Biomedical subjects

D M Strobino

Publications and source records attributed to D M Strobino.

41 records · Page 3Linked to original sources

PubMedDate not supplied

A comparison of the auscultated acceleration test and the nonstress test as predictors of perinatal outcomes.

In this prospective study, the predictive ability of the nonstress test (NST), the most widely used antepartum screening test to assess fetal well-being, was compared with that of the auscultated acceleration test (AAT) in predicting perinatal outcomes. The AAT is a more easily administered test than the NST, and, unlike the NST, does not use electronic fetal monitors. Study subjects were 205 women with singleton pregnancies greater than 34 weeks' gestation, whose delivery occurred within 7 days of receiving antepartum testing by NST at Johns Hopkins Hospital. The AAT yielded better prediction of poor perinatal outcomes than the NST. The NST, however, was a significantly better predictor of favorable outcomes than the AAT. The AAT has the potential to affect perinatal care if false positive results can be decreased through further research.

Adult↗

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

The use of preventive health services by disabled children.

As a measure of the use of general pediatric health services we assessed disabled children's receipt of preventive health care in relation to a control group of nondisabled children, matched by age, family size, and region of residence. The study and control subjects were identified in a household survey conducted in Minnesota in 1976 and ranged in age from 1 to 18 years. The proportion who made a preventive health visit was nearly identical in both groups. Binary variable multiple regression showed that 9 percent of the variation in outcome was explained by the independent variables, which included demographic and socioeconomic characteristics and access to health care. Disability did not contribute significantly to the explained variation, but family structure, mother's education, and mother's use of preventive health services reached the 95 percent level of significance. The results suggest that children in a community who are identified as disabled are not at a disadvantage, in comparison with the nondisabled, in gaining access to preventive health services. The use of such services by all children appears to be low when information on using school health services is not available.

Adolescent↗

PubMedDate not supplied

Declines in nonwhite and white neonatal mortality in Mississippi, 1975-80.

Linked birth and death records provided the population for an investigation of declines in nonwhite and white neonatal mortality rates (NMR) in Mississippi between 1975 and 1980. The effect of changes in the characteristics of women giving birth and in perinatal care on declining NMRs was analyzed. A decomposition of the difference in the 1975-76 and 1979-80 NMRs was performed to determine whether declines in NMRs were due to shifts in population characteristics or in characteristic-specific rates. Between 1975 and 1980, the NMR declined significantly by 1 death per 1,000 live births per year among nonwhites and by 0.8 per 1,000 among whites. Increases in the number of prenatal visits during the study period were associated with part of this decline, especially for nonwhites. The effect of rising use of prenatal care on NMRs was not, however, a result of shifts in the birth weight distribution. The decrease in NMRs was also associated with declining birth weight-specific rates; 75 percent of the decrease in rates was noted among low birth weight infants. Shifts in the distribution of birth weight and in maternal characteristics had little effect on declining NMRs. A strong commitment of the Mississippi State Board of Health to provide prenatal care to indigent women may be responsible for the large increases in use of prenatal care among Mississippi women. The decline in NMRs among low birth weight infants is likely linked to greater availability of specialized care for the sick neonate, although survival of these infants increased across the State, even where specialized care was not available.

Adolescent↗

PubMedDate not supplied

Trends in low birth weight infants and changes in Baltimore's childbearing population, 1972-77.

Linked birth and death records provided the population for a study of trends in low birth weight (LBW) rates in Baltimore between 1972 and 1977 and of the effect of changes in the characteristics of the childbearing population on these trends. The impact of shifts in the birth weight distribution on neonatal mortality rates was also investigated. Trends were analyzed for unstandardized LBW rates as well as for rates standardized on the distributions of maternal age, education, gravidity, prior pregnancy losses, and marital status.Between 1972 and 1977, the 1,500 and 2,000 gm rates rose significantly by approximately 1 infant per 1,000 live births per year among whites and 2 infants per 1,000 live births among nonwhites. Despite declines in rates for most weights, the effect of these increases was a rise in neonatal mortality rates for both races, but especially for nonwhites.The population of women delivering in Baltimore in 1977 became slightly older, slightly more educated, and of higher gravidity than in 1972, but these changes had little impact on yearly fluctuations in LBW rates. In contrast, increases in births to unmarried women and to women with at least one prior pregnancy loss were related to rising LBW rates. For both races, standardization on marital status and prior pregnancy losses diminishes the increase in the LBW rate over the study period, especially when standardization is performed simultaneously for both variables. These findings hold within maternal age, education, and gravidity groups. However, the LBW rates for nonwhite teenage mothers and for nonwhite women with 12 years of less education increased significantly over the study period, regardless of standardization.

Abortion, Induced↗