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S M Taffel

Publications and source records attributed to S M Taffel.

36 records · Page 2Linked to original sources
PubMed1987

Trends in the United States cesarean section rate and reasons for the 1980-85 rise.

The rate of cesarean section delivery in the United States rose from 4.5 per 100 deliveries in 1965 to 22.7 in 1985, and in 1985 an estimated 851,000 live births were cesarean deliveries, according to data from the National Hospital Discharge Survey. This increase has been observed for all ages, and within all regions of the country. The rate for teenagers and mothers aged 20 to 29 was five to six times as high in 1985 as in 1965, and four times as high for mothers aged 30 years and older. Repeat cesareans account for an increasing share of all cesarean deliveries; in 1985 one in three cesareans were repeats. The increase in the cesarean rate of 6.2 percentage points between 1980 and 1985 (from 16.5 to 22.7) was partitioned according to five complications of delivery recorded on hospital discharge records: previous cesarean delivery, breech presentation, dystocia, fetal distress, and all other complications. Nearly half (48 per cent) of the increase was associated with previous cesarean delivery, 29 per cent with dystocia, 16 per cent with fetal distress, 5 per cent with breech presentation, and 2 per cent with all other complications.

Adolescent↗
PubMed1986

Advice about weight gain during pregnancy and actual weight gain.

In the 1980 National Natality Survey, married mothers were asked whether their doctors had suggested a weight gain limit during pregnancy and, if so, what limit was suggested. Current obstetric recommendations call for 22-27 pound weight gain. Previous research indicates that gaining less than 16 pounds greatly increases the likelihood of a poor pregnancy outcome. Reported advice varied by mother's race, education, parity, and prepregnancy weight. Mothers given no advice or advised to gain less than 22 pounds were far more likely than others to have an inadequate gain. The findings suggest that many more women should be told that it is appropriate to gain at least 22 pounds.

Adult↗
PubMed1983

Complications in cesarean and non-cesarean deliveries: United States, 1980.

Using 1980 National Hospital Discharge Survey data, complications reported for cesarean and non-cesarean deliveries coded by the Ninth Revision ICD-CM are compared. While over 16 per cent of all deliveries in 1980 were by C-section, 94 per cent of the deliveries where maternal-infant disproportion was noted were by C-section, and this complication was noted in one-fourth of all C-section deliveries. Similarly, where malposition or malpresentation of the fetus was evident, 59 per cent of the mothers were delivered by C-section, and this complication was noted in one-sixth of all C-section deliveries. C-sections were also associated with placenta praevia, pre-eclampsia, infections of the genito-urinary tract, anemia, multiple births, and were almost universal for mothers who had had a previous C-section delivery. Competing explanations for the rise in C-sections from 5.5 per cent of deliveries in 1970 to 16.5 per cent in 1980 are discussed in the context of these findings.

Cesarean Section↗
PubMed1981

Postpartum sterilization in cesarean section and non-cesarean section deliveries: United States, 1970-75.

National Hospital Discharge Survey data indicate that the overall postpartum sterilization rate per 100 deliveries increased by 75 per cent from 4.0 in 1970 to 7.0 in 1975; by type of delivery, rates rose from 18.0 per 100 cesarean section deliveries and 3.2 for all other deliveries in 1970 to 19.0 and 5.6 respectively in 1975. The South had the highest postpartum sterilization rates overall. Deliveries to older mothers and cesarean section deliveries in hospitals with less than 100 beds were more often characterized by higher sterilization rates.

Adult↗
PubMedDate not supplied

Childbearing characteristics of U.S.- and foreign-born Hispanic mothers.

This study compares maternal and infant health and sociodemographic characteristics of U.S.-born and foreign- or Puerto Rican-born Hispanic mothers and their babies, using data from the national vital statistics system and the 1980 National Natality Survey. While nearly half of all Hispanic mothers and Mexican and Puerto Rican mothers were born in the United States, less than 10 percent of Cuban and other Hispanic mothers were U.S. born. Compared with foreign- or Puerto Rican-born Hispanic mothers, U.S.-born mothers tended to be younger, to have had fewer high-order births, to be less likely to receive delayed or no prenatal care, to have higher educational attainment, and to be more likely to be unmarried. The incidence of low birth weight among infants born to Hispanic mothers, particularly Mexican and Cuban women, was relatively low. When the proportions of low birth weight were examined by nativity status, infants born to foreign- or Puerto Rican-born women were consistently less likely to be of low birth weight. In an effort to account for these findings, the mother's smoking status before and during pregnancy is examined. Compared with non-Hispanic mothers, Hispanic mothers were much less likely to have smoked before or during pregnancy. These data are examined to see if they account for the better outcome as measured by birth weight for Hispanic births, especially those to foreign- or Puerto Rican-born women.

Adult↗
PubMedDate not supplied

Electronic fetal monitoring in relation to cesarean section delivery, for live births and stillbirths in the U.S., 1980.

In the 1980 National Natality and Fetal Mortality Surveys, information about fetal monitoring and type of delivery was obtained from hospitals for a sample of 9,941 live births and 6,386 fetal deaths of 28 weeks' gestation or more. Data in this analysis are weighted to provide national estimates of live births and late fetal deaths that occurred in U.S. hospitals during 1980. Electronic fetal monitoring (EFM) was used for 47.7 percent of live births; 27.2 percent were monitored by Doppler ultrasound only, 10.2 percent by scalp electrode only, 6.3 percent by Doppler ultrasound and scalp electrode only, and 4.0 percent by other methods and combinations. The distribution by type of EFM used was similar for the 42.7 percent of late fetal deaths (also called stillbirths) that were monitored. Variation in the use of EFM for live births and stillbirths is examined according to maternal age, parity, education, race, marital status, income, previous fetal loss, underlying medical conditions, complications of pregnancy, complications of labor, duration of labor, infant birth weight, and length of gestation. Among live births, 17.1 percent were delivered by cesarean section, as were 16.8 percent of stillbirths. The association between fetal monitoring and the primary cesarean section rate (the probability of cesarean section for women who had never had one) for all birth orders and for first births is examined according to characteristics of the mothers and the infants. Factors involved in the consistent association found between fetal monitoring and the primary cesarean section rate are discussed.

Adult↗
PubMedDate not supplied

The frequency of complications in cesarean and noncesarean deliveries, 1970 and 1978.

National Hospital Discharge Survey data, collected by the National Center for Health Statistics, were used to examine complications associated with cesarean and noncesarean deliveries in the years 1970 and 1978. Cesarean deliveries comprised 5.5 percent of all deliveries in 1970 and 15.2 percent in 1978. Two-thirds (68.4 percent) of the 1970 and 82.1 percent of the 1978 cesarean deliveries involved specified complications compared with only 14.6 percent of the 1970 vaginal deliveries and 17.8 percent of the 1978 vaginal deliveries. More than one-fourth of the 1970 and 1978 cesarean deliveries, but less than 1 percent of the vaginal deliveries, were preceded by a cesarean section delivery. From 1970 to 1978, there was both a rise in breech presentations and a shift toward surgical management of them. Also, cesarean deliveries were associated with placenta previa, fetopelvic disproportion, prolonged labor, and premature rupture of membranes. Several competing explanations have been offered for the rise in complication rates and in cesarean delivery rates.

Cesarean Section↗
PubMedDate not supplied

Trends in cesarean section rates for the United States, 1970--78.

With National Hospital Discharge Survey data collected by the National Center for Health Statistics as a basis, rates of cesarean section deliveries were computed for the United States and its regions for 1970 through 1978. For each year and within each region, trends were examined according to variations in the mother's color, age, and marital status and in the hospital size (number of beds), the form of hospital ownership, and the length of the mother's hospital stay. Within each region and for each variable considered, cesarean section deliveries rose fairly uniformly. Nationally, C-sections comprised 5.5 percent of all deliveries in 1970, but rose steadily to comprise 15.2 percent of all deliveries in 1978. Overall, 1978 rates were highest in the Northeast, among whites, among women age 30 and over, among married women, in hospitals with 500 beds or more, and in proprietary hospitals. The mean length of the mother's hospital stay in 1978 was 6.7 days for cesarean section deliveries and 3.2 days for other deliveries, down from the mean hospital stay of 7.8 days for C-sections and 3.9 days for other deliveries observed in 1970.

Adult↗
PubMedDate not supplied

State variation in rates of cesarean and VBAC delivery: 1989 and 1993.

There is wide variation among states in rates of cesarean and vaginal births after cesarean (VBAC) deliveries. In general, states in the South have the highest cesarean rates, states in the West have the lowest, and states in the Northeast and Midwest are intermediate. Louisiana had the highest overall rate in 1993 (27.7 per 100 births) while Alaska had the lowest rate (15.2). The majority of states had declines in their cesarean rate between 1989 and 1993. Patterns in primary cesarean rates are similar to those of the overall rate-states in the South generally have the highest rates while states in the West have the lowest rates. Primary cesarean rates ranged between a high of 19.6 in Louisiana to a low of 10.6 in Wisconsin. In general, states with low cesarean rates have among the highest rates of VBAC delivery. Alaska had the highest VBAC rate (40.0), which was almost quadruple the rate of Louisiana (11.2), the state with the lowest rate. Most states had substantial increases in VBAC rates between 1989 and 1993. When examining cesarean rates by maternal age and birth order, states with the highest overall rates also have among the highest age/birth order-specific rates. Cesarean rates were lowest for mothers under 25 years of age having a second or higher order birth in Alaska, 10.4, and highest for mothers 35 years of age or over having a first birth in Mississippi, 51.3. Standardized cesarean rates which were adjusted for differences between states in maternal age and birth order distributions did not diminish the variation among areas.

Adolescent↗
PubMedDate not supplied

Current and future impact of rising multiple birth ratios on low birthweight.

Before 1980, multiple births with their increased risk of low birthweight comprised too small a proportion of births in the United States to have a significant impact on overall low birthweight levels; the recent steep rise in the multiple birth ratio has heightened their influence, however. Between 1980 and 1992 the white multiple birth ratio rose from 18.5 to 24.0 multiple births per 1,000 births. While the overall level of white low birthweight newborns increased slightly between 1980 and 1992 (from 5.7 percent to 5.8 percent), low birthweight for white singletons actually improved, declining from 4.9 to 4.7 percent. Thus, the increase in overall white low birthweight levels is a reflection of the increase in white multiple births and, to a much lesser extent, of the small increase in low birthweight among these births. Black multiple birth ratios and overall low birthweight also rose in this period. The black multiple birth ratio increased from 24.4 in 1980 to 28.2 per 1,000 births in 1992, and low birthweight rose from 12.7 to 13.3 percent. Although low birthweight for black singletons also increased (from 11.5 percent to 11.8 percent), the increase was at a slower pace than for all pluralities combined. Thus, for both white and black births, overall trends in low birthweight mask the disparate patterns of singleton and multiple births. It is, therefore, essential to examine low birthweight trends by plurality to assess accurately changes in this key indicator of infant health.

Adult↗
PubMedDate not supplied

Trends and characteristics of births attended by midwives.

In 1994 there were 218,466 births attended by midwives in the United States more than seven times the number in 1975 (29,413). The percent of all births attended by midwives rose from 0.9 percent in 1975 to 5.5 percent in 1994. The vast majority of midwife attended births were by certified nurse-midwives (CNMs) and occurred in hospitals. Births attended by other midwives comprised only 6 percent of all midwife-attended births (down 11 percent since-1989) and are becoming increasingly concentrated in out of hospital settings, particularly residences. Due in large part to population characteristics, the proportions of births attended by midwives varies markedly between states. The percentages range from 19 percent in New Mexico to less than 1 percent in Kansas Louisiana Missouri and Nebraska Mothers with midwife attended births in out of hospital settings generally had demographic and lifestyle characteristics that were lower risk for obstetric complications and poor birth outcomes compared with mothers with physician- or midwife attended births in hospitals. That is these mothers were more likely to be married older more educated having higher order births and were less likely to smoke and gain and adequate amount of weight during pregnancy. However women with midwife attended births regardless of type of midwife or birth setting were more likely to initiate prenatal care later in the pregnancy and have fewer overall visits than were women whose births were attended by physicians. Despite less prenatal care a smaller proportion of babies whose births were attended by midwives were preterm or were of low or very low birth weight.

Adult↗