RESUMEN
In a large prospective study (1959--1966), the perinatal mortality rate for U.S. Whites was 34 deaths per 1000 total births, for Blacks 51/1000, for Puerto Ricans 41/1000, and for Orientals 23/1000. A number of disorders were responsible for these differences. Premature rupture of the fetal membranes occurred 92 per cent more often in Blacks than in Whites, marked placental growth retardation 56 per cent more often, amniotic fluid infections 45 per cent more often, and major congenital malformations 15 per cent more often. Most other disorders were less common in Blacks than in Whites. Stratifying the data by selected factors, such as prepregnancy body weight and antenatal medical care, eliminated or greatly reduced almost all of these interracial differences. The only major unexplained differences remaining were an excess of amniotic fluid infections and major congenital malformations in Blacks, and an excess of abruptio placentae and large placental infarcts in Whites.
Asunto(s)
Muerte Fetal/etiología , Mortalidad Infantil , Enfermedades del Recién Nacido/mortalidad , Negro o Afroamericano , Líquido Amniótico , Asia/etnología , Infecciones Bacterianas/mortalidad , Población Negra , Anomalías Congénitas/mortalidad , Etnicidad , Femenino , Muerte Fetal/epidemiología , Rotura Prematura de Membranas Fetales/mortalidad , Hispánicos o Latinos , Humanos , Recién Nacido , Enfermedades Placentarias/mortalidad , Embarazo , Estudios Prospectivos , Puerto Rico/etnología , Estados Unidos , Población BlancaRESUMEN
Dysmaturity, diagnosed according to the Clifford criteria, was studied for the first time in a black population. The infants and matched control subjects were participants in the Collaborative Perinatal Study in Philadelphia from birth to 7 years of age. The incidence of dysmaturity was 25/1,000 live births; more boys than girls were born dysmature, reversing the normal male/female ratio found among black infants in the Collaborative Study as a whole. The condition was more common among post-term infants but did occur in earlier gestational weeks. The overall characteristics of the condition among this black population did not differ from those previously reported among white populations of various races. Surviving infants developed mentally and physically as well as control subjects. No prenatal or environmental characteristics were found that distinguished mothers of dysmature infants from those of nondysmature infants.
Asunto(s)
Recién Nacido , Posmaduro , Puntaje de Apgar , Bilirrubina/sangre , Población Negra , Niño , Preescolar , Femenino , Estudios de Seguimiento , Edad Gestacional , Hematócrito , Humanos , Lactante , Recién Nacido Pequeño para la Edad Gestacional , Masculino , Edad Materna , Meconio , Paridad , Pennsylvania , Placenta/patología , Enfermedades Placentarias/sangre , Enfermedades Placentarias/mortalidad , Enfermedades Placentarias/patología , Embarazo , Pruebas Psicológicas , Enfermedades de la Piel/sangre , Enfermedades de la Piel/mortalidad , Síndrome , Vernix CaseosaRESUMEN
The reproductive outcome of pregnancies complicated by severe sickle cell hemoglobinopathies is not usually satisfactory. In this study, prophylactic partial exchange transfusions have been used in 35 patients with sickle hemoglobinopathies. There was significant improvement in results, both maternal and neonatal, as compared to those in 29 pregnancies complicated by similar disease processes who did not receive this therapy. The former group was also compared to 61 normal pregnant patients and 31 patients with sickle cell trait, none of whom received blood as part of their therapy. The results were similar in the group receiving transfusions and in the group with sickle cell trait. There was a decrease in perinatal wastage, prematurity, and incidence of low-birth-weight infants in the transfusion group when compared to the patients with hemoglobinopathies who were treated conservatively.