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THE ANESTHETIC HAZARDS IN OBSTETRICS

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1955年第4期70卷 861-875页

作者： LOCK, FR GREISS, FC From the Department of Obstetrics and Gynecology The Bowman Gray School of Medicine of Wake Forest College Winston-Salem N. C.

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Respiratory distress syndrome and maternal birth weight effects

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OBSTETRICS AND GYNECOLOGY 2000年第2期95卷 174-179页

作者： Strandjord, TP Emanuel, I Williams, MA Leisenring, WM Kimpo, C Univ Washington Dept Pediat Sch Med Seattle WA 98195 USA Univ Washington Dept Epidemiol Sch Publ Hlth Seattle WA 98195 USA Univ Washington Ctr Human Dev & Disabil Seattle WA 98195 USA Univ Washington Maternal & Child Hlth Program Seattle WA 98195 USA Fred Hutchinson Canc Res Ctr Seattle WA 98104 USA

Objective: To study traditional risk factors and the intergenerational risk factor maternal low birth weight (LBW) for respiratory distress syndrome (RDS) in infants in multiple ethnic groups. Methods: The population-based database consists of hospital records linked to Washington state maternal and infant vital records. Four racial-ethnic groups were studied, whites, blacks, Native Americans, and Hispanics. Poisson regression models were used to estimate relative risks of various factors for RDS, Results: Rates for RDS were whites 1.2%, blacks 1.9%, Native Americans 1.3%, and Hispanics 1.0%. Maternal LBW was associated with increased relative risk (RR) for RDS in whites (2.6, 95% confidence intevral [CI] 1.6, 4.2) and blacks (3.3, 95% CI 1.9, 5.6) for infants born vaginally. Compared with mothers of normal infants, birth weights of mothers of infants with RDS and delivered vaginally were significantly lower in whites, blacks, and Native Americans. The association of maternal LBW with RDS persisted in blacks even when multiple risk factors were added to the model (RR 2.4;95% CI 1.1, 5.1). Conclusion: The association of maternal LBW with RDS is probably due in part to the association of maternal LBW with infant LBW and preterm birth. The strong persistent association of maternal LBW with RDS in blacks suggests that improvement of perinatal outcomes in that group will require improvement of long-term birth weight distribution. (C) 2000 by The American College of Obstetricians and Gynecologists.

关键词：年龄分布年龄因素出生体重接生产科人种群/统计学和数值数据孕龄发病率婴儿极低出生体重病案母亲/统计学和数值数据泊松分布呼吸窘迫综合征新生儿/流行病学呼吸窘迫综合征新生儿/人种学危险因素华盛顿/流行病学成年人女(雌)性人类婴儿新生妊娠

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A DISCUSSION OF THE PROPER PLACE OF SURGICAL INDUCTION WITH A REVIEW OF ITS HAZARDS

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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1956年第2期71卷 291-299页

作者： BLAIKLEY, JB London England

Surgical induction of labor is not without risk to the mother, and should not be lightly undertaken. It has, I believe, an important place in the treatment of postmaturity, anyhow in primigra vidas; it can reduce the fetal loss, also the incidence of difficult labor in this class of case. Induction has no place, I believe, in the treatment of disproportion in primigravidas, and almost no place in multiparas. In pre-eclamptic toxemia, induction has an established place, in the interests of both the mother and the baby, but under certain circumstances cesarean section should be *** all the risks in surgical induction of labor, prolapsed cord is the most worrying, and if the head is above the brim the incidence is high. These days, most of us I think would undertake cesarean section if this accident happens, but even so it is not always possible to recognize the condition in time to save the *** will be interesting for me to learn how far the use of Pitocin drips has added, if at all, to the safety of surgical induction in the classes of ease discussed. Although I have had relatively little experience with it. J would hesitate to use it in postmaturity or in pre-eclamptic toxemia on account of increasing the already present risk of anoxia in the child.

关键词：婴儿新生/统计学和数值数据引产分娩产道母亲/统计学和数值数据会阴外阴女(雌)性人类妊娠

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Maternal mortality estimated using the Sisterhood method in Gulu district, Uganda

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TROPICAL DOCTOR 2000年第2期30卷 72-74页

作者： Orach, CG Makerere Univ Inst Publ Hlth Kampala Uganda

A community-based retrospective maternal mortality study using the Sisterhood method was conducted in Gulu district between February and March 1996. The objectives were to estimate the magnitude of and identify factors associated with maternal mortality in the district. A total of 5522 adult respondents, randomly selected from 27 parishes, of the five counties in the district were interviewed. Between 1960-1996 324 maternal deaths occurred in the sisterhood sample. The maternal mortality Fate (MMR) was estimated to be 662 per 100 000 deliveries [95% confidence interval (CI) 421-839 per 100 deliveries]. The leading causes of maternal death were: haemorrhage 45.1%;obstructed labour 26.2%;puerperal sepsis 9.6%;anaemia 2.2%;AIDS 2.2%;and gunshot wounds (GSW) 1.0%. Factors associated with maternal mortality included: age - 31.8% of the mothers who died were below 20 years;education - 57.1% had no formal education;65% of the mothers had delivered at home, 50.6% had been attended to by untrained traditional birth attendants (TBAs) while 37.8% were attended to by relatives. The MMR was found to be 1.3 times higher than the estimated national MMR of 500 per 100 000 deliveries. Most maternal deaths (80.9%) were due to preventable causes, being related to low socioeconomic status and low-level education of women in the district. The intractable civil war in the district was a major underlying and contributory factor to the high maternal mortality in the area. A multifaceted approach to reduce maternal mortality in the district should target improving the socioeconomic conditions in the district with special emphasis on encouraging and supporting female education. Intensive education on maternal healthcare in antenatal clinics be conducted targeting husbands/ spouses and relatives who care for the prenatal/pregnant and postnatal mothers. There is need for more trained TBAs per village who should be given effective support supervision. Ambulance transport services, motor and bic

关键词：偏倚(流行病学) 死亡原因数据收集/方法数据说明统计教育程度产妇死亡率助产学母亲/教育母亲/统计学和数值数据需求估价核型家庭人群监测/方法问卷调查/标准可重复性结果回顾性研究危险因素社会经济因素乌干达/流行病学青少年成年人女(雌)性人类

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FURTHER STUDIES ON THE RACIAL INCIDENCE AND MORTALITY OF ECTOPIC PREGNANCY

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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1955年第2期70卷 312-319页

作者： FONTANILLA, J ANDERSON, GW From the Department of Obstetrics the Johns Hopkins University Medical School and Hospital Baltimore Md.

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Nurses as working women.

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AORN journal 2001年第3期73.0卷 675-678,680-682页

作者： Letvak, S. University of North Carolina-Greensboro School of Nursing Greensboro NC USA.

Women today make up nearly half of the nation's workforce. A number of these women have children at home, and women also often are responsible for providing care to older adult family members or friends. The different roles assigned to women in today's society are burdensome, particularly for nurses who deal with the stress of managed care, downsizing, the nursing shortage, caring for increasingly ill patients, long and irregular hours, and daily crises. There are ways that nurses can modify their work situation, however, to help them cope with the rigors of the workplace and the home.

关键词：医疗护理提供者/心理学就业/心理学欧洲女权主义母亲/心理学母亲/统计学和数值数据护士/心理学护士/统计学和数值数据人员配备和时间安排/组织和管理权力(心理学) 应激心理学/病因学美国妇女就业/心理学工作安排忍受青少年成年人老年人女(雌)性人类中年人

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What influences the uptake and early cessation of breast feeding?

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MIDWIFERY 1998年第4期14卷 242-247页

作者： Bick, DE MacArthur, C Lancashire, RJ Univ Birmingham Sch Med Dept Publ Hlth & Epidemiol Birmingham B15 2TT W Midlands England

Objective: to examine obstetric, maternal and social factors associated with the uptake and early cessation of breast feeding and women's reasons for altering from breast to bottle feeding. Design: women who responded to a postal questionnaire on long-term postpartum health were contacted and asked to participate in a home-based interview, In addition to health problems, the interview obtained information on baby feeding and a number of social factors. Women were also asked to complete the Edinburgh Postnatal Depression Scale (EPDS), Obstetric and maternal data were obtained from maternity records. Setting: deliveries from a large maternity hospital in Birmingham. Participants: 906 women were interviewed at a mean of 45 weeks after delivery, Findings: 63% of the women said they had breast fed, but 40% of these stopped within three months of delivery, Many of the women gave physical problems with lactation as reasons for stopping. The factors found to be predictors of early cessation were: return to work within three months of birth;regular childcare support from other female relatives, and a high EPDS score. Non-initiation of breast feeding was predicted by a different set of factors: multiparity;general anaesthetic (GA);and unmarried status. Discussion and conclusion: despite evidence of the benefits of breast feeding, this remains an unacceptable long-term option for many women, and for over one-third it is never attempted. Factors within the woman's social environment were found to influence early cessation, Women who had a GA during or immediately following labour and delivery were less likely to initiate breast feeding, Implications for practice: if breast-feeding incidence and duration are to increase, more attention should be paid to establishing early, successful breast feeding and countering the negative influences of factors within the social environment.

关键词：母乳喂养/心理学母乳喂养/统计学和数值数据选择行为抑郁症产后/心理学随访研究健康知识态度实践母亲/教育母亲/心理学母亲/统计学和数值数据问卷调查社会支持社会经济因素时间因素妇女就业/教育妇女就业/心理学妇女就业/统计学和数值数据成年人女(雌)性人类婴儿

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The Health of Rural Homeless Women with Young Children

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The Journal of Rural Health 1994年第1期10卷 49-57页

作者： Wagner, Janet D. Menke, Edna M. Ciccone, Janet K. College of Nursing of Ohio State Univer:Stiy Department of Nursing Technology Columbus State Community College Columbus Ohio United States College of Nursing Ohio State University United States

More than 30 percent of the homeless are families with children;however, little is known about these families, particularly rural homeless mothers with children. The purpose of this study was to describe the characteristics of rural homeless mothers, their physical and mental health, and their health care practices. A descriptive cross‐sectional design was used to study a sample of 76 rural mothers with children younger than age 13. An interview schedule and the SCL‐90‐R were used to collect data about these families. The majority of the families had been homeless for more than four months, 46 percent were woman‐headed, 17 percent of the mothers reported having a physical health problem, and only 3 percent had scores on the SCL‐90‐R that were indicative of needing additional evaluation for possible mental health problems. The use of drugs was higher than expected, which puts both the mothers and their children at risk for health problems. Copyright © 1994, Wiley Blackwell. All rights reserved

关键词：年龄分布横断面研究家庭卫生卫生服务需求健康调查无家可归者/统计学和数值数据精神卫生母亲/统计学和数值数据俄亥俄/流行病学病人接受卫生保健的程度/统计学和数值数据问卷调查农村卫生成年人儿童儿童学龄前女(雌)性人类婴儿婴儿新生

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Job continuity among new mothers

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DEMOGRAPHY 1999年第2期36卷 145-155页

作者： Klerman, JA Leibowitz, A Rand Corp Santa Monica CA 90407 USA Univ Calif Los Angeles Sch Publ Policy Los Angeles CA 90024 USA

In the early 1990s, both state and federal governments enacted maternity-leave legislation. The key provision of that legislation is that after a leave of a limited duration, the recent mother is guaranteed the right to return to her preleave employer at the same or equivalent position. Using data from the National Longitudinal Survey of Youth, we correlate work status after childbirth with work status before pregnancy to estimate the prevalence, before the legislation, of returns to the preleave employer. Among women working full-time before the pregnancy, return to the prepregnancy employer was quite common. Sixty percent of women who worked full-time before the birth of a child continued to work for the same employer after the child was born. Furthermore, the labor market behavior of most of the remaining 40% suggests that maternity-leave legislation is unlikely to have a major effect on job continuity Compared with all demographically similar women, however;new mothers have an excess probability of leaving their jobs.

关键词：选择行为 Logistic模型模型理论母亲/统计学和数值数据双亲假/立法和法学双亲假/统计学和数值数据美国妇女就业/统计学和数值数据成年人女(雌)性人类婴儿婴儿新生妊娠

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ACUTE CHILDHOOD DIARRHEA AND MATERNAL TIME ALLOCATION IN THE NORTHERN CENTRAL SIERRA OF PERU

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HEALTH POLICY AND PLANNING 1995年第1期10卷 60-70页

作者： BENTLEY, ME ELDER, J FUKUMOTO, M STALLINGS, RH JACOBY, E BROWN, K WORLD BANK DEPT CENT WESTERN AFRICA WASHINGTON DC USA INST INVEST NUTR INST HUMAN NUTR LIMA PERU UNIV CALIF DAVIS DEPT NUTR PROGRAM INT NUTR DAVIS CA USA

Interventions to improve child health depend, at least implicitly, on changing maternal knowledge and behaviour and a reallocation of maternal time. There have been few studies, however, of the time cost involved in the adoption of new health technologies and even fewer that examine changes in maternal activities in response to child illness. The present study examines maternal daytime activities and investigates changes that occur when children are ill. We examine the impact of acute childhood diarrhoea episodes on the activity patterns of the mother/caretaker in this setting. The results show that mothers alter their usual activity patterns only slightly in response to acute diarrhoea episodes in their children. They continue to perform the same variety of activities as when the children are healthy, although they are more likely to perform them with the child 'carried' on their back. There is some indication that diarrhoea perceived to be more severe did result in the mother acting as caretaker more frequently. These findings have important implications for health interventions that depend on changing the amount of maternal or caretaker time spent for child health technologies, but the implications may vary depending on the reasons for the observed lack of changes in caretaker activities.

关键词：儿童抚育/统计学和数值数据数据收集发展中国家腹泻婴儿/护理食品处理和加工/统计学和数值数据健康知识态度实践纵向研究母子关系母亲/统计学和数值数据秘鲁时间和运动研究儿童学龄前人类婴儿

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