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Re: Perinatal statistics in YOUR country??From: DuBose, Terry (DuboseTerryJ@exchange.uams.edu)Tue Aug 11 19:36:32 1998
Dear Hans, How fortunate that you inquire now, how is the September case study coming? Just a gentle reminder. Hans van der Slikke, MD Hans.van.der.Slikke@obgyn.net September Agreed Now about your question. Birthing statistics in the United States are gathered from "Birth Certificates" and some states have Birth Defects Registries in addition. These Certificates are completed at the time of birth... theoretically. However, there are several problems, not the least of which they are not always accurate or even completed. There are a number of folks in the USA that do not trust any government and do not want their child to be "counted". Another problem that I noticed about 6 years ago came up because of an "epidemic" of anencephaly and neuro tube defects in the Rio Grande River Valley in south Texas. This was thought to be due to pollution in the water. A great epidemiological study by a physician (Dr. Carmen Racou, I think, in Brownsville, female) found that 36 anencephalics babies were all born to mothers who lived with in 1 mile of the river. Later it was realized that there were over 50 more on the Mexico side of the river during the same time period. High levels of organic solvents were found unofficially, it took over 2 years to get the two governments to agree a study was needed, in the mean time the corporations with operations along the Rio Grande cleaned up their act... somewhat. On of the major problems first encountered was when the Texas State Health Department did a statistical comparison they came up with pockets of neuro tube problems in Houston, San Antonio, Austin and other Texas cities. This made it appear that it was not just a Rio Grande River problem. I got involved when a woman came in for an Ob sonogram and we found an anencephalic fetus. Because the woman did not speak English I got our interpreter to ask about where she lived. She had moved from the Rio Grande valley in Mexico to Austin after she had gotten pregnant. However, when the baby was born, if a Birth Certificate was filled out at all, or if the baby was entered into a Birth Defect Registry, it will show up in Travis County, Austin, Texas rather than in the Rio Grande Valley where the pollution that caused the problem in the 1st trimester was located. I wrote several letters to the State Health Department and the Governor (Ann Richards, at that time), pointing out that environmental birth defects are caused in the 1st trimester, not at the place of birth. When I left Texas 2.5 years ago, they were still counting birth defects in the counties of birth, not conception. I think this is a wide spread problem in trying to find linkages between birth defects and the environmental causes. We need to be asking where the women lived during the first 2 to 3 months of the pregnancy, and be less concerned about where they actually deliver. I realize this will be problematic, especially with migrant farm workers, etc. Good luck. Let us know what you find out on these issues. Looking forward to the September Case Study. -- Peace, Terry J. DuBose, M.S., RDMS Director, Diagnostic Medical Sonography Program University of Arkansas for Medical Sciences, Assistant Professor DuBoseTerryJ@Exchange.uams.edu <mailto:DuBoseTerryJ@Exchange.uams.edu> http://www.uams.edu/chrp/dmshome.htm <http://www.uams.edu/chrp/dmshome.htm> VOICE: 501-686-6510 FAX: 501-686-6513 Chair, http://www.obgyn.net/us/us.htm <http://www.obgyn.net/us/us.htm> http://www.io.com/~dubose/ <http://www.io.com/~dubose/> Now is the time for all good folks to come to the aid of the Earth.
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