A comparative review of Asian and British-born maternity patients in Bradford, 1974-8.

The perinatal mortality rate for Asian babies born in Bradford during the five years 1974-8 was persistently higher than for babies born to United Kingdom mothers. A comparative review of 18 924 British indigenous and 6443 Asian immigrant maternity patients delivered in Bradford from 1974-8 demonstrated several differences between the two ethnic groups. Factors operating in favour of Asian women were fewer teenage mothers, lower rates of illegitimacy, and fewer smokers. On the other hand, a greater number of factors presented increased risks to Asian patients-more women aged over 35, lower social class, higher parity, shorter pregnancy intervals, previous perinatal deaths, shorter duration of antenatal care, anaemia, shorter gestations, more babies born without professional help, and more low-birthweight babies. Local health education programmes are now concentrating on encouraging expectant mothers to attend early and regularly for antenatal care, to breast-feed their babies, and to increase the interval between pregnancies to at least one year.     

Determinants of neonatal mortality in Indonesia

Background  

Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002.     

Disparities in child health in the Arab region during the 1990s

Background  

While Arab countries showed an impressive decline in child mortality rates during the past few decades, gaps in mortality by gender and socioeconomic status persisted. However, large socioeconomic disparities in child health were evident in almost every country in the region.     

Children who were vaccinated,breast fed and from low parity mothers live longer: A community based case-control study in Jimma,Ethiopia

Background  

Improving child survival through various health interventions has been one of the main preoccupations of public health programs in developing nations. However, efforts to understand the child death determinants and determine whether the health interventions are really contributing to the reduction of mortality were not satisfactory. The purpose of this study is to identify determinants and causes of child mortality.     

Drug problems among homeless individuals in Toronto,Canada: prevalence,drugs of choice,and relation to health status

Background  

Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status.     

Cognitive ability and self-control in relation to dietary habits,physical activity and bodyweight in adolescents

Background  

Previous studies showed that cognitive ability is related to health and mortality. The cause of this relationship remains largely unknown. One plausible explanation is that cognitive ability is related to behaviours that affect health. This study investigates whether cognitive ability is related to healthy dietary habits, physical activity and appropriate bodyweight in adolescents and examines whether self-control mediates the relationship between cognitive ability and health behaviour.     

Does health intervention improve socioeconomic inequalities of neonatal,infant and child mortality? Evidence from Matlab,Bangladesh

Background  

Although there are wide variations in mortality between developed and developing countries, socioeconomic inequalities in health exist in both the societies. The study examined socioeconomic inequalities of neonatal, infant and child mortality using data from the Matlab Health and Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).     

Neonatal Morbidity and Mortality in Tribal and Rural Communities in Central India

Background and Objectives:

Little is known about the natural history of neonates born in the rural and tribal areas in India. The Neonatal Disease Surveillance Study (NDSS) measures the incidence of high-priority neonatal diseases, neonatal health events and associated risk factors to plan appropriate and effective actions.

Materials and Methods:

The NDSS is being conducted in Ramtek Revenue Block, Nagpur district, Maharashtra state, given its considerably high level of neonatal mortality. All households from five selected primary health centers were screened. Both active and passive surveillance systems were used for systematic collection of mother''s health during pregnancy and of baby''s health from birth to 4 months after birth. First-year results from November 2006 to October 2007 are presented.

Results:

Pregnancy outcomes were available for 1,136 women, with an overall neonatal mortality of 73 per 1,000 live births. The pregnancy outcomes varied by gestational age of the baby; miscarriages and abortions were higher in tribal than in non-tribal women, and tribal women had higher rates of low-birth weight (LBW) neonates than non-tribal women. The main cause of neonatal mortality was LBW, followed by sepsis and respiratory illness. The mortality of non-tribal babies was most strongly associated with pre term. For tribal babies, mortality was also associated with maternal morbidity and delay in the initiation of breastfeeding.

Interpretation and Conclusions:

The NDSS provides valuable information on the potentially modifiable factors associated with increased likelihood of neonatal mortality and morbidity. The Neonatal Health Research Initiative is now developing community-based interventions to reduce the high rate of neonatal mortality and morbidity in the rural areas of India.     

Continued spread of HIV among injecting drug users in southern Sichuan Province, China

Background  

Young injection drug users (IDUs) may be at increased risk of premature mortality due to the health risks associated with injection drug use including overdoses and infections. However, there has been little research conducted on mortality causes, rates and associations among this population. We undertook this study to investigate patterns of premature mortality, prior to age 30 years, among young IDUs.     

Regional perinatal mortality differences in the Netherlands; care is the question

Background  

Perinatal mortality is an important indicator of health. European comparisons of perinatal mortality show an unfavourable position for the Netherlands. Our objective was to study regional variation in perinatal mortality within the Netherlands and to identify possible explanatory factors for the found differences.     

Capture-recapture analysis of all-cause mortality data in Bohol, Philippines

Background  

Despite the importance of mortality data for effective planning and monitoring of health services, official reporting systems rarely capture every death. The completeness of death reporting and the subsequent effect on mortality estimates were examined in six municipalities of Bohol province in the Philippines using a system review and capture-recapture analysis.     

Reproductive health care for asylum-seeking women - a challenge for health professionals

Background  

Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO) and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients.     

Health behaviour modelling for prenatal diagnosis in Australia: a geodemographic framework for health service utilisation and policy development

Background  

Despite the wide availability of prenatal screening and diagnosis, a number of studies have reported no decrease in the rate of babies born with Down syndrome. The objective of this study was to investigate the geodemographic characteristics of women who have prenatal diagnosis in Victoria, Australia, by applying a novel consumer behaviour modelling technique in the analysis of health data.     

Time series analysis of dengue fever and weather in Guangzhou, China

Background  

Monitoring and predicting dengue incidence facilitates early public health responses to minimize morbidity and mortality. Weather variables are potential predictors of dengue incidence. This study explored the impact of weather variability on the transmission of dengue fever in the subtropical city of Guangzhou, China.     

Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies

Background  

The increasing prevalence of obesity in young women is a major public health concern. These trends have a major impact on pregnancy outcomes in these women, which have been documented by several researchers. In a population based cohort study, using routinely collected data, this paper examines the effect of increasing Body Mass Index (BMI) on pregnancy outcomes in nulliparous women delivering singleton babies.     

Ethno-Specific Risk Factors for Adverse Pregnancy Outcomes: Findings from the Born in Bradford Cohort Study

Objectives Preterm birth (PTB) and small for gestational age (SGA) are major causes of perinatal mortality and morbidity. Previous studies indicated a range of risk factors associated with these poor outcomes, including maternal psychosocial and economic wellbeing. This paper will explore a range of psycho-social and economic factors in an ethnically diverse population. Methods The UK’s Born in Bradford cohort study recruited pregnant women attending a routine antenatal appointment at 26–28 weeks’ gestation at the Bradford Royal Infirmary (2007–2010). This analysis includes 9680 women with singleton live births who completed the baseline questionnaire. Data regarding maternal socio-demographic and mental health were recorded. Outcome data were collected prospectively, and analysed using multivariate regression models. The primary outcomes measured were: PTB (<37 weeks’ gestation) and SGA (<10th customised centile). Results After adjustment for socio-demographic and medical factors, financial strain was associated with a 45 % increase in PTB (OR 1.45: 95 % CI 1.06–1.98). Contrary to expectation, maternal distress in Pakistani women was negatively associated with SGA (OR 0.65: CI 0.48–0.88). Obesity in White British women was protective for PTB (OR 0.67: CI 0.45–0.98). Previously recognized risk factors, such as smoking in pregnancy and hypertension, were confirmed. Conclusions This study confirms known risk factors for PTB and SGA, along with a new variable of interest, financial strain. It also reveals a difference in the risk factors between ethnicities. In order to develop appropriate targeted preventative strategies to improve perinatal outcome in disadvantaged groups, a greater understanding of ethno-specific risk factors is required.     

Knowledge and attitude on maternal health care among rural-to-urban migrant women in Shanghai, China

Background  

In China, with the urbanization, women migrated from rural to big cities presented much higher maternal mortality rates than local residents. Health knowledge is one of the key factors enabling women to be aware of their rights and health status in order to seek appropriate health services. This study aims to assess the knowledge and attitude on maternal health care and the contributing factors to being knowledgeable among rural-to-urban migrant women in Shanghai.     

Measuring newborn foot length to identify small babies in need of extra care: a cross sectional hospital based study with community follow-up in Tanzania

Background  

Neonatal mortality because of low birth weight or prematurity remains high in many developing country settings. This research aimed to estimate the sensitivity and specificity, and the positive and negative predictive values of newborn foot length to identify babies who are low birth weight or premature and in need of extra care in a rural African setting.     

Demographic and circumstantial accounts of burn mortality in Cape Town, South Africa, 2001-2004: An observational register based study

Background  

Burns are a persisting public health problem in low- and middle-income countries; however, epidemiologic data for these settings is scarce. South Africa is no exception although there is an emerging knowledge base, especially for paediatric burns. The current study describes the epidemiology of burn mortality across the lifespan in Cape Town (2.9 million inhabitants in 2001), one of the six South African metropolitan centres.