Paediatric and perinatal epidemiology
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Paediatr Perinat Epidemiol · May 2009
Incidence and pattern of unintentional injuries and resulting disability among children under 5 years of age: results of the National Health Survey of Pakistan.
National estimates of injuries for children under 5 years based on population representative surveys are not readily available globally and have not been reported for developing countries. This study estimated the annual incidence, pattern and distribution of unintentional injuries according to age, gender, socio-economic status, urban/rural residence and disability caused among children aged under 5 years in Pakistan. The National Health Survey of Pakistan (NHSP 1990-94) is a nationally representative survey of households to assess the health profile of the country. ⋯ Road traffic injuries and injuries to the female child were more likely to result in disability. There is a high burden of unintentional injuries and disability among children under 5 in Pakistan. These results are useful for planning further research and for prioritising prevention programmes nationally and in other developing countries with similar situation.
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Paediatr Perinat Epidemiol · Jan 2009
Comparative StudySocio-economic inequality in preterm birth: a comparative study of the Nordic countries from 1981 to 2000.
During the 1980s and 1990s, there were large social and structural changes within the Nordic countries. Here we examine time changes in risks of preterm birth by maternal educational attainment in Denmark, Finland, Norway and Sweden. Information on gestational age and maternal socio-economic position was obtained from the NorCHASE database, which includes comparable population-based register data of births from Denmark, Finland, Sweden and Norway from 1981 to 2000. ⋯ In moderately preterm births, the educational inequality gap was constant over the study period in Denmark, Norway and Sweden, but narrowed in Finland. The educational gradient in preterm birth remained broadly stable from 1981 to 2000 in all four countries. Consequently, the socio-economic inequalities in preterm birth were not strongly influenced by structural changes during the period.
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Paediatr Perinat Epidemiol · Jul 2008
Prospective community-based cluster census and case-control study of stillbirths and neonatal deaths in the West Bank and Gaza Strip.
Obstetric complications and newborn illnesses amenable to basic medical interventions underlie most perinatal deaths. Yet, despite good access to maternal and newborn care in many transitional countries, perinatal mortality is often not monitored in these settings. The present study identified risk factors for perinatal death and the level and causes of stillbirths and neonatal deaths in the West Bank and Gaza Strip. ⋯ Stillbirths are not officially reportable in the West Bank and Gaza Strip and this is the first time that perinatal mortality has been examined. Interventions to lower stillbirths and neonatal deaths should focus on improving the quality of medical care for important obstetric complications and newborn illnesses. Other transitional countries can draw lessons for their health care systems from these findings.
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Intrauterine exposure to artificial sex hormones such as oral contraceptives may be associated with an increased risk of fetal death. Between 1996 and 2002, a total of 92 719 women were recruited to The Danish National Birth Cohort and interviewed about exposures during pregnancy. Outcome of pregnancy was identified through linkage to the Civil Registration System and the National Discharge Registry. ⋯ Neither use of COC nor POC prior to pregnancy was associated with fetal death. Stratification by maternal age and smoking showed elevated risks of fetal death for women <30 years and smokers using oral contraception during pregnancy, but the interactions were not significant. In conclusion, there was no evidence that oral contraceptive use before or during pregnancy is associated with an increased risk of fetal death.
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Paediatr Perinat Epidemiol · Jul 2008
Associated factors and consequences of late preterm births: results from the 2004 Pelotas birth cohort.
Although neonatal and infant mortality rates have fallen in recent decades in Brazil, the prevalence of preterm deliveries has increased in certain regions, especially in the number of late preterm births. This study was planned to investigate: (1) maternal antenatal characteristics associated with late preterm births and (2) the consequences of late preterm birth on infant health in the neonatal period and until age 3 months. A population-based birth cohort was enrolled in Pelotas, Southern Brazil, in 2004. ⋯ Compared with term births, late preterm births showed increased risk of depression at birth (Relative risk [RR] 1.7 [1.3, 2.2]), perinatal morbidity (RR 2.8 [2.3, 3.5]), and absence of breast feeding in the first hours after birth (PR 0.9 [0.8, 0.9]). RRs for neonatal and infant mortality were, respectively, 5.1 [1.7, 14.9] and 2.1 [1.0, 4.6] times higher than that observed among term newborns. In conclusion, in our setting, the prevention of all preterm births must be a priority, regardless of whether early or late.