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Biomedical subjects

I B Hassall

Publications and source records attributed to I B Hassall.

At least 19 recordsLinked to original sources

Postnatal depression and SIDS: a prospective study.

This study was carried out in response to reports from nurses to a post-neonatal mortality review committee that a number of mothers of infants dying from sudden infant death syndrome (SIDS) appeared to be depressed before the child's death. The New Zealand Cot Death Study was a 3 year multicentre case-control study for SIDS. There were 485 SIDS cases in the post-neonatal age group in the study regions, and these were compared with 1800 control infants. Infants of mothers with either a self-reported use of medication for psychiatric disorders, a history of hospitalization for psychiatric illness or a family history of postnatal depression had a significantly increased risk of SIDS compared with infants of mothers who were either not using medication (odds ratio (OR) = 1.45; 95% confidence interval (CI) = 1.03, 2.04) or were without a history of hospitalization for psychiatric illness (OR = 1.80; 95% CI = 1.03, 3.11) or a family history of postnatal depression (OR = 1.61; 95% CI = 1.06, 2.43). All mothers of infants born in the study areas over a 1 year period were eligible to complete a questionnaire measuring maternal depression when the infant was 4 weeks of age. Thirty-three infants subsequently died from SIDS, and they were compared with 174 controls. Fifteen (45.5%) of the mothers of cases were depressed, compared with 28 (16.1%) of the mothers of controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies

Four modifiable and other major risk factors for cot death: the New Zealand study.

New Zealand's high mortality rate from sudden infant death syndrome (SIDS) prompted the development of the New Zealand Cot Death Study. A report of the analysis of the data from the first year has been published. This report now gives the major identified risk factors from the full 3 year data set. In this case-control study there were 485 infants who died from SIDS in the post-neonatal age group, and 1800 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 97.5% and 86.9% of subjects, respectively. As expected many risk factors for SIDS were confirmed including: lower socio-economic status, unmarried mother, young mother, younger school-leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, non-attendance at antenatal classes, Maori, greater number of previous pregnancies, the further south the domicile, winter, low birthweight, short gestation, male infant and admission to a special care baby unit. In addition, however, we identified four risk factors that are potentially amenable to modification.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors

Further evidence supporting a causal relationship between prone sleeping position and SIDS.

A 3 year case-control study identifying the risk factors for SIDS was undertaken. Preliminary analysis of the data from the first year suggested that SIDS mortality could fall by 50% if the prevalence of the prone sleeping position changed from 40 to 0%. During the 3 year study the prevalence of the prone sleeping position among infants has fallen from 43% in the first year to 20% in the third year. SIDS mortality has fallen to 3.1/1000 live births, which is very close to that predicted. When considered with other available evidence this strongly supports a causal relationship between the prone sleeping position and SIDS.

Case-Control Studies

The New Zealand Cot Death Study: some legal and ethical issues.

The New Zealand Cot Death Study is a 3 year multicentre case-control study aimed at identifying the risk factors for sudden infant death syndrome (SIDS). The paper describes some of the legal and ethical issues which arose in the planning, implementation and analysis of the study.

Case-Control Studies

Results from the first year of the New Zealand cot death study.

New Zealand's high mortality rate from the sudden infant death syndrome (SIDS) prompted the development of the New Zealand cot death study. This report of the preliminary analysis of the first year of the data gives the major identified risk factors. One hundred and sixty-two infants who died from SIDS were compared with 589 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 96% and 89% of subjects respectively. Data were available for all the variables in this study in 95% of those interviewed, thus 128 cases and 503 controls make up the subjects of this report. As expected we confirmed many risk factors for SIDS including: lower socioeconomic status, unmarried mother, young mother, younger school leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, nonattendant at antenatal classes, Maori, greater number of previous pregnancies, lower birth weight, shorter gestation, male infant, admission to neonatal intensive care unit. In addition, however, we identified three risk factors which are potentially amenable to modification. These were the prone sleeping position of baby (odds ratio = 3.53, 95% confidence interval 2.26, 5.54), maternal smoking (1-9 cigarettes/day OR = 1.87, 95% CI = 0.98, 3.54; 10-19/day OR = 2.64, 95% CI = 1.47, 4.74; 20+/day OR = 5.06, 95% CI = 2.86, 8.95) and breast feeding (OR = 2.93, 95% CI = 1.84, 4.67).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Thirty-six consecutive under 5 year old domestic swimming pool drownings.

Data were collected by the local nurse on each of the 36 drownings in domestic swimming pools of under 5 year olds that occurred between 1 September 1982 and 31 December 1986. The likely effect of New Zealand's 1987, Fencing of Swimming Pools Act in preventing these drowings, had it been in effect, is considered. It is concluded that at least 29 (80%) of the 36 drownings would have been prevented. Examination of the circumstances of the drownings leads to the conclusion that certain alternatives to the fencing law that have been proposed, such as teaching water skills to infants, fencing property boundaries, and use of pool covers, are unlikely to have been as effective.

Child, Preschool

Postneonatal mortality review in Auckland: two years experience.

Postneonatal deaths in the Auckland Region in 1984 and 1985 were reviewed. There were 134 deaths and most deaths could be placed into four broad categories, namely sudden infant death syndrome (SIDS, 80 60%), congenital anomalies (24, 18%), infections (9, 7%) and problems arising in the perinatal period (8, 6%). There was good agreement with the cause of death as recorded by the National Health Statistics Centre (98.5%) Potentially preventable causes of death were infrequent (14, 10%), but notable factors were present in 90% of SIDS. For SIDS cases the following notable factors were identifiable: young mothers, Maori, low socioeconomic status, poor accommodation, frequent changes of address, maternal smoking, previous postneonatal death, poor antenatal care, male infant, low birth weight, twin, poor infant weight gain.

Cause of Death

Health trends.

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Humans

Infant sleep position: a New Zealand survey.

Four thousand and forty-one infants aged 1-4 months were included in a national survey to determine the position in which New Zealand infants usually sleep. Infants were most commonly put down on the side or on the front with the face to one side. Many changed position during sleep. By far the most common position in which infants ended up sleeping was on the front with the face to one side. The proportion of infants in the various sleep positions changed with age. Speculation as to a possible relationship between sleep position and sudden infant death must take into account that many infants do not sleep in the position in which they are put down and that there are changes in position with age.

Humans