[Disability as a result of respiratory tract disease].
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Biomedical subjects
Publications and source records attributed to J Jerković.
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During the 1970-1989 period, there were 23,915 deliveries of which 278 (1.16%) occurred in women 40 years of age or older. The latter included 62 (22.3%) primiparas, 158 (56.8%) pluriparas and 58 (20.9%) multiparas. The control group consisted of 14,400 women 20-34 years of age (50% primiparas and 50% pluriparas) from the same period. There was no antenatal visit in 9.4% of the women 40 years of age or older. This group included more housewives, more unmarried women and more women with previous spontaneous and induced abortions than the control group (P less than 0.05). Threatened abortion (16.2%), EPH gestosis (22.3%), impaired glucose tolerance (8.3%), gestational diabetes (7.2%), delivery before 37 weeks (11.5%), delivery after 42 weeks (3.6%), premature rupture of the membranes (18.3%), meconium-stained amniotic fluid (19.8%), elective caesarean section (11.5%), caesarean section delivery (16.5%), vacuum extraction (4.7%), placental lysis or uterine exploration (4.3%) were more frequent in the study than in the control group (P less than 0.05). There were more cases with episiotomy (P less than 0.001) in the control group, whereas there were no differences as regards cervical cerclage, weight gain above 14kg, breech presentation, transverse presentation and assisted breech delivery between the two groups (P greater than 0.05). There was no case of uterine rupture or maternal death either in the study or the control group. The authors conclude that a woman 40 years of age and older is in an advanced age for pregnancy and delivery.(ABSTRACT TRUNCATED AT 250 WORDS)
Pregnancy, delivery and the newborn infant of 212 old primiparas (aged greater than or equal to 35 years) and of 1968 age-matched old multiparas as controls were studied for the 1970-1989 period. The frequency of old primiparas and old multiparas was 0.9% and 4.1%, respectively, with no change for the 1970-1979 (1.0%) and 1980-1989 (0.8%) periods. The mean age in the old primiparous and old multiparous groups was 38.08 + 4.2 and 38.2 + 4.8 years, respectively (P greater than 0.05). The old primiparas had an average of 7.37 +/- 2.8 antenatal visits, whereas the old multiparas had 6.08 +/- 3.3 visits (P less than 0.05). The old primiparous group included more employees and fewer unskilled workers and housewives (P less than 0.05), more urban and unmarried pregnant women (P less than 0.001), whereas the old multiparas had more spontaneous and induced abortions (P less than 0.05). Threatened abortion (23.7%), EPH gestosis (20.3%), meconium-stained amniotic fluid (21.7%), caesarean section (35.8%), placental lysis or uterine exploration (6.6%) and episiotomy (100.0%) are more frequent in old primiparas than in old multiparas (P less than 0.05). The duration of labour in old primiparas tends to be longer: there was a significantly smaller number of pregnant women with an up 6-hour duration of labour (42.5%; P less than 0.05). The average duration of labour in the old primiparous and old multiparous groups was 8.18 +/- 5.40 and 5.89 +/- 3.80 hours, respectively (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
From 1971 to 1988, out of 22001 deliveries (multiple pregnancies excluded) 212 (0.96%) occurred in multiparas with five or more deliveries. The control group included 7340 pluriparas (two to four deliveries) from the same period. In 82.1% cases the multiparas were para 5 and 6, and 63 (29.7%) were less than 34 years of age. 15.9% had no antenatal visit; for the most part they were housewives and rural pregnant women. Transverse presentation, preterm delivery, meconium-stained amniotic fluid, and placental lysis or uterine exploration were more frequent in the multiparous group (P less than 0.001), whereas cervical cerclage and episiotomy were more frequent in the control group (P less than 0.05). Newborn infants in the multiparous group were severely asphyxiated at birth more frequently than those in the control group (P less than 0.05). There were no differences as regards late fetal and early neonatal deaths between the two study groups. The overall perinatal death rate in the multiparas and pluriparas was 2.83% and 1.81%, respectively (P less than 0.05). There was no case of uterine rupture or maternal death in the multiparous and pluriparous group.
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