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Biomedical subjects

L T Strauss

Publications and source records attributed to L T Strauss.

At least 19 recordsLinked to original sources
PubMed1989

Overview of the National Infant Mortality Surveillance (NIMS) project.

A slowdown in the decline of infant mortality in the United States and a continuing high risk of death among black infants (twice that of white infants) prompted a consortium of Public Health Service agencies, in collaboration with all states, to develop a national data base of linked birth and infant death certificates for the 1980 birth cohort. This project, referred to as National Infant Mortality Surveillance (NIMS), provides neonatal, postneonatal, and infant mortality risks for blacks, whites, and all races in 12 categories of birthweights. Tabulations were requested for infants born in single and multiple deliveries. For single-delivery births, tabulations included birthweight, age at death, race of infant, and each of these characteristics: infant's live-birth order, sex, gestation, type of delivery, and cause of death; and mother's age, education, prenatal care history, and number of prior fetal losses at greater than or equal to 20 weeks' gestation. An estimated 95% of eligible infant deaths were included in the NIMS tabulations. Analyses have focused on various components of infant mortality, including birthweight distribution of live births, neonatal mortality, and postneonatal mortality. The most important predictor for infant survival is birthweight; survival increases exponentially as birthweight increases to its optimal level. The nearly twofold higher risk of infant mortality among blacks than among whites was related to a higher prevalence of low birthweights, to higher mortality risks in the neonatal period for infants with birthweights of greater than or equal to 3,000 g, and to higher mortality during the postneonatal period for all infants, regardless of birthweight. Moreover, the black-white gap persisted for infants with birthweight of greater than or equal to 2,500 g, regardless of other infant or maternal risk factors.

Birth Weight↗
PubMed1988

Birthweight-specific infant mortality for native Americans compared with whites, six states, 1980.

We used data from the National Infant Mortality Surveillance (NIMS) project to compare birthweights and birthweight-specific mortality risks among Native American and White infants. Because race categories in NIMS were limited to White, Black, and all, we studied six states in which greater than 85 per cent of newborns who were neither White nor Black were Native American. In these states, the infant mortality risk (IMR) among Native Americans was 15.3 deaths per 1,000 live births compared with 8.7 deaths among Whites, relative risk (RR) = 1.8 (95% CI = 1.5-2.0). The percentage of Native American infants with less than 2,500 g birthweights was 5.8 per cent versus 5.0 per cent for White infants. Birthweight-specific neonatal mortality risks were similar for the two race groups, but birthweight-specific postneonatal mortality risks (PNMRs) were more than three times as high among Native Americans compared with Whites for infants of greater than or equal to 2,500 g birthweight. PNMRs were elevated for most causes of death and for all categories for maternal age, educational attainment, trimester prenatal care began, and number of previous live births. Leading causes of postneonatal death among Native Americans of greater than or equal to 2,500 g birthweight were sudden infant death syndrome and infections.

Birth Weight↗
PubMed1988

Older maternal age and infant mortality in the United States.

We used data from the National Infant Mortality Surveillance project to examine the effect of older maternal age on infant mortality for the 1980 United States birth cohort. The 1,579,854 births and 14,591 deaths of singletons who were black or white and whose mothers were 25-49 years of age were included. Direct standardization was used to calculate birth-weight-adjusted relative risks of neonatal and postneonatal mortality, using the birth weights of infants with maternal age 25-29 as the standard. We found that the risk of infant mortality was nearly equal for infants born to mothers 25-29 and 30-34 years of age; infants born to mothers 35-39 years of age were at a slightly elevated (18% higher) risk, and those born to mothers 40-49 years of age were at a much more elevated (69% higher) risk. Among whites, the higher neonatal mortality associated with a maternal age of 35-39 was mostly due to an increased prevalence of low birth weight; among blacks, it was due to higher birth-weight-specific risks. Neither white nor black postneonatal mortality risks were much elevated until a maternal age of 40-49, and this last elevation was mostly due to higher birth-weight-specific risks. These findings suggest that infertility and fetal mortality aside, and considering only the effect on infant mortality, it is relatively safe for women to postpone childbearing into their middle, and perhaps late, thirties.

Adult↗
PubMed1987

Pregnancy and birth rates among sexually experienced US teenagers--1974, 1980, and 1983.

We examined pregnancy rates and birth rates among United States teenagers aged 15 to 19 years in 1974, 1980, and 1983. Pregnancy rate refers to live births plus induced abortions per 1000 women; birth rate refers to live births per 1000 women. We present these rates for all teens aged 15 to 19 years and for teens aged 15 to 19 years who were sexually experienced. Data sources included National Center for Health Statistics birth records, Centers for Disease Control abortion surveillance reports, and Bureau of the Census population estimates. Sexual experience estimates came from national surveys of adolescent sexual behavior. Between 1974 and 1980, the pregnancy rate among all teens increased; the pregnancy rate among sexually experienced teens declined. From 1980 to 1983, the pregnancy rate declined among all teens and among sexually experienced teens. Birth rates among US teenagers (all teens and sexually experienced teens) declined between 1974 and 1983. Whereas the decline in the birth rate from 1974 to 1980 was primarily due to increased use of abortion, the decline from 1980 to 1983 related to the decrease in teenage pregnancies.

Abortion, Induced↗
PubMed1984

Previous experience of induced abortion as a risk factor for fetal death and preterm delivery.

As part of a community-based study in Korea to evaluate the effects of previous induced abortion on length of gestation and pregnancy outcome of subsequent pregnancies, we analyzed data obtained from January 1979 to December 1981 on pregnancies reported to family health workers in Kang Hwa Island, Korea. The preterm, live-birth rates were not significantly associated with previous induced abortion. Overall, the life table-estimated fetal death rate for women enrolled at the eighth or earlier weeks of gestation was 13.7%, 10.2% for women with no previous induced abortion and 28.9% for women with previous induced abortion. The relative risk for fetal death for women who had undergone a previous abortion was 2.8; relative risk for parous women compared to nulliparous women was 3.4. After controlling for parity, previous induced abortion was not a significant variable for fetal death rate.

Abortion, Induced↗
PubMed1984

Sterilization-associated deaths: a global survey.

Except for data from several geographically limited studies, little is known globally about the number and causes of death associated with surgical sterilization. To identify clinical characteristics and problems leading to deaths related to the procedures, the International Planned Parenthood Federation ( IPPF ) and the Centers for Disease Control (CDC) in the United States collaborated in a global mail survey of 4642 physicians. Usable responses were received from 1298 physicians (28%) in 80 countries. Fifty-five sterilization-associated deaths which occurred from January 1, 1980 to June 30, 1982 were reported. The most frequently reported causes of death were infection, anesthetic complications, and hemorrhage. There were some regional differences in the relative frequencies of these causes. Most cases did not involve surgical accident. The characteristics most frequently associated with the reported fatal procedures were: interval sterilizations, minilaparotomy incision, tubal ligation and general anesthesia. Most deaths were attributable to the surgical sterilization procedure.

Adolescent↗
PubMed1983

Agreement between women's histories of oral contraceptive use and physician records.

The histories of oral contraceptive (OC) use provided by women participating in a study of hepatocellular adenoma (HCA) were compared with records obtained from their physicians. In the HCA study two memory aids were used to assist women in their recall: a calendar of significant events during a woman's lifetime to which she might relate her use of OCs and a book of colour photographs of the 90 OC preparations available up to the time of the study. Using the number of months of a woman's history which could be checked against physician records (mean for all women of 33 months) as the denominator, the highest proportion of concordance was for month-specific duration of OC use (90%) with lower agreement for duration and brand (62%) and duration, brand, and dose (54%). Agreement was better for cases than for controls.

Adult↗
PubMed1983

A comparison of primary and secondary homicides in the United States.

In 1979, over 20,000 people in the United States were victims of homicide, but public health agencies have not yet defined their role in its prevention. Role definition might begin with differentiating various forms of homicide, so the authors used data on all homicides reported by law enforcement agencies for 1976-1979 to determine whether homicides that did not occur during the perpetration of another crime (primary homicides) differ from those that occurred during the perpetration of another crime (secondary homicides). Primary and secondary homicide rates were highest in the South and West, respectively. The relative risk for Standard Metropolitan Statistical Areas (SMSAs) compared with non-SMSAs was 2.4 for secondary homicide but only 1.3 for primary homicide. It was found that 17% of primary homicides and 3% of secondary homicides had a female offender. Primary homicides were more frequently intersexual and intraracial than were secondary homicides. Victim and offender ages were similar to one another in primary homicides and dissimilar in secondary ones. Over 75% of primary homicides involved family members or acquaintances, compared to only 24% of secondary homicides. The authors conclude that primary and secondary homicides are epidemiologically dissimilar, and they suggest that public health concern should focus on primary homicide. Prevention and intervention measures should concentrate on discussed target populations. Techniques might include stress reduction and conflict avoidance.

Adolescent↗
PubMed1983

Complications of interval laparoscopic tubal sterilization.

In 1978, the Centers for Disease Control initiated a multicenter prospective study to assess the safety of the various female sterilizing operations and the ways in which they could be made safer. During the first 31 months, 3500 women who underwent interval laparoscopic tubal sterilization by electrocoagulation or Silastic banding without other concurrent operations were enrolled in the study. When a standard definition of complications was used, the overall rate of an intraoperative or postoperative complication was 1.7 per 100 women. Several patients factors increased the risk of complications twofold or more: diabetes mellitus, previous abdominal or pelvic surgery, lung disease, a history of pelvic inflammatory disease, and obesity. There was a fivefold difference in complication rates between procedures performed under general anesthesia and those done under local anesthesia.

Adolescent↗
PubMed1981

Oral contraceptive during lactation: a global survey of physician practice.

The use of combined estrogen-progestogen oral contraceptives (EP-OC) by lactating women has been associated with suppression of lactation. To determine the extent to which physicians prescribe combined EP-OC for lactating women, the International Planned Parenthood Federation (IPPF) and the United States Centers for Disease Control (CDC) collaborated in a global mail survey of 3697 physicians affiliated with Family Planning Associations (FPA) in 72 countries. Usable responses were received from 831 physicians (22%) in 65 countries. The percent of clinicians who provide EP-OC to lactating women was higher in developing regions (63% or more) than in developed regions (40% or less). Patient preference was rated important more often than any other factor in the decision to prescribe EP-OC for lactating women. The percentage of clinicians who reported complaints of decreased milk production from women using EP-OC was higher (32% or more) in developing regions where breast milk is often essential to infant nutrition.

Contraception↗
PubMed1979

Epidemiology of hepatocellular adenoma. The role of oral contraceptive use.

A case-control study of hepatocellular adenoma (HCA), a serious though nonmalignant liver tumor, was conducted by the Center for Disease Control and the Armed Forces Institute of Pathology (AFIP). Interviews with 79 women with HCA and with 220 age- and neighborhood-matched controls were completed. Limited information was obtained on nine additional patients who had died. Women with HCA and hemorrhage have a greater risk of morbidity and death than those with other symptoms. Increasing duration of OC use increases the risk of HCA. Use of OCs with high hormonal potency and age over 30 years may further increase a woman's risk of HCA. Long-term users of OCs have an estimated annual incidence of HCA of 3 to 4 per 100,000.

Adolescent↗
PubMed1979

Fertility in psychiatric outpatients.

The fertility rates of 223 female schizophrenic outpatients and 479 female nonschizophrenic outpatients were compared to a probability sample of 300 women residing in the same geographic area, metropolitan Atlanta, and from the same social strata as the patients. Age- and race-adjusted comparisons showed that the mean number of children per woman and levels of unwanted and unplanned fertility did not differ in the different diagnostic groups. Furthermore, the rates were not lower for the psychiatric patients than for the general population. In order to reduce an important source of psychiatric morbidity, those in the mental health professions need to pay more attention to the family planning desires of their patients.

Adult↗
PubMed1977

The association between oral contraception and hepatocellular adenoma--a preliminary report.

Women with long-term use of oral contraception (OC) are at increased risk of developing a serious, though nonmalignant, liver tumor--hepatocellular ademona (HCA)--according to a case-control study conducted by the Center for Disease Control (CDC) in collaboration with the Armed Forces Institute of Pathology (AFIP). The tumor is sometimes fatal, deaths usually being due to sudden rupture and hemorrhage. This study suggests that, in addition to long-term OC use, a women's age and the hormonal potency of the OC she uses affect her changes of developing HCA. Women 27 years old and older who have used OC with high hormonal potency for 7 or more years are at the greatest risk.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Overview of the National Infant Mortality Surveillance (NIMS) project--design, methods, results.

The recent slowdown in the decline of infant mortality in the United States and the continued high risk of death among black infants (twice that of white infants) prompted a consortium of Public Health Service agencies to collaborate with all States in the development of a national data base from linked birth and infant death certificates. This National Infant Mortality Surveillance (NIMS) project for the 1980 U.S. birth cohort provides neonatal, postneonatal, and infant mortality risks for blacks, whites, and all races in 12 categories of birth weights. (Note: Neonatal mortality risk = number of deaths to infants less than 28 days of life per 1,000 live births; postneonatal mortality risk = number of deaths to infants 28 days to less than 1 year of life per 1,000 neonatal survivors; and infant mortality risk = number of deaths to infants less than 1 year of life per 1,000 live births.) Separate tabulations were requested for infants born in single and multiple deliveries. For single-delivery births, tabulations included birth weight, age at death, race of infant, and each of these characteristics: infant's live-birth order, sex, gestation, type of delivery, and cause of death; and mother's age, education, prenatal care history, and number of prior fetal losses at 20 weeks' or more gestation. An estimated 95 percent of eligible deaths were included in the NIMS tabulations. The analyses focus on three components of infant mortality: birth weight distribution of live births, neonatal mortality, and postneonatal mortality. The most important predictor for infant survival was birth weight, with an exponential improvement in survival by increasing birth weight to its optimum level. The nearly twofold higher risk of infant mortality among blacks was related to a higher prevalence of low birth weights and to higher mortality risks in the neonatal period for infants weighing 3,000 grams or more, and in the postneonatal period for all infants, regardless of birth weight. Regardless of other infant or maternal risk factors, the black-white gap persisted for infants weighing 2,500 grams or more.

Birth Certificates↗
PubMedDate not supplied

Regional differences in birth weight-specific infant mortality, United States, 1980.

To describe regional differences in birth weight-specific infant mortality in the United States, we used data from the National Infant Mortality Surveillance project. The infant mortality risk (IMR) for the nation was 11.0 deaths per 1,000 live births. The risk (with 95 percent confidence intervals [CI]) for the four U.S. Census regions were West 9.9 (9.7 to 10.1), Northeast 10.4 (10.1 to 10.6), North Central 10.8 (10.6 to 11.0), and South 12.1 (11.9 to 12.3). In all regions, the IMR for blacks was approximately twice that of whites. Seventy-two percent of the higher IMR in the South was due to a higher proportion of black births compared with the remainder of the nation, reflecting the higher mortality rates suffered by black infants, and 28 percent to higher mortality among southern whites. The IMR for whites in the South was significantly higher than in the remainder of the nation: 9.8 versus 9.1 (relative risk = 1.09, CI = 1.06 to 1.11). Thirty-six percent of this excess in IMR was due to a higher frequency of low birth weight (less than 2,500 grams), 18 percent was due to higher IMR in infants with birth weight less than 2,500 grams, and 46 percent due to higher IMR in infants with birth weights of 2,500 g or more. Black infants born in the West had a lower risk of death than black infants in the other regions. When compared with the Northeast and South, 36 percent of the lower risk in the West among black infants was due to a lower frequency of low birth weight, 38 percent due to lower IMR in infants w'ith birth weight less than 2,500 g, and 26 percent to lower IMR in infants with birth weight of 2,500 g or more.

Birth Weight↗
PubMedDate not supplied

Variation in state-specific infant mortality risks.

Data from the National Infant Mortality Surveillance project were used to examine the State-specific variations in infant, neonatal, and postneonatal mortality and to examine some of the factors affecting the risks of death. The infant mortality risk, defined as the risk of death before 1 year of age to an infant born in the 1980 birth cohort, in the highest risk State was nearly three times that in the lowest risk State. Mortality risk ratios of two or greater were found when comparing high and low States for overall black infant mortality risks, overall neonatal mortality, neonatal mortality risks for black and white infants examined separately, neonatal mortality risks for low birth weight infants regardless of race, and overall postneonatal mortality and postneonatal mortality for white infants. The lowest State-specific black mortality risks were higher than the highest white risks for overall infant mortality and neonatal mortality. The differences between State extremes in mortality risks are greater than the differences between the United States and the Scandinavian countries with the lowest infant mortality.

Female↗