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Biomedical subjects

J Fedrick

Publications and source records attributed to J Fedrick.

At least 19 recordsLinked to original sources

Intended place of delivery and perinatal outcome.

Data from the "1958 Perinatal Mortality Survey" have been analysed to assess differences in stillbirth and neonatal death rates according to the arrangements made for delivery. Only women aged 20-34 delivering at term, with no pregnancy abnormalities, were selected from three groups of women (normotensive primiparae, hypertensive primiparae, and normotensive women of parity 1, 2, or 3). Despite the fact that within each group the women booked for NHS consultant units were heavily weighted with adverse factors, the death rate of their infants was no more than 70% of that found among the women booked for either domiciliary, general practitioner unit, or private consultant delivery. Care and delivery in a NHS consultant unit carries least risk of death for the infant.

Adult↗

Factors associated with low birth weight of infants delivered at term.

The singleton births in the 1958 British Perinatal Mortality Survey (Butler and Bonhan, 1963; Butler and Alberman, 1969) were used to study the aetiology of low birth weight of infants delivered at term. After exclusion of macerated stillbirths and infants with lethal congenital defects, 468 infants of 259 days or more gestation and a birth weight which was less than 2500 g were identified. The mothers and their pregnancies were compared with those of the population of 16 994 singleton births. Delivery at term of a low birth weight infant was significantly associated with maternal prepregnant weight, maternal height, maternal smoking, primiparity, maternal employment, low social class, a previous infant of low birth weight, threatened abortion and severe toxaemia. No significant associations were found with illegitimacy, area of residence, previous spontaneous abortion, essential hypertension, mild toxaemia, chronic or acute infections or other conditions. There were significant negative associations with a history of previous large infants and with maternal blood group AB.

Adult↗

Obstetric practice and infant morbidity.

A method is described of using matched pairs of index infants and controls to examine the hypothesis that induction or some other obstetric practice is associated with increased morbidity in the mature infant. All infants over 2250 g and 37 weeks gestation, without severe congenital defect or history of severe maternal disorder, born in the John Radcliffe and admitted to the Special Care Baby Unit in 1975 were identified. For each of these index infants a matched control was chosen using strict criteria. Contrast between the 109 matched pairs showed no significant differences between maternal characteristics, induction of labour, use of forceps or duration of labour. There was an excess of index infants born to mothers who had had epidural anaesthesia (P less than 0.05).

Extraction, Obstetrical↗

Preceding pregnancy loss as an index of risk of stillbirth or neonatal death in the present pregnancy.

Details of 9,311 singleton births born to multiparae in the first week of March 1958 were compared with 3,707 singleton cases of stillbirth and neonatal death delivered in the 3-month period March-May, with respect to the outcome of the preceding delivery. It was shown that the risk of death was raised some 66% if the preceding delivery had been an abortion and by a factor of nearly 3 if the preceding delivery had itself been a stillbirth or neonatal death (SBND). The increased risk was especially pronounced for macerated stillbirths. Analysis because of death revealed very significant increases in the incidence of congenital defects, asphyxia and 'no major lesion' when the preceding delivery had been either an abortion or an SBND. It was shown that, in general, a woman who had had a preceding SBND was over 3 times more likely to delivery by 35 weeks than on whose preceding delivery had ended in either an abortion or a survivor.

Abortion, Spontaneous↗

Obstetric practice in the Oxford Record Linkage Study Area 1965-72.

The secular trends in induction in 111 818 births over eight years in the largely rural areas of Oxfordshire and west Berkshire were analysed. Although the induction rate started to rise only in 1969, the forceps and episiotomy rates had been increasing throughout, but both procedures were always twice as prevalent in induced as in non-induced cases. The proportion of women given an anaesthetic was also consistently higher in induced cases, but that of women with long labours fell considerably over the period. The reduction in stillbirth rate was more apparent in induced than in non-induced births.

Anesthesia↗

Anencephalus in the Oxford Record Linkage Study area.

The incidence of anencephalus in the largely rural areas of Oxfordshire and west Berkshire from 1965 to 1972 was ascertained from the files of the Oxford Record Linkage Study as 1-49 per 1000 total births. There was little variation within the area, but there was a marked increase in incidence over the eight years of the study. There was a slight seasonal variation, with an excess of conceptions in the first two quarters of the year, a slight excess of births to primiparous women and to women aged between 20 and 24 years. There was an increase in incidence with falling social class, with a significant excess of fathers who were printers, painters and decorators, transport drivers or in the armed forces. Among 115 siblings, 11 (9-6 per cent) had defects of the central nervous system, and the incidence of anencephalus among twins was twice as high as expected.

Abortion, Spontaneous↗

Factors associated with spontaneous pre-term birth.

Factors associated with spontaneous pre-term birth in 283 singleton pregnancies were compared with those present in a total population of 16 994 women at risk studied in the First British Perinatal Mortality Survey. It was shown that the risk of spontaneous pre-term birth was related to low maternal age, low maternal weight, maternal smoking, low social class, illegitimacy, threatened abortion, and a previous history of antepartum haemorrhage, perinatal loss, or low birth weight livebirths.

Birth Weight↗

Area differences in the incidence of neural tube defect and the rate of spontaneous abortion.

In an attempt to corroborate the finding of Roberts and Lloyd (1973) of increased incidence of previous abortions in women living in those areas of South Wales with relatively low incidences of malformations of the central nervous system, we examined the data of the 1958 British Perinatal Mortality Survey. We also found evidence that the history of preceding abortion among all mothers in this survey was slightly more prevalent in areas where the rates of stillbirth and neonatal death from anencephalus or spina bifida were low, but the order of magnitude was much less than in the Welsh study.

Abortion, Spontaneous↗

Anencephalus in Scotland 1961-72.

Data relating to the incidence of anencephalus for the 12-year period 1961-72 were abstracted from the Statistical Reviews of the Registrar General for Scotland. It was shown that considerable geographical variation is still apparent with the highlands having, in general, the lower incidences. In comparison with the earlier study of Edwards (1958), there were some changes: the incidence in the areas to the west had increased and that in those to the east decreased. During the 12-year period there was an overall decline in the incidence of the lesion; this was most marked in births to women under 20 years, and to those of social classes III, IV, and V. The decline was least apparent for births to women of high social class and the unmarried. It was shown that there was little seasonal variation in the time of delivery, but that even when the trend had been taken into account the yearly fluctuation was significantly different from that expected, with an excess of cases in 1961 and 1971.

Adult↗

Pyloric stenosis in the Oxford Record Linkage Study area.

The files of the Oxford Record Linkage Study were employed to identify 220 infants presenting with infantile hypertrophic pyloric stenosis (IHPS) in the 6-year period 1966 to 1971. Information on these infants was obtained from birth certificates and maternity notes. The overall incidence was 2.5 per 1000 livebirths. There was a distinct seasonal variation, with highest incidence to infants born in the third quarter of the year as well as variation in incidence with area: the cities had much lower rates of IHPS than the adjacent rural or small urban areas. It was shown that the rates in the south and east of the area studied were far greater than in the north and west. In the present study there was no excess of primiparae, the peak maternal age group was 20 to 24; there was a slight excess of parents of social classes I and II; and a significant association with mothers who were Rhesus negative. The rate of IHPS among sibs was 85 per 1000. Though there was the usual correlation with the male sex (M:F ratio = 5.5:1), there was no variation with birthweight and only among the females was an association found with prolonged gestation. There appeared to be an inverse relation between gestation and age on admission to hospital.

Adult↗