Biomedical subjects
P Rachootin
Publications and source records attributed to P Rachootin.
Effects of electronic fetal monitoring on rates of early neonatal death, low Apgar score, and cesarean section.
Using data from the University Hospital in Odense, Denmark, we have studied the effects of electronic fetal monitoring on rates of early neonatal death (death of liveborn within first week of life), low five-minute Apgar score (less than 7), and cesarean section. Approximately 22 000 births occurring in 1974 - 82 were studied, of which 13% were electronically monitored. Monitoring was significantly associated with an elevated cesarean rate in low-risk labors and certain high-risk labors, but appeared not to increase the cesarean rate in all high-risk labors. In high-risk labors, monitoring was associated with an approximate 40% reduction in rates of low Apgar score and early neonatal death, but neither reduction was statistically significant. The associations of monitoring with elevated cesarean rate declined significantly over the study period. These results accord closely with studies conducted in the United States, indicating that monitoring is of benefit in high-risk labors, but leads to excessive cesarean deliveries in low-risk labors. Our study additionally indicates that the effect of monitoring on the cesarean rate has been declining over time.
[Prognosis after treatment for sterility].
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Tobacco use, alcohol consumption and infertility.
An epidemiological study of the association between alcohol consumption, tobacco use and subfecundity is presented. Study subjects were recruited for a case-control study whose primary objective was to examine the association between occupational exposures and subfecundity. All 1069 women treated for infertility at Odense University Hospital during the period 1977-1980 were eligible for participation as cases. A control group was chosen consisting of 4305 women who had each delivered a healthy child with a gestational age over 258 days at the same hospital in the period 1977-1979. Data regarding occupational exposures and smoking and drinking habits were collected by mailed questionnaires. A response rate of 87% was obtained for both case and control groups. Use of tobacco and alcohol was significantly higher in cases compared to controls. A within-group comparison of alcohol consumption among controls with delayed conception of more than one year with controls who conceived their children within one year failed to demonstrate a statistical association. However, a statistically significant association was observed between smoking and delayed conception among controls. On the basis of this finding, along with further analyses, the authors suggest that the statistical association between smoking and subfecundity may be real and ought to be studied further. Moderate alcohol consumption does not seem to play a role in the development of subfecundity. The paper provides a systematic review of possible sources of bias in the study.
Organic solvents as possible risk factors of low birthweight.
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Alcohol use, conception time, and birth weight.
Predictors of birth weight and birth length were studied using sociodemographic data collected from 2259 women who resided in Funen County, Denmark, and delivered a healthy child during the period 1978-9 at Odense University Hospital. Low birth weight was significantly related to tobacco use in the year of delivery (p less than 0.01), alcohol use during the same period (p less than 0.05), and a delay in conception of over six months (p less than 0.01). Smoking history and a delay in conception were also significantly associated with short birth length (p less than 0.01 and p less than 0.01, respectively).
The end of the decline in twinning rates?
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The risk of infertility and delayed conception associated with exposures in the Danish workplace.
The association between infertility and a number of occupations and occupational exposures was examined in a case-control study utilizing data collected from medical records and mailed questionnaires. The results suggest that male exposure to heat and female exposure to noise, textile dyes and lead, mercury, and cadmium are associated with infertility. Further research is needed to examine the entire spectrum of abnormal reproductive and developmental outcomes of exposure to these agents and to identify their full effects.
[Occupational consequences of registered occupational disease].
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Prevalence and socioeconomic correlates of subfecundity and spontaneous abortion in Denmark.
This paper provides an estimate of the prevalence of subfecundity and spontaneous abortion in Denmark, and examines social factors associated with these problems of reproduction. The data of this study were collected by interviewing a stratified random sample of 1.4 women per thousand in Denmark between the ages 25 and 45. The interview generated detailed information on reproductive history and sociodemographic data for 709 women. The survey results indicate that reduced fecundity is a relatively common health problem. The proportion of women that either could not achieve a wanted conception or experienced a delay of one or more years before achieving conception was 0.16 in a first pregnancy and 0.17 in a second or subsequent pregnancy attempt. Four per cent of the women interviewed never produced a desired first child and an additional four per cent reported failure to produce a second or subsequent desired child. Social factors relating to subfecundity and spontaneous abortion were studied using logistic regression. No significant associations were found between the occurrence of subfecundity and family net income, employment status of the 'head of the household', area of residence, type of housing or age at time of interview. Women without a college education were more likely to exhibit primary subfecundity than college-educated women (p less than .05). The rate of spontaneous abortion was not found to be associated with socioeconomic class. A significantly higher rate of abortion was found among women with a history of subfecundity than among women with no such history.
Social selection in seeking medical care for reduced fecundity among women in Denmark.
This study is based on a representative sample of 709 Danish women aged between 25 and 45 who were interviewed in 1979. The purpose was to estimate the proportion of women with reduced fecundity who seek medical care and to identify sociodemographic variables associated with presentation to the medical care system. The study showed that the majority of women with reduced fecundity did not seek medical care. The propensity to seek care was not significantly associated with a woman's age or education, nor with family income or the employment status of the head of the household. Women living in rural areas or in homes with two or more rooms per family member had a greater tendency to seek medical care for secondary reduced fecundity compared with women living in cities or in more crowded homes. The implications of these findings for epidemiological studies of the association of reduced fecundity and occupation are discussed.
[Exogenous causes of infertility. A literature review].
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Secular changes in the twinning rate in Denmark 1931 to 1977.
The present study examines secular changes in the rate of twinning in Denmark during the period of 1931-77. Total twinning (i.e., mono- and dizygotic twinning combined) declined from a crude rate of 15.0 twin births per 100 deliveries in 1931 to 9.6 twin births per 100 deliveries at the end of the period. After direct adjustment for maternal age and parity (between the years 1935 and 1965), a 22% decline in total twinning rates was noted. Estimates of the rates of dizygotic twinning over the same period, again adjusted for maternal age and parity, show a decline of 20%. Thus there is evidence of a real decline in twinning, independent of the effects of changing patterns of maternal age and parity. These findings are consistent with reports of a general decline in twinning rates from a number of other countries. The interpretation of such secular changes is a matter for speculation.