Re: Perinatal statistics in YOUR country??
From: James S Smeltzer MD (gaperina@mindspring.com)
Fri Aug 14 11:07:05 1998
Hans,
THe US Birth record data are standardized for most states and kept by the
state, as location of birth is THE MAIN criterion for citizenship & other
things. Computer abstracts are available for research purposes with
personal identifiers removed. The data on sex, weight and apgar scores are
reliable, in my experience with these data. Other data is progressively
less reliable, when I compared them directly with my own carefully gathered
data on the same individuals and birth. The quality of the data depend on
the abstractor and certifier who may have special interest and training and
may not. The individual providers may or may not be careful about accurate
completion.
The WHO may be able to answer your question at
http://www.who.org
in the us there is a center for health statistics, and even an office in
dhhs to help you find the right information:
http://www.health.org
Abstract: The National Health Information Center (NHIC) is a
health information referral service. NHIC puts health
professionals and consumers with health questions in touch with
those organizations that are best able to provide answers. NHIC
meets these objectives by providing a variety of health information
resource materials, a toll-free telephone service, and a database
of health-related organizations. The Center refers requesters for
information on specific diseases, health statistics, health
education materials, health promotion programs, nutrition,
exercise, and many other general health topics. The Center
maintains an online directory of more than 1,100 health-related
organizations that can provide health information. They include
Federal and State agencies, voluntary associations, self-help and
support groups, trade associations, and professional societies.
The database is accessible to the public through DIRLINE, part of
the National Library of Medicine's MEDLARS system, via the
Internet, and through information specialist mediated telephone
inquiry. NHIC does not diagnose disease, recommend health care
providers, or perform in-depth research.
Purpose: NHIC was established by ODPHP in 1979 to assist ODPHP in
meeting its statutory responsibilities in the area of health
communication. NHIC has operated continuously since 1979.
Agency Program: The Office of Disease Prevention and Health
Promotion, established by the National Consumer Health Information
and Health Promotion Act of 1976 (Section 1706 of the PHS Act as
amended) and continued under the "Omnibus Health Act of 1988," was
mandated a number of responsibilities, including participation in
policy development; oversight and coordination of PHS activities in
disease prevention and health promotion; identification of unmet
needs related to health information and disease prevention and
development of resources to meet such needs; and dissemination of
health information.
At 07:37 PM 8/11/1998 -0500, you wrote:
>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.
>
> Sorry for crossposting!
>
> Dear friends,
>
> Who can help me answering the next question:
>
> In the Netherlands we try to accomplish a national perinatal
>registry, for which the data are provided by the actual obstetric caregiver:
>the midwives, the family doctor and the obstetricians.
>
> We started in 1972 and now we cover about 98% of all deliveries in
>our country (about 70 fields each delivery!!). At the moment we want to
>improve the database and you'll understand that this is a very critical
>procedure.
>
> Hence my question:
>
> 1. Can anybody tell me if there are countries where the perinatal
>statistics have about the same basis as ours?
>
> 2. From which data originate the national perinatal (mortality)
>figures in your country ?
> Thank you!!
> Hans
>
> **********************************************************
> * Hans van der Slikke, OB/GYN
> *
> * Editor in Chief NVOG-net
> * http://www.nvog.nl/
> * Chairman International Council OBGYN.net
> * http://www.obgyn.net/
> *
> * vdslikke@knmg.nl
> * or
> * NVOG@compuserve.com
> *
> * Fax: +31 (0) 299 413 281
> ********************************************************************
>
