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At least 19 recordsLinked to original sources
PubMed1997

Recent trends in infant mortality rates and proportions of low-birth-weight live births in Canada.

OBJECTIVE: To identify spatial patterns of changes in infant mortality rates and proportions of low-birth-weight live births observed in 1994. SETTING: Canada. SUBJECTS: Live births and infant deaths in Canada between 1987 and 1994. Data for Newfoundland were unavailable for 1987 through 1990. OUTCOME MEASURES: Annual infant mortality rates (crude and after excluding live newborns weighing less than 500 g); proportion of live births by low-birth-weight category (500-2499 g). RESULTS: Nova Scotia, New Brunswick, Quebec and Manitoba had lower crude and adjusted infant mortality rates in 1994 than in 1993. Newfoundland, Saskatchewan, Alberta and British Columbia had higher rates in 1994 than in 1993. The crude rate in Ontario was lower, and the adjusted rate higher, in 1994 than in 1993. A downward trend in the proportion of low-birth-weight live births was observed in Quebec (chi(2) for trend = 29.2, p < 0.01). Conversely, an upward trend was observed in Ontario (chi(2) for trend = 241.3, p < 0.01). However, the increase may have been due to data errors, especially in 1993 and 1994, involving truncation of ounces in 2 digits to 1 digit (e.g., 5 pounds 10 ounces became 5 pounds 1 ounce). CONCLUSIONS: Although the marginal increases in infant mortality observed in several provinces could be the result of random variation, future trends should be closely monitored. The proportion of low-birth-weight live births in Canada (excluding Ontario) appears to be stable, with Quebec showing significant reductions. The errors in data for Ontario need to be corrected before trends can be estimated for that province and for Canada as a whole.

Birth Weight↗
PubMed2000

Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil.

OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.

Adult↗
PubMed1999

Live-birth rates and multiple-birth risk using in vitro fertilization.

CONTEXT: To maximize birth rates, physicians who perform in vitro fertilization (IVF) often transfer multiple embryos, but this increases the multiple-birth risk. Live-birth and multiple-birth rates may vary by patient age and embryo quality. One marker for embryo quality is cryopreservation of extra embryos (if embryos are set aside for cryopreservation, higher quality embryos may have been available for transfer). OBJECTIVE: To examine associations between the number of embryos transferred during IVF and live-birth and multiple-birth rates stratified by maternal age and whether extra embryos were available (ie, extra embryos cryopreserved). DESIGN AND SETTING: Retrospective cohort of 300 US clinics reporting IVF transfer procedures to the Centers for Disease Control and Prevention in 1996. SUBJECTS: A total of 35554 IVF transfer procedures. MAIN OUTCOME MEASURES: Live-birth and multiple-birth rates (percentage of live births that were multiple). RESULTS: A total number of 9873 live births were reported (multiple births from 1 pregnancy were counted as 1 live birth). The number of embryos needed to achieve maximum live- birth rates varied by age and whether extra embryos were cryopreserved. Among women 20 to 29 years and 30 to 34 years of age, maximum live-birth rates (43 % and 36%, respectively) were achieved when 2 embryos were transferred and extra embryos were cryopreserved. Among women 35 years of age and older, live-birth rates were lower overall and regardless of whether embryos were cryopreserved, live-birth rates increased if more than 2 embryos were transferred. Multiple-birth rates varied by age and the number of embryos transferred, but not by whether embryos were cryopreserved. With 2 embryos transferred, multiple-birth rates were 22.7%, 19.7%, 11.6%, and 10.8% for women aged 20 to 29, 30 to 34, 35 to 39, and 40 to 44 years, respectively. Multiple-birth rates increased as high as 45.7% for women aged 20 to 29 years and 39.8% for women aged 30 to 34 years if 3 embryos were transferred. Among women aged 35 to 39 years, the multiple-birth rate was 29.4% if 3 embryos were transferred. Among women 40 to 44 years of age, the multiple-birth rate was less than 25% even if 5 embryos were transferred. CONCLUSIONS: Based on these data, the risk of multiple births from IVF varies by maternal age and number of embryos transferred. Embryo quality was not related to multiple birth risk but was associated with increased live-birth rates when fewer embryos were transferred.

Adult↗
PubMed2002

Prevalence of birth defects and parental work in Singapore live births from 1994 to 1998: a population-based study.

The aims of the study were to assess the prevalence of birth defects (BDs) among different occupational groups and non-working parents, and to identify possible risk factors associated with BDs in Singapore live births born between 1 January 1994 and 31 December 1998. To do this, information on live births (from the Singapore National Registry of Births and Deaths) and BD cases [from the National Birth Defects Register (NBDR)] was obtained from 1 January 1994 to 31 December 1998. There were a total of 237 755 live births in Singapore between 1 January 1994 and 31 December 1998. Over the same period, 3293 cases of BDs were reported to the NBDR, giving an overall rate of 13.9 per 1000 live births. A downward trend with time was noted. Of the live born with BDs in this series, 36.7% presented with multiple anomalies. The overall occurrence of malformation (per 1000 live births) among working versus non-working mothers was 13.4 versus 14.2, respectively, and 13.8 for working fathers compared with 16.8 for non-working fathers. Parents in the occupational group 'Legislators, Senior Officers & Managers' had the lowest prevalence rates of congenital anomalies (9.4 per 1000 for mothers and 10.3 per 1000 for fathers), while the 'Agricultural & Fishery Workers' had the highest rates (40.0 per 1000 for mothers and 23.4 per 1000 for fathers). However, the very small number of workers in this latter group makes the rate unreliable. The prevalence of BDs in Singapore is comparable to those in other countries. Parental work per se is not correlated with BDs.

Adult↗
PubMed1999

Analysis of geographical heterogeneity in live-birth ratio in Thailand.

BACKGROUND: Live-birth (male-female) ratios are a standard measure used in demography. Recently, live-birth ratios have been considered as a potential indicator for various environmental hazards. In this paper, mixture modeling is applied to analyse the geographic heterogeneity of live-births in their composition of male and female proportions (live-birth ratio) in the Kingdom of Thailand. METHODS: Live-birth data are taken from the 1990 census of the Kingdom of Thailand. The level of aggregation is the province, of which there are 73 in Thailand. The analysis is based on the simple observation that a logical equivalent to the live-birth ratio is available, namely the proportion of male live-births. Based on this measure a simple and exact statistical model is easily derived: conditional on the number of live-births, the number of male live-births forms a binomial distribution, with parameter lambda. If there is homogeneity in the proportion of male live-births, then all provinces can be described by means of a single binomial distribution. However, if there is heterogeneity in the proportion parameter lambda, then a mixture of binomial distributions will occur. RESULTS: For the 1990 census data, three groups could be identified: a majority group containing 84% of the provinces and a proportion parameter of lambda = 0.513, a group of five provinces having a reduced proportion parameter of lambda = 0.500 (fewer male live-births), and a group of four provinces having an increased proportion parameter of lambda = 0.525. CONCLUSIONS: It is unclear how this can be explained, although some potential explanations are offered. The stability of these groups in time should be confirmed and regularly monitored.

Bias↗
PubMed2001

Adolescent pregnancy, infant mortality, and source of payment for birth: Alabama residential live births, 1991-1994.

PURPOSE: To assess potential impact of programs to prevent adolescent pregnancy on infant mortality. METHODS: Infants (n = 247,503) born alive to Alabama residents from 1991 to 1994 were identified from birth cohort files and linked to infant death records. Deliveries funded by Medicaid, private insurance, and self-payers were studied separately. Relative risks (RR) and population attributable risks were calculated. The latter provided estimated percentages by which infant (<1 year) death risks would have decreased if adolescent (< or =19 years) pregnancies had been prevented. RESULTS: Infants of mothers <16 years of age were at higher risk of death than were infants of mothers aged 20 to 34 years (adults): the RRs were 4.1, 3.4, and 1.4 for self-payers, private insurance, and Medicaid groups, respectively. In the self-payer and private insurance groups, but not the Medicaid group, infants of mothers aged 17 to 19 years were more likely to die than were infants of adults. Infants from repeat adolescent pregnancies comprised nearly one-third of all infants born to adolescents, and in each payer-group were more likely to die than were infants of adults: The RRs were 4.9, 2.5, and 1.3 for self-payers, private-insurance, and Medicaid groups, respectively. Theoretically, preventing all adolescent pregnancies and preventing only repeat adolescent pregnancies would have reduced infant mortality in the total population by 8% and 4%, respectively. CONCLUSIONS: Programs to prevent first and subsequent adolescent pregnancies probably have little effect on infant mortality. Efforts to prevent adolescent pregnancies should not have a short-term goal of notably reducing infant mortality.

Adolescent↗
PubMed2003

The use of pulmonary interstitial emphysema as an indicator of live birth.

Making the determination of live birth versus stillbirth in a discarded newborn infant based on gross and microscopic autopsy findings can be a challenging task for the forensic pathologist. The traditional criteria for live birth determination are frequently challenged in court, and indisputable evidence of live birth remains elusive. The histologic finding of pulmonary interstitial emphysema has not been considered as a useful determinant of live birth. The authors report two cases of discarded newborn infants in which the finding of pulmonary interstitial emphysema was used as an indicator of live birth.

Adult↗
PubMed2004

Parental karyotype and subsequent live births in recurrent miscarriage.

OBJECTIVE: To compare the subsequent live birth rate in recurrently miscarrying women with and without parental balanced chromosomal aberrations. DESIGN: Retrospective comparative cohort study. SETTING: Tertiary referral unit in a university hospital. PATIENT(S): Nine hundred sixteen patients with 3-16 miscarriages before 20 weeks: 99 patients with and 817 patients without chromosomal aberrations. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Outcome of the subsequent pregnancy in terms of live births or repeat miscarriage. RESULT(S): Of the 916 patients, 661 subsequently conceived, 73 (73.7%) with parental chromosomal aberrations and 588 (71.9%) without aberrations. In patients with and without chromosomal aberrations, 33 of 73 pregnancies (45.2%) and 325 of 588 pregnancies (55.3%), respectively, resulted in live births. The difference is not statistically significant. There was a similar prevalence of aberrations in primary, secondary, and tertiary aborters. The prevalence of aberrations was not related to the number of previous miscarriages. Translocations, inversions, and mosaicism were followed by a similar live birth rate. CONCLUSION(S): Patients with parental chromosomal rearrangements do not have a significantly lower live birth rate than patients without aberrations. Parental karyotyping might not be a good predictor of the outcome of subsequent pregnancies.

Abortion, Habitual↗
PubMedDate not supplied

Live births resulting from unintended pregnancies: is there variation among states? The PRAMS Working Group.

CONTEXT: States need data on live births resulting from unintended pregnancies in order to assess the need for family planning services; however, many states do not collect such data. Some states may use extrapolated rates from other states. METHODS: Pregnancy Risk Assessment Monitoring System (PRAMS) data were assessed to explore the feasibility of extrapolating data on the percentage of live births resulting from unintended pregnancies from states that collect these data to states that do not. Data on women who had live births between 1993 and 1995 were examined for eight states: Alabama, Florida, Georgia, Michigan, New York (excluding New York City), Oklahoma, South Carolina and West Virginia. Logistic regression was used to determine state variation in the odds of delivering a live birth resulting from an unintended pregnancy after adjustment for maternal race, marital status, age, education, previous live birth and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). RESULTS: The percentage of live births resulting from unintended pregnancy ranged from 33% in New York to 49% in Alabama, Georgia and South Carolina. Compared with women in Alabama, women in Oklahoma were more likely to deliver a live birth resulting from an unintended pregnancy (odds ratio of 1.2, confidence interval of 1.1-1.3) and women in New York State were less likely (odds ratio of 0.7, confidence interval of 0.6-0.8) to have such a birth. However, unmarried white women in New York had lower odds of having a live birth resulting from an unintended pregnancy and married black women in Michigan had higher odds of having a live birth resulting from unintended pregnancy than their counterparts in Alabama. Although the percentages varied, in all eight states women who were black, were unmarried, were younger than 20 years of age, had less than 12 years of education or had more than one child had higher percentages of live births resulting from unintended pregnancy than women with other demographic characteristics. CONCLUSIONS: Data on which women have the greatest risk of delivering a live birth resulting from an unintended pregnancy may be extrapolated from one state to another, but the rate of such births may overestimate or underestimate the problem from one state to another.

Adolescent↗
PubMed2003

Waiting for in vitro fertilization treatment: spontaneous and ART live births.

This study analysed the live birth rates in 760 couples referred in 1994 to St Mary's Hospital, Manchester, a non-fee-paying National Health Service (NHS) centre, who had waited for up to 4 years for IVF treatment. These live birth rates were compared with those of 199 couples referred at a similar time to Manchester Fertility Services, a fee-paying unit, where they received IVF treatment shortly after referral. The waiting time was advantageous in that 17.8% (135 of 760) of the couples referred to St Mary's Hospital conceived without IVF treatment, 60% within one year of referral. However, the waiting time was detrimental to women aged 30-34 in whom treatment was delayed by 3-4 years. Only 26.8% (204 of 760) of couples originally referred eventually received NHS-funded IVF treatment at St Mary's. A waiting time not exceeding 18 months would allow most spontaneous conceptions and reduce the adverse effect of prolonged waiting on the take-up rate for treatment and on the chance of success in the older women.

Adult↗
PubMed1986

State reporting of live births of newborns weighing less than 500 grams: impact on neonatal mortality rates.

The National Center for Health Statistics reports that in 1983 65% of all infant deaths in the United States occurred in the neonatal period. Of these reported neonatal deaths, 17% were of infants weighing less than 500 g at birth. There was, however, variation in state-reported incidence of live births of newborns in this weight cohort (0.2 to 2.2 per 1,000 live births). The states with the lowest neonatal mortality rate have the lowest incidence of birth weights less than 500 g (rho = .77). If it is assumed that mortality for this weight category is nearly 100%, there is marked variation (5% to 32%) in the contribution of this weight cohort to a state's total neonatal mortality rate. Contributing to this variation may be definitions of live birth used by states. The World Health Organization defines a live birth as the product of conception showing signs of life "irrespective of the duration of pregnancy" and this definition is used by 33 states. Only one state (Ohio) includes the gestational criteria of "at least 20 weeks" in its definition of live birth. There is evidence to suggest that definitions are not uniformly used within individual states. For example, in 1983, 20 states did not report any live births with weights less than 500 g among their "other" populations of nonwhite, nonblack residents. Half of these states, however, use the World Health Organization definition of live birth. Despite the exclusionary wording in Ohio's definition of liver birth, 16% of newborns who died in that state had birth weights less than 500 g.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1994

Incidence of congenital heart disease among hospital live births in India.

Ten thousand nine hundred and sixty four consecutive live births weighing more than 500 g and more than 28 weeks of gestation were subjected to a thorough clinical examination within 24 h of birth. Those suspected of having congenital heart disease (CHD) were followed up every 4-6 weeks for a period of 6 to 18 months (mean 9.75 months). Forty three of 10,964 infants had CHD, i.e., 3.9/1000 live births. Incidence of CHD was higher in pre-terms as compared to full term live births (22.69 vs 2.36/1000 live births). Diagnosis was confirmed by echocardiography including 2D, Doppler and color flow imaging. Twenty eight per cent of the infants with CHD had other associated somatic anomalies, Down's syndrome being the commonest (9.3%). Patent ductus arteriosus (41.9%) and ventricular septal defects (VSD) (34.9%), were the commonest lesions with an incidence of 1.6 and 1.4/1000 live births, respectively. Incidence of PDA was higher probably because of larger number of pre-term deliveries. During follow up of 6-18 months, 34.9% of the infants with CHD died. The diagnosis of CHD was confirmed at autopsy in 20% of the deaths.

Abnormalities, Multiple↗