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At least 217 records · Page 12Linked to original sources
PubMed2000

Infant mortality by gestational age and birth weight in Canadian provinces and territories, 1990-1994 births.

We compared gestational age-specific and birth weight-specific infant mortality in the Canadian provinces (excluding Ontario) and territories using the linked birth and death records for 1990-1994 births. Compared with Quebec, early neonatal mortality rates were higher in Saskatchewan, Alberta and Newfoundland among extremely small and preterm infants and among infants with no information on gestational age and birth weight on their records. Post- neonatal mortality rates were higher in Prince Edward Island, Manitoba, Saskatchewan, Alberta, British Columbia and the Northwest Territories among preterm (and low birth weight) and term (and normal birth weight) infants. We suggest that differences in registration practices probably explain the substantial interprovincial variations in early neonatal mortality rates among extremely small and preterm infants, whereas differences in demographic profile and the quality of obstetric, neonatal and infant care probably explain interprovincial variations in infant mortality rates among less extremely small and preterm infants.

Adolescent↗
PubMed2000

Contribution of assisted reproductive technology and ovulation-inducing drugs to triplet and higher-order multiple births--United States, 1980-1997.

In the United States, pregnancies associated with assisted reproductive technology (ART) or ovulation-inducing drugs are more likely to result in multiple births than spontaneously conceived pregnancies (1). In addition, triplet and higher-order multiple births are at greater risk than singleton births to be preterm (< or = 37 completed weeks' gestation), low birthweight (LBW) (i.e., < or = 2500 g), or very low birthweight (i.e., < 1500 g), resulting in higher infant morbidity and mortality (2). Because preterm and LBW infants often require costly neonatal care and long-term developmental follow-up, the continuing increase in triplet and higher-order multiple births causes concern among health-care providers and policymakers (3). This report provides estimates of the contribution of ART and ovulation-inducing drugs to these birth outcomes for 1996 and 1997, and summarizes trends during 1980-1997, which indicate that the ratio of triplet and higher-order multiple births has more than quadrupled and that a large proportion of this increase can be attributed to ART or the use of ovulation-inducing drugs.

Adult↗
PubMed2001

Ethics and neonatology in Israel.

Israel is a country of controversies: with high-quality medical care available to all and a high antenatal detection rate of congenital anomalies followed by abortion, the incidence of infants born with malformations has been reduced dramatically in the last decade. On the other hand, religious and strong traditional ethnic attitudes on fertility have led to a world record rate of ARTs and multiple births, which have increased the incidence of VLBW infants and the long-term handicap that follows their survival.

Abortion, Eugenic↗
PubMed2002

[Evaluation of the developing human visual system using flash-visual evoked potential].

Flash visual evoked potential (Flash-VEP) is easily recorded in preterm infants. However, its clinical application has not been established due to its great variability in response. Our longitudinal studies on the two components of the N1 wave facilitated peak definition and established normal ranges that are clinically valuable. The N1a (early component of the N1) peak latency decreases at about 4.6 msec/week between 30 and 40 weeks postmenstrual age. A flash-VEP study in the preterm period enables us to observe the neuronal development in the human visual system that normally proceeds in utero. Flash-VEP analyses on preterm infants demonstrated that the decrease in the N1a peak latency reflects the progress of myelination in the visual pathway according to the developmental program irrespective of preterm birth. The developmental changes of the N1 wave configuration reflect the maturation of the neuronal networks in the visual cortex, which is accelerated by extrauterine visual experience. Using improved methodology and peak denomination that we proposed, flash-VEP can be applied to preterm infants safely, and should provide us with neuro-developmental information of the human cerebrum.

Cerebral Hemorrhage↗
PubMedDate not supplied

Mothers in the media: blamed and celebrated--an examination of drug abuse and multiple births.

The media has always had a profound interest in mothers and birth stories. This study examined the difference between media portrayal of "good" mothers and "bad" mothers. Did the media cover potential harm to fetuses and would-be children in the same way for two groups of mothers: (a) pregnant women addicted to illicit drugs and (b) women who chose to continue a high-order, multiple birth pregnancy? Two searches were conducted on Lexis-Nexis, one with keywords "McCaughey and birth" and another with the keywords "pregnancy and illegal drugs." A total of 210 articles were coded for the McCaughey search, and 90 articles were coded for the pregnancy and illegal drugs search. The media did not address potential harm in the same way in both cases. The harm from illegal drugs was exaggerated, while the harm from multiple births was downplayed. Consequently, the media response towards the two cases was dramatically different. In conclusion, the communal and regulatory responses to both drug-addicted pregnant women and large multiple births caused by infertility treatments needs to be rethought.

Female↗
PubMed2002

[Reference birthweight for multiple births in Japan].

PURPOSE: Intrauterine growth curves of twins, that is, birth weights according to gestational age, were calculated from birth certificate data. METHODS: Multiple births were identified by birthplace, ages of the parents, gestational age, and year and month of birth. There were 49,240 twin births in Japan between 1988 and 1991. Of these, 32,232 livebirth-livebirth pairs, 679 livebirth-stillbirth pairs, and 278 stillbirth-livebirth pairs were included in this analysis. There were also 1894 triplet live births from 744 sets of triplets and 206 quadruplet live births analyzed. For all, access was made to the database of birth certificates in the form of magnetic tapes giving birthweights in hundred gram categories. RESULTS: For all gestational ages, median birthweights of males were ca. 0.05 kg-0.1 kg larger than female values. Compared to singleton births in Japan, median birthweights of twins remained ca. 0.15 kg smaller until gestational age of 34 weeks, the difference then increasing to ca. 0.5 kg at 42 weeks of gestation. As for birth order, mean birthweight of the first twin was larger than that of the second and the standard deviation was larger for the second. Birthweights of twins from multiparous mothers were greater than those from primiparous mothers. Among the multiple births, median birthweight for gestational age was found to be greatest in twins, lower in triplets and lowest in quadruplets. In triplets, the 50th centile for boys was 0.08 kg larger than for girls. DISCUSSION: With regard to perinatal growth, the fetus is affected more or less by the limitation of uterine expansion in the late gestational weeks. Reference birthweights for exclusive use for multiple births are different from that for singletons.

Birth Order↗
PubMed2002

Interval delivery and aggressive tocolysis in high-order multiple gestation. A report of three cases.

BACKGROUND: High-order multiple pregnancy (four and above) should be avoided if at all possible. The major fetal risk of high-order multiple gestation is that of extreme prematurity. Interval delivery has been used with twin and triplet pregnancies. CASES: An octuplet, sextuplet and quadruplet pregnancies were managed with interval delivery. The interval from delivery of the first infant to the remainder of pregnancy was 12 days for the octuplet pregnancy, 24 for the sextuplet pregnancy and 12 for the quadruplet pregnancy. CONCLUSION: In high-order multiple pregnancy, delayed interval delivery is strongly recommended, provided that there are no signs of chorioamnionitis, fetal distress or maternal compromise.

Adult↗
PubMed2002

[The increase in multiple births and its consequences on perinatal health].

OBJECTIVE: To describe the trends in multiple maternity rates and the main responsible factors, and to present the main medical risks associated with multiple births. METHOD: A review of studies describing the situation in Europe and America North. RESULTS: Multiple maternity rates have increased dramatically in France and in other Western countries since the mid 1970s. However the triplet maternity rates leveled off in the 1990s in several European countries. One-fourth to one-third of the increase in multiple maternities is explained by the increase in maternal age. Moreover 30 to 50% of twin maternities and at least three-fourths of triplet maternities would occur after fertility treatments, according to surveys or estimations made from various sources. Twins and triplets have high risks for mortality and morbidity. In France in 1995/98, among live birth twins, the proportion of births before 37 weeks was 43.7% and the proportion of births before 33 weeks was 8.1%. The risk fraction of preterm delivery (<37 weeks) attributable to twins rose from 13% in 1981 to 19% in 1995/98. This trend is explained by the increase in occurrence of multiple births as much as by an increase in preterm births among twins. A similar situation is found in Canada and the USA. Whereas triplets have very high risk of preterm birth, the risk fraction attributable to triplets is very much lower than for twins: in Canada it was 1.1% in 1995-97. CONCLUSION: These results suggest that research and preventive interventions should not be restricted to triplets, but should also include twins.

Computer Graphics↗
PubMedDate not supplied

Is paternal age associated with an increased risk of low birthweight, preterm delivery, and multiple birth?

OBJECTIVE: To determine if paternal age elevates the risk of low birthweight (< 2500g, LBW), preterm birth (< 37 weeks gestation), and multiple gestation among mothers whose age does not predict an elevated risk. DESIGN/METHODS: Population data on birth outcome, maternal age and paternal age was obtained from Alberta Health and Wellness for all births 1990-1996. RESULTS: Among women aged 25 to 29, regardless of parity, there was no linear relationship between paternal age and preterm birth or LBW. However, multiple birth rates increased with increased paternal age (p < 0.01). Among singleton births, advanced paternal age (>50 years) increased the risk of LBW and preterm birth (p < 0.05). CONCLUSIONS: Paternal age is not a risk factor for LBW or preterm delivery among low risk women. The increased risk of multiple birth with increased paternal age, regardless of parity, requires confirmation among other populations.

Adult↗
PubMed2003

Trends in multiple births conceived using assisted reproductive technology, United States, 1997-2000.

OBJECTIVE: To examine trends in multiple births conceived using assisted reproductive technology (ART) in the United States between 1997 and 2000 and to estimate the proportion of all US multiple births attributable to ART use. METHODS: We analyzed population-based data of 109 519 live-born infants who were conceived in the United States using ART and born between 1997 and 2000 and population-based data of 15 856 809 live-born infants who were delivered in the United States between 1997 and 2000. Multiple birth rates (the number of live-born infants delivered in multiple gestation pregnancies per 1000 live births) and the proportion of all US multiple births attributable to ART were evaluated. RESULTS: The twin rate for ART patients increased between 1997 and 2000, reaching 444.7 per 1000 live births in 2000, whereas the triplet/+ rate declined substantially from 134.3 to 98.7 per 1000 live births from 1997-2000. From 1997-2000, the proportion of multiple births in the United States attributable to ART increased from 11.2% to 13.6%, whereas the proportion attributable to natural conception decreased from 69.9% to 64.5%. In 2000, the proportion of triplet/+ births attributable to ART and to natural conception was 42.5% and 17.7%, respectively. The contribution of ART to multiple births increased substantially with maternal age, from 11.6% for triplet/+ infants born to women aged 20 to 24 to 92.8% for women aged 45 to 49 years. CONCLUSIONS: The contribution of ART to twin birth rates continues to increase, but the contribution of ART to triplet/+ birth rates has declined.

Adult↗