Preterm delivery is one of the important causes of infant morbidity and mortality in the United States (U.S.). Annually, 12% of infants are born preterm in the U.S. and preterm birth related causes of death account for approximately 35% of all infant deaths. Using the latest (2012) National Survey of Children’s Health, the study aims to estimate the prevalence rates of preterm birth in the U.S., and identify key risk factors associated with it. Data (n=42,282) was obtained from the 2012 NSCH. Using the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommendations, preterm birth was defined as one occurring less than 37 completed weeks of gestation from the first day of Page 26 2015 Appalachian Student Research Forum the last menstrual period. Based on existing literature, the following maternal and child characteristics were included as potential factors associated with preterm birth in the U.S. – infant gender, race, maternal smoking or maternal exposure to secondhand smoke (SHS), family income and maternal general health status. Descriptive statistics were reported using frequencies and proportions. Multiple logistic regression analyses were conducted to assess the association of selected variables with the preterm birth. Overall, 10.65% of live births were born preterm in the U.S. during 2012. Preterm birth prevalence rates were higher among males (12.07%), non-Hispanic blacks (14.34%) and those born to mothers who were smokers or exposed to secondhand smoke during pregnancy (23.8%). Males had higher odds of being born preterm (OR 1.07 95% CI 1.01-1.15) than females. Non-Hispanic White is less likely to be born preterm (OR 0.86 95% CI 0.74-0.99) compared to non-Hispanic black. Infants born to mothers who were smokers or exposed to SHS during pregnancy had higher odds of being born preterm (OR 1.05, 95% CI 0.97-1.13) compared to those born to women who were non-smokers and not exposed to SHS. Infants born to women who reported better general health status were less likely to be born preterm (Excellent/Very good vs Fair/Poor: OR 0.51 95% CI 0.46-0.56, Good vs Fair/Poor: OR 0.68 95% CI 0.61-0.75) than referent group. Approximately one-tenths of live births in the U.S. were born preterm. Study findings demonstrated infant race, gender, maternal general health status and maternal smoking or secondhand smoke exposure during pregnancy as factors associated with preterm birth. Determining these factors is important in the development of effective intervention programs and policies to reduce the rates of preterm birth in the U.S.

Estudaram-se as perdas fetais ocorridas no distri to de São Paulo, no período de dois anos (1 de junho de 1968 a 31 de maio de 1970) e cuja residência da mãe se localizasse também no distrito de São Paulo. O trabalho objetivou o estudo das mesmas segundo as variáveis fornecidas pelos atestados dos nascidos mortos, que se constituiram em seu material básico. O ponto de vista social foi focalizado através dos aspectos referentes à cor, filiação, naturalidade e profissão dos pais. Os itens relativos a sexo, duração da gestação, local onde ocorreu o evento, história obstétrica, idade da mãe e causa da perda constituiram o conjunto de dados para análise do ponto de vista médico-estatístico. Quanto ao problema da causa, é de se destacar que esta é a primeira vez que tal aspecto é analisado entre nós. Utilizando dados obtidos atravês da \"Investigação Interamericana de Mortalidade na Infância\", foi possível obter o coeficiente corrigido de mortalidade perinatal. A pesquisa visou ainda ao estudo das implicações que as perdas fetais acarretam no campo Jurídico. Quanto aos resultados, devem ser destacados o problema do registro de perdas por local de ocorrência e não de residência, a maior proporção de ilegitimidade nas perdas fetais precoces e a maior proporção de pais naturais da região leste do Brasil. A razão de masculinidade se mostrou maior quanto menor fosse o tempo de gestação. Alguns dados permitiram inferir que existe uma sub-enumeração de perdas precoces e intermediárias. Verificou-se ainda que, aproximadamente, 86% das perdas ocorreram em hospitais,que a quarta parte dos casos estudados foi produto de primeira gestação e que em 85% das perdas o parto foi normal. Relativamente à idade da mãe, foi verificado que o risco de vir a ter uma perda - excetuando-se o grupo de mulheres de menos de vinte anos - aumenta com a idade materna. Em face de erros e imperfeições quanto ao preenchimento do atestado e da ausência de alguns dados de grande interesse para a Saúde Pública, foi sugerida a adoção de novo modelo de atestado de óbitos perinatais. / Foetal loss of resident women of the district of Sao Paulo that occurred in this area, were studied for a two years period, from June 1st, 1968 to May 31st, 1970. The objectives of this study were: - analysis of the foetal mortality differentials according to the available information in the certificates of stillbirths; - analysis of legal involvements pertinent to the foetal deaths. The variables considered were: - social: color, legitimacy, parents birth place and their occupation; - medical-demographic: sex, lenght of pregnancy, birth-order, single or plural deliveries, age of mother, and cause of death. Data available in the Inter American Investigation in Childhood permitted the calculation of the Perinatal Mortality rate. The conclusions were: - a large proportion of illegitimacy observed among the early foetal deaths - the sex-ratio (x 1000 women) was higher in the early pregnancy\'s foetal loss; - there is an under-registration of foetal loss occurred before 28 weeks of gestation; - 86% of the foetal loss occurred in hospitals; - 25% of foetal loss occurred in women pregnant for the first time; - 11% of the foetal loss were delivered by Caesarean section; - the risk of having a foetal loss increases with the increasing of the mother\'s age. The recommendations were: - the tabulation of the stillbirth certificate data should be done by local of residence instead of by occurrence; - a new model of Perinatal death certificate was proposed in order to provide more complete data that are important from the point of view of Public Health.

Estudaram-se as perdas fetais ocorridas no distri to de São Paulo, no período de dois anos (1 de junho de 1968 a 31 de maio de 1970) e cuja residência da mãe se localizasse também no distrito de São Paulo. O trabalho objetivou o estudo das mesmas segundo as variáveis fornecidas pelos atestados dos nascidos mortos, que se constituiram em seu material básico. O ponto de vista social foi focalizado através dos aspectos referentes à cor, filiação, naturalidade e profissão dos pais. Os itens relativos a sexo, duração da gestação, local onde ocorreu o evento, história obstétrica, idade da mãe e causa da perda constituiram o conjunto de dados para análise do ponto de vista médico-estatístico. Quanto ao problema da causa, é de se destacar que esta é a primeira vez que tal aspecto é analisado entre nós. Utilizando dados obtidos atravês da \"Investigação Interamericana de Mortalidade na Infância\", foi possível obter o coeficiente corrigido de mortalidade perinatal. A pesquisa visou ainda ao estudo das implicações que as perdas fetais acarretam no campo Jurídico. Quanto aos resultados, devem ser destacados o problema do registro de perdas por local de ocorrência e não de residência, a maior proporção de ilegitimidade nas perdas fetais precoces e a maior proporção de pais naturais da região leste do Brasil. A razão de masculinidade se mostrou maior quanto menor fosse o tempo de gestação. Alguns dados permitiram inferir que existe uma sub-enumeração de perdas precoces e intermediárias. Verificou-se ainda que, aproximadamente, 86% das perdas ocorreram em hospitais,que a quarta parte dos casos estudados foi produto de primeira gestação e que em 85% das perdas o parto foi normal. Relativamente à idade da mãe, foi verificado que o risco de vir a ter uma perda - excetuando-se o grupo de mulheres de menos de vinte anos - aumenta com a idade materna. Em face de erros e imperfeições quanto ao preenchimento do atestado e da ausência de alguns dados de grande interesse para a Saúde Pública, foi sugerida a adoção de novo modelo de atestado de óbitos perinatais. / Foetal loss of resident women of the district of Sao Paulo that occurred in this area, were studied for a two years period, from June 1st, 1968 to May 31st, 1970. The objectives of this study were: - analysis of the foetal mortality differentials according to the available information in the certificates of stillbirths; - analysis of legal involvements pertinent to the foetal deaths. The variables considered were: - social: color, legitimacy, parents birth place and their occupation; - medical-demographic: sex, lenght of pregnancy, birth-order, single or plural deliveries, age of mother, and cause of death. Data available in the Inter American Investigation in Childhood permitted the calculation of the Perinatal Mortality rate. The conclusions were: - a large proportion of illegitimacy observed among the early foetal deaths - the sex-ratio (x 1000 women) was higher in the early pregnancy\'s foetal loss; - there is an under-registration of foetal loss occurred before 28 weeks of gestation; - 86% of the foetal loss occurred in hospitals; - 25% of foetal loss occurred in women pregnant for the first time; - 11% of the foetal loss were delivered by Caesarean section; - the risk of having a foetal loss increases with the increasing of the mother\'s age. The recommendations were: - the tabulation of the stillbirth certificate data should be done by local of residence instead of by occurrence; - a new model of Perinatal death certificate was proposed in order to provide more complete data that are important from the point of view of Public Health.

The purpose of this study was to investigate the relationship between residential segregation (the physical separation of Blacks and Whites in residential contexts) and adverse perinatal outcomes (low birth weight, preterm delivery and small for gestational age births) in Florida, Georgia and Louisiana. The study determined the independent effect of the level of residential segregation on the likelihood of adverse perinatal outcomes after controlling for contextual and individual factors. The study also assessed whether the relationship between residential segregation and adverse perinatal outcomes were moderated by ethnicity and median income.The studied employed an observational, cross-sectional study design that utilized secondary data. Live birth certificates between 1999 and 2001 provided information on individual covariates and perinatal outcomes. Structural indicators of residential segregation and contextual covariates were obtained from the U.S. Census Bureau. Th e nested data structure for each birth outcome model was composed of individual, contextual, and structural data. Three-level, hierarchical generalized linear models were used to test research hypotheses.The study population consisted of non-Hispanic White and Black primaparous women between 15 and 49 years of age experiencing singleton live births delivered at less than or equal to 45 weeks gestation. The final sample consisted of 255,548 women nested within 4,360 census tracts and 63 Metropolitan or Micropolitan Statistical Areas. Residential segregation did not have a direct relationship with low birth weight, preterm delivery or small for gestational age, after controlling for other variables in multilevel models. Models testing the moderating effects of ethnicity indicated that increased Isolation decreased the risk of LBW among Black women. Several contextual --level variables and the majority of individual-level variables were significantly associated with perinatal outcome risk .Findings indicate that effects of residential segregation may be birth outcome and ethnic group specific. Relationships between individual factors, contextual factors and adverse perinatal outcomes signal the importance of proximal factors to perinatal outcomes. There is a need for specification of a broader constellation of biological, social and spatial factors and a thorough assessment of residential preferences and experiences in order to better understand the associations between neighborhoods and perinatal outcomes.

Univ., Diss.--Mainz, 2005. / Literaturverz. S. 15 - 24.

The main goal of this thesis is the analysis of multiple-births in Czech Republic between the years of 1950 and 2005 including the international comparison and assess of the influence of assisted reproduction on occurrence of multiple-births. The thesis is divided into five different parts. The first part is dedicated to the analysis of fertility according to a succession of births in Czech Republic while using the indicators of total fertility, the average age of mothers in the time of childbirth and the total number of new-born babies. The second part focuses on multiple-births considering both historical and contemporary point of view and on possible risks for both the mother and the foetus. Next part describes the assisted reproduction, its history, present and commonly used methods. The fourth part is dedicated to the influence of assisted reproduction on the occurrence of multiple-births and to the analysis of multiple-births with the use of absolute and relative number of mono-births and multiple-births indicators, indicators of total fertility, masculinity index, the rate of stillborn babies and the proportion of children born outside of marriage. The last part compares the development of multiple-births within the European countries according to NIDI 1999 classification.

La recherche en anthropologie biodémographique effectuée sur les communautés de Chiomonte(Haute Vallée de Suse), de 1670 à 1929, et de L’Argentière-la-Bessée (Hautes-Alpes), de 1690 à1889, a permis d’analyser les changements survenus tout au long de ces siècles pour ces deux pays.L’analyse des naissances a permis d’avoir un tableau général des deux populations, pouvant êtreinterprété tant au niveau biologique-démographique qu’au niveau économique-culturel.L’analyse des décès a mis en évidence l’importance des facteurs environnementaux sur l’évolutionde la mortalité, même si l’on peut reconnaître que, grâce à l’amélioration des conditions de vie, il ya eu une diminution du taux de mortalité infantile et infanto-juvénile ainsi qu’une augmentationprogressive des décès des personnes âgées.La culture, la société, l’économie et la religion sont les facteurs les plus importants qui influencentle comportement matrimonial; mais l’environnement aussi a joué un rôle important.La reconstruction des familles de Chiomonte nous a permis de constater que les changements auniveau économique et social qui se sont produits entre 1670 et 1830 ont eu des répercussions,quoique de manière différente, sur les aspects relatifs à la structure et à la descendance des familles.L’augmentation de la duré de la vie a produit une augmentation de la durée des mariages et ladécroissance de la mortalité infantile a déterminé un accroissement du nombre d’enfants quiatteignent l’âge reproductif. Restent, par contre, relativement constants l’âge des conjoints à leurpremier mariage, le nombre d’enfants l’intervalle protogénésique ainsi que l’intervalleintergénésique. / The research on biodemographical anthropology worked out on the community of Chiomonte(Haute Vallée de Suse), from 1670 to 1929, and of L’Argentière-la-Bessée (Hautes-Alpes), from1690 to 1889, has allowed the analysis of the changes in the periods considered in these twocountries.The analysis of births has worked out an overall view of the two populations both from a biologicdemographicperspective and from and economic-cultural one.The analysis of deaths has highlighted the importance of environmental factors on death, although ithas been possible to define that through better conditions of life, infantile and juvenile mortality ratecould decreased as well as old aged people mortality increased.Culture, society, economy and religion are the main factors which influenced marriage behaviors ;also environment played an important role.Families’ reconstructions in Chiomonte enabled us to understand that economical changes whichoccurred from 1670 and 1830 had different consequences on the structure and the lineage of thefamily. The increase of life time led to an increase of marriages and at the same time the decrease ofinfantile mortality determined the rise of children who reached the reproductive age.On the other hand, the age of partners at their first marriage, the number of children, theprotogenesic and intergenesic intervals remain constant.

Magister Artium (Development Studies) - MA(DVS) / Civil registration has not been recognised as a matter of concern or public interest in South Africa. It has not been part of discussion in platforms concerned with children’s rights including the government. Consequently, led to failure in understanding the implications it has on children’s lives, in realising their rights and having access to other significant and essential services (Brito, Corbacho & Osorio, 2013). Birth registration proves to be a global problem and a concern for children. Thus many countries have made it a priority and a matter of urgency as indicated in the Sustainable Development Goals for 2030. The objective is for every child to be registered before the year 2030 to ensure that all children are accounted for and prevent invisibility and them having no access to their rightful services.

Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2022 / The psychological impact of perinatal death in the form of bereavement has been widely researched especially from the western perspective. The aim of this study was to establish the help-seeking pathways by mothers bereaved through perinatal death from the African perspective. The qualitative research paradigm in particular the phenomenological approach was adopted for the study. Phenomenology is described as an approach that focuses on the study of the lived experiences of individuals within their world. The application of this approach included personal interviews of 20 mothers who have experienced perinatal death at Doctor George Mukhari hospital in Gauteng province. The aim was to establish the help-seeking pathways they adopted to relief their distress, in terms of how they managed their bereavement and the help that they sought to relief their emotional distress. The findings of the study indicated that mothers lacked knowledge about what precipitated the onset of sudden symptoms such as early rupture of membrane, bleeding, lack of foetal movement which finally led to perinatal death. This lack of knowledge led mothers to attribute the cause of perinatal death to various reasons and conclusions such as distance decay, bad roads that delayed their arrival timeously at the hospital for their babies to be saved. Some cited lack of sense of urgency from the medical personnel and shortage of staff, especially doctors. However, they perceived positive social support from their families, spouses and medical professionals as one of the factors that contributed to their level of calmness and ability to bear the pain of loss. However, participants sought alternative help to facilitate clear understanding about what could have caused their babies to die, also how to manage their grief and how to deal with their subsequent pregnancies. Most of the participants benefited from the various healing pathways they chose. There is a need for healthcare system and community support to be more responsive to the plight of bereaved mothers, in reducing the stigma and the self-blame by bereaved mothers by offering support through counseling center. The findings reaffirm that despite the great studies taken in reducing perinatal deaths, there is a need for collaboration between the modern healthcare system and the traditional healthcare practitioners. Furthermore, emphasis v is needed on the preventative measures and training of healthcare practitioners within the maternal and child healthcare system to further reduce the alarming increase of prenatal deaths

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