Demographic echoes of the maternity data in the Split-Dalmatia County, Croatia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Marasovic Šušnjara
Keyword(s):  
Public Policy ◽  
Population Decline ◽  
Live Birth Rate ◽  
Natural Increase ◽  
Age Group ◽  
Birth Rates ◽  
Live Births ◽  
Societal Challenges ◽  
Adoption And Implementation ◽  
Policy Measures

Abstract Background The demographic situation in the Split-Dalmatia County (SDC) is characterized by negative trends in the new millennium. Such a demographic picture entails many societal challenges. Considering the far-reaching consequences of population decline, the goal is to show what maternity data have been like in the SDC in the last decade. Methods Individual birth reports from health institutions in the SDC were used in the presentation of the maternity data. Demographic indicators were calculated based on data from the Croatian Bureau of Statistics. Results In 2018, in the SDC were reported 4,438 deliveries (13% less vs 2009; 5,103 deliveries) with a total of 4,577 children delivered, whereof 4,561 were live births and 16 were stillbirths. From a total of 4,516 live births, 13 live-born neonates died during the first week of their life. Most of women in labor (89%) were residents of the SDC. The average age of the new mothers was 28.9 years (in 2009; 26.9 years). Childbirth was most frequently recorded in the maternal age group 30 -34 (1,556 deliveries, i.e. 110,9/1,000 women of said age group; 92/1,000 in 2009). Among childbearing women with known data on earlier deliveries (4,431), 2,029 or 45.8% had their first deliveries, 1,549 or 35% had their second deliveries, 808 or 18% had their third or higher birth order deliveries. According to an estimate in 2018, 448,071 people lived in the SDC, less 1.5% from the last census (2011). The live birth rate was 9.5 /1,000 in 2018 (2009; 10.9/1,000). The total fertility rate was 1.53 in 2018 (2009; 1.6). The natural increase rate in 2018 was negative at -1.8 (-830 persons) (2009; 0.5 (250 persons)). Conclusions Depopulation, low birth rates and fertility, are the demographic reality of Split-Dalmatia County as well as Croatia, which requires adoption and implementation of various public policy measures that positively affect fertility to improve the demographic picture. Key messages Depopulation, low birth rates and fertility, are the demographic reality of Split-Dalmatia County as well as Croatia. Adoption and implementation of various public policy measures that positively affect fertility to improve the demographic picture are needed.

scholarly journals Applying growth hormone as an adjuvant to correct poor prognosis outcomes in IVF: Study 2 compares dehydroepiandrosterone

2021 ◽  
Vol 16 (3) ◽  
pp. 164-190
Author(s):  
John Lui Yovich ◽  
Shanthi Srinivasan ◽  
Mark Sillender ◽  
Shipra Gaur ◽  
Philip Rowlands ◽  
...  
Keyword(s):  
Live Birth ◽  
Ovarian Reserve ◽  
Poor Prognosis ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Utilization Rate ◽  
Recurrent Implantation Failure ◽  
Birth Rates ◽  
Live Births ◽  
Live Birth Rates

This retrospective study examines the influence of recombinant growth hormone (rGH) and dehydroepiandrosterone (DHEA) adjuvants on oocyte numbers, embryo utilization and live births arising from 3637 autologous IVF±ICSI treatment cycles undertaken on 2376 women across ten years (2011-2020) within a pioneer Australian facility. Despite using an FSH-dosing algorithm enabling maximal doses up to 450 IU for women with reduced ovarian reserve, younger women had significantly higher mean numbers of oocytes recovered than older women ranging from 11.1 for women <35 years to 9.4 for women aged 35-39 years reducing to 6.5 for women aged 40-44 years and 4.1 for those aged ≥45 years (p<0.0001). Overall, the embryo utilization rate was 48.5% and live birth productivity rate was 35.4 % across all ages and neither rGH nor DHEA showed any benefit on these rates, in fact, those women with nil adjuvants showed the highest live birth rate per initiated cycle (44.94% overall: p<0.0001, and 55.2% for the youngest group: p<0.001). Embryo utilization was increased by rGH in those women aged 40-44 years who had low ovarian reserve (p<0.0001), but this benefit did not translate into any improvement in the live birth rate, in fact those women who did not use adjuvants had the highest overall birth rate (p<0.0001). Similarly, other factors known to cause a poor prognosis, including low IGF-1 profile, recurrent implantation failure, and low oocyte numbers at OPU, showed no improvement in embryo utilization nor in live births from the adjuvants. The relevance of embryo quality was examined on 1135 women whose residual embryos after a single fresh-embryo transfer failed to develop to a suitable grade for cryopreservation. From 1727 cycles such women often displayed an improved embryo utilization rate with both rGH, and with DHEA or combined rGH+DHEA. Even so, live birth rates were not improved by either of the adjuvants excepting young women <35 years using rGH without DHEA (p<0.05). Examining poor prognosis sub-groups, indicated both rGH and DHEA or combined rGH+DHEA consistently improved embryo utilization in those women with low ovarian reserve (p<0.0001), or those with low IGF-1 levels (p<0.0001) or with recurrent implantation failure (p<0.02). All the poor-prognosis sub-groups showed low live birth rates and, notwithstanding the improvements in embryo utilization, the live birth rates were not significantly improved by the adjuvants, albeit the rates were closer to the nil adjuvant groups (not significantly different).

scholarly journals Epidemiological characteristics and trends of birth movements in Serbia

2020 ◽  
Vol 49 (4) ◽  
pp. 17-34
Author(s):  
Snežana Radovanović ◽  
Milena Maričić ◽  
Slađana Radivojević ◽  
Predrag Stanojlović ◽  
Divna Simović-Šiljković ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Mortality Rates ◽  
Fertility Rate ◽  
Age Group ◽  
Fertility Rates ◽  
Birth Rates ◽  
Live Births ◽  
General Fertility Rate ◽  
Maternity Hospitals ◽  
Epidemiological Characteristics

Introduction/Aim: In recent decades, declines in fertility rates have been reported in almost every country in the world. The aim of the research is the analysis of epidemiological characteristics and childbirth trends in Serbia in the period 2007-2016. Methods: The study was designed as a retrospective, descriptive, epidemiological study. The research data were collected from the Health Statistical Yearbooks of the Institute of Public Health of the Republic of Serbia "Dr Milan Jovanovic Batut" in the period 2007-2016. Total fertility rates, stillbirth rates, birth rates, infant mortality rates, and preterm birth rates were used for the analysis of data, while the linear trend and regression analysis were used to analyze the trend. Results: Average rate of general fertility in Serbia in the period 2007-2016 was 1.5 children per woman. In the period 2007-2016, 660,069 births were registered in Serbia with a total of 671,715 children born, of which 4,054 were stillborn (0.6%). Two thirds (66.1%) of stillborn children were born prematurely. The number of premature births increased with maternal age. Of 667,661 live births in maternity hospitals, 924 newborns died (0.1%). In the observed period, a continuous trend of decreasing number of births was registered (y = 68,427-439.99x, R2 = 0.628), as well as the number of live births (y = 69,084-421.44x, R2 = 0.591). The trend of still birth rates showed a slight decrease (y = 6,138-0,012x, R2 = 0,016), as well as the trend of infant mortality rates (y = 1,882-50,091x, R2 = 0,683), but there came to an increase in the trend of the general fertility rate (y = 39.481 + 0.242x, R2 = 0.544). The average general fertility rate for the ten-year period was 41.1 live births per 1000 women of the fertile period and ranged from 38.2‰ to 41.7‰. The largest increase in the fertility rate was registered in the age group 40-44 years from 3.8‰ in 2007 to 9.9‰ in 2016 (2.6 times more), and then in the age group 30-39 years with 43.2‰ in 2007 to 63.0 ‰ in 2016 (1.4 times more). There came to a decline in the fertility rate at the age of 20-29 from 80.4‰ in 2007 to 72.2 ‰ in 2016. The highest rates of stillbirth were registered in the oldest group of 45-49 years (23.3 ‰), and the lowest in persons younger than 15 years (0.7‰). Conclusion: Birth revitalization policies must engage all levels of society to build awareness and moral responsibility for fertility.

scholarly journals Time associations between U.S. birth rates and add-Ons to IVF practice between 2005–2016

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Norbert Gleicher ◽  
Lyka Mochizuki ◽  
David H. Barad
Keyword(s):  
Live Birth ◽  
Outcome Data ◽  
Single Embryo Transfer ◽  
Additional Treatment ◽  
Birth Rates ◽  
Preimplantation Genetic Testing ◽  
Vitro Fertilization ◽  
Live Births ◽  
Live Birth Rates

AbstractUntil 2010, the National Assisted Reproductive Technology Surveillance System (NASS) report, published annually by the Center for Disease Control and Prevention (CDC), demonstrated almost constantly improving live birth rates following fresh non-donor (fnd) in vitro fertilization (IVF) cycles. Almost unnoticed by profession and public, by 2016 they, however, reached lows not seen since 1996–1997. We here attempted to understand underlying causes for this decline. This study used publicly available IVF outcome data, reported by the CDC annually under Congressional mandate, involving over 90% of U.S. IVF centers and over 95% of U.S. IVF cycles. Years 2005, 2010, 2015 and 2016 served as index years, representing respectively, 27,047, 30,425, 21,771 and 19,137 live births in fnd IVF cycles. Concomitantly, the study associated timelines for introduction of new add-ons to IVF practice with changes in outcomes of fnd IVF cycles. Median female age remained at 36.0 years during the study period and center participation was surprisingly stable, thereby confirming reasonable phenotype stability. Main outcome measures were associations of specific IVF practice changes with declines in live IVF birth rates. Time associations were observed with increased utilization of “all-freeze” cycles (embryo banking), mild ovarian stimulation protocols, preimplantation genetic testing for aneuploidy (PGT-A) and increasing utilization of elective single embryo transfer (eSET). Among all add-ons, PGT-A, likely, affected fndIVF most profoundly. Though associations cannot denote causation, they can be hypothesis-generating. Here presented time-associations are compelling, though some of observed pregnancy and live birth loss may have been compensated by increases in frozen-thawed cycles and consequential pregnancies and live births not shown here. Pregnancies in frozen-thawed cycles, however, represent additional treatment cycles, time delays and additional costs. IVF live birth rates not seen since 1996–1997, and a likely continuous downward trend in U.S. IVF outcomes, therefore, mandate a reversal of current outcome trends, whatever ultimately the causes.

P-377 Association between antinuclear antibodies and pregnancy prognosis in recurrent pregnancy loss patients

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Yoshihara ◽  
M Sugiura-Ogasawara ◽  
T Kitaori ◽  
S Goto
Keyword(s):  
Live Birth ◽  
Pregnancy Loss ◽  
Birth Rate ◽  
Recurrent Pregnancy Loss ◽  
Live Birth Rate ◽  
Negative Group ◽  
Birth Rates ◽  
Positive Group ◽  
Live Birth Rates ◽  
Uterine Anomaly

Abstract Study question Can antinuclear antibody (ANA) affect the subsequent live birth rate in patients with recurrent pregnancy loss (RPL) who have no antiphospholipid antibodies (aPLs)? Summary answer ANA did not affect the pregnancy prognosis of RPL women. What is known already The prevalence of ANA is well-known to be higher in RPL patients. Our previous study found no difference in the live birth rates of ANA-positive and -negative patients who had no aPLs. Higher miscarriage rates were also reported in ANA-positive patients compared to ANA-negative patients with RPL. The RPL guidelines of the ESHRE state that “ANA testing can be considered for explanatory purposes.” However, there have been a limited number of studies on this issue and sample sizes have been small, and the impact of ANA on the pregnancy prognosis is unclear. Study design, size, duration An observational cohort study was conducted at Nagoya City University Hospital between 2006 and 2019. The study included 1,108 patients with a history of 2 or more pregnancy losses. Participants/materials, setting, methods 4D-Ultrasound, hysterosalpingography, chromosome analysis for both partners, aPLs and blood tests for ANA and diabetes mellitus were performed before a subsequent pregnancy. ANAs were measured by indirect immunofluorescence. The cutoff dilution used was 1:40. In addition, patients were classified according to the ANA pattern on immunofluorescence staining. Live birth rates were compared between ANA-positive and ANA-negative patients after excluding patients with antiphospholipid syndrome, an abnormal chromosome in either partner and a uterine anomaly. Main results and the role of chance The 994 patients were analyzed after excluding 40 with a uterine anomaly, 43 with a chromosome abnormality in either partner and 32 with APS. The rate of ANA-positive patients was 39.2 % (390/994) when the 1: 40 dilution result was positive. With a 1:160 dilution, the rate of ANA-positive patients was 3.62 % (36/994). The live birth rate was calculated for 798 patients, excluding 196 patients with unexplained RPL who had been treated with any medication. With the use of the 1 40 dilution, the subsequent live birth rates were 71.34 % (219/307) for the ANA-positive group and 70.67 % (347/491) for the ANA-negative group (OR, 95%CI; 0.968, 0.707-1.326). After excluding miscarriages with embryonic aneuploidy, chemical pregnancies and ectopic pregnancies, live birth rates were 92.41 % (219/237) for the ANA-positive group and 92.04 % (347/377) for the ANA-negative group (0.951, 0.517-1.747). Using the 1:160 dilution, the subsequent live birth rates were 84.62 % (22/26) for the ANA-positive group, and 70.47 % (544/772) for the ANA-negative group (0.434, 0.148-1.273). Subgroup analyses were performed for each pattern on immunofluorescence staining, but there was no significant difference in the live birth rate between the two groups. Limitations, reasons for caution The effectiveness of immunotherapies could not be evaluated. However, the results of this study suggest that it is not necessary. Wider implications of the findings The measurement of ANA might not be necessary for the screening of patients with RPL who have no features of collagen disease. Trial registration number not applicable

Workshop 2 (synthesis): water pollution abatement within the industrial sector

2003 ◽  
Vol 47 (6) ◽  
pp. 115-117
Author(s):  
S. Matsui ◽  
J. Oatridge ◽  
A. Blomqvist
Keyword(s):  
Water Pollution ◽  
Public Policy ◽  
Pollution Abatement ◽  
Industrial Sector ◽  
New Public ◽  
Cleaner Technologies ◽  
Policy Measures

This workshop aimed at demonstrating and discussing how effective abatement of water pollution can be achieved through introducing cleaner technologies, recycling and reuse of water, and implementing new public policy measures.

Infant Mortality Among Singletons and Twins in Japan During 1999–2008 on the Basis of Risk Factors

2013 ◽  
Vol 16 (2) ◽  
pp. 639-644 ◽  
Author(s):  
Yoko Imaizumi ◽  
Kazuo Hayakawa
Keyword(s):  
Infant Mortality ◽  
Maternal Age ◽  
Survival Rates ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Infant Mortality Rate ◽  
Age Group ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Live Births

The infant mortality rate (IMR) among single and twin births from 1999 to 2008 was analyzed using Japanese Vital Statistics. The IMR was 5.3-fold higher in twins than in singletons in 1999 and decreased to 3.9-fold in 2008. The reduced risk of infant mortality in twins relative to singletons may be related, partially, to survival rates, which improved after fetoscopic laser photocoagulation for twin — twin transfusion syndrome. The proportion of neonatal deaths among total infant deaths was 54% for singletons and 74% for twins. Thus, intensive care of single and twin births may be very important during the first month of life to reduce the IMR. The IMR decreased as gestational age (GA) rose in singletons, whereas the IMR in twins decreased as GA rose until 37 weeks and increased thereafter. The IMR was significantly higher in twins than in singletons from the shortest GA (<24 weeks) to 28 weeks as well as ≥38 weeks, whereas the IMR was significantly higher in singletons than in twins from 30 to 36 weeks. As for maternal age, the early neonatal and neonatal mortality rates as well as the IMR in singletons were significantly higher in the youngest maternal age group than in the oldest one, whereas the opposite result was obtained in twins. The lowest IMR in singletons was 1.1 per 1,000 live births for ≥38 weeks of gestation and heaviest birth weight (≥2,000 g), while the lowest IMR in twins was 1.8 at 37 weeks and ≥2,000 g.

The Demography of Two West African (Gambian) Villages, 1951–75

1981 ◽  
Vol 13 (2) ◽  
pp. 219-240 ◽  
Author(s):  
W. Z. Billewicz ◽  
I. A. McGregor
Keyword(s):  
Population Growth ◽  
Child Mortality ◽  
West African ◽  
Small Scale ◽  
Wet Season ◽  
Birth Rates ◽  
Death Rates ◽  
Live Births ◽  
First Child ◽  
Specific Mortality

SummaryFrom a longitudinal study over 25 years (1951–75) of two adjacent Gambian villages, the data allow estimates of population growth, birth rates, age-specific mortality, female fertility, and infertility rates in the two sexes. Such intensive but small scale local inquiries provide valuable information on topics not covered in official published statistics, and also data from which the reliability of some census details can be estimated. There are many similarities but also differences between the two villages. Population growth rate was 1·1% per annum for Keneba and 2·2% for Manduar. Crude death rates averaged 36·7 per thousand for Keneba and 24·7 for Manduar and showed little difference between the sexes. For Keneba and Manduar respectively stillbirth rates were 63·9 and 88·6, first week mortality 49·2 and 44·9 and neonatal mortality 85·2 and 49·6 per thousand live births. In Keneba, where survival to age 5 years averaged 50%, young child mortality was significantly higher than in Manduar but mortality at older ages was not. Season profoundly affected child mortality: about 45% of all deaths under 15 years occurred in the late wet season, August–October. Maternal mortality in Keneba was 10·5 and in Manduar 9·5 per thousand. Crude birth rates averaged 58·4 per thousand for Keneba and 49·0 for Manduar, rates per thousand women aged 15·44 years averaging 248·5 and 215·3 respectively.In both villages mean birth interval increased progressively with the survival of the preceding child. In Keneba the interval increased from about 16 months when the first of the two children was stillborn to nearly 37 months when the first child survived to 2 years. In Manduar the corresponding values were 19 and 36 months. Analyses of obstetric histories indicated that total fertility was of the order of 7·5 live births per woman in Keneba and 6·4 in Manduar. Estimates of primary infertility for females were 3·6% in Keneba and 5·6% in Manduar, and for males 3·1% and 1·9%. Estimates of secondary infertility in females were 13% in Keneba and 19% in Manduar.

OBSTETRIC MANAGEMENT OF TEENAGE PREGNANCY

2006 ◽  
Vol 17 (4) ◽  
pp. 317-325 ◽  
Author(s):  
JENNY E MYERS ◽  
ALEXANDER EP HEAZELL ◽  
REBECCA L JONES ◽  
PHILIP N BAKER
Keyword(s):  
United Kingdom ◽  
Adolescent Pregnancy ◽  
Teenage Pregnancy ◽  
Western Europe ◽  
Pregnancy Rates ◽  
Birth Rates ◽  
Teenage Birth ◽  
Live Births ◽  
The United Kingdom ◽  
Obstetric Management

Adolescent pregnancy rates in the United Kingdom remain the highest in Western Europe. Interestingly, throughout most of Western Europe teenage birth rates fell during the 1970s, 80s and 90s, but in the United Kingdom rates have remained high. An increasing incidence has also been noted, with 49.9 births per 1,000 women under 18 in 2001 and 52.8 live births per 1,000 women in 2002.

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