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Biomedical subjects

J D Keeping

Publications and source records attributed to J D Keeping.

15 recordsLinked to original sources

The mental health of women 6 months after they give birth to an unwanted baby: a longitudinal study.

This study reports a longitudinal prospective study of the impact of an unwanted pregnancy on the mental health of the mother. Data are derived from a Brisbane, Australian sample of 8556 mothers who were enrolled at their first clinic visit (mean gestation 18 weeks) and then interviewed again some 3-5 days after the birth and when the baby was 6 months of age. Standard scales of mental health were administered on each of these occasions and mothers whose babies were unwanted were compared with the rest of the sample. The results indicate that mothers of unwanted children have somewhat higher rates of anxiety and depression than the comparison group, but that the magnitude of the mental health differences between the two groups: (a) diminishes over the period of the follow-up, (b) may be partly attributable to the prior poor mental health of women giving birth to an unplanned and unwanted baby, (c) is such that relatively few women who give birth to an unwanted baby experience mental health problems. The paper considers the implications of these results for health planners, notes the absence of contrary data and the need to acknowledge that these results may reflect situational factors which are characteristic of but not necessarily limited to Brisbane.

Adolescent

Social factors associated with the decision to relinquish a baby for adoption.

Little is known about the characteristics, social circumstances and mental health of women who give a child up for adoption. This paper reports data from a longitudinal study of 8556 women interviewed initially at their first obstetrical visit. In total, 7668 proceeded to give birth to a live singleton baby, of which 64 then relinquished the baby for adoption. Relinquishing mothers were predominantly 18 years of age or younger, in the lowest family income group, single, having an unplanned and/or unwanted baby and reported that they were not living with a partner. These women were somewhat more likely to manifest symptoms of anxiety and depression both prior, and subsequent to, the adoption, but the majority of relinquishing mothers were of 'normal' mental health. The decision to relinquish a baby appears to be a consequence of an unwanted pregnancy experienced by an economically deprived single mother rather than the result of emotional or psychological/psychiatric considerations. These findings document a particular dimension of the impact of poverty on health.

Adolescent

The employment of mothers and the outcomes of their pregnancies: an Australian study.

One of the more dramatic structural changes in a number of western industrial societies has involved the increased participation of women in the paid labour force. Little is known about the health consequences of this change. This paper reports the findings of a prospective longitudinal study of 8,556 pregnant women who were interviewed on three occasions; early in their pregnancy, shortly after the birth of the baby and some six months later. Additional data were derived from the medical record of the delivery. The findings suggest that employed women and housewives differ in their health behaviour (e.g. number of missed appointments, attendance at antenatal classes, smoking) and emotional health in pregnancy, but that there are no significant differences between employed women and housewives in their physical health or pregnancy outcomes. Although none of the differences was statistically significant, virtually all of the indices of outcome were slightly more favourable for the housewives than for the employed women.

Adult

A prospective longitudinal study of social, psychological and obstetric factors in pregnancy: response rates and demographic characteristics of the 8556 respondents.

This paper introduces the Mater Misericordiae Mothers' Hospital-University of Queensland Study of Pregnancy, a prospective study of 8556 pregnant women interviewed at their first clinic visit, and subsequently interviewed some days after the birth of the baby and again 6 months later. Additional data were derived from the medical record of the pregnancy and delivery. The study was designed to assess the impact of social, psychological and obstetric factors on pregnancy outcome. We present here details of the study design, sampling, response rates and demographic characteristics of the sample.

Age Factors

Socio-economic status and pregnancy outcome. An Australian study.

A prospective cohort of 8556 pregnant women attending the Mater Misericordiae Mothers' Hospital in Brisbane was examined to consider the impact of socio-economic status on pregnancy outcome. The indicators of socio-economic status selected were family income, maternal education and paternal occupational status. Pregnancy outcomes considered were preterm delivery, low birthweight, low birthweight for gestational age, and perinatal death. Subsidiary analyses were also undertaken for Apgar scores, time to establish respiration, need for mechanical respiration and admission to intensive care. Before adjustment, the main consistent association was between the occupational status of the father and three measures of perinatal morbidity. Initial adjustment for the mother's socio-demographic background and weight/height ratio reduced the strength and statistical significance of the above associations, while further adjustment for lifestyle variations between the three status groups further reduced the above associations to marginal statistical significance. The findings suggest that observed class differences in pregnancy outcome are attributable to the mother's personal characteristics (height/weight, parity) and her lifestyle.

Body Weight

Unemployment and reproductive outcome. An Australian study.

The Mater-University of Queensland Study involves the follow-up of 8556 pregnant women who were enrolled at their first clinic visit. This analysis compares four groups of women categorized according to their own and their partners' employment status. Group 1 comprised women unemployed, partners not unemployed. Group 2 comprised women not unemployed with unemployed partners. Group 3 comprised women and partners who were both unemployed. In group 4 neither partner was unemployed. Initial analysis showed that there was a significant association between birthweight and birthweight for gestational age, and unemployment as reported by mothers. After adjustment for lifestyle variables (principally smoking) there were no remaining statistically significant associations.

Birth Weight

Patient age and success in a human IVF programme.

Previous studies suggest that at around 40 years of age, pregnancy rates achieved by IVF programmes fall and pregnancy loss rates increase. The actual age at which this occurs has not been clearly delineated. This study of 2,692 patients including 94 aged 41 or over shows that satisfactory pregnancy rates can be achieved up to and including age 40. As age 40 is approached the pregnancy loss rate increases to around 40%. In the 41 years and over group the pregnancy rate was poor at 6% (6/94) and the pregnancy loss rate very discouraging at 83% (5/6).

Adult

Kielland's forceps.

Explore the source record for details and available documents.

Attitude of Health Personnel

Spontaneous rupture of the spleen in late pregnancy.

Two cases of spontaneous rupture of the spleen are described. The first patient presented with fetal distress in the second stage of labour; the second with hypovolaemic shock. Both mothers and babies survived.

Adult

Sterilization: a comparative review.

Publications relating to surgical procedures for sterilization have been reviewed, and the incidences of complications and subsequent pregnancies compared. Laparoscopic sterilization has the lowest incidence of complication, the morbidity rate being lower than that of laparotomy sterilization or hysterectomy, and the mortality rate lower than that of a single pregnancy or taking oral contraceptives for 1 year.

Female

Perinatal death: audit and classification.

Two hundred and thirteen perinatal deaths occurred in a population of 10,539 deliveries over a 4-year period. The associated obstetric complications and circumstances were analysed. The majority of perinatal deaths occurred in fetuses in whom there was a serious malformation, or whose birth weight was less than 800 g. Of the 110 deaths which occurred in normal babies weighing 800 g or more, 54 were antepartum, 5 were intrapartum, and 51 were neonatal. The clinical features surrounding these deaths were classified, and their implications discussed.

Birth Weight

A comparison of obstetric morbidity and management between clinic and private patients.

The patterns of morbidity and management among clinic and private patients in a teaching hospital were compared by an audit of computerized case records. The clinic patients were more likely to have a poor obstetric history and antenatal complications, and the private patients were managed more actively. Perinatal mortality in the clinic patients was higher and was related to the higher frequency of low birth weight babies.

Adolescent

Outpatient laparoscopic sterilization.

A prospective survey is described of 200 consecutive patients who had outpatient laparoscopic sterilizations by coagulation and division of the Fallopian tubes. The procedures were acceptable to patients, free of morbidity or complications and made minimal demands on the existing hospital services.

Adult

The origin of amnitoic fluid lecithin.

Lecithin has been measured in amniotic fluid, pharyngeal aspirate, fetal and maternal plasma and fetal membranes from the same pregnancy. In the amniotic fluid from a term pregnancy 79 per cent of the lecithin is found in the reconstituted precipitate of centrifuged fluid. It is suggested that the lecithin of amniotic fluid may originate from sources other than fetal lung and that lecithin concentration is therefore a measure of overall fetal maturity.

Amniotic Fluid