Biomedical subjects

Cynthia Berg

Publications and source records attributed to Cynthia Berg.

5 recordsLinked to original sources

PubMed2005

Injury deaths, suicides and homicides associated with pregnancy, Finland 1987-2000.

BACKGROUND: Only few studies have been carried out on the relationship between pregnancy and deaths from external causes. METHODS: Information on deaths from external causes among women aged 15-49 years in Finland in 1987-2000 (n = 5299) was linked to three national health registers to identify pregnancy-associated deaths (n = 212). RESULTS: The mortality rate for women during pregnancy and within 1 year of pregnancy termination from external causes was lower than mortality from external causes among non-pregnant women (relative risk 0.79; 95% confidence interval 0.69-0.91). Owing to elevated suicide and homicide rates, however, an increased risk was observed for women after abortions, especially in the age group of 15-24 years. CONCLUSIONS: The low rate of deaths from external causes suggests the protective effect of childbirth, but the elevated risk after a terminated pregnancy needs to be recognized in the provision of health care and social services.

Adolescent↗

PubMed2005

Underreporting of pregnancy-related mortality in the United States and Europe.

OBJECTIVE: Available maternal mortality statistics do not allow valid international comparisons. Our objective was to uniformly measure underreporting of mortality from pregnancy in official statistics from selected regions within the U.S. and Europe, and to provide comparable revised profiles of pregnancy-related mortality. METHODS: We developed a standardized enhanced method to uniformly identify and classify pregnancy-associated deaths from 2 U.S. states, Massachusetts and North Carolina, and 2 European countries, Finland and France, for the years 1999-2000. Identification method included the use of all data available from the death certificate as well as computerized linkage of births and deaths registers. All cases were reviewed and classified by an international panel of experts. RESULTS: Four-hundred-and-four pregnancy-associated deaths were identified and reviewed. Underestimation of mortality causally related to pregnancy based on International Classification of Diseases cause-of-death codes alone varied from 22% in France to 93% in Massachusetts. Underreporting was greater in the regions with lower initial maternal mortality ratios. The distribution of causes of pregnancy-related mortality was specific to each region. The leading causes of death were cardiovascular conditions in Massachusetts; hemorrhage, pregnancy-induced hypertension, and peripartum cardiomyopathy in North Carolina; noncardiovascular medical conditions in Finland; and hemorrhage in France. CONCLUSION: This study shows the limitations of maternal mortality statistics based on International Classification of Diseases cause-of-death codes alone. Linkage of births and deaths registers should routinely be used in the ascertainment of pregnancy-related deaths. In addition, extension of the definition of a maternal death should be considered. Beyond pregnancy-related mortality ratios, considering the specific distribution of causes-of-death is important to define prevention strategies.

Adult↗

PubMed2004

Pregnancy-associated mortality after birth, spontaneous abortion, or induced abortion in Finland, 1987-2000.

OBJECTIVE: To test the hypothesis that pregnant and recently pregnant women enjoy a "healthy pregnant women effect," we compared the all natural cause mortality rates for women who were pregnant or within 1 year of pregnancy termination with all other women of reproductive age. STUDY DESIGN: This is a population-based, retrospective cohort study from Finland for a 14-year period, 1987 to 2000. Information on all deaths of women aged 15 to 49 years in Finland (n=15,823) was received from the Cause-of-Death Register and linked to the Medical Birth Register (n=865,988 live births and stillbirths), the Register on Induced Abortions (n=156,789 induced abortions), and the Hospital Discharge Register (n=118,490 spontaneous abortions) to identify pregnancy-associated deaths (n=419). RESULTS: The age-adjusted mortality rate for women during pregnancy and within 1 year of pregnancy termination was 36.7 deaths per 100,000 pregnancies, which was significantly lower than the mortality rate among nonpregnant women, 57.0 per 100,000 person-years (relative risk [RR] 0.64, 95% CI 0.58-0.71). The mortality was lower after a birth (28.2/100,000) than after a spontaneous (51.9/100,000) or induced abortion (83.1/100,000). We observed a significant increase in the risk of death from cerebrovascular diseases after delivery among women aged 15 to 24 years (RR 4.08, 95% CI 1.58-10.55). CONCLUSION: Our study supports the healthy pregnant woman effect for all pregnancies, including those not ending in births.

Abortion, Induced↗

PubMed2004

Methods for identifying pregnancy-associated deaths: population-based data from Finland 1987-2000.

To find maternal and pregnancy-related deaths, it is important that all pregnancy-associated deaths are identified. This article examines the effect of data linkages between national health care registers and complete death certificate data on pregnancy-associated deaths. All deaths among women of reproductive age (15-49 years) in Finland during the period 1987-2000 (n = 15 823) were identified from the Cause-of-Death Register and linked to the Medical Birth Register (n = 865 988 births), the Register on Induced Abortions (n = 156 789 induced abortions), and the Hospital Discharge Register (n = 118 490 spontaneous abortions) to determine whether women had been pregnant within 1 year before death. The death certificates of the 419 women thus identified were reviewed to find whether the pregnancy or its termination was coded or mentioned. In total, 405 deaths (96.7%) were identified in registers other than the Cause-of-Death Register. Without data linkages, 73% of all pregnancy-associated deaths would have been missed; the percentage after induced and spontaneous abortions was even higher. Data linkages to national health care registers provide better information on maternal deaths and pregnancy-associated deaths than death certificates alone. If possible, pregnancies not ending in a live birth should be included in the data linkages.

Abortion, Induced↗

PubMed2003

Magnitude of maternal morbidity during labor and delivery: United States, 1993-1997.

OBJECTIVES: This study sought to determine the prevalence of maternal morbidity during labor and delivery in the United States. METHODS: Analyses focused on National Hospital Discharge Survey data available for women giving birth between 1993 and 1997. RESULTS: The prevalence of specific types of maternal morbidity was low, but the burden of overall morbidity was high. Forty-three percent of women experienced some type of morbidity during their delivery hospitalization. Thirty-one percent (1.2 million women) had at least 1 obstetric complication or at least 1 preexisting medical condition. CONCLUSIONS: Maternal morbidity during delivery is frequent and often preventable. Reducing maternal morbidity is a national health objective, and its monitoring is key to improving maternal health.

Female↗