ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00487.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Summary.The Jamaican Perinatal Mortality Survey was designed to identify the true perinatal mortality rate, and assess the factors which could contribute towards a reduction in perinatal mortality on the island.All births in a 2‐month period (n= 10527) were compared with all perinatal deaths occurring over a 12‐month period (n= 2069). Over half the deaths (n= 1058) received a detailed post‐mortem examination.Use of the Wigglesworth classification identifies the major component of perinatal death in this country to be associated with intrapartum asphyxia (44% of deaths). Deaths due to congenital malformations and miscellaneous causes contribute relatively little (<10%) to the overall mortality rate. Over a quarter of deaths apparently occur before the onset of labour, and a fifth are prematurely liveborn but die of causes related to immat

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00488.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00431.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Summary.Social and environmental factors in Jamaica were compared between 9919 mothers delivering in a 2‐month period a singleton who survived the early neonatal period and 1847 mothers who were delivered of a singleton perinatal death in a contiguous 12‐month period.Logistic regression showed independent positive statistically significant increased odds of having a perinatal death among mothers who lived in rural parishes, older mothers (aged 30+), single parents, no other children in the household, large number of adults in the household, mother unemployed, the major wage earner of the household not being in a managerial, professional or skilled non‐manual occupation, the household not having sole use of toilet facilities, smaller mothers and those classified as obese or undernourished.Variations were found for different categories of death. Intrapartum asphyxia deaths were not related to union (marital) status, occupation of major wage earner, number of adults nor to the use of the toilet. Antepartum fetal deaths did not vary significantly with occupation of major wage earner or maternal height, but did show a relationship with maternal education, mothers with lowest levels having reduced risk. Deaths from immaturity were significantly related only to occupation of major wage earner, number of children in the household, number of social amenities available (negative relationships) and maternal age (<17 at highest risk).In conclusion there was little to indicate that social deprivationper sewas related to perinatal death, although specific features of the environment showed strong relation

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00489.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00432.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Summary.In order to describe ethnic differences in the incidence of the sudden infant death syndrome (SIDS) records of all livebirths in the State of Victoria, Australia, 1985–1989, excluding those who died in the first month of life, were linked to death certificates. Cases were defined as infants dying with a diagnosis of SIDS between 1 month and 1 year of age (n= 601) from the cohort of 308052 neonatal survivors. Ethnicity was defined by the mother's country of birth. The SIDS incidence was 2.04/1000 in infants of Australian‐born mothers. The relative risk of SIDS was 0.28 (95% confidence interval (CI) 0.15,0.55) in infants whose mothers had been born in Southern Europe and 0.48 (95% CI 0.29, 0.78) in infants whose mothers had been born in Asia. SIDS in infants of Australian‐born mothers was associated with low maternal age, high parity, marital status other than married, male sex, multiple birth, low birthweight and preterm birth. After adjustment for those factors in a case‐control analysis using a logistic regression model the adjusted odds ratio for SIDS was 0.34 (95% CI 0.17, 0.69) comparing infants whose mothers were born in Southern Europe with infants of Australian‐born mothers, and 0.60 (95% CI 0.35, 1.04) for infants whose mothers were born in Asia, compared with infants of the Australian‐born. Thus there are substantial ethnic differences in SIDS which are not explained by the classic social and perinatal r

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00433.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Summary.Singleton survivors born to multigravidae in the whole island of Jamaica in 2 months (September‐October 1986) were compared with singleton perinatal deaths occurring to multigravidae throughout the island in the 12‐month period September 1986 to August 1987. Past obstetric history was obtained from the mothers using a structured questionnaire. Deaths were categorised using the Wigglesworth classification. Logistic regression was used to compare current outcomes in women who had had at least one previous pregnancy.Antepartum fetal deaths were associated with (1) outcome of last pregnancy; (2) previous Caesarean section; (3) previous stillbirth; and (4) increasing gravidity. In the presence of these factors maternal age ceased to be statistically significant. Deaths from immaturity were strongly associated with the past obstetric history, with increased risks for pregnancies to mothers with a history of previous miscarriage, perinatal death and premature live births. In general, however, the higher the gravidity the lower the risk. In the presence of these factors, maternal age showed no significant association. Intrapartum asphyxia was also associated with the outcome of the last pregnancy, history of prior stillbirth or neonatal death. First pregnancies were at significantly higher risk than second pregnancies (P<0.05).For perinatal deaths as a whole, and in the presence of maternal age, the following were statistically significant independent factors: (1) the outcome of the immediately preceding pregnancy (high risks associated with prior miscarriage, stillbirth and premature live births); (2) previous Caesarean section (increased risk); (3) previous perinatal deaths; and (4) more than one prior early fetal loss.The results indicated that prior poor obstetric history bears similar risks of subsequent adverse outcome in the developing as in the developed world. There was no variation in risk, however, with interpregnancy interval or previous termination. Much of the variation in risk of perinatal death with maternal age among multigravidae appears largely to be secondary to past obstetric hist

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00490.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Summary.The paper addresses the lack of information concerning parental visiting in neonatal intensive care units (NICU) across European Community (EC) countries. It reports on a study involving 11 EC countries and 38 units carried out under the auspices of a Concerted Action project. Information gathered from the 38 units yields data on the parental and family visiting policies. The study reveals a wide variation in the policies from considerable parental access to the infant in the NICU to restricted visiting. Policies concerned with unit facilities and unit support staff reflect the orientation of the overall unit policy with regard to visiting.

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00434.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Summary.Very low birthweight (VLBW) is a commonly used endpoint in perinatal epidemiology, but the population of VLBW infants comprises a wide range of gestational ages and rates of fetal growth. We used data from a population‐based study of all 1072 black and white VLBW liveborn infants born in 29 counties in Georgia between April 1986 and March 1988. Less than 1% of the VLBW infants were ≥ 37 weeks gestation; most were 29–32 weeks (26%) or 25 to 28 weeks (40%); 12% were 22 weeks or less. All infants 33 weeks gestation or greater were growth retarded. The population of VLBW infants seems to comprise three groups: approximately 11% very immature infants of 22 weeks or less; the majority of infants, born between 23 and 30 weeks, 90% of which are of normal weight for their gestational age; and a group of less premature, growth‐retarded infants from 31 to 36 weeks. We found little or no difference in the distribution of gestational age or the percentage of intrauterine growth rates (IUGR) between black and white infants. In the USA the VLBW rate among black infants is over three times greater than that among white infants and consequently the rates of the three types of VLBW among black infants are likely to be triple those among white

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00435.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Summary.Features of behaviour of mothers of singleton perinatal deaths collected over the 12‐month period from 1 September 1986 to 31 August 1987 were compared with 9919 mothers of singleton infants born in September and October 1986 and surviving the first week of life, as part of the Jamaican Perinatal Mortality Survey.For perinatal deaths as a whole, and in the presence of maternal age and social and environmental features, logistic regression analyses showed that the following were independently related with higher risk of mortality: (1) deliberately trying to get pregnant; (2) ever having used Depo Provera; (3)notdrinking alcohol in pregnancy; and (4) smoking cigarettes in pregnancy. There were no associations with coital frequency, ever using the contraceptive pill or smoking ganja (cannabis).Deaths were classified using the Wigglesworth scheme, and separate analyses carried out for the three major groups ‐ antepartum fetal deaths, deaths from immaturity and deaths from intrapartum asphyxia. Antepartum fetal deaths were at increased risk if (1) mothers were deliberately trying to get pregnant or (2) they had ever used Depo Provera. Deaths from immaturity were not associated with any health behaviour variables. Deaths from intrapartum asphyxia were more likely if (1) the mother was deliberately trying to get pregnant or (2) she had never used an intrauterine contraceptive dev

ISSN:0269-5022    

DOI:10.1111/j.1365-3016.1994.tb00491.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY