ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00061.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.Use of Caesarean sections has notably increased in many countries. This article reviews existing cohort type studies to compare subsequent reproduction after Caesarean section with a comparable control group, with exposure at the earliest in the 1960s. Eight studies were found. They suggested that a Caesarean section is a risk factor for lowered fertility, for uncompleted pregnancy (ectopic pregnancy and possibly miscarriage), for complications in the next pregnancy and birth (including placental complications) and for health problems in the next infant. The review was impeded by the lack of relevant research, and all studies to date potentially suffer from selection bias by indication. Trials and other studies on the long‐term outcomes of Caesarean sections are needed, especially in populations with a high risk for reproductive problem

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00062.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.We present an assessment of studies published in the last decade that consider the relationship of stress and social support to preterm delivery or fetal growth retardation. Included in the review are all reports on the direct effects of stressors or psychological distress; the indirect effects of stressors or distress through health behaviours such as smoking; and the direct and buffering effects of social support. Although an important stimulus for recent stress research has been the attempt to explain racial and social class differences in birth outcome, the recent data show that stressful life events during pregnancy, though more common in disadvantaged groups, do not increase the risk of preterm birth. In contrast, intimate social support from a partner or family member appears to improve fetal growth, even for women with little life stress. Questions unanswered by the research to date are whether elevated levels of depressive symptoms affect pregnancy outcome, either directly or by encouraging negative health behaviours, and whether chronic (vs. acute) stressors are harmful. Additional research is also needed to determine whether psychosocial factors interact with specific clinical conditions to promote adverse pregnancy outcomes. Focusing on intimate support and how it benefits pregnancy outcome could lead to the design of more effective interventions.

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00063.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00064.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Fumes from the spleenKnowledge does not automatically order itself in human terms … More startling, and contrary to workaday beliefs of most scientists, knowledge does not even accumulate, in the simplest, additive sens

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00065.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary..To determine whether increased rates of childhood acute lymphoblastic leukaemia (ALL) which had been reported in isolated areas could be attributed to higher proportions of households owning cars, ecological analysis was performed with electoral wards as area units. Previous data were re‐analysed using the proportion of households having no car, taken from the 1981 census of England and Wales, as an additional explanatory factor. A specialist registry of haematopoietic malignancies covering one‐third of England and Wales (3270 electoral wards) recorded 438 cases of ALL in children diagnosed 1984‐89, including 304 in the childhood peak (at ages 1–7 years). Relative risks were derived by Poisson regression of total childhood ALL and at ages 1–7 years for groups of electoral wards classified by isolation and car ownership. Multivariable analyses included adjustment for socio‐economic status. No evidence of increased risk of childhood ALL in areas where more households own cars was found. ALL at ages 1–7 years was inversely associated with car ownership (risk in wards with least cars relative to those with most cars = 2.28,95% CI: 1.12‐4.64). The associations with geographic isolation persisted after allowing for car ownership (risks for ALL in young children in isolated relative to built‐up areas = 2.19,95% CI: 1.44‐3.33). Levels of car ownership cannot explain the increased rates of childhood ALL which have been observed in isolated areas. No support has been found for a hypothesis relating these excesses to benzene exposure of children transported in cars. The previous explanation for the small area variation of childhood ALL in terms of geographical isolation and interpretation in terms of exposure to common infections contin

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00066.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.In the UK, the decline in maternal mortality rates has stopped. In France, where they are higher than in most European countries, maternal mortality rates have been increasing since 1990. Based on the population projections published by Eurostat, maternal mortality predictions have been made for 1995, 2000, 2005 and 2010. A rise in the level of maternal mortality rates of more than 0.5 per 100000 livebirths is expected between now and 2005, in both countries. In the present context of near stability, this rise could be viewed as an important increase. Maternal mortality rises with maternal age and the proportion of births to women over thirty is growing and will continue to rise until 2000–2005. This structural and demographic evolution explains the expected rise of maternal mortality rates and shows how the change in the maternal age distribution of births will affect these rate

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00067.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.Neonatal intensive care has increased neonatal survival, but has also led to postponement of some of the neonatal deaths to the postneonatal period, particularly in very low birthweight (<1.5kg) infants. Our report assesses the impact of the increased neonatal survival and the accompanying delayed deaths on the crude postneonatal mortality rateoithe US, using the national livebirth cohort data of 1960,1980, and 1986. With increased neonatal survival, very low birthweight infants comprised 0.68% of all neonatal survivors in 1986, compared with only 0.31% in 1960. However, postneonatal mortality was increased in infants with birth weights2.5 kg birthweight gr

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00068.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00069.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Summary.This study was set up to estimate the incidence of neonatal herpes simplex virus (HSV) infection in the British Isles, and to document the outcome of neonatal infection. Paediatricians reported cases of neonatal HSV through the active reporting scheme of the British Paediatric Association Surveillance Unit. Over a 5half year period (1986‐91) 76 infants with neonatal HSV infection were reported, an incidence of recognised infection in the British Isles of 1.65/100000 livebirths. Twenty‐five infants had HSV‐1 infection, 24 HSV‐2 and in 27 virus type was unknown. Twenty‐seven had disseminated infection, 23 herpes encephalitis and 26 localised infection. Nineteen infants (25%) died in the neonatal period, and a further 25 (33%) have subsequently died or have long‐term sequelae. At least half of the infants had been discharged home before symptoms became apparent. For 21 women there was evidence of a maternal genital herpes infection at some time, but this was reported or diagnosed retrospectively after neonatal HSV was suspected in 19 cases, and ante‐natally in only two. Neonatal HSV is rare in the British Isles and routine antenatal screening for genital herpes infection during pregnancy is not justified. A high proportion of infected infants present with non‐specific signs and symptoms and without mucocutaneous involvement; furthermore, there is rarely a history of maternal infection. As early diagnosis and prompt treatment is essential, there must be a high level of awareness of the serious nature of neonata

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1996.tb00070.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY