of training traditional birth attendants (TBAs) is to attend to women in uncomplicated labor and to refer them immediately to hospitals when complications develop. The aim was to audit childbirth emergency referrals by trained TBAs to a specialist hospital in Enugu, Nigeria. A retrospective study of 205 childbirth emergencies referred to Semino Hospital and Maternity (SHM), Enugu by trained TBAs from August 1, 2011 to January 31, 2014. Data analysis was descriptive and inferential at 95% confidence level. Most of the patients (185/205, 90.2%) were married and (100/205, 48.8%) had earlier booked for antenatal care in formal health facilities. There were obstetric danger signs or previous bad obstetric histories (pregnancies with unfavorable outcome) in 110 (110/205, 53.7%) women on admission at SHM. One hundred and fifteen (115/205, 56.1%) women walked into the hospital by themselves while 50 (50/205, 24.39%) could not walk. The fetal heart sounds were normal in 94 (94/205, 45.6%), abnormal in 65 (65/205, 31.8%) and absent in 42 (42/205, 20.4%) of the women on admission. Five healthy babies were delivered by the TBAs before referring their mothers. Delays of more than 12 h had occurred in 155 (155/205, 76.6%) of the women before referrals. Prolonged labor (100/205, 48.8%), obstructed labor (40/205, 19.5%), attempted vaginal birth after previous cesarean delivery (40/205, 19.5%) and malpresentation (30/205, 14.6%) were the common indications for referrals. The maternal mortality and perinatal mortality ratios were 610/100,000 live births and 228/1000 total births respectively. Delays at TBA centers are common before referral and most patients are referred in poor clinical state. Further training and re-training of the TBAs with more emphasis on recognition of obstetric danger signs and bad obstetric histories may help in screening high-risk patients for prompt referral to hospitals before complications develop.

  1. Comparative primate obstetrics: Observations of 15 diurnal births in wild gelada monkeys (Theropithecus gelada) and their implications for understanding human and nonhuman primate birth evolution.

    Science.gov (United States)

    Nguyen, Nga; Lee, Laura M; Fashing, Peter J; Nurmi, Niina O; Stewart, Kathrine M; Turner, Taylor J; Barry, Tyler S; Callingham, Kadie R; Goodale, C Barret; Kellogg, Bryce S; Burke, Ryan J; Bechtold, Emily K; Claase, Megan J; Eriksen, G Anita; Jones, Sorrel C Z; Kerby, Jeffrey T; Kraus, Jacob B; Miller, Carrie M; Trew, Thomas H; Zhao, Yi; Beierschmitt, Evan C; Ramsay, Malcolm S; Reynolds, Jason D; Venkataraman, Vivek V

    2017-05-01

    The birth process has been studied extensively in many human societies, yet little is known about this essential life history event in other primates. Here, we provide the most detailed account of behaviors surrounding birth for any wild nonhuman primate to date. Over a recent ∼10-year period, we directly observed 15 diurnal births (13 live births and 2 stillbirths) among geladas (Theropithecus gelada) at Guassa, Ethiopia. During each birth, we recorded the occurrence (or absence) of 16 periparturitional events, chosen for their potential to provide comparative evolutionary insights into the factors that shaped birth behaviors in humans and other primates. We found that several events (e.g., adopting standing crouched positions, delivering infants headfirst) occurred during all births, while other events (e.g., aiding the infant from the birth canal, licking infants following delivery, placentophagy) occurred during, or immediately after, most births. Moreover, multiparas (n = 9) were more likely than primiparas (n = 6) to (a) give birth later in the day, (b) isolate themselves from nearby conspecifics while giving birth, (c) aid the infant from the birth canal, and (d) consume the placenta. Our results suggest that prior maternal experience may contribute to greater competence or efficiency during the birth process. Moreover, face presentations (in which infants are born with their neck extended and their face appearing first, facing the mother) appear to be the norm for geladas. Lastly, malpresentations (in which infants are born in the occiput anterior position more typical of human infants) may be associated with increased mortality in this species. We compare the birth process in geladas to those in other primates (including humans) and discuss several key implications of our study for advancing understanding of obstetrics and the mechanism of labor in humans and nonhuman primates. © 2017 Wiley Periodicals, Inc.

  2. 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.

  3. Acquired versus innate prey capturing skills in super-precocial live-bearing fish

    NARCIS (Netherlands)

    Lankheet, Martin J.; Stoffers, Twan; Leeuwen, van Johan L.; Pollux, Bart J.A.

    2016-01-01

    Live-bearing fish start hunting for mobile prey within hours after birth, an example of extreme precociality. Because prenatal, in utero, development of this behaviour is constrained by the lack of free-swimming sensory-motor interactions, immediate success after birth depends on innate,

  4. 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.

  5. The relationship between air pollution and low birth weight: effects by mother's age, infant sex, co-pollutants, and pre-term births

    International Nuclear Information System (INIS)

    Bell, Michelle L; Ebisu, Keita; Belanger, Kathleen

    2008-01-01

    Previously we identified associations between the mother's air pollution exposure and birth weight for births in Connecticut and Massachusetts from 1999-2002. Other studies also found effects, though results are inconsistent. We explored potential uncertainties in earlier work and further explored associations between air pollution and birth weight for PM 10 , PM 2.5 , CO, NO 2 , and SO 2 . Specifically we investigated: (1) whether infants of younger (≤24 years) and older (≥40 years) mothers are particularly susceptible to air pollution's effects on birth weight; (2) whether the relationship between air pollution and birth weight differed by infant sex; (3) confounding by co-pollutants and differences in pollutants' measurement frequencies; and (4) whether observed associations were influenced by inclusion of pre-term births. Findings did not indicate higher susceptibility to the relationship between air pollution and birth weight based on the mother's age or the infant's sex. Results were robust to exclusion of pre-term infants and co-pollutant adjustment, although sample size decreased for some pollutant pairs. These findings provide additional evidence for the relationship between air pollution and birth weight, and do not identify susceptible sub-populations based on infant sex or mother's age. We conclude with discussion of key challenges in research on air pollution and pregnancy outcomes.

  6. Trends and racial differences in birth weight and related survival.

    Science.gov (United States)

    Alexander, G R; Tompkins, M E; Allen, M C; Hulsey, T C

    1999-06-01

    In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates. Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life. Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans. The ongoing decline in neonatal mortality is mainly due to reductions in birth weight specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.

  7. 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.

  8. 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.

  9. Live birth after rescue in vitro maturation–intracytoplasmic sperm injection in type 1 diabetes, polycystic ovary syndrome patient using clomiphene–antagonist protocol

    Directory of Open Access Journals (Sweden)

    Samundi Sankari

    2018-01-01

    Full Text Available Infertility in patients with polycystic ovary syndrome (PCOS associated with diabetes leads to challenging situations seeking alternative treatments. In vitro maturation (IVM followed by intracytoplasmic sperm injection (ICSI could overcome the challenges with promising pregnancies in such patients. In the treatment of a 32-year-old diabetic woman who also had PCOS, single immature oocyte was retrieved. Rescue IVM followed by ICSI yielded a grade 1 day 3 embryo which on transferring resulted in pregnancy and a healthy infant was delivered. Rescue IVM–ICSI could help in achieving pregnancy and live birth. Stimulation involving clomiphene and gonadotropin-releasing hormone antagonist is an effective and patient-friendly protocol for women with PCOS and diabetes and also for poor responders.

  10. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study.

    Science.gov (United States)

    Leppold, Claire; Nomura, Shuhei; Sawano, Toyoaki; Ozaki, Akihiko; Tsubokura, Masaharu; Hill, Sarah; Kanazawa, Yukio; Anbe, Hiroshi

    2017-05-19

    Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (effects on maternal and perinatal health.

  11. What is vaginal birth after cesarean (VBAC)?

    Science.gov (United States)

    ... Pinterest Email Print What is vaginal birth after cesarean (VBAC)? VBAC refers to vaginal delivery of a baby after a previous pregnancy was delivered by cesarean delivery. In the past, pregnant women who had ...

  12. 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.

  13. Life-Course Relationship between Socioeconomic Circumstances and Timing of First Birth in a Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Thea van Roode

    Full Text Available This study examines the influence of socioeconomic circumstances in childhood (childhood SES and adulthood (adult SES on timing of first birth by age 37.A longitudinal study of a 1972-1973 New Zealand birth cohort collected information on socioeconomic characteristics from age 3-32 and reproductive histories at 21, 26, 32 and 38; information on first birth was available from 978 of the original 1037. Relative Risks (RR and 95% Confidence Intervals (CI were calculated using Poisson regression to examine first live birth prior to age 21, from 21-25, from 26-31, and from 32-37, by socioeconomic characteristics at different ages.Overall, 68.5% of men had fathered a child and 75.9% of women had given birth, by age 37; with overall differences in parenthood to age 31 for men, and 37 for women evident by childhood SES. While parenthood by age 20 was strongly associated with lower childhood SES for both sexes, first entry into motherhood from 32-37 was more likely with higher adult SES at age 32 (RR = 1.8, 95% CI 1.1-3.0 for medium and RR = 1.9, 95% CI 1.1-3.3 for high compared with low. Education also differientated age at parenthood, with those with higher education more likely to defer fatherhood past age 31, and motherhood past age 25 followed by a period of increased likelihood of motherhood for women with higher levels of education from age 32-37 (RR = 1.4, 95% CI 0.87-2.2 and RR = 1.7, 95% CI 1.1-2.6 for medium and high respectively compared with low.SES varies across the lifecourse, and SES at the time has the strongest association with first births at that time. Low childhood SES drives adolescent parenthood, with resulting cumulative differences in parenthood past age 30. Those with more education and higher adult SES are deferring parenthood but attempt to catch up in the mid to late thirties.

  14. The Birth of Matter

    CERN Multimedia

    2005-01-01

    To mark the World Year of Physics, the Physics Section of the University of Geneva is organising a series of lectures for the uninitiated. Each lecture will begin with a demonstration in the auditorium of the detection of cosmic rays and, in collaboration with Professor E. Ellberger of the Conservatoire de Musique de Genève, of how these signals from the farthest reaches of the Universe can be used to create 'cosmic music'. The fourth lecture in the series, entitled 'The Birth of Matter', will take place on Tuesday 3 May 2005 and will be given by CERN's theoretical physicist, John Ellis. Where does matter come from? Where do the structures that surround us, such as galaxies, come from? Are we living in a world of invisible matter? Why is the universe so old and so big? John Ellis will show how elementary particle physics and, in particular, the LHC under construction at CERN, can answer these questions. The Birth of Matter Professor John Ellis Tuesday 3 May, starting 8.00 p.m. Main Auditorium...

  15. The Birth of Matter

    CERN Multimedia

    2005-01-01

    To mark the World Year of Physics, the Physics Section of the University of Geneva is organising a series of lectures for the uninitiated. Each lecture will begin with a demonstration in the auditorium of the detection of cosmic rays and, in collaboration with Professor E. Ellberger of the Conservatoire de Musique de Genève, of how these signals from the farthest reaches of the Universe can be used to create "cosmic music". The fourth lecture in the series, entitled "The Birth of Matter", will take place on Tuesday 3 May 2005 and will be given by CERN's theoretical physicist, John Ellis. Where does matter come from? Where do the structures that surround us, such as galaxies, come from? Are we living in a world of invisible matter? Why is the universe so old and so big? John Ellis will show how elementary particle physics and, in particular, the LHC under construction at CERN, can answer these questions. The Birth of Matter Professor John Ellis Tuesday 3 May, starting 8.00 p.m. Main Audito...

  16. Immobility reaction at birth in newborn infant.

    Science.gov (United States)

    Rousseau, Pierre Victor; Francotte, Jacques; Fabbricatore, Maria; Frischen, Caroline; Duchateau, Delphine; Perin, Marie; Gauthier, Jean-Marie; Lahaye, Willy

    2014-08-01

    To describe an immobility reaction (IR) that was not previously reported at or immediately after birth in human newborns. We analyzed 31 videos of normal term vaginal deliveries recorded from Time 0 of birth defined as the as the moment that lies between the birth of the thorax and the pelvis of the infant. We searched for perinatal factors associated with newborn's IR. IR at birth was observed in 8 of the 31 newborns. The main features of their behavior were immobilization, frozen face, shallow breathing and bradycardia. One of the 8 newborns had sudden collapse 2h after birth. We found significant relationships between maternal prenatal stress (PS) and IR (p=.037), and a close to significant one between infants' lividness at Time 0 and IR (p=.053). The first breath of the 31 newborns occurred before and was not associated with the first cry (psyndrome. This first report of an IR reaction at birth in human infants could open up new paths for improving early neonatal care. Further research is needed for maternal PS, stress hormones, umbilical cord blood pH measurements in IR newborns. The challenge of education and support for parents of IR newborns is outlined. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Small for gestational age birth outcomes in pregnant women with perinatally acquired HIV.

    Science.gov (United States)

    Jao, Jennifer; Sigel, Keith M; Chen, Katherine T; Rodriguez-Caprio, Gabriela; Posada, Roberto; Shust, Gail; Wisnivesky, Juan; Abrams, Elaine J; Sperling, Rhoda S

    2012-04-24

    To compare small for gestational age (SGA) birth weight in children born to women with perinatally acquired HIV (PAH) vs. those with behaviorally acquired HIV (BAH). Retrospective cohort study of HIV-infected pregnant women who received care and delivered a live born at a single hospital in New York City from January 2004 to April 2011. We collected data via chart review on demographics, behavioral risk factors, HIV clinical markers, antiretroviral therapy (ART), mode of HIV acquisition, and pregnancy outcomes on study participants. We compared rates of these exposures among participants by method of HIV acquisition. Generalized Estimating Equation was applied to evaluate the effect of HIV acquisition type on SGA birth weight, adjusting for potential confounders. Of 87 live births evaluated, 17 were born to 14 women with PAH. Overall, 20 (23%) were SGA. Eight of these SGA neonates were born preterm. Live births to women with PAH were more likely to be born SGA in our unadjusted analysis [odds ratio (OR) = 4.13, 95% confidence interval (CI) = 1.38-12.41). After adjusting for mother's age, substance use during pregnancy, nadir CD4 cell count during pregnancy, viral suppression at delivery, and second-line ART use during pregnancy, this relationship persisted with an adjusted OR of 5.7 (95% CI = 1.03-31.61). In comparison to infants born to women with BAH, infants born to women with PAH were at high risk for compromised intrauterine growth. Future studies are warranted to determine possible causal mechanisms.

  18. 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.

  19. RESEARCH ON THE MEAT PRODUCTION DIFFERENCES DETERMINED BY THE BIRTH MONTH OF THE FATTENED STEERS

    Directory of Open Access Journals (Sweden)

    Agatha POPESCU

    2014-04-01

    Full Text Available The purpose of the paper was to assess the effect of the birth month on some meat production characters such as live weight at the age of 180 days, live weight at the age of 365 days and daily gain during the fattening period in progeny testing for bulls' breeding value estimation in order to correct the biases determined by this environmental factor. In this purpose, the following linear mathematical model was used: xij=m . ai . eij, where xij - the live record of the "j" steer in the month "i" (i=1,2,....12, m- geometrical average of the meat production characters taken into account, ai- the multiplicative effect of the birth month "i" and eij – the residual multiplicative effect. A number of 1,705 half-brothers belonging to 105 Friesian bulls from Romania was included in this progeny testing. In order to eliminate the biases âi, adequate multiplicative adjusting factors were calculated as 1/âi.. The conclusion was that the effects of birth month on the meat production in terms of live weight at the age of 180 days, live weight at the age of 365 days and daily gain during the fattening period should not be ignored, on the contrary, they should be eliminated by correcting the real data using corresponding adjusting factors. Therefore, adjusting factors are justifed to be used in order to improve the accuracy of the bulls' breeding value estimation for meat production.

  20. Ownership of dwelling affects the sex ratio at birth in Uganda.

    Directory of Open Access Journals (Sweden)

    Bernard Wallner

    Full Text Available BACKGROUND: Socio-economic conditions can affect the secondary sex ratio in humans. Mothers under good environmental conditions are predicted to increase the birth rates of sons according to the Trivers-Willard hypothesis (TWH. This study analyzed the effects of ownership and non-ownership of dwellings on the sex ratio at birth (SRB on a Ugandan sample. METHODOLOGY/PRINCIPAL FINDINGS: Our investigation included 438,640 mothers aged between 12 and 54 years. The overall average SRB was 0.5008. Mothers who live in owned dwellings gave increased births to sons (0.5019 compared to those who live in non-owned dwellings (0.458. Multivariate statistics revealed the strongest effects of dwelling ownership when controlling for demographic and social variables such as marital status, type of marriage, mothers' age, mothers' education, parity and others. CONCLUSIONS/SIGNIFICANCE: The results are discussed in the framework of recent plausible models dealing with the adjustment of the sex ratio. We conclude that the aspect of dwelling status could represent an important socio-economic parameter in relation to SRB variations in humans if further studies are able to analyze it between different countries in a comparative way.

  1. Ownership of dwelling affects the sex ratio at birth in Uganda.

    Science.gov (United States)

    Wallner, Bernard; Fieder, Martin; Seidler, Horst

    2012-01-01

    Socio-economic conditions can affect the secondary sex ratio in humans. Mothers under good environmental conditions are predicted to increase the birth rates of sons according to the Trivers-Willard hypothesis (TWH). This study analyzed the effects of ownership and non-ownership of dwellings on the sex ratio at birth (SRB) on a Ugandan sample. Our investigation included 438,640 mothers aged between 12 and 54 years. The overall average SRB was 0.5008. Mothers who live in owned dwellings gave increased births to sons (0.5019) compared to those who live in non-owned dwellings (0.458). Multivariate statistics revealed the strongest effects of dwelling ownership when controlling for demographic and social variables such as marital status, type of marriage, mothers' age, mothers' education, parity and others. The results are discussed in the framework of recent plausible models dealing with the adjustment of the sex ratio. We conclude that the aspect of dwelling status could represent an important socio-economic parameter in relation to SRB variations in humans if further studies are able to analyze it between different countries in a comparative way.

  2. Ownership of Dwelling Affects the Sex Ratio at Birth in Uganda

    Science.gov (United States)

    Wallner, Bernard; Fieder, Martin; Seidler, Horst

    2012-01-01

    Background Socio-economic conditions can affect the secondary sex ratio in humans. Mothers under good environmental conditions are predicted to increase the birth rates of sons according to the Trivers-Willard hypothesis (TWH). This study analyzed the effects of ownership and non-ownership of dwellings on the sex ratio at birth (SRB) on a Ugandan sample. Methodology/Principal Findings Our investigation included 438,640 mothers aged between 12 and 54 years. The overall average SRB was 0.5008. Mothers who live in owned dwellings gave increased births to sons (0.5019) compared to those who live in non-owned dwellings (0.458). Multivariate statistics revealed the strongest effects of dwelling ownership when controlling for demographic and social variables such as marital status, type of marriage, mothers’ age, mothers’ education, parity and others. Conclusions/Significance The results are discussed in the framework of recent plausible models dealing with the adjustment of the sex ratio. We conclude that the aspect of dwelling status could represent an important socio-economic parameter in relation to SRB variations in humans if further studies are able to analyze it between different countries in a comparative way. PMID:23284697

  3. [Birth weight distribution among premature infants and related social factors].

    Science.gov (United States)

    Guo, Li-jun; Ye, Rong-wei; Wang, Gui-xia; Wang, Juan; Li, Zhi-wen; Ren, Ai-guo

    2009-12-01

    To understand the distribution of birth weight among premature infants and the associated social factors. The study population consisted of 97 537 women who delivered singleton live birth of 20 to 41 gestational weeks in 4 counties/cities, Jiangsu and Zhejiang provinces, China from 1995 to 2000. Chi-square test was employed to test the difference of proportions between respective groups. One- way ANOVA was used to test the differences regarding the mean of gestational weeks at the first prenatal visit and the mean of prenatal visits between the two groups. Multivariate logistic regression was conducted to examine the factors associated with premature birth. Women aged 35 years had higher (8.8%) premature incidence than those aged less than 24 years (5.6%), 25 - 29 years (4.6%), or 30 - 34 years (4.5%, P premature incidence than those with height taller than 150 cm (5.0%). Women whose BMI were at least 28 and 24 - 28 had higher (5.5%, 5.5%) premature incidences than those whose BMI were 18.5 - 24.0 (5.0%), premature birth was 6.0% among women without previous pregnancy, higher than that among those women with 4 times of pregnancies (5.7%), 2 times of pregnancies (4.3%), and 3 times of pregnancies (4.0%). Parous women with at least two deliveries had higher (9.3%) premature incidence than the primiparous women (5.2%) and whose women with only one delivery (4.5%, P premature incidence than those who did not receive the service (6.1%). The mean times of prenatal visits among women with premature births was 8.53, less than that of those with full term delivery (10.97). Women with less than four times of prenatal visit had higher (18.9%) premature incidence than those with at least five prenatal visits (4.9%). Multivariate logistic regression showed that premature delivery risk was associated with age, height, BMI, gravidity, parity, early prenatal care, the mean of gestational weeks at first prenatal visit and the mean number of prenatal visits etc. Premature delivery

  4. Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records.

    Science.gov (United States)

    Piper, J M; Mitchel, E F; Snowden, M; Hall, C; Adams, M; Taylor, P

    1993-04-01

    In 1989, the state of Tennessee adopted a new birth certificate which incorporates changes recommended by the National Center for Health Statistics in the revised US Standard Certificate of Live Birth. The data now being collected are intended to provide improved information for understanding maternal and infant health issues. To assess data quality, the authors compared information reported on the 1989 Tennessee birth certificates with the same data obtained from an ongoing case-control study in which the delivery hospital medical records of mothers and infants were reviewed by trained nurse abstractors using a structured data collection instrument. Cases (n = 1,016) were all infants born in Tennessee in 1989 with birth weights less than 1,500 g or other infants who died during the first 28 days of life. The infants were identified from linked birth-death certificate files. Control infants (n = 634) were randomly selected from the noncase population. The most reliable information obtained from birth certificates was descriptive demographic data and birth weight. The quality of information obtained from the new birth certificate checkboxes varied. Routine medical procedures were better reported on the birth certificates than relatively uncommon conditions and occurrences, even serious ones. Caution is needed in using birth certificate data for assessment of maternal medical risk factors, complications of labor and delivery, abnormal conditions of the newborn, and congenital anomalies, since sensitivity is low.

  5. Birth planning in Cuba: a basic human right.

    Science.gov (United States)

    Swanson, J M

    1981-01-01

    This paper reports on the development of birth planning in Cuba and strategies that are relevant to nurses in the communities of Cuba. Cuba reduced its crude birth rate by 40% from 1964-75 without formal family planning programs and resources. By 1975, Cuba had achieved the lowest birth rate in Latin America (21/1000) except Barbados (19/1000). By 1978, Cuba's crude birth rate declined to a low of 15.3/1000. The demographic transition in Cuba has been a process of equalization by: 1) community participation to ensure basic human rights for everyone, 2) increasing the status of women while providing child care centers, 3) providing equal availability of health care services including contraceptive services, sterilization, and abortion, and 4) focusing on individual birth choice, not on limiting population growth. Emphasis in Cuba for reducing fertility has been put on literacy, education, and infant mortality. The illiteracy rate in 1961 decreased from 20% to 4%. Infant mortality decreased from 38.8/1000 live births in 1970 to 22.3/1000 in 1978. 1/3 of Cuban women were participating fully in the labor force in 1978. Polyclinics have been established as preventive care medical centers throughout Cuba and health care is free. Family planning options are integrated into routine primary health care at polyclinics and assure equal access to the total Cuban population. Abortion is freely available and increased to 61/1000 in 1976. The implications for nursing are that: 1) the traditional work of nurses places them in a key position to help extend basic human rights beyond current levels, 2) nurses can initiate discussions of birth planning with women and men in a variety of settings, and 3) nurses can increase case-finding related to birth planning needs both in health care classes or within established groups in the community.

  6. Distillability Sudden Birth of Entanglement for Qutrit-Qutrit Systems

    International Nuclear Information System (INIS)

    Huang Jiang; Ali Mazhar

    2014-01-01

    We report the sudden appearance of distillability between two statistically independent reservoirs modelled as qutrit-qutrit systems. This feature of bipartite quantum systems is different from the previously observed phenomenon of entanglement sudden birth. It is found that the states of reservoirs first become bound entangled, thus exhibiting entanglement sudden birth, consequently followed by the sudden birth of distillability, and it is shown that whenever distillability is lost abruptly from principal system, it also necessarily appears abruptly among reservoirs' degrees of freedom. This surprising observation reflects yet another peculiarity of dynamical aspects of quantum entanglement

  7. Incinerator Pollution and Child Development in the Taiwan Birth Cohort Study

    Directory of Open Access Journals (Sweden)

    Bih-Ching Shu

    2013-05-01

    Full Text Available This study aimed to investigate the direct and indirect effects of environmental pollutants on child development and parental concerns. It focused on the pathway relationships among the following factors: living within three kilometers of an incinerator, breastfeeding, place of residence, parental concerns about development, and parent-perceived child development. The Taiwan Birth Cohort Study (TBCS dataset includes randomized community data on 21,248 children at six, 18, and 36 months of age. The Parental Concern Checklist and the Taiwan Birth Cohort Study-Developmental Instrument were used to measure parental concern and parent-perceived child development. Living within three kilometers of an incinerator increased the risk of children showing delayed development in the gross motor domain at six and 36 months. Although breastfeeding is a protective factor against uneven/delayed developmental disability (U/DDD, children living near an incinerator who were breastfed had an increased risk of U/DDD compared with those who did not live near incinerators. The presence of a local incinerator affected parent-perceived child development directly and indirectly through the mediating factor of breastfeeding. Further follow-up of these children to investigate the long-term effects of specific toxins on their development and later diagnostic categorization is necessary.

  8. Ordered Delinquency: The “Effects” of Birth Order On Delinquency

    Science.gov (United States)

    Cundiff, Patrick R.

    2014-01-01

    Juvenile delinquency has long been associated with birth order in popular culture. While images of the middle child acting out for attention or the rebellious youngest child readily spring to mind, little research has attempted to explain why. Drawing from Adlerian birth order theory and Sulloway's born to rebel hypothesis I examine the relationship between birth order and a variety of delinquent outcomes during adolescence. Following some recent research on birth order and intelligence, I use new methods that allow for the examination of both between-individual and within-family differences to better address the potential spurious relationship. My findings suggest that contrary to popular belief the relationship between birth order and delinquency is spurious. Specifically, I find that birth order effects on delinquency are spurious and largely products of the analytic methods used in previous tests of the relationship. The implications of this finding are discussed. PMID:23719623

  9. Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK.

    Science.gov (United States)

    Nove, Andrea; Berrington, Ann; Matthews, Zoë

    2012-11-19

    The aim of this study is to compare the odds of postpartum haemorrhage among women who opt for home birth against the odds of postpartum haemorrhage for those who plan a hospital birth. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, and which resulted in a live or stillbirth in the years 1988-2000 inclusive, excluding 'high-risk' pregnancies, unplanned home births, pre-term births, elective Caesareans and medical inductions. Even after adjustment for known confounders such as parity, the odds of postpartum haemorrhage (≥1000ml of blood lost) are significantly higher if a hospital birth is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval 1.7 to 3.8). The 'home birth' group included women who were transferred to hospital during labour or shortly after birth. Women and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home, but that further research is needed to understand (a) whether the same pattern applies to the more life-threatening categories of PPH, and (b) why hospital birth is associated with increased odds of PPH. If it is due to the way in which labour is managed in hospital, changes should be made to practices which compromise the safety of labouring women.

  10. [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.

  11. The Growing Trend of Moderate Preterm Births: An Ecological Study in One Region of Brazil.

    Directory of Open Access Journals (Sweden)

    Rosana Rosseto de Oliveira

    Full Text Available Preterm birth is a serious public health problem, as it is linked to high rates of neonatal and child morbidity and mortality, with Brazil listed among the countries with the ten highest numbers of premature births. Nonetheless, knowledge is scarce regarding prematurity and associated factors in mid-sized cities. The objective of this study was to analyze the trend of preterm births and associated factors in a municipality located in the state of Paraná, Brazil.This was an ecological time series study of births recorded into the Live Birth Information System for residents of Maringá, Paraná, Brazil, between 2000 and 2013. The polynomial regression model was used for trend analysis of preterm birth, characteristics of the mother, gestation and delivery, and newborn. The association with preterm birth was analyzed using odds ratio (OR.A total of 61,634 live births were analyzed, of which 5,632 were preterm births. Prematurity increased from 7.9% in 2000 to 11.2% in 2013 -an average increase of 0.54% per year (r2 = 0.93-with a growing share of moderate preterm births (32 to <37 weeks, which rose from 7.0% in 2000 to 9.7% in 2013. Between 2011 and 2013, multiple pregnancy (OR = 16.64; CI = 13.24-20.92, inadequate number of prenatal visits (OR = 2.81; CI = 2.51-3.15, Apgar score below 7 at 1 (OR = 4.07; CI = 3.55-4.67 and 5 minutes (OR = 10.88; CI = 7.71-15.36, low birth weight (OR = 38.75; CI = 33.72-44.55 and congenital malformations (OR = 3.18; CI = 2.14-4.74 were associated with preterm birth. A growing trend was observed for multiple pregnancies, with an average annual increase of 0.32% (r2 = 0.90, as well as for C-section birth (2.38% yearly increase. Of all newborn characteristics, Apgar score below 7 at 5 minutes (-0.19% per year and low birth weight (-1.43% decreased, whereas congenital malformations rose (0.20% per year.Efforts are required to prevent premature delivery, particularly during the moderate period, as well as greater care

  12. The Growing Trend of Moderate Preterm Births: An Ecological Study in One Region of Brazil.

    Science.gov (United States)

    Oliveira, Rosana Rosseto de; Melo, Emiliana Cristina; Falavina, Larissa Pereira; Mathias, Thais Aidar de Freitas

    2015-01-01

    Preterm birth is a serious public health problem, as it is linked to high rates of neonatal and child morbidity and mortality, with Brazil listed among the countries with the ten highest numbers of premature births. Nonetheless, knowledge is scarce regarding prematurity and associated factors in mid-sized cities. The objective of this study was to analyze the trend of preterm births and associated factors in a municipality located in the state of Paraná, Brazil. This was an ecological time series study of births recorded into the Live Birth Information System for residents of Maringá, Paraná, Brazil, between 2000 and 2013. The polynomial regression model was used for trend analysis of preterm birth, characteristics of the mother, gestation and delivery, and newborn. The association with preterm birth was analyzed using odds ratio (OR). A total of 61,634 live births were analyzed, of which 5,632 were preterm births. Prematurity increased from 7.9% in 2000 to 11.2% in 2013 -an average increase of 0.54% per year (r2 = 0.93)-with a growing share of moderate preterm births (32 to 2000 to 9.7% in 2013. Between 2011 and 2013, multiple pregnancy (OR = 16.64; CI = 13.24-20.92), inadequate number of prenatal visits (OR = 2.81; CI = 2.51-3.15), Apgar score below 7 at 1 (OR = 4.07; CI = 3.55-4.67) and 5 minutes (OR = 10.88; CI = 7.71-15.36), low birth weight (OR = 38.75; CI = 33.72-44.55) and congenital malformations (OR = 3.18; CI = 2.14-4.74) were associated with preterm birth. A growing trend was observed for multiple pregnancies, with an average annual increase of 0.32% (r2 = 0.90), as well as for C-section birth (2.38% yearly increase). Of all newborn characteristics, Apgar score below 7 at 5 minutes (-0.19% per year) and low birth weight (-1.43%) decreased, whereas congenital malformations rose (0.20% per year). Efforts are required to prevent premature delivery, particularly during the moderate period, as well as greater care during the prenatal period towards

  13. Iranian mothers' perception of the psychological birth trauma: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Ziba Taghizadeh

    2014-03-01

    Full Text Available Childbirth is one of the most vulnerable moments and the most important and memorable events in the lives of women that despite of bringing happiness, it can be associated with psychological trauma and endanger the mother and neonate health. Mothers' perception of the psychological birth trauma is a highly subjective process that depends on the cultural, social and biological conditions of mothers that is not achievable except with examination of their views. This study aimed to understand psychological birth trauma from the perceptions of Iranian mothers.A qualitative research design using in-depth interviews of 23 Iranian mothers was conducted from Tehran and Isfahan health centers. The interviews were transcribed and analyzed using conventional content analysis.Two themes were extracted from the data: impact of psychological birth trauma and trends of psychological birth trauma. Several categories and sub-categories also emerged from the data. Feelings of fear, anxiety, helplessness and sense of impending death (collapse were reported by the mothers.By considering the unforgettable experience of mothers from the psychological birth trauma, a plan for supportive care before, during and after birth is critical.

  14. Traditional beliefs about pregnancy and child birth among women from Chiang Mai, Northern Thailand.

    Science.gov (United States)

    Liamputtong, Pranee; Yimyam, Susanha; Parisunyakul, Sukanya; Baosoung, Chavee; Sansiriphun, Nantaporn

    2005-06-01

    To examine women's embodied knowledge of pregnancy and birth, women's explanations of precautions during pregnancy and birth and preparations for easy birth and the role of a traditional midwife in a Thai birthing care. In-depth interviews relating to traditional and changed beliefs and practices of pregnancy and childbirth with Thai women in Northern Thailand. Chiang Mai city and Mae On sub-district in Chiang Mai province, Northern Thailand. 30 Thai women living in Chiang Mai in Thailand. The social meaning of childbirth in Thai culture is part of the larger social system, which involves the woman, her family, the community, society and the supernatural world. Traditional beliefs and practices in Thai culture clearly aim to preserve the life and well-being of a new mother and her baby. It seems that traditional childbirth practices have not totally disappeared in northern Thailand, but have gradually diminished. Women's social backgrounds influence traditional beliefs and practices. The traditions are followed by most rural and some urban poor women in Chiang Mai. The findings of this study may assist health professionals to better understand women from different cultures. It is important to recognise many factors discussed in this paper within the context of Thai lives and traditions. This will prevent misunderstanding and, consequently, encourage more sensitive pregnancy and birthing care for pregnant women.

  15. Neighborhood contextual factors, maternal smoking, and birth outcomes: multilevel analysis of the South Carolina PRAMS survey, 2000-2003.

    Science.gov (United States)

    Nkansah-Amankra, Stephen

    2010-08-01

    Previous studies investigating relationships among neighborhood contexts, maternal smoking behaviors, and birth outcomes (low birth weight [LBW] or preterm births) have produced mixed results. We evaluated independent effects of neighborhood contexts on maternal smoking behaviors and risks of LBW or preterm birth outcomes among mothers participating in the South Carolina Pregnancy Risk Assessment and Monitoring System (PRAMS) survey, 2000-2003. The PRAMS data were geocoded to 2000 U.S. Census data to create a multilevel data structure. We used a multilevel regression analysis (SAS PROC GLIMMIX) to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI). In multivariable logistic regression models, high poverty, predominantly African American neighborhoods, upper quartiles of low education, and second quartile of neighborhood household crowding were significantly associated with LBW. However, only mothers resident in predominantly African American Census tract areas were statistically significantly at an increased risk of delivering preterm (OR 2.2, 95% CI 1.29-3.78). In addition, mothers resident in medium poverty neighborhoods remained modestly associated with smoking after adjustment for maternal-level covariates. The results also indicated that maternal smoking has more consistent effects on LBW than preterm births, particularly for mothers living in deprived neighborhoods. Interventions seeking to improve maternal and child health by reducing smoking during pregnancy need to engage specific community factors that encourage maternal quitting behaviors and reduce smoking relapse rates. Inclusion of maternal-level covariates in neighborhood models without careful consideration of the causal pathway might produce misleading interpretation of the results.

  16. Pregnancy and live birth after follicle-stimulating hormone treatment for an infertile couple including a male affected by Sertoli cell-only syndrome

    Directory of Open Access Journals (Sweden)

    Paulis G

    2017-10-01

    established and developed. Subsequently, the pregnancy resulted in the live birth of a girl. Keywords: azoospermia, Sertoli cell-only syndrome, FSH, ICSI, TESE sperm retrieval, live birth pregnancy

  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. Methods for developing useful estimates of the costs associated with birth defects.

    Science.gov (United States)

    Case, Amy P; Canfield, Mark A

    2009-11-01

    Cost estimates for birth defects are useful to policy makers in deciding the best use of resources to prevent these conditions. Much of the effort in this area has focused on spina bifida, in part because cost savings can be estimated from folic acid-preventable cases. However, comprehensive cost-of-illness estimates for this condition may be too outdated, too general, or not applicable to individual states' environments. Using the live birth prevalence for spina bifida in Texas, we applied recent spina bifida cost estimates to approximate total lifetime medical and other costs for an average live birth cohort of spina bifida cases in Texas. In addition, we queried various government programs that provide services for persons with spina bifida to provide program-specific annual costs for this condition. Applying a recently published average lifetime medical cost of $635,000 per case of spina bifida to the average annual birth cohort of 120 Texas cases, an estimated $76 million in direct and indirect medical and other costs will be incurred in Texas over the life span of that cohort. Examples of estimated medical costs for one year are $5 million for infants using actual employer-paid insurance claims data and $6 million combined for children in two public sector programs. Stakeholders and state policy makers may look to state birth defects registries for useful cost data. Although comprehensive state-specific figures are not available, applying prevalence data to existing estimates and obtaining actual claims and program expenditures may help close this information gap.

  19. 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.

  20. Live birth rates are satisfactory following multiple IVF treatment cycles in poor prognosis patients.

    Science.gov (United States)

    Mustafa, Kamarul B; Keane, Kevin N; Walz, Nikita L; Mitrovic, Katarina I; Hinchliffe, Peter M; Yovich, John L

    2017-03-01

    This seven-year retrospective study analysed the live birth rate (LBR) for women undergoing IVF treatment with various antral follicle counts (AFC). The LBR decreased with lower AFC ratings, and in 290 treatment cycles for women in the poorest AFC category, ≤4 follicles (group E), the LBR was the lowest at 10.7%. The pregnancy loss rate (PLR) significantly increased with poorer AFC categories, from 21.8% in AFC group A (≥20 follicles), to 54.4% in AFC group E (p<0.0001). This trend was repeated with advancing age, from 21.6% for younger women (<35years), to 32.9, 48.5 and 100% for ages 35-39, 40-44 and ≥45 years, respectively (p<0.0001). However, LBR within the specific AFC group E cohort was also age-dependent and decreased significantly from 30.0% for <35 years old, to 13.3, 3.9 and 0% for patients aged 35-39, 40-44 and ≥45 years, respectively. Most, importantly, LBR rates within these age groups were not dependent on the number of IVF attempts (1st, 2nd, 3rd or ≥4 cycles), which indicated that cycle number should not be the primary deciding factor for cessation of IVF treatment in responding women <45years old. Copyright © 2016 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  1. Birth defects data for 8 California counties by county, maternal age, maternal race/ethnicity, and infant gender for the years 2000-2006.

    Data.gov (United States)

    California Environmental Health Tracking Program — This dataset contains counts, rates, and confidence intervals of 12 selected birth defects among live births during 2000-2006 within eight California counties:...

  2. The birth of the first child as a positive event in the lives of young parents

    Directory of Open Access Journals (Sweden)

    Wójtowicz-Dacka Małgorzata

    2014-06-01

    Full Text Available The aim of the study was to research the relatioship between level of knowledge possessed by the contemporary parents about the psychological needs of small children and their perception of the birth of their child as a positive event. Study involved 90 parents, aged 25-30, who are currently raising young children up to 1 year of age. The analyses that were carried out verified the existence of such a correlation, but the event of birth is not a positive event for all parents. In summary, the sense of satisfaction with the birth of a child and perceiving this situation as a positive event is especially high among women and those with a higher education. For men and for parents with a low level of education, it can become a positive experience if they raise their level of knowledge about the needs of small children.

  3. Prenatal investments, breastfeeding, and birth order.

    Science.gov (United States)

    Buckles, Kasey; Kolka, Shawna

    2014-10-01

    Mothers have many opportunities to invest in their own or their child's health and well-being during pregnancy and immediately after birth. These investments include seeking prenatal care, taking prenatal vitamins, and breastfeeding. In this paper, we investigate a potential determinant of mothers' investments that has been largely overlooked by previous research-birth order. Data are from the National Longitudinal Study of Youth 1979 (NLSY79) Child and Young Adult Survey, which provides detailed information on pre- and post-natal behaviors of women from the NLSY79. These women were between the ages of 14 and 22 in 1979, and form a nationally representative sample of youth in the United States. Our sample includes births to these women between 1973 and 2010 (10,328 births to 3755 mothers). We use fixed effects regression models to estimate within-mother differences in pre- and post-natal behaviors across births. We find that mothers are 6.6 percent less likely to take prenatal vitamins in a fourth or higher-order birth than in a first and are 10.6 percent less likely to receive early prenatal care. Remarkably, mothers are 15.4 percent less likely to breastfeed a second-born child than a first, and are 20.9 percent less likely to breastfeed a fourth or higher-order child. These results are not explained by changing attitudes toward investments over time. These findings suggest that providers may want to increase efforts to encourage these behaviors at women with higher parity. The results also identify a potential mechanism for the emergence of differences in health and other outcomes across birth orders. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Birth weight discordance and perinatal mortality among triplets

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    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

  5. Use of donor sperm in addition to oocyte donation after repeated implantation failure in normozoospermic patients does not improve live birth rates.

    Science.gov (United States)

    Blázquez, A; García, D; Rodríguez, A; Vassena, R; Vernaeve, V

    2016-11-01

    Does switching to donor semen after at least three failed oocyte donation (OD) cycles with the partner normozoospermic semen increase the live birth rate in a subsequent OD cycle? Switching to donor semen after at least three failed OD cycles with the partner normozoospermic semen does not increase the live birth rate. In some patients, a viable pregnancy cannot be achieved after several OD cycles, despite normal diagnostic findings for the couple. The ESHRE Capri Workshop Group indicates that, in order to improve reproductive outcomes, a semen donation can be offered after three failed ICSI cycles. A retrospective cohort analysis of fourth and fifth OD cycles with either the partner's normozoospermic semen (OD) or double-donation cycles (DD), performed between January 2011 and December 2014 in a private fertility center. These couples did not have a known male factor. The study included 228 cycles (159 OD and 69 DD). The fertilization method was ICSI in all cycles and embryos were transferred fresh. Fertilization rates were compared between groups using ANOVA while pregnancy outcomes were compared using Chi-square tests. Effect of DD on pregnancy outcomes was further analyzed using a logistic regression model adjusted for recipient's age and BMI, number of embryos transferred, day of embryo transfer and morphological embryo quality score. There was no difference in live birth rate between the DD and OD groups (38.2 versus 35.8%, P = 0.73), even after adjustment for confounding factors (odds ratio 1.41, 95% confidence interval 0.72, 2.76; P = 0.31). Rates of biochemical pregnancy (52.2 versus 54.1%, P = 0.79), clinical pregnancy (41.2 versus 45.9%, P = 0.51) and ongoing pregnancy (38.2 versus 37.1%, P = 0.87) were not different between the DD and the OD groups, as well as fertilization rate (75.3 versus 75.2%, P = 0.97). The DD and OD groups were comparable at baseline in all demographic and cycle variables analyzed (recipient's BMI, number of

  6. Evaluation of effective factors on low birth weight neonates' mortality using path analysis

    Directory of Open Access Journals (Sweden)

    Babaee Gh

    2008-06-01

    Full Text Available Background: This study have conducted in order to determine of direct or indirect effective factors on mortality of neonates with low birth weight by path analysis.Methods: In this cohort study 445 paired mothers and their neonates were participated in Tehran city. The data were gathered through an answer sheet contain mother age, gestational age, apgar score, pregnancy induced hypertension (PIH and birth weight. Sampling was convenience and neonates of women were included in this study who were referred to 15 government and private hospitals in Tehran city. Live being status of neonates was determined until 24 hours after delivery.Results: The most changes in mortality rate is related to birth weight and its negative score means that increasing in weight leads to increase chance of live being. Second score is related to apgar sore and its negative score means that increasing in apgar score leads to decrease chance of neonate death. Third score is gestational age and its negative score means that increasing in weight leads to increase chance of live being. The less changes in mortality rate is due to hypertensive disorders in pregnancy.Conclusion: The methodology has been used could be adopted in other investigations to distinguish and measuring effect of predictive factors on the risk of an outcome.

  7. Factors influencing the incidence of pre-term birth in Calabar, Nigeria

    African Journals Online (AJOL)

    Women who had pre-term birth in the University of Calabar Teaching Hospital, Calabar, over a 2 ½ year period were studied. The aim was to establish the factors influencing the incidence of pre-term birth in Calabar. Factors which significantly increase the incidence of pre-term delivery included: previous induced abortion ...

  8. SECULAR TRENDS AND LATITUDE GRADIENTS IN THE MALE-FEMALE RATIO AT BIRTH IN YUGOSLAVIA AND THE EX-YUGOSLAVIAN STATES

    Directory of Open Access Journals (Sweden)

    Victor Grech

    2013-01-01

    Full Text Available Background: Latitude gradients and secular trends in Europe and North America have been found in the male-female ratio at birth (M/F: male births divided by total births which approximates 0.515. Methods: Annual national data for Yugoslavia and the post-Yugoslavia States for male and female live births were obtained from the World Health Organisation and analysed with contingency tables. Results: This study analysed 22,020,729 live births. There was a increasing trend in M/F prior to the breakup of the former Yugoslavia (1950–1990, p = 0.002, followed by a decreasing trend after 1990 (p = 0.02. A latitude gradient was also noted, with more males being born in southern, warmer latitudes (p < 0.0001. There was an overall excess of 42,753 male births based on an anticipated M/F of 0.515. Conclusion: M/F is decreasing in this region, similar to the rest of Europe and North America. A latitude gradient is also present with more males being born in warmer (more Southern latitudes (p < 0.0001, even in this small region and over the short time-frame studied.

  9. BIRTH ORDER AND ANDROPHILIC MALE-TO-FEMALE TRANSSEXUALISM IN BRAZIL.

    Science.gov (United States)

    Vanderlaan, Doug P; Blanchard, Ray; Zucker, Kenneth J; Massuda, Raffael; Fontanari, Anna Martha Vaitses; Borba, André Oliveira; Costa, Angelo Bradelli; Schneider, Maiko Abel; Mueller, Andressa; Soll, Bianca Machado Borba; Schwarz, Karine; Da Silva, Dhiordan Cardoso; Lobato, Maria Inês Rodrigues

    2017-07-01

    Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.

  10. Data from: Acquired versus innate prey capturing skills in super-precocial live-bearing fish

    NARCIS (Netherlands)

    Lankheet, M.J.M.; Stoffers, Twan; Leeuwen, van J.L.; Pollux, B.J.A.

    2016-01-01

    Live-bearing fish start hunting for mobile prey within hours after birth, an example of extreme precociality. Because prenatal, in utero, development of this behaviour is constrained by the lack of free-swimming sensory-motor interactions, immediate success after birth depends on innate,

  11. Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria.

    Science.gov (United States)

    Butali, Azeez; Ezeaka, Chinyere; Ekhaguere, Osayame; Weathers, Nancy; Ladd, Jenna; Fajolu, Iretiola; Esezobor, Christopher; Makwe, Christian; Odusanya, Bukola; Anorlu, Rose; Adeyemo, Wasiu; Iroha, Edna; Egri-Okwaji, Mathias; Adejumo, Prisca; Oyeneyin, Lawal; Abiodun, Moses; Badejoko, Bolaji; Ryckman, Kelli

    2016-01-01

    Preterm birth is a dire complication of pregnancy that poses huge long-term medical and financial burdens for affected children, their families, and the health care system. The aim of the present study was to identify characteristics associated with preterm births at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria from 2011 to 2013. We obtained Information from 5,561 maternal, fetal/neonatal and obstetric records from the labor ward. We excluded delivery at less than 22 weeks (0.25%), post-term birth at ≥42 weeks gestation (1.3%), and unknown gestation (1.4%). Additionally, we excluded records of multiple births (5.4%) and stillbirths (8.3%) leaving 4,691 records of singleton live-births for analysis. Logistic regression analysis was performed comparing preterm birth (22-36 weeks gestation) to term birth (37-41 weeks gestation). Multiple variable models adjusting for maternal age, parity, fetal position, delivery method and booking status were also evaluated. Multinomial regression was used to identify characteristics associated with preterm birth (PTB) defined as early PTB (22-31 weeks gestation), moderate PTB (32-34 weeks gestation), late PTB (35-36 weeks gestation), compared to term birth (37-41 completed weeks gestation). From our data, 16.8% of the singleton live-birth deliveries were preterm (PTBs. Older maternal age (≥35 years) [odds ratio (OR) = 1.41], hypertension (OR = 3.44) and rupture of membranes (OR = 4.03) were significantly associated with increased odds of PTB. Women being treated for the prevention of mother-to-child transmission of HIV were at a significantly decreased risk for PTB (OR = 0.70). Sixteen percent of women in this cohort were not registered for antenatal care in LUTH. These non-registered subjects had significantly greater odds of all categories of PTB, including early (odds ratio (OR) = 20.8), moderate (OR = 8.68), and late (OR = 2.15). PTB and risks for PTB remain high in Nigeria. We recommend that any high risk

  12. Induction of labor in grand multiparous women with previous cesarean delivery: how safe is this?

    Science.gov (United States)

    Chibber, Rachana; Al-Harmi, Jehad; Foda, Mohamed; Mohammed K, Zeinab; Al-Saleh, Eyad; Mohammed, Asiya Tasneem

    2015-02-01

    To compare the outcome of induced and spontaneous labor in grand multiparous women with one previous lower segment cesarean section (CS), so that the safety of labor induction could be assessed. In 102 women (study group), labor was induced and the outcome was compared with 280 women (control group) who went into spontaneous labor. All 382 women were grand multiparous and had one previous CS. There were no significant difference in oxytocin augmentation, CS, scar dehiscence, fetal birth weight or apgar scores between groups. There was one neonatal death, two still births, one early neonatal death and one congenital malformation in the study group and this was not significant. There was no significant difference in vaginal birth in the study (80.9%) and the control group (83.8%). In this moderate-sized study, induction of labor may be a safe option in grand multiparous women, if there is no absolute induction for repeating CS.

  13. Use of previous maternal health services has a limited role in reattendance for skilled institutional delivery: cross-sectional survey in Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Kebede B

    2013-02-01

    Full Text Available Bekana Kebede,1 Abebaw Gebeyehu,2 Gashaw Andargie11Department of Health Services Management, 2Department of Reproductive Health, Institute of Public Health, University of Gondar, EthiopiaBackground: Maternal mortality rates are unacceptably high in Ethiopia. Institutional delivery with skilled care of the mother is one of the interventions proven to reduce the risk of complications that can cause maternal and neonatal mortality. Quality of service given during antenatal visits and childbirth are important measures. The purpose of this study was to investigate the use of skilled institutional delivery and its repeat use during a subsequent pregnancy and to identify any reasons why women avoid institutional delivery.Methods: A community-based cross-sectional study was conducted from March to June 2012 in Chilga Woreda, Northwest Ethiopia. Data were collected from women who gave birth during the year preceding the survey. Information was entered and cleaned using the Statistical Package for Social Sciences. Multivariate and binary logistic regression was used to identify the relative effect of each explanatory variable on the outcome.Results: A total of 402 (84.2% women gave birth at home. Previous experience of skilled institutional delivery had a limited role in subsequent acceptance or use of institutional delivery. Most mothers who had previously had institutional delivery gave birth at home. Although 111 (40.8% women visited the health facility during their pregnancy only because of illness, 184 (38.8% did not know when to visit for antenatal care. In multivariate analysis, lower maternal education, being a rural resident, previous use of institutional delivery, remoteness of the health facility, and multiparity were factors significantly associated with less likelihood of institutional delivery. Number of months pregnant at the time of the first antenatal visit had no role in increasing the likelihood of institutional delivery.Conclusion: The

  14. Live birth after IVF in a 46-year-old woman.

    Science.gov (United States)

    Dal Prato, Luca; Borini, Andrea; Cattoli, Monica; Preti, Maria Serena; Serrao, Lucia; Flamigni, Carlo

    2005-10-01

    Pregnancies after IVF have been reported in women aged > or =44 years, but nobody older than 45 years at oocyte retrieval delivered. We report a case of birth of a healthy child after IVF in a 46-year-old infertile woman. Ovarian stimulation was performed with clomiphene citrate, 150 mg daily for 5 days. Three oocytes were retrieved and one embryo was replaced. The patient delivered a healthy male infant after Caesarean section at 39 weeks. A successful pregnancy after IVF with homologous oocytes can be achieved in women older than 45 years. At this age IVF is not a cost-effective treatment compared with oocyte donation, but it may be offered in countries in which gamete donation is forbidden.

  15. The impact of Down syndrome screening on Taiwanese Down syndrome births: a nationwide retrospective study and a screening result from a single medical centre.

    Directory of Open Access Journals (Sweden)

    Shin-Yu Lin

    Full Text Available A retrospective analysis of the Taiwanese National Birth Defect Registration and Notification System was conducted in order to determine the live birth- and stillbirth rates in infants with Down syndrome, trisomy 18, trisomy 13 and Turner syndrome between 2001 and 2010. The objective was to investigate the impact of Down syndrome screening on the Taiwanese Down syndrome live birth rate. In addition, the results of first-trimester Down syndrome screening between 2006 and 2011, and of second-trimester quadruple testing between 2008 and 2011, were obtained from the National Taiwan University Hospital. All Taiwanese infants born between 2001 and 2010 were included in the first part of the analysis, and women receiving first-trimester Down syndrome screening or second-trimester quadruple testing from the National Taiwan University Hospital were included in the second part. The live birth rate of infants with Down syndrome, per 100 000 live births, decreased from 22.28 in 2001 to 7.79 in 2010. The ratio of liveborn DS to total DS was 48.74% in 2001, and then decreased to 25.88% in 2006, when first-trimester screening was widely introduced in Taiwan. This ratio dropped to 20.64% in 2008, when the second-trimester quadruple test was implemented. The overall positive rate in first-trimester screening in the National Taiwan University Hospital was 3.1%, with a Down syndrome detection rate of 100%; the quadruple test had values of 9.0% and 75%, respectively. The use of first-trimester screening and the second-trimester quadruple test may be responsible for the marked decrease in the Taiwanese Down syndrome live birth rate observed between 2001 and 2010.

  16. 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 ...

  17. The inner state differences of preterm birth rates in Brazil: a time series study

    Directory of Open Access Journals (Sweden)

    Rosana Rosseto de Oliveira

    2016-05-01

    Full Text Available Abstract Background Preterm birth is a serious public health problem, as it is linked to high rates of neonatal and child morbidity and mortality. The prevalence of premature births has increased worldwide, with regional differences. The objective of this study was to analyze the trend of preterm births in the state of Paraná, Brazil, according to Macro-regional and Regional Health Offices (RHOs. Methods This is an ecological time series study using preterm births records from the national live birth registry system of Brazil’s National Health Service - Live Birth Information System (Sinasc, for residents of the state of Paraná, Brazil, between 2000 and 2013. The preterm birth rates was calculated on a yearly basis and grouped into three-year periods (2000–2002, 2003–2005, 2006–2008, 2009–2011 and one two-year period (2012–2013, according to gestational age and mother’s Regional Health Office of residence. The polynomial regression model was used for trend analysis. Results The predominance of preterm birth rate increased from 6.8 % in 2000 to 10.5 % in 2013, with an average increase of 0.20 % per year (r2 = 0.89, and a greater share of moderate preterm births (32 to <37 weeks, which increased from 5.8 % to 9 %. The same pattern was observed for all Macro-regional Health Offices, with highlight to the Northern Macro-Regional Office, which showed the highest average rate of prematurity and average annual growth during that period (7.55 % and 0.35 %, respectively. The trend analysis of preterm birth rates according to RHO showed a growing trend for almost all RHOs – except for the 7th RHO where a declining trend was observed (−0.95 a year; and in the 20th, 21st and 22nd RHOs which remained unchanged. In the last three-year of the study period (2011–2013, no RHO showed preterm birth rates below 7.3 % or prevalence of moderate preterm birth below 9.4 %. Conclusions The results show an increase in preterm births

  18. Live births after polar body biopsy and frozen-thawed cleavage stage embryo transfer: case report.

    Science.gov (United States)

    Guimarães, Fernando; Roque, Matheus; Valle, Marcello; Kostolias, Alessandra; Azevedo, Rodrigo A de; Martinhago, Ciro D; Sampaio, Marcos; Geber, Selmo

    2016-12-01

    Pre-implantation genetic diagnosis (PGD) or screening (PGS) technology, has emerged and developed in the past few years, benefiting couples as it allows the selection and transfer of healthy embryos during IVF treatments. These techniques can be performed in oocytes (polar-body biopsy) or embryos (blastomere or trophectoderm biopsy). In this case report, we describe the first two live births to be published in Brazil after a polar-body (PB) biopsy. In case 1, a 42-year-old was submitted to PB biopsy with PGS due to advanced maternal age and poor ovarian reserve. Five MII oocytes underwent first and second polar body biopsy and four cleavage embryos were cryopreserved. The PGS analysis resulted in two euploid embryos (next generation sequence). A frozen-thawed embryo transfer (FET) was performed after endometrial priming and a healthy baby was delivered after a cesarean section (37 weeks, female, 3390g, 47.5 cm). In case 2, a 40-year old patient with balanced translocation and poor ovarian response was submitted to PB biopsy. Two MII oocytes underwent first and second polar body biopsy and two embryos were cryopreserved in cleavage stage. The analysis resulted in one euploid embryo that was transferred after endometrial priming. A preterm healthy baby (34 weeks, female, 2100g, 40 cm) was delivered via cesarean section. In conclusion, although the blastocyst biopsy is the norm when performing PGS/PGD during IVF treatments, other alternatives (as PB biopsy) should be considered in some specific situations.

  19. A decomposition analysis of change in skilled birth attendants, 2003 to 2008, Ghana Demographic and Health Surveys.

    Science.gov (United States)

    Bosomprah, Samuel; Aryeetey, Genevieve Cecelia; Nonvignon, Justice; Adanu, Richard M

    2014-12-24

    The single most critical intervention to improve maternal and neonatal survival is to ensure that a competent health worker with midwifery skills is present at every birth, and transport is available to a referral facility for obstetric care in case of an emergency. This study aims to describe changes in percentage of skilled birth attendants in Ghana and to identify causes of the observed changes as well as the contribution of different categories of mother's characteristics to these changes. This study uses two successive nationally representative household surveys: the 2003 and 2008 Ghana Demographic and Health Surveys (GDHS). The two datasets have comparable information on household characteristics and skilled attendants at birth at the time of the survey. The 2003 GDHS database includes information on 6,251 households and 3639 live births in the five years preceding the survey, whereas the 2008 GDHS database had information on11, 778 households and 2909 live births in the five years preceding the survey. A decomposition approach was used to explain the observed change in percentage of skilled birth attendants. Random-effects generalized least square regression was used to explore the effect of changes in population structure in respect of the mother's characteristics on percentage of skilled birth attendants over the period. Overall, the data showed absolute gain in the proportion of births attended by a health professional from 47.1% in 2003 to 58.7% in 2008, which represents 21.9% of gap closed to reach universal coverage. The increase in skilled birth attendants was found to be caused by changes in general health behaviour. The gain is regardless of the mother's characteristics. The structural change in the proportion of births in respect of birth order and mother's education had little effect on the change in percentage of skilled birth attendants. Improvement in general health behaviour can potentially contribute to an accelerated increase in proportion

  20. Neonatal birth weight and related factors in south of Iran, Jahrom

    Directory of Open Access Journals (Sweden)

    Fatemeh Emamghorashi

    2008-12-01

    Full Text Available Objective: This study aimed to determinate the relationship between neonatal birth weight and related factors in Jahrom, Iran. Materials and methods: All women delivering in two hospitals, in which obstetric services were presented, entered the study. In this cross sectional study, 2311 women were enrolled prospectively in a 12- month period during 2006-7. Data were collected during first three post partum days from the following sources: maternal hospital files and charts, interview with the mothers, measurement of anthropometric indices of fathers and the infants. Percentile distribution of birth weight for classified gestational age was calculated.Results: Results showed significant correlation between neonatal birth weight with neonatal gender, maternal age, weight, education and working status. There was no relation between neonatal weight with paternal weight, maternal education and living in urban or rural areas.Conclusion: Neonatal birth weight is affected by neonatal gender, maternal age and weight; education and job.

  1. The influence of living arrangements, marital patterns and family configuration on employment rates among the 1945-1954 birth cohort: evidence from ten European countries.

    Science.gov (United States)

    Ogg, Jim; Renaut, Sylvie

    2007-09-01

    As they approach retirement, Europeans in mid-life display a range of living arrangements and marital patterns. These configurations influence labour force participation for men and women in different ways and these differences are accentuated between countries. Using data from the first Wave (2004) of the Survey on Health, Ageing and Retirement in Europe (SHARE), the paper examines the relationship between living arrangements, marital patterns, family configurations and participation in the labour force for the birth cohort of 1945-1954. The data show that the probability of being in paid employment was higher for respondents living in a couple in northern Europe than in southern Europe. In all countries, men in a couple had significantly higher employment rates than women in a couple, but employment rates of women in a couple differed significantly between countries. Multivariate analysis with country effects confirmed the negative influence of age, poor health, lower levels of education and household income on the probability of being in paid employment, but the effect of variables concerning living arrangements, marital patterns and family configurations varied according to country. A multilevel analysis showed that the between country variance of being in paid employment could not be explained by individual characteristics alone, that a large part of the country variance could be explained by the country specific effect of women in a couple, and that the level of 'modern' life styles in each country (rates of cohabitation outside marriage, divorce or separation and recomposed families) had a significant effect on employment rates, especially for women in a couple.

  2. Effect of sibling number in the household and birth order on prevalence of Helicobacter pylori: a cross-sectional study.

    Science.gov (United States)

    Ford, Alexander C; Forman, David; Bailey, Alastair G; Goodman, Karen J; Axon, Anthony T R; Moayyedi, Paul

    2007-12-01

    Infection with Helicobacter pylori (H. pylori) is acquired mainly in childhood, with studies demonstrating this is related to living conditions. Effects of sibling number and birth order on prevalence of infection have not been extensively studied. The authors performed a cross-sectional survey of adults, aged between 50 and 59 years, previously involved in a community-screening programme for H. pylori in Leeds and Bradford, UK. Prevalence of H. pylori was assessed at baseline with urea breath test. All individuals who were alive, and could be traced, were contacted by postal questionnaire in 2003 obtaining information on number of siblings and birth order. Data concerning childhood socioeconomic conditions were stored on file from the original study. 3928 (47%) of 8407 original participants provided data. Prevalence of infection increased according to sibling number (20% in those with none vs 63% with eight or more). Controlling for childhood socioeconomic conditions and birth order using multivariate logistic regression, infection odds were substantially increased with three siblings compared with none [odds ratio (OR) 1.51; 95% confidence interval (CI) 1.06-2.15], and a gradient of effect continued up to eight or more siblings (OR 5.70; 95% CI 2.92-11.14). Odds of infection also increased substantially with birth order, but the positive gradient disappeared on adjustment for sibling number and childhood socioeconomic conditions. : In this cross section of UK adults, aged 50-59 years, sibling number in the household, but not birth order, was independently associated with prevalence of H. pylori infection.

  3. Rural community birth: Maternal and neonatal outcomes for planned community births among rural women in the United States, 2004-2009.

    Science.gov (United States)

    Nethery, Elizabeth; Gordon, Wendy; Bovbjerg, Marit L; Cheyney, Melissa

    2017-11-13

    Approximately 22% of women in the United States live in rural areas with limited access to obstetric care. Despite declines in hospital-based obstetric services in many rural communities, midwifery care at home and in free standing birth centers is available in many rural communities. This study examines maternal and neonatal outcomes among planned home and birth center births attended by midwives, comparing outcomes for rural and nonrural women. Using the Midwives Alliance of North America Statistics Project 2.0 dataset of 18 723 low-risk, planned home, and birth center births, rural women (n = 3737) were compared to nonrural women. Maternal outcomes included mode of delivery (cesarean and instrumental delivery), blood transfusions, severe events, perineal lacerations, or transfer to hospital and a composite (any of the above). The primary neonatal outcome was a composite of early neonatal intensive care unit or hospital admissions (longer than 1 day), and intrapartum or neonatal deaths. Analysis involved multivariable logistic regression, controlling for sociodemographics, antepartum, and intrapartum risk factors. Rural women had different risk profiles relative to nonrural women and reduced risk of adverse maternal and neonatal outcomes in bivariable analyses. However, after adjusting for risk factors and confounders, there were no significant differences for a composite of maternal (adjusted odds ratio [aOR] 1.05 [95% confidence interval {CI} 0.93-1.19]) or neonatal (aOR 1.13 [95% CI 0.87-1.46]) outcomes between rural and nonrural pregnancies. Among this sample of low-risk women who planned midwife-led community births, no increased risk was detected by rural vs nonrural status. © 2017 Wiley Periodicals, Inc.

  4. Associations between maternal exposure to air pollution and traffic noise and newborn's size at birth

    DEFF Research Database (Denmark)

    Hjortebjerg, Dorrit; Andersen, Anne Marie Nybo; Ketzel, Matthias

    2016-01-01

    BACKGROUND: Maternal exposure to air pollution and traffic noise has been suggested to impair fetal growth, but studies have reported inconsistent findings. Objective To investigate associations between residential air pollution and traffic noise during pregnancy and newborn's size at birth....... METHODS: From a national birth cohort we identified 75,166 live-born singletons born at term with information on the children's size at birth. Residential address history from conception until birth was collected and air pollution (NO2 and NOx) and road traffic noise was modeled at all addresses...... between air pollution and birth weight. Exposure to residential road traffic noise was weakly associated with reduced head circumference, whereas none of the other newborn's size indicators were associated with noise, neither before nor after adjustment for air pollution. CONCLUSIONS: This study indicates...

  5. Genetic and environmental influences on adult human height across birth cohorts from 1886 to 1994.

    Science.gov (United States)

    Jelenkovic, Aline; Hur, Yoon-Mi; Sund, Reijo; Yokoyama, Yoshie; Siribaddana, Sisira H; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Tan, Qihua; Zhang, Dongfeng; Pang, Zengchang; Aaltonen, Sari; Heikkilä, Kauko; Öncel, Sevgi Y; Aliev, Fazil; Rebato, Esther; Tarnoki, Adam D; Tarnoki, David L; Christensen, Kaare; Skytthe, Axel; Kyvik, Kirsten O; Silberg, Judy L; Eaves, Lindon J; Maes, Hermine H; Cutler, Tessa L; Hopper, John L; Ordoñana, Juan R; Sánchez-Romera, Juan F; Colodro-Conde, Lucia; Cozen, Wendy; Hwang, Amie E; Mack, Thomas M; Sung, Joohon; Song, Yun-Mi; Yang, Sarah; Lee, Kayoung; Franz, Carol E; Kremen, William S; Lyons, Michael J; Busjahn, Andreas; Nelson, Tracy L; Whitfield, Keith E; Kandler, Christian; Jang, Kerry L; Gatz, Margaret; Butler, David A; Stazi, Maria A; Fagnani, Corrado; D'Ippolito, Cristina; Duncan, Glen E; Buchwald, Dedra; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth Jf; Martin, Nicholas G; Medland, Sarah E; Montgomery, Grant W; Jeong, Hoe-Uk; Swan, Gary E; Krasnow, Ruth; Magnusson, Patrik Ke; Pedersen, Nancy L; Dahl-Aslan, Anna K; McAdams, Tom A; Eley, Thalia C; Gregory, Alice M; Tynelius, Per; Baker, Laura A; Tuvblad, Catherine; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Lichtenstein, Paul; Spector, Timothy D; Mangino, Massimo; Lachance, Genevieve; Bartels, Meike; van Beijsterveldt, Toos Cem; Willemsen, Gonneke; Burt, S Alexandra; Klump, Kelly L; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas Sevenius; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Corley, Robin P; Hjelmborg, Jacob V B; Goldberg, Jack H; Iwatani, Yoshinori; Watanabe, Mikio; Honda, Chika; Inui, Fujio; Rasmussen, Finn; Huibregtse, Brooke M; Boomsma, Dorret I; Sørensen, Thorkild I A; Kaprio, Jaakko; Silventoinen, Karri

    2016-12-14

    Human height variation is determined by genetic and environmental factors, but it remains unclear whether their influences differ across birth-year cohorts. We conducted an individual-based pooled analysis of 40 twin cohorts including 143,390 complete twin pairs born 1886-1994. Although genetic variance showed a generally increasing trend across the birth-year cohorts, heritability estimates (0.69-0.84 in men and 0.53-0.78 in women) did not present any clear pattern of secular changes. Comparing geographic-cultural regions (Europe, North America and Australia, and East Asia), total height variance was greatest in North America and Australia and lowest in East Asia, but no clear pattern in the heritability estimates across the birth-year cohorts emerged. Our findings do not support the hypothesis that heritability of height is lower in populations with low living standards than in affluent populations, nor that heritability of height will increase within a population as living standards improve.

  6. We Are Never Alone: Living with the Human Microbiota

    OpenAIRE

    da Silva, Gabriela Jorge; Domingues, Sara

    2017-01-01

    The human body is inhabited by millions of tiny living organisms, which, all together, are called the human microbiota. Bacteria are microbes found on the skin, in the nose, mouth, and especially in the gut. We acquire these bacteria during birth and the first years of life, and they live with us throughout our lives. The human microbiota is involved in healthy growth, in protecting the body from invaders, in helping digestion, and in regulating moods. Some changes in the microbiota may occur...

  7. The tyranny of distance: maternity waiting homes and access to birthing facilities in rural Timor-Leste.

    Science.gov (United States)

    Wild, Kayli; Barclay, Lesley; Kelly, Paul; Martins, Nelson

    2012-02-01

    To examine the impact of maternity waiting homes on the use of facility-based birthing services for women in two remote districts of Timor-Leste. A before-and-after study design was used to compare the number of facility-based births in women who lived at different distances (0-5, 6-25, 26-50 and > 50 km) from the health centre before and after implementation of maternity waiting homes. Routine data were collected from health centre records at the end of 2007; they included 249 births in Same, Manufahi district, and 1986 births in Lospalos, Lautem district. Population data were used to estimate the percentage of women in each distance category who were accessing facility-based care. Most facility-based births in Same (80%) and Lospalos (62%) were among women who lived within 5 km of the health centre. There was no significant increase in the number of facility-based births among women in more remote areas following implementation of the maternity waiting homes. The percentage of births in the population that occurred in a health facility was low for both Manufahi district (9%) and Lautem district (17%), and use decreased markedly as distance between a woman's residence and the health facilities increased. The maternity waiting homes in Timor-Leste did not improve access to facility-based delivery for women in remote areas. The methods for distance analysis presented in this paper provide a framework that could be used by other countries seeking to evaluate maternity waiting homes.

  8. The effect of genotype and birth type on gestation length and linear ...

    African Journals Online (AJOL)

    The effect of genotype and birth type on gestation length and linear body ... was conducted in Enugu State University of Science and Technology, in the then ... Weekly weights and live body measurements of the kids were recorded from ...

  9. The association between height and birth order: evidence from 652,518 Swedish men.

    Science.gov (United States)

    Myrskylä, Mikko; Silventoinen, Karri; Jelenkovic, Aline; Tynelius, Per; Rasmussen, Finn

    2013-07-01

    Birth order is associated with outcomes such as birth weight and adult socioeconomic position (SEP), but little is known about the association with adult height. This potential birth order-height association is important because height predicts health, and because the association may help explain population-level height trends. We studied the birth order-height association and whether it varies by family characteristics or birth cohort. We used the Swedish Military Conscription Register to analyse adult height among 652,518 men born in 1951-1983 using fixed effects regression models that compare brothers and account for genetic and social factors shared by brothers. We stratified the analysis by family size, parental SEP and birth cohort. We compared models with and without birth weight and birth length controls. Unadjusted analyses showed no differences between the first two birth orders but in the fixed effects regression, birth orders 2, 3 and 4 were associated with 0.4, 0.7 and 0.8 cm (pbirth order 1, respectively. The associations were similar in large and small and high-SEP and low-SEP families, but were attenuated in recent cohorts. Birth characteristics did not explain these associations. Birth order is an important determinant of height. The height difference between birth orders 3 and 1 is larger than the population-level height increase achieved over 10 years. The attenuation of the effect over cohorts may reflect improvements in living standards. Decreases in family size may explain some of the secular-height increases in countries with decreasing fertility.

  10. Effect of maternal multiple micronutrient vs iron-folic acid supplementation on infant mortality and adverse birth outcomes in rural Bangladesh: the JiVitA-3 randomized trial.

    Science.gov (United States)

    West, Keith P; Shamim, Abu Ahmed; Mehra, Sucheta; Labrique, Alain B; Ali, Hasmot; Shaikh, Saijuddin; Klemm, Rolf D W; Wu, Lee S-F; Mitra, Maithilee; Haque, Rezwanul; Hanif, Abu A M; Massie, Allan B; Merrill, Rebecca Day; Schulze, Kerry J; Christian, Parul

    Maternal micronutrient deficiencies may adversely affect fetal and infant health, yet there is insufficient evidence of effects on these outcomes to guide antenatal micronutrient supplementation in South Asia. To assess effects of antenatal multiple micronutrient vs iron-folic acid supplementation on 6-month infant mortality and adverse birth outcomes. Cluster randomized, double-masked trial in Bangladesh, with pregnancy surveillance starting December 4, 2007, and recruitment on January 11, 2008. Six-month infant follow-up ended August 30, 2012. Surveillance included 127,282 women; 44,567 became pregnant and were included in the analysis and delivered 28,516 live-born infants. Median gestation at enrollment was 9 weeks (interquartile range, 7-12). Women were provided supplements containing 15 micronutrients or iron-folic acid alone, taken daily from early pregnancy to 12 weeks postpartum. The primary outcome was all-cause infant mortality through 6 months (180 days). Prespecified secondary outcomes in this analysis included stillbirth, preterm birth (<37 weeks), and low birth weight (<2500 g). To maintain overall significance of α = .05, a Bonferroni-corrected α = .01 was calculated to evaluate statistical significance of primary and 4 secondary risk outcomes (.05/5). Among the 22,405 pregnancies in the multiple micronutrient group and the 22,162 pregnancies in the iron-folic acid group, there were 14,374 and 14,142 live-born infants, respectively, included in the analysis. At 6 months, multiple micronutrients did not significantly reduce infant mortality; there were 764 deaths (54.0 per 1000 live births) in the iron-folic acid group and 741 deaths (51.6 per 1000 live births) in the multiple micronutrient group (relative risk [RR], 0.95; 95% CI, 0.86-1.06). Multiple micronutrient supplementation resulted in a non-statistically significant reduction in stillbirths (43.1 vs 48.2 per 1000 births; RR, 0.89; 95% CI, 0.81-0.99; P = .02) and significant

  11. 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

  12. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate.

    Science.gov (United States)

    Racowsky, Catherine; Stern, Judy E; Gibbons, William E; Behr, Barry; Pomeroy, Kimball O; Biggers, John D

    2011-05-01

    To evaluate the validity of collecting day 3 embryo morphology variables into the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS). Retrospective. National database-SART CORS. Fresh autologous assisted reproductive technology (ART) cycles from 2006-2007 in which embryos were transferred singly (n=1,020) or in pairs (n=6,508) and embryo morphology was collected. None. Relationship between live birth, maternal age, and morphology of transferred day 3 embryos as defined by cell number, fragmentation, and blastomere symmetry. Logistic multiple regressions and receiver operating characteristic curve analyses were applied to determine specificity and sensitivity for correctly classifying embryos as either failures or successes. Live birth rate was positively associated with increasing cell number up to eight cells (8 cells: 16.2%), but was negatively associated with maternal age, increasing fragmentation, and asymmetry scores. An area under the receiver operating curve of 0.753 (95% confidence interval 0.740-0.766) was derived, with a sensitivity of 45.0%, a specificity of 83.2%, and 76.4% of embryos being correctly classified with a cutoff probability of 0.3. This analysis provides support for the validity of collecting morphology fields for day 3 embryos into SART CORS. Standardization of morphology collections will assist in controlling for embryo quality in future database analyses. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. 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.

  14. Re-birth after coronary bypass graft surgery: a hermeneutic-phenomenological study.

    Science.gov (United States)

    Abbasi, Mohammad; Mohammadi, Nooredin; Nasrabadi, Alireza Nikbakht; Fuh, Suh Boudouin; Sadeghi, Tahereh

    2014-03-31

    Although coronary artery bypass graft surgery has significant effects on reducing the symptoms of coronary artery disease, there is not enough knowledge and understanding of lived experience of patients after surgery. Understanding lived experience of this group of patients would be helpful for healthcare staff to provide better services to the patients. The aim of this study was to describe with a deeper understanding, the lived experiences of patients after Coronary Artery Bypass Graft Surgery. Using a hermeneutic phenomenological approach and a Van-Manen analysis method, in-depth semi-structured interviews were conducted with eleven participants who had lived experienced of at least six months post - coronary artery bypass graft surgery. Re-birth was the main theme that emerged in the process of data analysis. This theme was derived from four sub-themes including "feels younger", ''vigorous heart'', ''intrepid life'' and ''oriented to be healthy''. Life after a coronary artery bypass graft surgery is often appreciated as a re-birth by persons with these experiences as surgery did not only provide a feeling of wellness, but also added a sensation of youthfulness and improvement in the quality of life for these participants. In addition, they would actively participate in health promotional activities such as; adherence to medication and diet regimes, changes in lifestyle to maintain their health.

  15. Epidemiologic Surveillance of Teenage Birth Rates in the United States, 2006-2012.

    Science.gov (United States)

    Amin, Raid; Decesare, Julie Zemaitis; Hans, Jennifer; Roussos-Ross, Kay

    2017-06-01

    To investigate the geographic variation in the average teenage birth rates by county in the contiguous United States. Data from the National Center for Health Statistics were used in this retrospective cohort to count the total number of live births to females aged 15-19 years by county between 2006 and 2012. Software for disease surveillance and spatial cluster analysis was used to identify clusters of high or low teenage births in counties or areas of greater than 100,000 teenage females. The analysis was then adjusted for percentage of poverty and high school diploma achievement. The unadjusted analysis identified the top 10 clusters of teenage births. The cluster with the highest rate was a city and the surrounding 40 counties, demonstrating an average teen birth rate of 67 per 1,000 females in the age range, 87% higher than the rate in the contiguous United States. Adjustments for poverty rates and high school diploma achievement shifted the top clusters to other areas. Despite an overall national decline in the teenage birth rate, clusters of elevated teenage birth rates remain. These clusters are not random and remain higher than expected when adjusted for poverty and education. This data set provides a framework to focus targeted interventions to reduce teenage birth rates in this high-risk population.

  16. Women's and men's negative experience of child birth-A cross-sectional survey.

    Science.gov (United States)

    Nystedt, Astrid; Hildingsson, Ingegerd

    2018-04-01

    A negative birth experience may influence both women and men and can limit their process of becoming a parent. This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth. A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n=928) and men (n=818) completed the same questionnaire that investigated new parents' birth experiences in relation to socio-demographic background and birth related variables. Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0-10.8) and men (OR 4.5, Cl 95% 1.4-17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; 'It was a pain to give birth' were a strong contributing factor for both women and men. A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  17. IMPACT OF PRENATAL MATERNAL FACTORS AND BIRTH ORDER ON THE ANTHROPOMETRIC STATUS OF NEWBORNS IN IRAN.

    Science.gov (United States)

    Kheirouri, Sorayya; Alizadeh, Mohammad

    2017-03-01

    This cross-sectional study was carried out to capture possible maternal factors affecting newborns' anthropometric measurements. Data were collected from eight public health centres and referral university hospital records in Tabriz and Heriss districts, north-west Iran, for 807 mother-neonate pairs delivering live singleton births and their offspring during the two years up to August 2014. The incidence of low birth weight (LBW) was 5.1%. A close correlation was found between maternal anthropometry and birth order with neonatal anthropometric data. Birth order and maternal height and body mass index (BMI) positively affected neonates' birth size (weight, length and head circumference). The rate of LBW was significantly higher for older (≥35 years), taller (≥170 cm), underweight (BMIbirth neonates. The results indicate that maternal anthropometric indices, age, iron intake and birth order influence the risk of LBW in newborns.

  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, 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

  19. 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

  20. Prenatal nitrate intake from drinking water and selected birth defects in offspring of participants in the national birth defects prevention study.

    Science.gov (United States)

    Brender, Jean D; Weyer, Peter J; Romitti, Paul A; Mohanty, Binayak P; Shinde, Mayura U; Vuong, Ann M; Sharkey, Joseph R; Dwivedi, Dipankar; Horel, Scott A; Kantamneni, Jiji; Huber, John C; Zheng, Qi; Werler, Martha M; Kelley, Katherine E; Griesenbeck, John S; Zhan, F Benjamin; Langlois, Peter H; Suarez, Lucina; Canfield, Mark A

    2013-09-01

    Previous studies of prenatal exposure to drinking-water nitrate and birth defects in offspring have not accounted for water consumption patterns or potential interaction with nitrosatable drugs. We examined the relation between prenatal exposure to drinking-water nitrate and selected birth defects, accounting for maternal water consumption patterns and nitrosatable drug exposure. With data from the National Birth Defects Prevention Study, we linked addresses of 3,300 case mothers and 1,121 control mothers from the Iowa and Texas sites to public water supplies and respective nitrate measurements. We assigned nitrate levels for bottled water from collection of representative samples and standard laboratory testing. Daily nitrate consumption was estimated from self-reported water consumption at home and work. With the lowest tertile of nitrate intake around conception as the referent group, mothers of babies with spina bifida were 2.0 times more likely (95% CI: 1.3, 3.2) to ingest ≥ 5 mg nitrate daily from drinking water (vs. nitrate daily (vs. water nitrate intake did not increase associations between prenatal nitrosatable drug use and birth defects. Higher water nitrate intake was associated with several birth defects in offspring, but did not strengthen associations between nitrosatable drugs and birth defects.

  1. Trends and characteristics of home births in the United States by race and ethnicity, 1990-2006.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Menacker, Fay

    2011-03-01

    After a gradual decline from 1990 to 2004, the percentage of births occurring at home in the United States increased by 5 percent in 2005 and that increase was sustained in 2006. The purpose of the study was to analyze trends and characteristics in home births in United States by race and ethnicity from 1990 to 2006. U.S. birth certificate data on home births were analyzed and compared with hospital births for a variety of demographic and medical characteristics. From 1990 to 2006, both the number and percentage of home births increased for non-Hispanic white women, but declined for all other race and ethnic groups. In 2006, non-Hispanic white women were three to four times more likely to have a home birth than women of other race and ethnic groups. Home births were more likely than hospital births to occur to older, married women with singleton pregnancies and several previous children. For non-Hispanic white women, fewer home births than hospital births were born preterm, whereas for other race and ethnic groups a higher percentage of home births than hospital births were born preterm. For non-Hispanic white women, two-thirds of home births were delivered by midwives. In contrast, for other race and ethnic groups, most home births were delivered by either physicians or "other" attendants, suggesting that a higher proportion of these births may be unplanned home births because of emergency situations. Differences in the risk profile of home births by race and ethnicity are consistent with previous research, suggesting that, compared with non-Hispanic white women, a larger proportion of non-Hispanic black and Hispanic home births represent unplanned, emergency situations. © 2010, Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc.

  2. A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives.

    Science.gov (United States)

    Salasibew, Mihretab Melesse; Filteau, Suzanne; Marchant, Tanya

    2014-12-12

    Ethiopia is among seven high-mortality countries which have achieved the fourth millennium development goal with over two-thirds reduction in under-five mortality rate. However, the proportion of neonatal deaths continues to rise and recent studies reported low coverage of the essential interventions saving newborn lives. In the context of low uptake of health facility delivery, it is relevant to explore routine practices during home deliveries and, in this study, we explored the sequence of immediate newborn care practices and associated beliefs following home deliveries in rural communities in Ethiopia. Between April-May 2013, we conducted 26 semi-structured interviews and 2 focus group discussions with eligible mothers, as well as a key informant interview with a local expert in traditional newborn care practices in rural Basona woreda (district) near the urban town of Debrebirhan, 120 km from Addis Ababa, Ethiopia. The most frequently cited sequence of newborn care practices reported by mothers with home deliveries in the rural Basona woreda was to tie the cord, immediately bath then dry the newborn, practice 'Lanka mansat' (local traditional practice on newborns), give pre-lacteal feeding and then initiate breastfeeding. For 'Lanka mansat', the traditional birth attendant applies mild pressure inside the baby's mouth on the soft palate using her index finger. This is performed believing that the baby will have 'better voice' and 'speak clearly' later in life. Coverage figures fail to tell the whole story as to why some essential interventions are not practiced and, in this study, we identified established norms or routines within the rural communities that determine the sequence of newborn care practices following home births. This might explain why some mothers delay initiation of breastfeeding and implementation of other recommended essential interventions saving newborn lives. An in-depth understanding of established routines is necessary, and community

  3. Influence of birth weight on differences in infant mortality by social class and legitimacy.

    Science.gov (United States)

    Leon, D A

    1991-01-01

    OBJECTIVE--To investigate the influence of birth weight on the pronounced social class differences in infant mortality in Britain. DESIGN--Analysis of routine data on births and infant deaths. SETTING--England and Wales. SUBJECTS--All live births and infant deaths, 1983-5. MAIN OUTCOME MEASURE--Mortality in infants by social class, birth weight, and legitimacy according to birth and death certificates. RESULTS--Neonatal and postneonatal mortality (deaths/1000 births) increased with social class. Neonatal and postneonatal mortality was 4.2/1000 and 2.3/1000 respectively for social class I and 6.8/1000 and 5.6/1000 respectively for social class V. Mortality was lower among births registered within marriage (postneonatal 3.5/1000; neonatal 5.2/1000) than among those jointly registered outside marriage (5.1/1000; 6.4/1000); mortality was highest in those solely registered outside marriage (7.2/1000; 7.0/1000). For neonatal mortality the effect of social class varied with birth weight. Social class had little effect on neonatal mortality in low birthweight babies and increasing effect in heavier babies. For postneonatal mortality the effect of social class was similar for all birth weights and was almost as steep as for all birth weights combined. CONCLUSION--Birth weight mediates little of the effect of social class on postneonatal mortality. PMID:1954421

  4. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    NARCIS (Netherlands)

    van Rijn, Rick R.; Bilo, Rob A. C.; Robben, Simon G. F.

    2009-01-01

    BACKGROUND: Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases

  5. Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

    Directory of Open Access Journals (Sweden)

    Nove Andrea

    2012-11-01

    Full Text Available Abstract Background The aim of this study is to compare the odds of postpartum haemorrhage among women who opt for home birth against the odds of postpartum haemorrhage for those who plan a hospital birth. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, and which resulted in a live or stillbirth in the years 1988–2000 inclusive, excluding ‘high-risk’ pregnancies, unplanned home births, pre-term births, elective Caesareans and medical inductions. Results Even after adjustment for known confounders such as parity, the odds of postpartum haemorrhage (≥1000ml of blood lost are significantly higher if a hospital birth is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval 1.7 to 3.8. The ‘home birth’ group included women who were transferred to hospital during labour or shortly after birth. Conclusions Women and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home, but that further research is needed to understand (a whether the same pattern applies to the more life-threatening categories of PPH, and (b why hospital birth is associated with increased odds of PPH. If it is due to the way in which labour is managed in hospital, changes should be made to practices which compromise the safety of labouring women.

  6. The relationship between air pollution and low birth weight: effects by mother's age, infant sex, co-pollutants, and pre-term births

    Energy Technology Data Exchange (ETDEWEB)

    Bell, Michelle L; Ebisu, Keita [School of Forestry and Environmental Studies, Yale University, 205 Prospect Street, New Haven, CT 06511 (United States); Belanger, Kathleen [Department of Epidemiology and Public Health, School of Medicine, Yale University, One Church Street, 6th Floor, New Haven, CT 06510 (United States)], E-mail: michelle.bell@yale.edu

    2008-10-15

    Previously we identified associations between the mother's air pollution exposure and birth weight for births in Connecticut and Massachusetts from 1999-2002. Other studies also found effects, though results are inconsistent. We explored potential uncertainties in earlier work and further explored associations between air pollution and birth weight for PM{sub 10}, PM{sub 2.5}, CO, NO{sub 2}, and SO{sub 2}. Specifically we investigated: (1) whether infants of younger ({<=}24 years) and older ({>=}40 years) mothers are particularly susceptible to air pollution's effects on birth weight; (2) whether the relationship between air pollution and birth weight differed by infant sex; (3) confounding by co-pollutants and differences in pollutants' measurement frequencies; and (4) whether observed associations were influenced by inclusion of pre-term births. Findings did not indicate higher susceptibility to the relationship between air pollution and birth weight based on the mother's age or the infant's sex. Results were robust to exclusion of pre-term infants and co-pollutant adjustment, although sample size decreased for some pollutant pairs. These findings provide additional evidence for the relationship between air pollution and birth weight, and do not identify susceptible sub-populations based on infant sex or mother's age. We conclude with discussion of key challenges in research on air pollution and pregnancy outcomes.

  7. 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.

  8. Occupational lifting during pregnancy and child's birth size in a large cohort study

    DEFF Research Database (Denmark)

    Juhl, Mette; Larsen, Pernille Stemann; Andersen, Per Kragh

    2014-01-01

    OBJECTIVES: It has been suggested that the handling of heavy loads during pregnancy is associated with impaired fetal growth. We examined the association between quantity and frequency of maternal occupational lifting and the child's size at birth, measured by weight, length, ponderal index, small......-for-gestational-age (SGA), abdominal circumference, head circumference, and placental weight. METHODS: We analyzed birth size from the Danish Medical Birth Registry of 66 693 live-born children in the Danish National Birth Cohort according to the mother's self-reported information on occupational lifting from telephone...... women with occupational lifting versus women with no lifting, but the differences were very small, and there was a statistically significant trend only for placental weight showing lighter weight with increasing number of kilos lifted per day. In jobs likely to include person-lifting, we found increased...

  9. Education, labour, and the demographic consequences of birth postponement in Europe

    Directory of Open Access Journals (Sweden)

    Hippolyte d'Albis

    2017-02-01

    Full Text Available Background: This article questions the demographic consequences of birth postponement in Europe. Objective: Starting from the fact that there is no obvious link between the timing of first births and fertility levels in Europe, we find that under certain circumstances, birth postponement potentially facilitates rather than impedes starting a family. Methods: We apply a synthetic cohort approach and distinguish between different socioeconomic determinants of the timing of first births by using the European Union Statistics on Income and Living Conditions (EU-SILC. Data is compiled specifically to reduce endogeneity and to eliminate structure effects. Results: We find that the probability of becoming a mother is higher for women who postpone first childbirth due to education and career investment than for women who postpone due to unrealized labour market integration. Conclusions: Educated and economically active women certainly postpone first childbirth in comparison to women who are less educated and who are not working, but they end up with a higher probability of starting a family. Contribution: The article contributes to the academic discussion of circumstances that may lead to birth postponement resulting in higher fertility for younger cohorts in European countries.

  10. 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.

  11. Preeclampsia and retinopathy of prematurity in preterm births.

    Science.gov (United States)

    Yu, Xiao Dan; Branch, D Ware; Karumanchi, S Ananth; Zhang, Jun

    2012-07-01

    The relationship between gestational hypertension, preeclampsia, and the risk of retinopathy of prematurity (ROP) remains unclear. Thus, we used a large cohort database to study the influence of maternal gestational hypertension and preeclampsia on the occurrence of ROP in preterm infants. We used data from a previous retrospective cohort study that includes 25,473 eligible preterm neonates. We examined the association between gestational hypertension, preeclampsia, and ROP while controlling for potential confounders by multiple logistic regression analysis. Of the 8758 early preterm infants (gestational age <34 weeks), 1024 (11.69%) had ROP, while of the 16,715 late preterm infants, only 29 (0.17%) had ROP. After adjusting for confounders, preeclampsia was associated with a significantly reduced risk of ROP (adjusted odds ratio [aOR], 0.65; 95% confidence interval [CI], 0.49-0.86 for early preterm birth; aOR, 0.10; 95% CI, 0.01-0.93 for late preterm birth; aOR, 0.66; 95% CI, 0.50-0.87 for all preterm births). Gestational hypertension was not significantly associated with ROP at early or late preterm births. Preeclampsia, but not gestational hypertension, was associated with a reduced risk of ROP in preterm births.

  12. Implications of teen birth for overweight and obesity in adulthood.

    Science.gov (United States)

    Chang, Tammy; Choi, HwaJung; Richardson, Caroline R; Davis, Matthew M

    2013-08-01

    The objective of this study was to examine whether teen birth was independently associated with overweight and obesity in a US cohort. We examined whether teen birth is independently associated with overweight and obesity in a multiyear US cohort using the 2001-2010 National Health and Nutrition Examination Survey, a nationally representative cross-sectional survey of the US civilian, noninstitutionalized population. We performed multinomial logistic regression adjusting for survey cohort, age at survey, race, education, and parity. We included women 20-59 years old at the time of survey, with at least 1 live birth, not currently or recently pregnant (unweighted, n = 5220; weighted, n = 48.4 million). Our outcome measure was the effect of teen birth on subsequent overweight and obesity. In bivariate analyses, women with a teen birth were significantly more likely than women without a teen birth to be overweight (relative risk ratios [RRRs], 1.61; 95% confidence interval [CI], 1.37-1.90) or obese (RRR, 1.84; 95% CI, 1.56-2.16) at the time of the survey. In multivariate models, women with a teen birth remained significantly more likely to be overweight (adjusted RRR, 1.33; 95% CI, 1.10-1.62) or obese (adjusted RRR, 1.32; 95% CI, 1.09-1.61) than women without a teen birth. For women in the United States, giving birth as a teen is associated with subsequent overweight/obese status later in life. To inform clinical and policy interventions with the goal to improve the long-term health of teenage mothers, future studies must examine modifiable physiological and sociomedical reasons for early child-bearing and later risk of obesity. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review.

    Science.gov (United States)

    Kazemier, B M; Buijs, P E; Mignini, L; Limpens, J; de Groot, C J M; Mol, B W J

    2014-09-01

    Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies. Studies comparing the risk of spontaneous preterm birth after a previous preterm and previous term pregnancy. The absolute risk of recurrence with a 95% confidence interval and the absolute risk of preterm birth after a term delivery were calculated. Data from studies were pooled using the Mantel-Haenszel method. We detected 13 relevant studies. The risk of recurrence of preterm birth was significantly increased in all preterm pregnancy subtypes, compared with their term counterparts. Women pregnant with twins after a previous preterm singleton had the highest absolute risk of recurrence (57.0%, 95% CI 51.9-61.9%), and after a previous term singleton their absolute risk was 25% (95% CI 24.3-26.5%). Women pregnant with a singleton after a previous preterm twin pregnancy have an absolute recurrence risk of 10% (95% CI 8.2-12.3%), whereas a singleton pregnancy after delivering a previous twin up to term yields a low absolute risk of only 1.3% (95% CI 0.8-2.2). Women pregnant with a singleton after a previous preterm singleton have an absolute recurrence risk of 20% (95% CI 19.9-20.6). The risk of recurrence of preterm birth is influenced by the singleton/twin order in both pregnancies, and varies between 10% for a singleton after previous preterm twins to 57% for twins after a previous preterm singleton. © 2014 Royal College of Obstetricians and Gynaecologists.

  14. Health and function assessments in two adjacent Danish birth cohorts of centenarians

    DEFF Research Database (Denmark)

    Vestergaard, Sonja; Andersen-Ranberg, Karen; Skytthe, Axel

    2016-01-01

    Using the results from measures of functional ability, cognitive and physical performance from two adjacent birth cohorts of 100-year-old adults, we aimed to elucidate the possible impact of difference in participation rates, design, and interviewer mode. Participants were birth cohort members born...... proportions of DK-1911 independently performed all activities of daily living (ADL) compared to DK-1910, but only significantly for toileting, bathing, and feeding (all p examination (MMSE) score was higher in DK-1911 than in DK-1910 (23.5 vs. 21.0; p

  15. Validity of parental work information on the birth certificate

    Directory of Open Access Journals (Sweden)

    Langlois Peter H

    2008-03-01

    Full Text Available Abstract Background In the most recent revision (2003 of the U.S. standard certificate of live births, the National Center for Health Statistics recommended that all states collect maternal and paternal usual occupation. Because such information might be useful in the surveillance of job-related risk areas, we assessed the quality of parental work information on the U.S. birth certificate. Methods Occupational histories obtained from maternal interviews with Texas (USA participants in the National Birth Defects Prevention Study were linked to and compared with parental work information on birth certificates. With occupational information from interviews serving as the gold standard, we assessed the quality of occupational information on the birth certificate with measures of sensitivity, specificity, and the kappa statistic. Results Of the 649 births available for study, parental occupation agreed between the birth certificate and interview for 77% of mothers and 63% of fathers with similar agreement by case-control status. Among occupations and industries with 10 or more workers by interview, sensitivity of the birth certificate information ranged from 35% to 100% for occupational groups and 55% to 100% for industrial sectors. Specificities of occupations/industries studied ranged from 93 to 100%. Kappa statistics for maternal occupations (0.76 to 0.90 and industries (0.59 to 0.94 were higher than those for paternal occupations (0.48 to 0.92 and industries (0.47 to 0.89. Mothers were frequently misclassified as homemakers or otherwise unemployed while the paternal information was often missing altogether on the birth certificate. Women who worked as health diagnosing and treating practitioners were the least likely (0% and women in food preparation or serving occupations were the most likely (65% to be misclassified as not employed on the birth certificate. Among fathers, the proportion of missing occupations was the lowest for occupations in

  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. Validation of birth outcomes from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS): population-based analysis from the Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART).

    Science.gov (United States)

    Stern, Judy E; Gopal, Daksha; Liberman, Rebecca F; Anderka, Marlene; Kotelchuck, Milton; Luke, Barbara

    2016-09-01

    To assess the validity of outcome data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) compared with data from vital records and the birth defects registry in Massachusetts. Longitudinal cohort. Not applicable. A total of 342,035 live births and fetal deaths from Massachusetts mothers giving birth in the state from July 1, 2004, to December 31, 2008; 9,092 births and fetal deaths were from mothers who had conceived with the use of assisted reproductive technology (ART) and whose cycle data had been reported to the SART CORS. Not applicable. Percentage agreement between maternal race and ethnicity, delivery outcome (live birth or fetal death), plurality (singleton, twin, or triplet+), delivery date, and singleton birth weight reported in the SART CORS versus vital records; sensitivity and specificity for birth defects among singletons as reported in the SART CORS versus the Massachusetts Birth Defects Monitoring Program (BDMP). There was >95% agreement between the SART CORS and vital records for fields of maternal race/ethnicity, live birth/fetal death, and plurality; birth outcome date was within 1 day with 94.9% agreement and birth weight was within 100 g with 89.6% agreement. In contrast, sensitivity for report of any birth defect was 38.6%, with a range of 18.4%-50.0%, for specific birth defect categories. Although most SART CORS outcome fields are accurately reported, birth defect variables showed poor sensitivity compared with the gold standard data from the BDMP. We suggest that reporting of birth defects be discontinued. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Brain and Cognitive-Behavioural Development after Asphyxia at Term Birth

    Science.gov (United States)

    de Haan, Michelle; Wyatt, John S.; Roth, Simon; Vargha-Khadem, Faraneh; Gadian, David; Mishkin, Mortimer

    2006-01-01

    Perinatal asphyxia occurs in approximately 1-6 per 1000 live full-term births. Different patterns of brain damage can result, though the relation of these patterns to long-term cognitive-behavioural outcome remains under investigation. The hippocampus is one brain region that can be damaged (typically not in isolation), and this site of damage has…

  19. Three-Generation Family Households: Differences by Family Structure at Birth

    Science.gov (United States)

    Pilkauskas, Natasha V.

    2012-01-01

    Using data from the Fragile Families and Child Wellbeing Study (N = 4,898), this study investigated how the share, correlates, transition patterns, and duration of 3-generation households vary by mother's relationship status at birth. Nine percent of married mothers, 17% of cohabiting mothers, and 45% of single mothers lived in a 3-generation…

  20. Feminism, biomedicine and the 'reproductive destiny' of women in clinical texts on the birth control pill.

    Science.gov (United States)

    Carson, Andrea

    2018-07-01

    The birth control pill is one of the most popular forms of contraception in North America and has been a key player in women's rights activism for over 50 years. In this paper, I conduct a feminist deconstructive analysis of 12 biomedical texts on the birth control pill, published between 1965 and 2016. This study is situated amongst the feminist scholarship that challenges the representation of women's bodies in biomedicine. Findings suggest that clinical texts on the birth control pill continue to universalise women's lives and experiences, and essentialise them based on their reproductive capacities. One way the texts accomplish this is by making women absent or passive in the literature thereby losing concern for the diversity of their lives, interpretations and identities as more than reproductive beings. The consequence of such representations is that biomedical texts disseminate limited forms of knowledge, in particular concerning definitions of 'natural' and 'normal' behaviour, with important consequences for the embodied experiences of women.

  1. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study

    Science.gov (United States)

    Leppold, Claire; Nomura, Shuhei; Sawano, Toyoaki; Ozaki, Akihiko; Tsubokura, Masaharu; Hill, Sarah; Kanazawa, Yukio; Anbe, Hiroshi

    2017-01-01

    Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (increased proportions of low birthweight or preterm births in any year after the disaster (merged post-disaster risk ratio of low birthweight birth: 0.98, 95% confidence interval (CI): 0.64–1.51; and preterm birth: 0.68, 95% CI: 0.38–1.21). No significant associations between birth outcomes and residential area or food purchasing patterns were identified, after adjustment for covariates. In conclusion, no changes in birth outcomes were found in this institution-based investigation after the Fukushima disaster. Further research is needed on the pathways that may exacerbate or reduce disaster effects on maternal and perinatal health. PMID:28534840

  2. Birth weight and cognitive function at age 11 years: the Scottish Mental Survey 1932

    OpenAIRE

    Shenkin, S; Starr, J; Pattie, A; Rush, M; Whalley, L; Deary, I; PHARAOH, E. P.

    2001-01-01

    AIMS—To examine the relation between birth weight and cognitive function at age 11 years, and to examine whether this relation is independent of social class.
METHODS—Retrospective cohort study based on birth records from 1921 and cognitive function measured while at school at age 11 in 1932.Subjects were 985 live singletons born in the Edinburgh Royal Maternity and Simpson Memorial Hospital in 1921. Moray House Test scores from the Scottish Mental Survey 1932 were trace...

  3. The influence of maternal body composition on birth weight.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: To identify the maternal body composition parameters that independently influence birth weight. STUDY DESIGN: A longitudinal prospective observational study in a large university teaching hospital. One hundred and eighty-four non-diabetic caucasian women with a singleton pregnancy were studied. In early pregnancy maternal weight and height were measured digitally in a standardised way and the body mass index (BMI) was calculated. At 28 and 37 weeks\\' gestation maternal body composition was assessed using segmental multifrequency bioelectrical impedance analysis. At delivery the baby was weighed and the clinical details were recorded. RESULTS: Of the women studied, 29.2% were overweight and 34.8% were obese. Birth weight did not correlate with maternal weight or BMI in early pregnancy. Birth weight correlated with gestational weight gain (GWG) before the third trimester (r=0.163, p=0.027), but not with GWG in the third trimester. Birth weight correlated with maternal fat-free mass, and not fat mass at 28 and 37 weeks gestation. Birth weight did not correlate with increases in maternal fat and fat-free masses between 28 and 37 weeks. CONCLUSIONS: Contrary to previous reports, we found that early pregnancy maternal BMI in a non-diabetic population does not influence birth weight. Interestingly, it was the GWG before the third trimester and not the GWG in the third trimester that influenced birth weight. Our findings have implications for the design of future intervention studies aimed at optimising gestational weight gain and birth weight. CONDENSATION: Maternal fat-free mass and gestational weight gain both influence birth weight.

  4. Skilled care at birth among rural women in Nepal: practice and challenges.

    Science.gov (United States)

    Dhakal, Sulochana; van Teijlingen, Edwin; Raja, Edwin Amalraj; Dhakal, Keshar Bahadur

    2011-08-01

    In Nepal, most births take place at home, and many, particularly in rural areas, are not attended by a skilled birth attendant. The main objectives of the study were to assess the use of skilled delivery care and barriers to access such care in a rural community and to assess health problems during delivery and seeking care. This cross-sectional study was carried out in two Village Development Committees in Nepal in 2006. In total, 150 women who had a live birth in the 24 months preceding the survey were interviewed using a structured questionnaire. The sample population included married women aged 15-49 years. Forty-six (31%) women delivered their babies at hospital, and 104 (69%) delivered at home. The cost of delivery at hospital was significantly (p home. Results of univariate analysis showed that women from Brahmin-Chhetri ethnicity, women with higher education or who were more skilled, whose husbands had higher education and more skilled jobs, had first or second childbirth, and having adverse previous obstetric history were associated with institutional delivery while women with higher education and having an adverse history of pregnancy outcome predicted the uptake of skilled delivery care in Nepal. The main perceived problems to access skilled delivery care were: distance to hospital, lack of transportation, lack of awareness on delivery care, and cost. The main reasons for seeking intrapartum care were long labour, retained placenta, and excessive bleeding. Only a quarter of women sought care immediately after problems occurred. The main reasons seeking care late were: the woman or her family not perceiving that there was a serious problem, distance to health facility, and lack of transport. The use of skilled birth attendants at delivery among rural women in Nepal is very poor. Home delivery by unskilled birth attendants is still a common practice among them. Many associated factors relating to the use of skilled delivery care that were identified

  5. Young women's recent experience of labour and birth care in Queensland.

    Science.gov (United States)

    Redshaw, Maggie; Hennegan, Julie; Miller, Yvette

    2014-07-01

    young parenthood continues to be an issue of concern in terms of clinical and psychosocial outcomes for mothers and their babies, with higher rates of medical complications such as preterm labour and hypertensive disease and a higher risk of depression. The aim of this study was to investigate how young age impacts on women's experience of intrapartum care. secondary analysis of data collected in a population based survey of women who had recently given birth in Queensland, comparing clinical and interpersonal aspects of the intrapartum maternity care experience for 237 eligible women aged 15-20 years and 6534 aged more than 20 years. Descriptive and multivariate analyses were undertaken. in the univariate analysis a number of variables were significantly associated with clinical aspects of labour and birth and perceptions of care: young women were more likely to birth in a public facility, to travel for birth and to live in less economically advantaged areas, to have a normal vaginal birth and to have one carer through labour. They were also less likely to report being treated with respect and kindness and talked to in a way they could understand. In logistic regression models, after adjustment for parity, other socio-demographic factors and mode of birth, younger mothers were still more likely to birth in a public facility, to travel for birth, to be more critical about interpersonal and aspects of care and the hospital or birth centre environment. this study shows how experience of care during labour and birth is different for young women. Young women reported poorer quality interpersonal care which may well reflect an inferior care experience and stereotyping by health professionals, indicating a need for more effective staff engagement with young women at this time. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Neighbourhood socioeconomic status and maternal factors at birth as moderators of the association between birth characteristics and school attainment: a population study of children attending government schools in Western Australia.

    Science.gov (United States)

    Malacova, E; Li, J; Blair, E; Mattes, E; de Klerk, N; Stanley, F

    2009-10-01

    This article investigates whether reading and writing skills among children of equivalent perinatal characteristics differ by neighbourhood socioeconomic status and maternal factors. Notifications of births for all non-Aboriginal singletons born in 1990-7 in Western Australia subsequently attending government primary schools were linked to the State literacy tests in grade three and with information on socioeconomic status of the school and the residential area. Using multilevel modelling, the associations between birth characteristics (gestational age, intrauterine growth, birth order and Apgar score at 5 minutes) and literacy attainment in grade three were examined in models that included socioeconomic and demographic factors of the child, mother and community. Higher percentages of optimal head circumference and birth length and term birth were positively and independently associated with literacy scores. A higher percentage of optimal birth weight was associated with higher reading scores especially for children born to mothers residing in educationally advantaged areas. First birth was positively associated with reading and writing attainment: this association was stronger for children born to single mothers and additional advantage in writing was also associated with first birth in children living in disadvantaged areas. These findings suggest that having suboptimal growth in utero or an older sibling at birth increases vulnerability to poor literacy attainment especially among children born to single mothers or those in disadvantaged neighbourhoods. These data provide evidence for advocating lifestyles compatible with optimum fetal growth and socioeconomic conditions conducive to healthy lifestyles, particularly during pregnancy.

  7. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery

    NARCIS (Netherlands)

    Schaaf, J. M.; Hof, M. H. P.; Mol, B. W. J.; Abu-Hanna, A.; Ravelli, A. C. J.

    2012-01-01

    Please cite this paper as: Schaaf J, Hof M, Mol B, Abu-Hanna A, Ravelli A. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery.BJOG 2012;119:16241629. Objective To determine the risk of preterm birth in a subsequent twin pregnancy after previous singleton

  8. 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 ...

  9. [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.

  10. 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

  11. Association between ambient fine particulate matter and preterm birth or term low birth weight: An updated systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Li, Xiangyu; Huang, Shuqiong; Jiao, Anqi; Yang, Xuhao; Yun, Junfeng; Wang, Yuxin; Xue, Xiaowei; Chu, Yuanyuan; Liu, Feifei; Liu, Yisi; Ren, Meng

    2017-01-01

    An increasing number of studies have been conducted to determine a possible linkage between maternal exposure to ambient fine particulate matter and effects on the developing human fetus that can lead to adverse birth outcomes, but, the present results are not consistent. A total of 23 studies published before July 2016 were collected and analyzed and the mean value of reported exposure to fine particulate matter (PM 2.5 ) ranged from 1.82 to 22.11 We found a significantly increased risk of preterm birth with interquartile range increase in PM 2.5 exposure throughout pregnancy (odds ratio (OR) = 1.03; 95% conditional independence (CI): 1.01–1.05). The pooled OR for the association between PM 2.5 exposure, per interquartile range increment, and term low birth weight throughout pregnancy was 1.03 (95% CI: 1.02–1.03). The pooled ORs for the association between PM 2.5 exposure per 10 increment, and term low birth weight and preterm birth were 1.05 (95% CI: 0.98–1.12) and 1.02 (95% CI: 0.93–1.12), respectively throughout pregnancy. There is a significant heterogeneity in most meta-analyses, except for pooled OR per interquartile range increase for term low birth weight throughout pregnancy. We here show that maternal exposure to fine particulate air pollution increases the risk of preterm birth and term low birth weight. However, the effect of exposure time needs to be further explored. In the future, prospective cohort studies and personal exposure measurements needs to be more widely utilized to better characterize the relationship between ambient fine particulate exposure and adverse birth outcomes. - Highlights: • The results had shorter intervals indicate and smaller heterogeneity by using IQR increment increase as selected standard. • The manuscript included the latest research results and updated the previous systematic review and meta-analysis. - Meta-analysis of preterm birth and term low birth weight of PM 2.5

  12. 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

  13. The Birth and Death of Tragedy in Nietzsche's thought

    Directory of Open Access Journals (Sweden)

    S TA

    2014-08-01

    Full Text Available Friedrich Nietzsche, one of the most influential and thoughtful philosopher in the 19th century, in an attempt to reassess values, finds himself in confrontation with accepted ideas of the modern world. Therefore, in his critical review, in order to reform and revive the modern civilization and culture, he writes his first book, i.e. The Birth of Tragedy. His various intentions in this book are as following: a cultural concerns and saving the culture of his age from nihilism and the danger of falling apart, b reassessing values, c showing the opposition of Christianity and conceptual philosophy of Socrates with the nature of life, Dionysus element as well as the desire to live, d aesthetic interpretation of living and being and e viewing life from the perspective of art. Nietzsche considers the last two cases as the special features of Greek's tragic art and praises Greek's tragic age for such perspective. He admires ancient Greeks as well as their culture and thought because they are the creators of tragic art and through such creation as well as by considering Dionysus element they accepted life with all of its good and bad aspects. Nietzsche discusses two fundamental concepts of birth and death of tragedy as well. However, he views the birth and death of tragedy in two different ways a in a particular age, Greek tragedy emerged from Greek culture and became an influential factor in the development of that nation’s culture but died later on, b Nietzsche's hope in the re-emergence of Greek tragic art in the modern world lies in Wagner's music which died, too. In his view, the factors behind the death of tragedy are as following: the Socrates' conceptual philosophy and Euripides' plays, Christianity and ethicality as well as modern dialectic and Wagner himself. This article, first, tries to study Nietzsche’s important intentions in writing The Birth of Tragedy and explain such birth in the first sense emphasizing the interpretation of

  14. A population-level analysis of birth weight indices in Peel Region, Ontario: the impact of ethnic diversity.

    Science.gov (United States)

    Ramuscak, Nancy L; Jiang, Depeng; Dooling, Kathleen L; Mowat, David L

    2012-07-18

    The purpose of this paper is to examine whether the elevated rate of low birth weight (LBW) in the Region of Peel, Ontario can be attributed to the high proportion of immigrants in the population. In addition, we examined how the infant birth weight distribution in Peel differs by maternal region of birth. Provincial live birth registration data were used to compare rates of LBW, preterm birth and small-for-gestational-age (SGA) births in Peel and Ontario for the years 2002 through 2006 by maternal region of birth. Birth weight for gestational age curves were developed for singletons and were specific for infant sex and maternal region of birth using the lambda-mu-sigma (LMS) method. Quantile regression was used to examine whether the median birth weight at term (37 to 42 weeks) differed by maternal region of birth. The rate of LBW was higher in Peel than in Ontario (6.8% and 6.0%, respectively). This is the result of a higher SGA rate and not due to differences in rates of preterm birth. Infants of immigrant mothers had significantly lower median birth weights at all gestations, showing that the birth weight distribution among infants of immigrant mothers is shifted towards lower birth weights. At the population level, the shifted birth weight distribution among singleton infants of immigrant mothers has significant impact on the LBW rate observed in Peel.

  15. 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.

  16. Use of complementary and alternative medicines associated with a 30% lower ongoing pregnancy/live birth rate during 12 months of fertility treatment

    DEFF Research Database (Denmark)

    Boivin, J; Schmidt, L

    2009-01-01

    BACKGROUND There seems to be little discussion between patient and physician about the use of complementary and alternative medicines (CAMs), perhaps because they are not perceived to have adverse effects on fertility. We therefore compared ongoing pregnancy and live birth rate in spontaneous users......, years infertile). CONCLUSIONS Concurrent use of CAM during treatment with ART was associated with a 30% lower pregnancy rate that could not be explained by poor prognosis or life style factors. The mechanisms that could account for this association were discussed. Concurrent CAM use should be monitored...... women about to have ART for the first time completed self-report assessments prior to treatment (Time 1, T1) and at 12-month follow-up (Time 2, T2). Data from treatment records were also available for n = 590. RESULTS About 30.6% (n = 223) of women used CAMs during the observation period. At T2...

  17. 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.

  18. Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

    Science.gov (United States)

    Zulyniak, Michael A; de Souza, Russell J; Shaikh, Mateen; Desai, Dipika; Lefebvre, Diana L; Gupta, Milan; Wilson, Julie; Wahi, Gita; Subbarao, Padmaja; Becker, Allan B; Mandhane, Piush; Turvey, Stuart E; Beyene, Joseph; Atkinson, Stephanie; Morrison, Katherine M; McDonald, Sarah; Teo, Koon K; Sears, Malcolm R; Anand, Sonia S

    2017-11-14

    Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight. Four multiethnic birth cohorts based in Canada (the NutriGen Alliance). 3997 full-term mother-infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores-plant-based, Western and health-conscious-and birth weight data. No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (β=-67.6 g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (β=-65.9 g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95% CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95% CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (β=+40.5 g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption. Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. New loci associated with birth weight identify genetic links between intrauterine growth and adult height and metabolism

    NARCIS (Netherlands)

    Horikoshi, M.; Yaghootkar, H.; Mook-Kanamori, D.O.; Sovio, U.; Taal, H.R.; Hennig, B.J.; Bradfield, J.P.; St Pourcain, B.; Evans, D.M.; Charoen, P.; Kaakinen, M.; Cousminer, D.L.; Lehtimäki, T.; Kreiner-Møller, E.; Warrington, N.M.; Bustamante, M.; Feenstra, B.; Berry, D.J.; Thiering, E.; Pfab, T.; Barton, S.J.; Shields, B.M.; Kerkhof, M.; Leeuwen, E. M.; Fulford, A.J.; Kutalik, Z.; Zhao, J.H.; van den Hoed, M.; Mahajan, A.; Lindi, V.; Goh, L.K.; Hottenga, J.J.; Wu, Y.; Raitakari, O.T.; Harder, M.N.; Meirhaeghe, A.; Ntalla, I.; Salem, R.M.; Jameson, K.A.; Zhou, K.; Monies, D.M.; Lagou, V.; Kirin, M.; Heikkinen, J.; Adair, L.S.; Alkuraya, F.S.; Al-Odaib, A.; Amouyel, P.; Andersson, E.A.; Bennett, A.J.; Blakemore, A.I.F.; Buxton, J.L.; Dallongeville, J.; Das, S.; de Geus, E.J.C.; Estivill, X.; Flexeder, C.; Froguel, P.; Geller, F.; Godfrey, K.M.; Gottrand, F.; Groves, C.J.; Hansen, T.; Hirschhorn, J.N.; Hofman, A.; Hollegaard, M.V.; Hougaard, D. M.; Hyppönen, E.; Inskip, H.M.; Isaacs, A.; Jørgensen, T.; Kanaka-Gantenbein, C.; Kemp, J.P.; Kiess, W.; Kilpeläinen, T.O.; Klopp, N.; Knight, B.A.; Kuzawa, C.W.; McMahon, G.; Newnham, J.P.; Niinikoski, H.; Oostra, B.A.; Pedersen, L.; Postma, D.S.; Ring, S.M.; Rivadeneira, F.; Robertson, N.R.; Sebert, S.; Simell, O.; Slowinski, T.; Tiesler, C.M.T.; Tönjes, A.; Vaag, A.A.; Viikari, J.S.; Vink, J.M.; Vissing, N.H.; Wareham, N.J.; Willemsen, G.; Witte, D.R.; Zhang, H.; Zhao, J.; Wilson, J.F.; Stumvoll, M.; Prentice, A.M.; Meyer, B.F.; Pearson, E.R.; Boreham, C.A.; Cooper, C.; Gillman, M.W.; Dedoussis, G.V.; Moreno, L.A.; Pedersen, O.; Saarinen, M.; Mohlke, K.L.; Boomsma, D.I.; Saw, S.M.; Lakka, T.A.; Körner, A.; Loos, R.J.; Ong, K.K.; Vollenweider, P.; van Duijn, C.M.; Koppelman, G.H.; Hattersley, A.T.; Holloway, J.W.; Hocher, B.; Heinrich, J.; Power, C.; Melbye, M.; Guxens, M.; Pennell, C.E.; Bønnelykke, K.; Bisgaard, H.; Eriksson, J.G.; Widén, E.; Hakonarson, H.; Uitterlinden, A.G.; Pouta, A.; Lawlor, D.A.; Smith, G.D.; Frayling, T.M.; McCarthy, M.I.; Grant, S.F.; Jaddoe, V.W.; Järvelin, M.R.; Timpson, N.J.; Prokopenko, I.; Freathy, R.M.

    2013-01-01

    Birth weight within the normal range is associated with a variety of adult-onset diseases, but the mechanisms behind these associations are poorly understood. Previous genome-wide association studies of birth weight identified a variant in the ADCY5 gene associated both with birth weight and type 2

  20. 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....

  1. The usefulness of traditional birth attendants to women living with HIV in resource-poor settings: the case of Mfuwe, Zambia.

    Science.gov (United States)

    Muzyamba, Choolwe; Groot, Wim; Tomini, Sonila M; Pavlova, Milena

    2017-01-01

    Although there is increased attention on the role of trained traditional birth attendants (TBAs) in maternal care, most of the research has mainly focused on providing evidence of the relevance of trained TBAs to women in general without a specific focus on women who are HIV positive, despite them being most vulnerable. Therefore, the aim of this study is to fill this gap by assessing the relevance of trained TBAs to women living with HIV in resource-poor settings by using Zambia as a case study. Our data collection consisted of two focus group discussions, one involving HIV-positive women utilizing trained TBAs and the other with women not utilizing TBAs. Additionally, in-depth interviews were conducted with trained TBAs and health workers. Thematic analysis was used to analyze the data. In general, women living with HIV positively characterized the services of TBAs. In the face of an inefficient health system, trained TBAs were seen to be useful in providing efficient, cheap and quality care, counseling, and referral and logistical support, including treatment adherence support. In Zambia, trained TBAs and professional care are not mutually exclusive but complementary. There is no doubt that HIV-positive women need professionals to handle complications and offer antiretroviral treatment to ensure prevention of mother to child transmission (PMTCT). However, additional "soft" services offered by trained TBAs are equally important in the promotion of maternal health care among HIV-positive women. Thus, it seems there is more to gain by systematically allowing trained TBAs to work alongside professionals in a well-coordinated and complementary manner.

  2. Infant outcomes of certified nurse midwife attended home births: United States 2000 to 2004.

    Science.gov (United States)

    Malloy, M H

    2010-09-01

    Home births attended by certified nurse midwives (CNMs) make up an extremely small proportion of births in the United States (home deliveries compared with certified nurse midwife in-hospital deliveries in the United States as measured by the risk of adverse infant outcomes among women with term, singleton, vaginal deliveries. United States linked birth and infant death files for the years 2000 to 2004 were used for the analysis. Adverse neonatal outcomes including death were determined by place of birth and attendant type for in-hospital certified nurse midwife, in-hospital 'other' midwife, home certified nurse midwife, home 'other' midwife, and free-standing birth center certified nurse midwife deliveries. For the 5-year period there were 1 237 129 in-hospital certified nurse midwife attended births; 17 389 in-hospital 'other' midwife attended births; 13 529 home certified nurse midwife attended births; 42 375 home 'other' midwife attended births; and 25 319 birthing center certified nurse midwife attended births. The neonatal mortality rate per 1000 live births for each of these categories was, respectively, 0.5 (deaths=614), 0.4 (deaths=7), 1.0 (deaths=14), 1.8 (deaths=75), and 0.6 (deaths=16). The adjusted odds ratio (95% confidence interval) for neonatal mortality for home certified nurse midwife attended deliveries vs in-hospital certified nurse midwife attended deliveries was 2.02 (1.18, 3.45). Deliveries at home attended by CNMs and 'other midwives' were associated with higher risks for mortality than deliveries in-hospital by CNMs.

  3. Birth weight and cognitive function at age 11years: the Scottish Mental Survey 1932

    OpenAIRE

    Shenkin, S D; Starr, John M; Pattie, Alison; Rush, M A; Whalley, Lawrence J; Deary, Ian J

    2001-01-01

    AIMS---To examine the relation between birth weight and cognitive function at age 11 years, and to examine whether this relation is independent of social class. METHODS---Retrospective cohort study based on birth records from 1921 and cognitive function measured while at school at age 11 in 1932. Subjects were 985 live singletons born in the Edinburgh Royal Maternity and Simpson Memorial Hospital in 1921. Moray House Test scores from the Scottish Mental Survey 1932 were traced on 449 of th...

  4. Toward an ethically responsible approach to vaginal birth after cesarean.

    Science.gov (United States)

    Lyerly, Anne Drapkin; Little, Margaret Olivia

    2010-10-01

    Determining approach to delivery after a previous cesarean is among the most contentious areas of obstetrics. We present a framework for ethically responsible guidelines and practice regarding vaginal birth after cesarean. We describe ethical complexities of 3 key issues that mark the debate: the cesarean delivery rate, safety, and patient autonomy. We then describe a taxonomy of considerations that should inform a responsible framework for guideline development and highlight critical distinctions between types of guidelines that have been blurred in the past. We then forward 2 central claims. First, in otherwise uncomplicated birth after a single previous cesarean, both vaginal birth after cesarean and repeat cesarean should be regarded as reasonable options; women, rather than policymakers, providers, insurance carriers, or hospitals, should determine delivery approach. Second, in complicated cases, providers and policymakers should carefully calibrate the strength of evidence to ensure differential risk and cost are adequate to justify directive guidelines given important variations in values women bring to childbirth. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. The Life Course of Children Born to Unmarried Mothers: Childhood Living Arrangements and Young Adult Outcomes.

    Science.gov (United States)

    Aquilino, William S.

    1996-01-01

    Explored living arrangements among children born to unmarried mothers and the impact of childhood living arrangements on the young adult's life course. Analyses showed that living arrangement patterns after birth to a single mother influenced the likelihood of high school completion, post secondary education, and other conditions. (RJM)

  6. 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.

  7. The Study of Mothers’ Periodontal Status and Newborn’s Low Birth Weight

    Directory of Open Access Journals (Sweden)

    M. Shirinzad

    2006-10-01

    Full Text Available Introduction & Objective: Recent studies have presented evidence that periodontal disease in pregnant women may be a determining factor for newborn’s low birth weight. The present investigation was carried out to verify whether there is an association between maternal periodontal disease and low birth weight of newborns.Materials and Methods: This was a case-control study on 330 women, containing 110 mothers having live newborns with weight 2500 g (control group. The existence of an association between periodontal disease and newborn’s low birth weight was evaluated by means of analytic statistics that considered other risk factors for low weight. The two groups were compared with regard to urinary infection, preeclampsia, premature rupture of membrane, placenta previa, primiparous, smoking, age, height, socioeconomic status and periodontal disease.Results: There were no statistically significant differences between the case and control groups for any of the covariables (P>0.05, but there was significant differences for principal independent variable (periodontal disease P<0.05.Conclusion: Results indicated a positive association between periodontal disease and newborn’s low birth weight. Thus periodontal disease is a possible risk factor for low birth weight.

  8. Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

    Directory of Open Access Journals (Sweden)

    Fatemeh Nayeri

    2013-05-01

    Full Text Available The objective of this study is to determine risk factors causing increase in very low birth way (VLBW neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004 were studied. Two groups of neonates (living and dead were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02, low birth weight, lower than 1000 g (P=0.001, Apgar score <6 at 5th minutes (P=0.001, resuscitation at birth (P=0.001, respiratory distress syndrome (P=0.001 need for mechanical ventilation (P=0.001, neurological complications (P=0.001 and intraventricular hemorrhage (P=0.001. Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

  9. Intimate partner violence during pregnancy and its association with preterm birth and low birth weight in Tanzania: A prospective cohort study

    Science.gov (United States)

    Mushi, Declare; Meyrowitsch, Dan Wolf; Manongi, Rachel; Rogathi, Jane Januarius; Gammeltoft, Tine; Rasch, Vibeke

    2017-01-01

    Introduction Intimate partner violence (IPV) is a public health problem that affects millions of women worldwide. The role of violence as an underlying factor in poor birth outcomes remains an area where strong evidence is lacking. The aim of this study was to determine the association between intimate partner violence (IPV) and preterm delivery (PTB) and low birth weight (LBW). Materials and methods A prospective cohort study was conducted among 1112 pregnant women attending antenatal care in Moshi–Tanzania. The women were enrolled before 24 weeks gestation, followed-up at week 34 to determine exposure to violence during pregnancy, and after delivery to estimate gestation age at delivery and birth weight. Logistic regression analysis was performed to assess the association between exposure to IPV during pregnancy and PTB and LBW while adjusting for possible confounders. In addition, stratified analysis based on previous history of adverse pregnancy outcome was performed. Results One-third of the women experienced IPV during pregnancy, 22.3% reported emotional, 15.4% sexual and 6.3% physical violence. Women exposed to physical IPV were three times more likely to experience PTB (AOR = 2.9; CI 95%: 1.3–6.5) and LBW (AOR = 3.2; CI 95%: 1.3–7.7). Women with previous adverse pregnancy outcomes and exposure to physical IPV had a further increased risk of PTB (AOR = 4.5; CI 95%: 1.5–13.7) and LBW (AOR = 4.8; CI 95%: 1.6–14.8) compared to those without previous history of adverse outcome. Conclusion Women who are exposed to IPV during pregnancy are at increased risk of PTB and LBW. The risk is even stronger if the women additionally have suffered a previous adverse pregnancy outcome. Interventions addressing IPV are urgently needed to prevent occurrence and reoccurrence of PTB and LBW. PMID:28235031

  10. Complexities of sibling analysis when exposures and outcomes change with time and birth order

    OpenAIRE

    Sudan, M; Kheifets, LI; Arah, OA; Divan, HA; Olsen, J

    2014-01-01

    In this study, we demonstrate the complexities of performing a sibling analysis with a re-examination of associations between cell phone exposures and behavioral problems observed previously in the Danish National Birth Cohort. Children (52,680; including 5441 siblings) followed up to age 7 were included. We examined differences in exposures and behavioral problems between siblings and non-siblings and by birth order and birth year. We estimated associations between cell phone exposures and b...

  11. 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.

  12. Birth weight curves tailored to maternal world region.

    Science.gov (United States)

    Ray, Joel G; Sgro, Michael; Mamdani, Muhammad M; Glazier, Richard H; Bocking, Alan; Hilliard, Robert; Urquia, Marcelo L

    2012-02-01

    Newborns of certain immigrant mothers are smaller at birth than those of domestically born mothers. Contemporary, population-derived percentile curves for these newborns are lacking, as are estimates of their risk of being misclassified as too small or too large using conventional rather than tailored birth weight curves. We completed a population-based study of 766 688 singleton live births in Ontario from 2002 to 2007. Smoothed birth weight percentile curves were generated for males and females, categorized by maternal world region of birth: Canada (63.5%), Europe/Western nations (7.6%), Africa/Caribbean (4.9%), Middle East/North Africa (3.4%), Latin America (3.4%), East Asia/Pacific (8.1%), and South Asia (9.2%). We determined the likelihood of misclassifying an infant as small for gestational age (≤ 10th percentile for weight) or as large for gestational age (≥ 90th percentile for weight) on a Canadian-born maternal curve versus one specific to maternal world region of origin. Significantly lower birth weights were seen at gestation-specific 10th, 50th, and 90th percentiles among term infants born to mothers from each world region, with the exception of Europe/Western nations, compared with those for infants of Canadian-born mothers. For example, for South Asian babies born at 40 weeks' gestation, the absolute difference at the 10th percentile was 198 g (95% CI 183 to 212) for males and 170 g (95% CI 161 to 179) for females. Controlling for maternal age and parity, South Asian males had an odds ratio of 2.60 (95% CI 2.53 to 2.68) of being misclassified as small for gestational age, equivalent to approximately 116 in 1000 newborns; for South Asian females the OR was 2.41 (95% CI 2.34 to 2.48), equivalent to approximately 106 per 1000 newborns. Large for gestational age would be missed in approximately 61 per 1000 male and 57 per 1000 female South Asian newborns if conventional rather than ethnicity-specific birth weight curves were used. Birth weight curves

  13. Exploring weathering: effects of lifelong economic environment and maternal age on low birth weight, small for gestational age, and preterm birth in African-American and white women.

    Science.gov (United States)

    Love, Catherine; David, Richard J; Rankin, Kristin M; Collins, James W

    2010-07-15

    White women experience their lowest rate of low birth weight (LBW) in their late 20s; the nadir LBW for African-American women is under 20 years with rates rising monotonically thereafter, hypothesized as due to "weathering" or deteriorating health with cumulative disadvantage. Current residential environment affects birth outcomes for all women, but little is known about the impact of early life environment. The authors linked neighborhood income to a transgenerational birth file containing infant and maternal birth data, allowing assessment of economic effects over a woman's life course. African-American women who were born in poorer neighborhoods and were still poor as mothers showed significant weathering with regard to LBW and small for gestational age (SGA) but not preterm birth (PTB). However, African-American women in upper-income areas at both time points had a steady fall in LBW and SGA rate with age, similar to the pattern seen in white women. No group of white women, even those always living in poorer neighborhoods, exhibited weathering with regard to LBW, SGA, or PTB. In contrast, the degree of weathering among African-American women is related to duration of exposure to low-income areas and disappears for those with a life residence in non-poor neighborhoods.

  14. Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil Fatores de risco para a tendência ascendente do baixo peso ao nascer em nascidos vivos de parto vaginal no Sudeste do Brasil

    Directory of Open Access Journals (Sweden)

    Marco A Barbieri

    2000-12-01

    Full Text Available OBJECTIVE: To identify risk factors for low birth weight (LBW among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.OBJETIVO: Identificar fatores de risco para o baixo peso ao nascer (BPN entre nascidos vivos de parto vaginal e verificar se o desaparecimento da associação entre BPN e fatores socioeconômicos foi devido ao confundimento pela cesariana. MÉTODOS: Foram estudadas duas coortes de base populacional de recém-nascidos únicos de parto

  15. Becoming a parent to a child with birth asphyxia—From a traumatic delivery to living with the experience at home

    Directory of Open Access Journals (Sweden)

    Alina Heringhaus

    2013-04-01

    Full Text Available The aim of this study is to describe the experiences of becoming a parent to a child with birth asphyxia treated with hypothermia in the neonatal intensive care unit (NICU. In line with the medical advances, the survival of critically ill infants with increased risk of morbidity is increasing. Children who survive birth asphyxia are at a higher risk of functional impairments, cerebral palsy (CP, or impaired vision and hearing. Since 2006, hypothermia treatment following birth asphyxia is used in many of the Swedish neonatal units to reduce the risk of brain injury. To date, research on the experience of parenthood of the child with birth asphyxia is sparse. To improve today's neonatal care delivery, health-care providers need to better understand the experiences of becoming a parent to a child with birth asphyxia. A total of 26 parents of 16 children with birth asphyxia treated with hypothermia in a Swedish NICU were interviewed. The transcribed interview texts were analysed according to a qualitative latent content analysis. We found that the experience of becoming a parent to a child with birth asphyxia treated with hypothermia at the NICU was a strenuous journey of overriding an emotional rollercoaster, that is, from being thrown into a chaotic situation which started with a traumatic delivery to later processing the difficult situation of believing the child might not survive or was to be seriously affected by the asphyxia. The prolonged parent–infant separation due to the hypothermia treatment and parents’ fear of touching the infant because of the high-tech equipment seemed to hamper the parent–infant bonding. The adaption of the everyday life at home seemed to be facilitated by the follow-up information of the doctor after discharge. The results of this study underline the importance of family-centered support during and also after the NICU discharge.

  16. Becoming a parent to a child with birth asphyxia-From a traumatic delivery to living with the experience at home.

    Science.gov (United States)

    Heringhaus, Alina; Blom, Michaela Dellenmark; Wigert, Helena

    2013-04-30

    The aim of this study is to describe the experiences of becoming a parent to a child with birth asphyxia treated with hypothermia in the neonatal intensive care unit (NICU). In line with the medical advances, the survival of critically ill infants with increased risk of morbidity is increasing. Children who survive birth asphyxia are at a higher risk of functional impairments, cerebral palsy (CP), or impaired vision and hearing. Since 2006, hypothermia treatment following birth asphyxia is used in many of the Swedish neonatal units to reduce the risk of brain injury. To date, research on the experience of parenthood of the child with birth asphyxia is sparse. To improve today's neonatal care delivery, health-care providers need to better understand the experiences of becoming a parent to a child with birth asphyxia. A total of 26 parents of 16 children with birth asphyxia treated with hypothermia in a Swedish NICU were interviewed. The transcribed interview texts were analysed according to a qualitative latent content analysis. We found that the experience of becoming a parent to a child with birth asphyxia treated with hypothermia at the NICU was a strenuous journey of overriding an emotional rollercoaster, that is, from being thrown into a chaotic situation which started with a traumatic delivery to later processing the difficult situation of believing the child might not survive or was to be seriously affected by the asphyxia. The prolonged parent-infant separation due to the hypothermia treatment and parents' fear of touching the infant because of the high-tech equipment seemed to hamper the parent-infant bonding. The adaption of the everyday life at home seemed to be facilitated by the follow-up information of the doctor after discharge. The results of this study underline the importance of family-centered support during and also after the NICU discharge.

  17. Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

    Science.gov (United States)

    Eiríksdóttir, Védís Helga; Ásgeirsdóttir, Tinna Laufey; Bjarnadóttir, Ragnheiður Ingibjörg; Kaestner, Robert; Cnattingius, Sven; Valdimarsdóttir, Unnur Anna

    2013-01-01

    Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes. The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st) 2006 to December 31(st) 2009. LBW infants were defined as those weighing birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6(th) 2008. Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6-9 months after the collapse. The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.

  18. Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

    Directory of Open Access Journals (Sweden)

    Védís Helga Eiríksdóttir

    Full Text Available Infants born small for gestational age (SGA or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB and low birth weight (LBW. We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st 2006 to December 31(st 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6(th 2008.Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52], particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72] and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]. Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51] particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23] and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]. No change in risk of PB was observed. The increase of LBW was most distinct 6-9 months after the collapse.The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.

  19. Birth order and hospitalization for alcohol and narcotics use in Sweden.

    Science.gov (United States)

    Barclay, Kieron; Myrskylä, Mikko; Tynelius, Per; Berglind, Daniel; Rasmussen, Finn

    2016-10-01

    Previous studies have shown that birth order is an important predictor of later life health as well as socioeconomic attainment. In this study, we examine the relationship between birth order and hospitalization for alcohol and narcotics use in Sweden. We study the relationship between birth order and hospitalization related to alcohol and narcotics use before and after the age of 20 using Swedish register data for cohorts born 1987-1994. We apply Cox proportional hazard models and use sibling fixed effects, eliminating confounding by factors shared by the siblings. Before age 20 we find that later born siblings are hospitalized for alcohol use at a higher rate than first-borns, and there is a monotonic increase in the hazard of hospitalization with increasing birth order. Second-borns are hospitalized at a rate 47% higher than first-borns, and third-borns at a rate 65% higher. Similar patterns are observed for hospitalization for narcotics use. After age 20 the pattern is similar, but the association is weaker. These patterns are consistent across various sibling group sizes. Later born siblings are more likely to be hospitalized for both alcohol and narcotics use in Sweden. These birth order effects are substantial in size, and larger than the estimated sex differences for the risk of hospitalization related to alcohol and drug use before age 20, and previous estimates for socioeconomic status differences in alcohol and drug abuse. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  20. Revisiting the Table 2 fallacy: A motivating example examining preeclampsia and preterm birth.

    Science.gov (United States)

    Bandoli, Gretchen; Palmsten, Kristin; Chambers, Christina D; Jelliffe-Pawlowski, Laura L; Baer, Rebecca J; Thompson, Caroline A

    2018-05-21

    A "Table Fallacy," as coined by Westreich and Greenland, reports multiple adjusted effect estimates from a single model. This practice, which remains common in published literature, can be problematic when different types of effect estimates are presented together in a single table. The purpose of this paper is to quantitatively illustrate this potential for misinterpretation with an example estimating the effects of preeclampsia on preterm birth. We analysed a retrospective population-based cohort of 2 963 888 singleton births in California between 2007 and 2012. We performed a modified Poisson regression to calculate the total effect of preeclampsia on the risk of PTB, adjusting for previous preterm birth. pregnancy alcohol abuse, maternal education, and maternal socio-demographic factors (Model 1). In subsequent models, we report the total effects of previous preterm birth, alcohol abuse, and education on the risk of PTB, comparing and contrasting the controlled direct effects, total effects, and confounded effect estimates, resulting from Model 1. The effect estimate for previous preterm birth (a controlled direct effect in Model 1) increased 10% when estimated as a total effect. The risk ratio for alcohol abuse, biased due to an uncontrolled confounder in Model 1, was reduced by 23% when adjusted for drug abuse. The risk ratio for maternal education, solely a predictor of the outcome, was essentially unchanged. Reporting multiple effect estimates from a single model may lead to misinterpretation and lack of reproducibility. This example highlights the need for careful consideration of the types of effects estimated in statistical models. © 2018 John Wiley & Sons Ltd.

  1. Changes in Yearly Birth Prevalence Rates of Children with Down Syndrome in the Period 1986-2007 in the Netherlands

    Science.gov (United States)

    de Graaf, G.; Haveman, M.; Hochstenbach, R.; Engelen, J.; Gerssen-Schoorl, K.; Poddighe, P.; Smeets, D.; van Hove, G.

    2011-01-01

    Background: The Netherlands are lacking reliable national empirical data in relation to the development of birth prevalence of Down syndrome. Our study aims at assessing valid national live birth prevalence rates for the period 1986-2007. Method: On the basis of the annual child/adult ratio of Down syndrome diagnoses in five out of the eight Dutch…

  2. Critical evaluation of national vital statistics: the case of preterm birth trends in Portugal.

    Science.gov (United States)

    Correia, Sofia; Rodrigues, Teresa; Montenegro, Nuno; Barros, Henrique

    2015-11-01

    Using vital statistics, the Portuguese National Health Plan predicts that 14% of live births will be preterm in 2016. The prediction was based on a preterm birth rise from 5.9% in 2000 to 8.8% in 2009. However, the same source showed an actual decline from 2010 onwards. To assess the plausibility of national preterm birth trends, we aimed to compare the evolution of preterm birth and low birthweight rates between vital statistics and a hospital database. A time-trend analysis (2004-2011) of preterm birth (rates was conducted using data on singleton births from the national birth certificates (n = 801,783) and an electronic maternity unit database (n = 21,392). Annual prevalence estimates, ratios of preterm birth:low birthweight and adjusted prevalence ratios were estimated to compare data sources. Although the national prevalence of preterm birth increased from 2004 (5.4%), particularly between 2006 and 2009 (highest rate was 7.5% in 2007), and decreased after 2009 (5.7% in 2011), the prevalence at the maternity unit remained constant. Between 2006 and 2009, preterm birth was almost 1.4 times higher in the national statistics (using the national or the catchment region samples) than in the maternity unit, but no differences were found for low birthweight. Portuguese preterm birth prevalence seems biased between 2006 and 2009, suggesting that early term babies were misclassified as preterm. As civil registration systems are important to support public health decisions, monitoring strategies should be taken to assure good quality data. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  3. Adequacy of antenatal care and its relationship with low birth weight in Botucatu, Sao Paulo, Brazil: a case-control study

    OpenAIRE

    Fonseca, Cátia Regina Branco da [UNESP; Louzada Strufaldi, Maria Wany; Carvalho, Lidia Raquel de [UNESP; Puccini, Rosana Fiorini [UNESP

    2014-01-01

    Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. the purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil.Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the...

  4. First birth and the trajectory of women's empowerment in Egypt.

    Science.gov (United States)

    Samari, Goleen

    2017-11-08

    Women's empowerment is often used to explain changes in reproductive behavior, but no consideration is given to how reproductive events can shape women's empowerment over time. Fertility may cause changes in women's empowerment, or they may be mutually influencing. Research on women's empowerment and fertility relies on cross-sectional data from South Asia, which limits the understanding of the direction of association between women's empowerment and fertility in other global contexts. This study uses two waves of a panel survey from a prominent Middle Eastern country, Egypt, to examine the trajectory of women's empowerment and the relationship between first and subsequent births and empowerment over time. Using longitudinal data from the 2006 and 2012 Egyptian Labor Market Panel Survey, a nationally representative sample of households in Egypt, for 4660 married women 15 to 49 years old, multilevel negative binomial, ordinary least squares, and logistic regression models estimate women's empowerment and consider whether a first and subsequent births are associated with empowerment later in life. Women's empowerment is operationalized through four measures of agency: individual household decision-making, joint household decision-making, mobility, and financial autonomy. A first birth and subsequent births are significantly positively associated with all measures of empowerment except financial autonomy in 2012. Women who have not had a birth make 30% fewer individual household decisions and 14% fewer joint household decisions in 2012 compared to women with a first birth. There is also a positive relationship with mobility, as women with a first birth have more freedom of movement compared to women with no births. Earlier empowerment is also an important predictor of empowerment later in life. Incorporating the influence of life events like first and subsequent births helps account for the possibility that empowerment is dynamic and that life course experiences shape

  5. The Australian baby bonus maternity payment and birth characteristics in Western Australia.

    Directory of Open Access Journals (Sweden)

    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: The Australian baby bonus maternity payment introduced in 2004 has been reported to have successfully increased fertility rates in Australia. We aimed to investigate the influence of the baby bonus on maternal demographics and birth characteristics in Western Australia (WA. METHODS AND FINDINGS: This study included 200,659 birth admissions from WA during 2001-2008, identified from administrative birth and hospital data-systems held by the WA Department of Health. We estimated average quarterly birth rates after the baby bonus introduction and compared them with expected rates had the policy not occurred. Rate and percentage differences (including 95% confidence intervals were estimated separately by maternal demographics and birth characteristics. WA birth rates increased by 12.8% following the baby bonus implementation with the greatest increase being in mothers aged 20-24 years (26.3%, 95%CI = 22.0,30.6, mothers having their third (1.6%, 95%CI = 0.9,2.4 or fourth child (2.2%, 95%CI = 2.1,2.4, mothers living in outer regional and remote areas (32.4%, 95%CI = 30.2,34.6, mothers giving birth as public patients (1.5%, 95%CI = 1.3,1.8, and mothers giving birth in public hospitals (3.5%, 95%CI = 2.6,4.5. Interestingly, births to private patients (-4.3%, 95%CI = -4.8,-3.7 and births in private hospitals (-6.3%, 95%CI = -6.8,-5.8 decreased following the policy implementation. CONCLUSIONS: The introduction of the baby bonus maternity payment may have served as an incentive for women in their early twenties and mothers having their third or fourth child and may have contributed to the ongoing pressure and staff shortages in Australian public hospitals, particularly those in outer regional and remote areas.

  6. Pre-Pregnancy Dating Violence and Birth Outcomes Among Adolescent Mothers in a National Sample.

    Science.gov (United States)

    Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily W

    2014-07-01

    Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birth weight and gestational age of infants born to adolescent mothers. Data from the National Longitudinal Study of Adolescent Health Waves I (1995/1996), II (1996), and IV (2007/2008) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (N = 558) self-reported infants' birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age, parent education, age at pregnancy, time between reporting abuse and birth, and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black).On average, births occurred 2 years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birth weight and prevalence of verbal dating violence victimization were significantly lower in Black compared with non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birth weight (pdating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers. Reducing physical dating violence in adolescent relationships prior to pregnancy may improve Black adolescent mothers' birth outcomes. Intervening on long-term violence may be particularly important.

  7. Could changes in reported sex ratios at birth during China's 1958-1961 famine support the adaptive sex ratio adjustment hypothesis?

    Directory of Open Access Journals (Sweden)

    Anna Reimondos

    2013-10-01

    Full Text Available Background: The adaptive sex ratio adjustment hypothesis suggests that when mothers are in poor conditions the sex ratio of their offspring will be biased towards females. Major famines provide opportunities for testing this hypothesis because they lead to the widespread deterioration of living conditions in the affected population. Objective: This study examines changes in sex ratio at birth before, during, and after China's 1958-1961 famine, to see whether they provide any support for the adaptive sex ratio adjustment hypothesis. Methods: We use descriptive statistics to analyse data collected by both China's 1982 and 1988 fertility sample surveys and examine changes in sex ratio at birth in recent history. In addition, we examine the effectiveness of using different methods to model changes in sex ratio at birth and compare their differences. Results: During China's 1958-1961 famine, reported sex ratio at birth remained notably higher than that observed in most countries in the world. The timing of the decline in sex ratio at birth did not coincide with the timing of the famine. After the famine, although living conditions were considerably improved, the sex ratio at birth was not higher but lower than that recorded during the famine. Conclusions: The analysis of the data collected by the two fertility surveys has found no evidence that changes in sex ratio at birth during China's 1958-1961 famine and the post-famine period supported the adaptive sex ratio adjustment hypothesis.

  8. Reproductive and Birth Outcomes in Haiti Before and After the 2010 Earthquake.

    Science.gov (United States)

    Harville, Emily W; Do, Mai

    2016-02-01

    We aimed to examine the relationship between exposure to the 2010 Haiti earthquake and pregnancy wantedness, interpregnancy interval, and birth weight. From the nationally representative Haiti 2012 Demographic and Health Survey, information on "size of child at birth" (too small or not) was available for 7280 singleton births in the previous 5 years, whereas information on birth weight was available for 1607 births. Pregnancy wantedness, short (earthquake and by level of damage. Multiple logistic regression and linear regression analyses were conducted. Post-earthquake births were less likely to be wanted and more likely to be born after a short interpregnancy interval. Earthquake exposure was associated with increased likelihood of a child being born too small: timing of birth (after earthquake vs. before earthquake, adjusted odds ratio [aOR]: 1.27, 95% confidence interval [CI]: 1.12-1.45), region (hardest-hit vs. rest of country; aOR: 1.43, 95% CI: 1.14- 1.80), and house damage (aOR: 1.27 95% CI: 1.02-1.58). Mean birth weight was 150 to 300 g lower in those exposed to the earthquake. Experience with the earthquake was associated with worse reproductive and birth outcomes, which underscores the need to provide reproductive health services as part of relief efforts.

  9. A population-based study of effect of multiple birth on infant mortality in Nigeria

    Directory of Open Access Journals (Sweden)

    Uthman Mubashir B

    2008-09-01

    Full Text Available Abstract Background Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life. Methods We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. Results Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19 holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality. Conclusion Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

  10. 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 ...

  11. Plurality of Birth and Infant Mortality Due to External Causes in the United States, 2000-2010.

    Science.gov (United States)

    Ahrens, Katherine A; Thoma, Marie E; Rossen, Lauren M; Warner, Margaret; Simon, Alan E

    2017-03-01

    Risk of death during the first year of life due to external causes, such as unintentional injury and homicide, may be higher among twins and higher-order multiples than among singletons in the United States. We used national birth cohort linked birth-infant death data (2000-2010) to evaluate the risk of infant mortality due to external causes in multiples versus singletons in the United States. Risk of death from external causes during the study period was 3.6 per 10,000 live births in singletons and 5.1 per 10,000 live births in multiples. Using log-binomial regression, the corresponding unadjusted risk ratio was 1.40 (95% confidence interval (CI): 1.30, 1.50). After adjustment for maternal age, marital status, race/ethnicity, and education, the risk ratio was 1.68 (95% CI: 1.56, 1.81). Infant deaths due to external causes were most likely to occur between 2 and 7 months of age. Applying inverse probability weighting and assuming a hypothetical intervention where no infants were low birth weight, the adjusted controlled direct effect of plurality on infant mortality due to external causes was 1.64 (95% CI: 1.39, 1.97). Twins and higher-order multiples were at greater risk of infant mortality due to external causes, particularly between 2 and 7 months of age, and this risk appeared to be mediated largely by factors other than low-birth-weight status. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  12. Sibship size, birth order, family structure and childhood mental disorders.

    Science.gov (United States)

    Carballo, Juan J; García-Nieto, Rebeca; Alvarez-García, Raquel; Caro-Cañizares, Irene; López-Castromán, Jorge; Muñoz-Lorenzo, Laura; de Leon-Martinez, Victoria; Baca-García, Enrique

    2013-08-01

    The aim of this study was to determine the role that birth order, sibship size and family structure have as risk factors in the development of common childhood mental disorders. A case-control study design was conducted (N = 16,823). The group under study consisted of all those subjects who had consulted with a psychiatrist/psychologist and had received a clinical diagnosis at public mental health centres within the Region of Madrid (Spain), between 1980 and 2008. A multiple logistic regression was used to explore the independent association with each diagnosis: emotional disorders (ED) with onset specific to childhood, attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), mental retardation (MR), and pervasive developmental disorder (PDD). Birth order and family structure significantly predicted the risk of being diagnosed with ED or ADHD. In addition, sibship size and sex predicted the risk of being diagnosed with a childhood mental disorder. We concluded that being the middle child and living with both biological parents appear to be protective factors against the development of ED or ADHD. Living in large families appears to increase the risk of receiving a CD, MR, or PDD diagnosis. Further research is warranted.

  13. 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.

  14. 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

  15. Infant mortality in Pelotas, Brazil: a comparison of risk factors in two birth cohorts.

    Science.gov (United States)

    Menezes, Ana Maria Baptista; Hallal, Pedro Curi; Santos, Iná Silva dos; Victora, Cesar Gomes; Barros, Fernando Celso

    2005-12-01

    To compare two population-based birth cohorts to assess trends in infant mortality rates and the distribution of relevant risk factors, and how these changed after an 11-year period. Data from two population-based prospective birth cohorts (1982 and 1993) were analyzed. Both studies included all children born in a hospital (> 99% of all births) in the city of Pelotas, Southern Brazil. Infant mortality was monitored through surveillance of all maternity hospitals, mortality registries and cemeteries. There were 5,914 live-born children in 1982 and 5,249 in 1993. The infant mortality rate decreased by 41%, from 36.0 per 1,000 live births in 1982 to 21.1 per 1,000 in 1993. Socioeconomic and maternal factors tended to become more favorable during the study period, but there were unfavorable changes in birthweight and gestational age. Poverty, high parity, low birthweight, preterm delivery, and intrauterine growth restriction were the main risk factors for infant mortality in both cohorts. The 41% reduction in infant mortality between 1982 and 1993 would have been even greater had the prevalence of risk factors remained constant during the period studied here. There were impressive declines in infant mortality which were not due to changes in the risk factors we studied. Because no reduction was seen in the large social inequalities documented in the 1982 cohort, it is likely that the reduction in infant mortality resulted largely from improvements in health care.

  16. The Birth and Death of Tragedy in Nietzsche\\'s thought

    Directory of Open Access Journals (Sweden)

    S TA

    2014-09-01

    Full Text Available Friedrich Nietzsche, one of the most influential and thoughtful philosopher in the 19th century, in an attempt to reassess values, finds himself in confrontation with accepted ideas of the modern world. Therefore, in his critical review, in order to reform and revive the modern civilization and culture, he writes his first book, i.e. The Birth of Tragedy. His various intentions in this book are as following: a cultural concerns and saving the culture of his age from nihilism and the danger of falling apart, b reassessing values, c showing the opposition of Christianity and conceptual philosophy of Socrates with the nature of life, Dionysus element as well as the desire to live, d aesthetic interpretation of living and being and e viewing life from the perspective of art. Nietzsche considers the last two cases as the special features of Greek's tragic art and praises Greek's tragic age for such perspective. He admires ancient Greeks as well as their culture and thought because they are the creators of tragic art and through such creation as well as by considering Dionysus element they accepted life with all of its good and bad aspects. Nietzsche discusses two fundamental concepts of birth and death of tragedy as well. However, he views the birth and death of tragedy in two different ways a in a particular age, Greek tragedy emerged from Greek culture and became an influential factor in the development of that nation’s culture but died later on, b Nietzsche's hope in the re-emergence of Greek tragic art in the modern world lies in Wagner's music which died, too. In his view, the factors behind the death of tragedy are as following: the Socrates' conceptual philosophy and Euripides' plays, Christianity and ethicality as well as modern dialectic and Wagner himself. This article, first, tries to study Nietzsche’s important intentions in writing The Birth of Tragedy and explain such birth in the first sense emphasizing the interpretation of its

  17. Induced abortion: a means of postponing childbirth? Changes in maternal age at induced abortion and child birth in Norway during 1979-2007.

    Science.gov (United States)

    Vlietman, Marianne; Sarfraz, Aashi Ambareen; Eskild, Anne

    2010-12-01

    the maternal age at child birth is increasing. If induced abortion is an important means of postponing childbirth in a population, it is to be expected that in young women the rate of conceived pregnancies is stable over time, but the induced abortion rate is increasing. We studied birth rates, induced abortion rates and the sum of these rates by maternal age during four decades. register-based study. all women 15-49 years living in Norway. we present temporal changes in birth rates and induced abortion rates within age groups during the period 1979-2007. We also estimated the sum rate of births and induced abortions. Data were obtained from national statistics. live births and induced abortions per 1000 women per year. the induced abortion rates have been relatively stable within age groups, except for a decrease in women 15-19 years (from 24.2 in 1979 to 17.0 in 2007) and an increase in women 20-24 years (from 23.2 to 29.5). The birth rates however, have decreased dramatically in women 20-24 years old (from 113.6 to 60.5). Hence, the sum rate of births and induced abortions in women 20-24 years old has decreased from 136.8 to 90.0. In women 30 years old or older, the birth rates have increased. the induced abortion rate has been relatively stable in all age groups over time, suggesting a limited influence of induced abortions on the postponement of childbearing.

  18. 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....

  19. 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.

  20. 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....