Annual report upon the births, marriages, and deaths in the City of Providence ...

Registrar: Edwin M. Snow, 1855-

Health officer's annual report of births, marriages and deaths.

Report year ends Dec. 31.

Report relating to the registration of births, marriages and deaths in the province of Ontario ...

Mode of access: Internet.

Watch that space! The county hierarchy in firm births and deaths in the UK, 1980-1999

The paper investigates the relationships between registrations, de-registrations and population density at county level in the UK using VAT data for 20 years over the period 1980–1999. The rationale for this is based on the need to understand how the extent to which, in different parts of the UK, differences in the relationship between birth rates and death rates combine to produce an interpretable pattern in net birth rates. The analysis of the net birth rate shows that a strategy aimed at the net birth rate might, in principle, just as well aim at reducing business failure, rather than raising the birth rate. Indeed this might be more efficient, since it implies that less start-ups are ‘‘wasted’’ as it would avoid the necessity, if targets are to be reached, of encouraging those individuals who are patently unsuited to running their own business into business ownership.

Mothers but not wives: The increasing lag between nonmarital births and marriage

This study analyzed trends in marital behavior for unwed mothers who gave birth between 1960 and 2004. With nationally representative data on 15,353 White and Black unmarried mothers, results indicated that mothers who gave birth after 1989 were waiting much longer to marry than were mothers giving birth before 1968. The most pronounced delays were found immediately after a birth. Over the study period, the cumulative proportion of women who married within three years of a birth decreased for Whites by 27% and for Blacks by 60%. Findings underscore the separation that has developed between first births and first marriages in the United States, and they highlight the older ages at which children are experiencing a transition to marriage. © National Council on Family Relations, 2011.

The Pratt Pouch Provides a Three-Fold Access Increase to Antiretroviral Medication for Births outside Health Facilities in Southern Zambia.

INTRODUCTION: Modern day antiretroviral therapy allows HIV+ pregnant women to lower the likelihood of viral transmission to their infants before, during, and after birth from 20-45% to less than 5%. In developing countries, where non-facility births may outnumber facility births, infant access to safe antiretroviral medication during the critical first three days after birth is often limited. A single-dose, polyethylene pouch ("Pratt Pouch") addresses this challenge by allowing the medication to be distributed to mothers during antenatal care. METHODS: The Pratt Pouch was introduced as part of a one year clinical feasibility study in two districts in Southern Province, Zambia. Participating nurses, community health workers, and pharmacists were trained before implementation. Success in achieving improved antiretroviral medication access was assessed via pre intervention and post intervention survey responses by HIV+ mothers. RESULTS: Access to medication for HIV-exposed infants born outside of a health facility increased from 35% (17/51) before the introduction of the pouch to 94% (15/16) after (p<0.05). A non-significant increase in homebirth rates from 33% (pre intervention cohort) to 50% (post intervention cohort) was observed (p>0.05). Results remained below the national average homebirth rate of 52%. Users reported minimal spillage and a high level of satisfaction with the Pratt Pouch. CONCLUSION: The Pratt Pouch enhances access to infant antiretroviral medication in a rural, non-facility birth setting. Wide scale implementation could have a substantial global impact on HIV transmission rates from mother to child.

Delays In Receiving Obstetric Care And Poor Maternal Outcomes: Results From A National Multicentre Cross-sectional Study.

The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death. This was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated. A total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD. Although this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival.

Neonatal Outcomes Of Late Preterm And Early Term Birth.

To compare neonatal deaths and complications in infants born at 34-36 weeks and six days (late preterm: LPT) with those born at term (37-41 weeks and six days); to compare deaths of early term (37-38 weeks) versus late term (39-41 weeks and six days) infants; to search for any temporal trend in LPT rate. A retrospective cohort study of live births was conducted in the Campinas State University, Brazil, from January 2004 to December 2010. Multiple pregnancies, malformations and congenital diseases were excluded. Control for confounders was performed. The level of significance was set at p<0.05. After exclusions, there were 17,988 births (1653 late preterm and 16,345 term infants). A higher mortality in LPT versus term was observed, with an adjusted odds ratio (OR) of 5.29 (p<0.0001). Most complications were significantly associated with LPT births. There was a significant increase in LPT rate throughout the study period, but no significant trend in the rate of medically indicated deliveries. A higher mortality was observed in early term versus late term infants, with adjusted OR: 2.43 (p=0.038). LPT and early term infants have a significantly higher risk of death.

Association Between Parity, Pre-pregnancy Body Mass Index And Gestational Weight Gain.

To analyze the relationship between parity, pre-pregnancy body mass index (BMI), and gestational weight gain (GWG). This observational controlled study was conducted from November 2013 to April 2014, with postpartum women who started antenatal care up to 14 weeks and had full-term births. Data were collected from medical records and antenatal cards. Descriptive and bivariate analyses were performed. The significance level was 5%. Data were collected from 130 primiparous and 160 multiparous women. At the beginning of prenatal care, 54.62% of the primiparous were eutrophic, while the majority of multiparous were overweight or obese (62.51%). Multiparas are two times more likely to be obese at the beginning of their pregnancies, when compared to primiparas. The average pre-pregnancy weight and final pregnancy weight was significantly higher in multiparous, however, the mean GWG was higher among primiparous. We found an inverse correlation between parity and the total GWG, but initial BMI was significantly higher in multiparas. Nevertheless, monitoring of the GWG through actions that promote a healthier lifestyle is needed, regardless of parity and nutritional status, in order to prevent excessive GWG and postpartum weight retention and consequently inadequate pre-pregnancy nutritional status in future pregnancies.

Severe Maternal Morbidity And Near Miss Due To Postpartum Hemorrhage In A National Multicenter Surveillance Study.

To assess the occurrence of severe maternal complications owing to postpartum hemorrhage (PPH) and its associated factors. A secondary analysis of data from a multicenter cross-sectional prospective surveillance study included 9555 cases of severe maternal morbidity at 27 centers in Brazil between July 2009 and June 2010. Complications of PPH, conditions of severity management, and sociodemographic and obstetric characteristics were assessed. Factors independently associated with severe maternal outcome (SMO) were identified using multiple regression analysis. Overall, 1192 (12.5%) of the 9555 women experienced complications owing to PPH (981 had potentially life-threatening conditions, 181 maternal near miss, and 30 had died). The SMO ratio was 2.6 per 1000 live births among women with PPH and 8.5 per 1000 live births among women with other complications. Women with PPH had a higher risk of blood transfusion and return to the operating theater than did those with complications from other causes. Maternal age, length of pregnancy, previous uterine scar, and cesarean delivery were the main factors associated with an increased risk of SMO secondary to PPH. PPH frequently leads to severe maternal morbidity. A surveillance system can identify the main causes of morbidity and could help to improve care, especially among women identified as being at high risk of PPH.

Crescimento da pessoa com Síndrome de Down : contribuição para a construção de um referencial

Universidade Estadual de Campinas . Faculdade de Educação Física

Caracterização das mães, partos e recém-nascidos em Campinas, São Paulo, 2001 e 2005

OBJETIVO: Comparar dados pré-natais, dos partos e dos recém-nascidos de Campinas em 2001 e 2005. MÉTODOS: Estudo transversal que analisou 13.656 documentos do Sistema de Informações sobre Nascidos Vivos (Sinasc) de 2005, comparando-as aos resultados de 2001. Analisou-se o local de moradia e parto, idade materna, estado civil, escolaridade, ocupação, paridade, consultas de pré-natal, tipo de parto, duração da gestação e peso ao nascer. Para avaliar a associação entre as variáveis, utilizou-se o teste de qui-quadrado, sendo significante p<0,05. RESULTADOS: Os nascidos nos Distritos de Saúde (DS) com piores índices de condições de vida (ICV) diminuíram em relação a 2001. A taxa de adolescentes passou de 17,7% para 14,7%. Em 2001, 39,4% das mães trabalhavam e, em 2005, 42,9%. Quanto à presença de companheiro, 35,9 e 54,3% não o referiam em 2001 e 2005, respectivamente. A escolaridade passou de 37,8% de mães com até sete anos de estudo para 25,7%, com aumento das que estudaram entre oito e 11 anos e 12 anos ou mais. O comparecimento a mais de seis consultas no pré-natal passou de 74,4 para 86,6%. Houve aumento de cesáreas (54,9 para 60,3%) e de prematuridade (7,1 para 8,9%). Não houve alteração no perfil de peso ao nascimento. CONCLUSÕES: Verificou-se queda da paridade nos DS com piores ICV e no percentual de mães adolescentes. Elevou-se o número de trabalhadoras, mulheres sem companheiro, escolaridade e frequência ao pré-natal.

Morte neonatal precoce segundo complexidade hospitalar e rede SUS e não-SUS na Região Metropolitana de São Paulo, Brasil

O objetivo foi analisar o perfil dos recém-nascidos, mães e mortalidade neonatal precoce, segundo complexidade do hospital e vínculo com o Sistema Único de Saúde (SUS), na Região Metropolitana de São Paulo, Brasil. Estudo baseado em dados de nascidos vivos, óbitos e cadastro de hospitais. Para obter a tipologia de complexidade e o perfil da clientela, empregaram-se análise fatorial e de clusters. O SUS atende mais recém-nascidos de risco e mães com baixa escolaridade, pré-natal insuficiente e adolescentes. A probabilidade de morte neonatal precoce foi 5,6‰ nascidos vivos (65% maior no SUS), sem diferenças por nível de complexidade do hospital, exceto nos de altíssima (SUS) e média (não-SUS) complexidade. O diferencial de mortalidade neonatal precoce entre as duas redes é menor no grupo de recém-nascidos < 1.500g (22%), entretanto, a taxa é 131% mais elevada no SUS para os recém-nascidos > 2.500g. Há uma concentração de nascimentos de alto risco na rede SUS, contudo a diferença de mortalidade neonatal precoce entre a rede SUS e não-SUS é menor nesse grupo de recém-nascidos. Novos estudos são necessários para compreender melhor a elevada mortalidade de recém-nascidos > 2.500g no SUS.

Fatores de risco para nascimentos pré-termo em Londrina, Paraná, Brasil

Objetivou-se identificar fatores de risco para nascimentos pré-termo por meio de estudo caso-controle populacional que envolve nascidos vivos hospitalares de mães residentes em Londrina, Paraná, Brasil. Os casos foram os 328 nascimentos pré-termo e os controles, uma amostra proporcional de 369 nascimentos com 37 semanas ou mais. Realizou-se análise de regressão logística múltipla hierarquizada. Verificou-se associação (p < 0,05) para as variáveis: sócio-econômicas - moradia em favela e baixa idade do chefe familiar; características maternas: IMC < 19 e > 30kg/m², com filho anterior pré-termo, com tratamento para engravidar; características maternas durante a gestação: com companheiro há no máximo dois anos, preocupações, bebida alcoólica semanal, pré-natal inadequado, prática de caminhada como proteção; agravos na gestação - sangramento, infecção do trato genital, volume alterado do líquido amniótico, hipertensão arterial e internação; gestação múltipla. A identificação de fatores de risco e a melhoria da qualidade da atenção pré-concepcional e pré-natal podem reduzir a prematuridade.

Características dos nascidos vivos, das mães e mortalidade neonatal precoce na Região Metropolitana de São Paulo, Brasil

O objetivo foi descrever as características do recém-nascido, da mãe e da mortalidade neonatal precoce, segundo local de parto, na Região Metropolitana de São Paulo, Brasil. Utilizou-se coorte de nascidos vivos vinculados aos respectivos óbitos neonatais precoces, por técnica determinística. Identificou-se o parto domiciliar a partir da Declaração de Nascido Vivo e os ocorridos em estabelecimentos a partir da vinculação com o Cadastro Nacional de Estabelecimentos de Saúde. Foram estudados 154.676 nascidos vivos, dos quais 0,3% dos nascimentos ocorreram acidentalmente em domicílio, 98,7% em hospitais e menos de 1% em outro serviço de saúde. A mortalidade foi menor no Centro de Parto Normal e nas Unidades Mistas de Saúde, condizente com o perfil de baixo risco obstétrico. As taxas mais elevadas ocorreram nos prontos-socorros (54,4 óbitos por mil nascidos vivos) e domicílios (26,7), representando um risco de morte, respectivamente, 9,6 e 4,7 vezes maior que nos hospitais (5,6). Apesar da alta predominância do parto hospitalar, há um segmento de partos acidentais tanto em domicílios como em prontos-socorros que merece atenção, por registrar elevadas taxas de mortalidade neonatal precoce.