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Biomedical subjects

M E Wegman

Publications and source records attributed to M E Wegman.

At least 19 recordsLinked to original sources
PubMed1996

Infant mortality: some international comparisons.

Comparison of infant mortality rates (IMRs) among the world's countries requires assessment of completeness and accuracy of data. The United Nations Statistical Office classifies as "C", complete, meaning at least 90% of events are actually recorded, 1994 data supplied by 80 governments, comprising one fourth of the world's population, ie, 1,450,000,000 people, and as incomplete the other three fourths, 4,180,000,000. All the "C" countries officially accept the World Health Organization definition of a live birth (any product of gestation showing any sign of life), but it has been argued that some countries routinely report as stillbirths infants counted as live births in the United States (US), thus understating their IMRs. In 1994, 22 countries had IMRs varying from 4.2 for Japan to 8.0 for the US, a remarkable achievement in the light of IMRs of 124.0 and 60.0 for these two countries in 1930. Compensating for possible underreporting of live births by excluding all deaths in the first hour of life would reduce the US IMR to about 7, still higher than 17 other countries. Between 1930 and 1994 the IMR in the US declined more slowly than several other countries, particularly during the time period 1951 through 1965, when the US rate declined by 16% and the Japanese rate, for instance, declined by 68%. Between 1983 and 1994, decline in Puerto Rico was slower than in Chile, Cuba, and the US. IMRs in all the "C" countries are lower than the US rate was in 1930. IMRs in most of the world, estimated from surveys and special studies, vary from 27 to 190. Correlation studies suggest that a high rate of teenage pregnancies has relatively little effect on IMRs but that high total fertility rates are accompanied by high infant mortality.

Adolescent↗
PubMed1994

Annual summary of vital statistics--1993.

A new low in the infant mortality rate was reached again in 1993, at 828.8 deaths per 100,000 live births, a decline of 2% from 848.7 in 1992. Births, marriages, and divorces were all lower, both in number and rate. Deaths and the death rate, however, both increased and, more significantly, the age-adjusted death rate increased. A likely explanation is the occurrence of influenza epidemics in early and late 1993. The rate of natural increase declined 8%, to a level of 6.9 per 1000 population. Final figures on births for 1992 indicate that, for the first time in many years, birth rates to teen-agers declined more among black mothers than white. Increase in birth rate among older mothers continued at a somewhat slower rate than recently; older mothers tended to be better educated than the general population in their age groups. Total fertility rates were higher among mothers of Hispanic origin than among non-Hispanic blacks who, in turn, had higher rates than non-Hispanic whites. Among Hispanics the highest rates were in those of Mexican origin. Unlike recent years, birth rates to unmarried mothers did not increase in 1992. Prenatal care coverage improved, with more mothers seeking care early and fewer receiving late or no care. Electronic and fetal monitoring was performed on more than three-quarters of all births and ultrasound on more than half. Life expectancy decreased slightly, in contrast to recent years. Among major causes of death, increases were recorded in 1993 for chronic obstructive pulmonary diseases, pneumonia and influenza, and HIV infection, the latter having the largest percentage increase. Internationally, infant mortality rates in most other industrialized countries declined further in 1992. Comparatively, as in 1991, 21 other countries had infant mortality rates lower than the United States.

Cause of Death↗
PubMed1993

Annual summary of vital statistics--1992.

A new low in the infant mortality rate was reached in 1992, at 848.7 deaths per 100,000 live births, a decline of 5% from 894.4 in 1991. Birth, death, and marriage rates were also lower, but the divorce rate inched up to 4.8 per 1000 population, the same level as in 1988. The age-adjusted death rate was 504.9 per 100,000 population, the lowest in US history. Natural increase in the population, excess of births over deaths, decreased from 1,941,389 to 1,907,000, from 7.7 to 7.5 per 1000 population. Births outside hospital were fewer, both in numbers and in proportion to all births. Birth rates increased at both ends of the age range but declined in the principal childbearing years. Births to unmarried mothers increased again, comprising more than one fifth of white births and two thirds of black births. A higher proportion of newborns weighed less than 2500 g than in 1989. Life expectancy at birth increased again, to 75.7 years overall, paralleled in both sexes and white and black races. The age-adjusted death rate for cardiovascular diseases declined, but malignancies of the respiratory system increased again, to almost six times what it was in 1940. Chronic obstructive pulmonary diseases, despite slight improvement since 1991, caused death more than eight times as often as in 1940. Black and white infant mortality rates both showed a decline, greater in the white neonatal component; the black/white discrepancy widened slightly. Infant mortality in those of Hispanic origin was slightly higher than non-Hispanic whites, but the National Center for Health Statistics warns that Hispanic rates may be understated. There was little change in causes of infant mortality, or in black to white ratios for the several causes. On the world scene, most industrialized countries showed declines in infant mortality matching the US. In 1991, 21 countries, 15 in Europe, 3 in Asia, 2 in Oceania, and 1 in North America, had infant mortality rates less than the US. The decline in most other countries has been more rapid than in the US.

Birth Weight↗
PubMed1992

Annual summary of vital statistics--1991.

Between 1990 and 1991, provisional data show that the infant mortality rate decreased again, from 9.1 to 8.9, a decline of 2% in contrast to the 7% decline from 1989 to 1990. Birth, death, and marriage rates were also lower, but the divorce rate stayed at about the same level as in 1990. Natural increase in the population, excess of births over deaths, was less than 2 million, 4% less than the increase in 1990. Detailed analysis of changes and of the influence of factors like age and race requires final data; at the time of preparation of this report final birth and death data were available only through 1989. For a variety of reasons, including staff shortages and delays in receipt of state data by the National Center for Health Statistics (NCHS), final data for 1990, which would usually have been available in late August 1992, are not expected before early 1993. Unlike recent years, the decline in the infant mortality rate was only in the neonatal component, which decreased 3.6%. Postneonatal mortality increased, for the first time in many years, by 1.6%, suggesting that the decline in the total is related more to therapeutic advances in neonatology than to improved prevention. Internationally, newly independent Latvia was added to the list of countries with rates less than 15, but Costa Rica was deleted. With the reunification of Germany the list shrank to 28 and, by default, the United States moved up from 21st to 20th. Some 12.5 million births, less than 9% of the world total, took place in countries with under-5 mortality rates of less than 20 per 1000. At the other end of the scale, 42% of the world's births occurred in countries with under-5 mortality rates of more than 140 per 1000. The median under-5 mortality rate for those countries in 1990 was 189 per 1000, meaning that almost 20% of the infants born alive in these countries died before their fifth birthday.

Birth Rate↗
PubMed1991

Age influence on mononuclear phagocyte system Fc-receptor function in poststreptococcal nephritis.

The Fc-receptor function of the mononuclear phagocyte system (MPS) was examined in 41 children and adult patients, by measuring the clearance of IgG-sensitized, 51Cr-labeled erythrocytes. The Fc-receptor-mediated clearance observed in patients (mean +/- SE) was not significantly different as compared to the control group of similar age distribution. However, the immune clearance time was significantly age-correlated in both groups (acute poststreptococcal glomerulonephritis, APSGN, r = 0.39, p less than 0.05; control r = 0.63, p less than 0.01). The magnitude of the Fc-specific immune clearance and the serum creatinine were also significantly correlated (r = 0.59; p less than 0.01). Circulating immune complexes (as measured by the C1q and conglutinin ELISA) did not correlate with immune clearance, which remained stable in longitudinal studies. Age-related changes in MPS Fc-receptor function could explain, at least in part, prognostic differences between children and adult patients with APSGN.

Adolescent↗
PubMed1991

Annual summary of vital statistics--1990.

Infant mortality declined more rapidly between 1989 and 1990 than in any year since 1977; the provisional 1990 rate, 9.1 per 1000 live births, was the lowest ever recorded. Absence of final 1989 data prevents updating sex and race differences, but in 1988 data the rate for black persons was more than twice for white. Most of the decline in 1990 was in the neonatal period with a substantial drop in perinatal categories involving respiration. Surfactant therapy earned deserved kudos for much of the decrease, but more attention is needed to the more cost-effective potential of preventive measures. Births increased in number and rate; there were more women in the childbearing years and they had higher fertility rates. Marriages and divorces both increased slightly. Deaths increased but the death rate decreased; the estimated age-adjusted death rate was the lowest ever. Excess of births over deaths added more than 2 million persons to the US population. Worldwide, 22 countries with more than 2,500,000 population had 1989 infant mortality rates less than 10, led by Japan at 4.4; the US, at 9.7, was 21st on the list. An additional 7 countries had rates less than 15 per 1000 live births.

Adolescent↗
PubMed1990

Annual summary of vital statistics--1989.

US infant mortality continued to decline slowly and the provisional 1989 rate, 9.7 per 1000 live births, was the lowest ever recorded. Final 1988 data showed no change in cause of death distribution or in the wide discrepancy between white and black infant mortality. State rates varied from 6.8 in Vermont to 12.6 in Georgia. Worldwide, the US rate of 10.0 was bettered by 21 other countries, with Japan lowest at 4.8. Births increased in number and rate, because of a higher fertility rate and more women in the childbearing years. The birth rate to mothers 17 years of age and younger increased again. The proportion of women who had no or inadequate prenatal care was essentially unchanged. Deaths, crude death rate, and age-adjusted death rate decreased. The excess of births over deaths added almost 1.9 million persons to the US population, the highest rate of natural increase since 1971. The marriage rate was essentially unchanged, whereas the divorce rate decreased slightly, to the lowest level since 1973. With the exception of human immunodeficiency virus infection, homicide, and pulmonary malignancies, rates for most causes of death declined from 1988 to 1989. In comparison with 1940, most declines were substantial, led by pneumonia, down about 80%, and perinatal conditions, down about 75%. The only large-scale increases among major causes in the half century were in two diseases related to cigarette smoking: chronic obstructive pulmonary disease, up eightfold, and respiratory cancer, up almost sixfold. Death rates from all other cancers, as a group, decreased by some 20% and from cardiovascular diseases by some 60%.

Adolescent↗
PubMed1988

Annual summary of vital statistics--1987.

Data for this article, as in previous reports, are drawn principally from Monthly Vital Statistics Report, published in the National Center for Health Statistics (NCHS). The international data come from the annual Demographic Yearbook and the quarterly Population and Vital Statistics Report, both published by the Statistical Office of the United Nations, which has also been kind enough to provide directly more recent data reported by various countries. US data for 1987 are estimates by place of occurrence, based upon a count of all certificates received in state offices between two dates, one month apart, regardless of when the event occurred. Mortality data by cause and age, however, come from the Current Mortality Sample, a systematic 10% of those certificates, and thus may not correspond to the actual month of death. For the US as a whole the estimates, with few exceptions, are close to the subsequent final figures. There are considerable variations in some states, however, particularly in comparing provisional figures by place of occurrence and final data by place of residence. State information should be interpreted cautiously. Careful attention should be paid to differing denominators when studying rates presented in this article. For overall rates, like the birth rate or death rate, the standard denominator is 1,000 total population. In instances in which more refined analysis is possible, other denominators are used, such as 100,000; the character of the population is specified. The particular denominator is indicated in the table or in the context.

Birth Rate↗
PubMed1987

Annual summary of vital statistics--1986.

Data from this article, as in previous reports, are drawn principally from Monthly Vital Statistics Report, published by the National Center for Health Statistics (NCHS). The international data come from the Demographic Yearbook and the quarterly Population and Vital Statistics Report, both published by the Statistical Office of the United Nations, which has also been kind enough to provide directly more recent data. Except for mortality data by cause and age, which are based on a 10% sample, all the US data for 1986 are estimates by place of occurrence, based upon a count of certificates received in state offices between two dates, 1 month apart, regardless of when the event occurred. Experience has shown that for the country as a whole the estimates, with few exceptions, are close to the subsequent final figures. There are considerable variations in some states, however, particularly in comparing provisional figures by place of occurrence and final data by place of residence. State information should be interpreted cautiously. Careful attention should be paid to the denominator when studying rates presented in this article. For overall rates, like the birth rate or death rate, the standard denominator is 1,000 total population. In instances where more refined analysis is possible, the denominator may be 100,000 and the character of the population specified. The particular denominator is indicated in the table or in the context.

Birth Rate↗