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Biomedical subjects

D A Cornely

Publications and source records attributed to D A Cornely.

7 recordsLinked to original sources
PubMed1985

Maternal perinatal risk factors and child abuse.

A retrospective matched pair study was designed to compare maternal perinatal factors such as abnormal pregnancy history and labor and delivery experience in families who subsequently were reported as physically abusive to one or more of their children as compared to non-abusive families. The study population consisted of the mothers of 532 children reported to the Baltimore (Maryland) Department of Social Services as physically abused during the years 1975-77. The comparison group was handmatched to the study group from State of Maryland birth certificates on the basis of the abused child's birth year and sex, maternal race, education and hospital of delivery. The study population was 67% black with a mean maternal education of 10.5 completed years. The abused children were 59% male with 48% less than 2 years of age. Results indicated that selected medical definitions of abnormal pregnancy, labor and delivery did not identify families at differential risk of maltreatment. However, mothers in maltreating families were younger, had shorter birth intervals, less prenatal care and were significantly more likely to have had a stillbirth or reported abortion or a prior child death. Study limitations are addressed as are suggestions for future research.

Adolescent↗
PubMed1978

Interdisciplinary training for child welfare and health.

Recognition of the symbiotic relationship of the child welfare and child health disciplines led to a project that developed and tested health concepts and methods curricula for child welfare administrators and research staff.

Child↗
PubMedDate not supplied

Follow-up of the use of local health department clinics for preventive care among young children.

We followed 18,490 infants from their first visit to a county child health clinic (CHC) in Maryland through visits through their third year of age to investigate whether their continued use of the CHCs was related to their characteristics or to the services they were provided as an infant. We classified as provided services immunization, an Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) recommended screening, and number of visits. Immunization was associated with an increased percentage of infants who returned to the CHCs at two and three years of age. Half of the children, on the other hand, never returned to the clinics if they were not immunized as infants. These findings persisted, regardless of race, Medicaid status, completion of a screening, or number of visits in the first year of life. One-fifth of infants did not receive an immunization during one or more visits to CHCs in their first year. Failure to administer an immunization to infants appears to impede subsequent use of public health clinics for well child care.

Child Health Services↗
PubMedDate not supplied

Gestational age reporting and preterm delivery.

This study examines recent trends in the reporting completeness and quality of gestational age estimates derived from the date of the last normal menses (DLNM) as reported in South Carolina vital records from 1974 to 1985. Noteworthy improvements in the completeness of reporting emerged during this period with a decline from 31.1 percent missing information in 1974 to 6.6 percent missing in 1985. Completeness of reporting and strategies for imputing values for missing data were analyzed for their impact on the calculation of the percentage of preterm live births. The results indicate that the underreporting of gestational age can lead to marked underestimation of the preterm percentage in a population and to misinterpretation of trends in these percentages. Based on the results of this analysis, it is recommended that preterm percentages be based on cases with DLNM gestational age values between 20 and 50 weeks. Since cases with missing or implausible gestational age data have a greater risk of a poor pregnancy outcome, these findings emphasize the importance of identifying both the completeness of data reporting and the use of imputation and deletion strategies when employing population-based DLNM data to calculate gestational age related indicators.

Adolescent↗
PubMedDate not supplied

Prenatal care utilization: its measurement and relationship to pregnancy outcome.

This study proposes a redesigned measure of prenatal care utilization based on modifications made to a preexisting index of the adequacy of such care. Six prenatal care utilization groups were delineated: intensive, adequate, intermediate, inadequate, no-care, and missing/unknown. Using 430,349 cases from South Carolina and North Carolina vital records from 1978 to 1982 (live birth-infant death cohort files for white resident mothers), this proposed prenatal care utilization measure was examined by maternal sociomedical risk characteristics (age-parity, marital status, education, complications of pregnancy, and previous pregnancy terminations) and by pregnancy outcomes (birth weight, gestational age, and birth weight- and gestational age-specific neonatal mortality). The intensive prenatal care group had relatively more pregnancy complications but also the most preferred pregnancy outcomes. Appreciable differences in birth weight and gestational age distributions were observed among the prenatal care categories within maternal risk status groups. Increased utilization of prenatal care was associated with higher mean birth weight and gestational age. However, after controlling for maternal risk status, an appreciable variation in birth weight- and gestational age-specific neonatal mortality was not apparent across prenatal care groups.

Adolescent↗
PubMedDate not supplied

Racial disparities in pregnancy outcomes: the role of prenatal care utilization and maternal risk status.

Distinct black-white differences in pregnancy outcome and prenatal care utilization have been a persistent feature of U.S. natality-related statistics. Using South Carolina and North Carolina live birth-infant death cohort files for 1978-1982, this study examines the extent to which variations in prenatal care utilization may be associated with racial disparities in pregnancy outcome within maternal sociomedical risk groups. After taking indicators of maternal risk into account (age-parity, education, marital status, complications of pregnancy and previous pregnancy terminations), birth weight and gestational age distributions and birth weight- and gestational age-specific neonatal mortality rates of blacks and whites were compared by level of prenatal care utilization. Distinct racial differences in birth weight and gestational age distributions were observed within equivalent maternal risk and prenatal care categories, with whites having an approximately 200-gram mean birth weight and five-day mean gestational age advantage compared to blacks. In this analysis of more than 650,000 cases, low-risk blacks adequately utilizing prenatal care had a lower mean birth weight (3,266 grams) and a higher neonatal mortality rate (6.6) than low-risk, inadequate-care whites (3,302 grams; 6.1).

Black or African American↗