scholarly journals A compelling symmetry: The extended fetuses-at-risk perspective on modal, optimal and relative birthweight and gestational age

2020 ◽  
Author(s):  
K.S. Joseph
Keyword(s):  
At Risk ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Death Rate ◽  
Perinatal Death ◽  
The United States ◽  
Rate Of Change ◽  
Death Rates ◽  
First Derivative ◽  
Perinatal Death Rate

AbstractBackgroundThe relationship between several intriguing perinatal phenomena, namely, modal, optimal, and relative birthweight and gestational age, remains poorly understood, especially the mechanism by which relative birthweight and gestational age resolve the paradox of intersecting perinatal mortality curves.MethodsBirthweight and gestational age distributions and birthweight- and gestational age-specific perinatal death rates of low- and high-risk cohorts in the United States, 2004-2015, were estimated using births-based and extended fetuses-at-risk formulations. The relationships between these births-based distributions and rates, and the first derivatives of fetuses-at-risk birth and perinatal death rates were examined in order to assess how the rate of change in fetuses-at-risk rates affects gestational age distributions and births-based perinatal death rate patterns.ResultsModal gestational age typically exceeded optimal gestational age because both were influenced by the peak in the first derivative of the birth rate, while optimal gestational age was additionally influenced by the point at which the first derivative of the fetuses-at-risk perinatal death rate showed a sharp increase in late gestation. The clustering and correlation between modal and optimal gestational age within cohorts, the higher perinatal death rate at optimal gestational age among higher-risk cohorts, and the symmetric left-shift in births-based gestational age-specific perinatal death rates in higher-risk cohorts explained how relative gestational age resolved the paradox of intersecting perinatal mortality curves.ConclusionsChanges in the first derivative the fetuses-at-risk birth and perinatal death rates underlie several births-based perinatal phenomena and this explanation further unifies the fetuses-at-risk and births-based models of perinatal death.

scholarly journals A compelling symmetry: The extended fetuses-at-risk perspective on modal, optimal and relative birthweight and gestational age

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0238673
Author(s):  
K. S. Joseph
Keyword(s):  
At Risk ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Death Rate ◽  
Perinatal Death ◽  
The United States ◽  
Rate Of Change ◽  
Death Rates ◽  
First Derivative ◽  
Perinatal Death Rate

Background The relationship between several intriguing perinatal phenomena, namely, modal, optimal, and relative birthweight and gestational age, remains poorly understood, especially the mechanism by which relative birthweight and gestational age resolve the paradox of intersecting perinatal mortality curves. Methods Birthweight and gestational age distributions and birthweight- and gestational age-specific perinatal death rates of low- and high-risk cohorts in the United States, 2004–2015, were estimated using births-based and extended fetuses-at-risk formulations. The relationships between these births-based distributions and rates, and the first derivatives of fetuses-at-risk birth and perinatal death rates were examined in order to assess how the rate of change in fetuses-at-risk rates affects gestational age distributions and births-based perinatal death rate patterns. Results Modal gestational age typically exceeded optimal gestational age because both were influenced by the peak in the first derivative of the birth rate, while optimal gestational age was additionally influenced by the point at which the first derivative of the fetuses-at-risk perinatal death rate showed a sharp increase in late gestation. The clustering and correlation between modal and optimal gestational age within cohorts, the higher perinatal death rate at optimal gestational age among higher-risk cohorts, and the symmetric left-shift in births-based gestational age-specific perinatal death rates in higher-risk cohorts explained how relative gestational age resolved the paradox of intersecting perinatal mortality curves. Conclusions Changes in the first derivative of the fetuses-at-risk birth and perinatal death rates underlie several births-based perinatal phenomena and this explanation further unifies the fetuses-at-risk and births-based models of perinatal death.

scholarly journals Bias in comparisons of mortality among very preterm births: A cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253931
Author(s):  
Amélie Boutin ◽  
Sarka Lisonkova ◽  
Giulia M. Muraca ◽  
Neda Razaz ◽  
Shiliang Liu ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
Cohort Study ◽  
Perinatal Death ◽  
Preterm Births ◽  
The United States ◽  
Death Rates ◽  
Very Preterm ◽  
Hypertensive Disorders ◽  
White Mothers

Background Several studies of prenatal determinants and neonatal morbidity and mortality among very preterm births have resulted in unexpected and paradoxical findings. We aimed to compare perinatal death rates among cohorts of very preterm births (24–31 weeks) with rates among all births in these groups (≥24 weeks), using births-based and fetuses-at-risk formulations. Methods We conducted a cohort study of singleton live births and stillbirths ≥24 weeks’ gestation using population-based data from the United States and Canada (2006–2015). We contrasted rates of perinatal death between women with or without hypertensive disorders, between maternal races, and between births in Canada vs the United States. Results Births-based perinatal death rates at 24–31 weeks were lower among hypertensive than among non-hypertensive women (rate ratio [RR] 0.67, 95% CI 0.65–0.68), among Black mothers compared with White mothers (RR 0.94, 95%CI 0.92–0.95) and among births in the United States compared with Canada (RR 0.74, 95%CI 0.71–0.75). However, overall (≥24 weeks) perinatal death rates were higher among births to hypertensive vs non-hypertensive women (RR 2.14, 95%CI 2.10–2.17), Black vs White mothers (RR 1.86, 95%CI 184–1.88;) and births in the United States vs Canada (RR 1.08, 95%CI 1.05–1.10), as were perinatal death rates based on fetuses-at-risk at 24–31 weeks (RR for hypertensive disorders: 2.58, 95%CI 2.53–2.63; RR for Black vs White ethnicity: 2.29, 95%CI 2.25–2.32; RR for United States vs Canada: 1.27, 95%CI 1.22–1.30). Conclusion Studies of prenatal risk factors and between-centre or between-country comparisons of perinatal mortality bias causal inferences when restricted to truncated cohorts of very preterm births.

Population-level analysis of antibiotic use and death rates in beef feedlots over ten years in three cattle-feeding regions of the United States

2021 ◽  
pp. 1-7
Author(s):  
Stephanie C. Rutten-Ramos ◽  
Shabbir Simjee ◽  
Michelle S. Calvo-Lorenzo ◽  
Jason L. Bargen
Keyword(s):  
Death Rate ◽  
Live Weight ◽  
Population Level ◽  
Antibiotic Use ◽  
The United States ◽  
Death Rates ◽  
Cattle Feeding ◽  
The Us ◽  
Rate Ratios ◽  
Beef Feedlots

Abstract OBJECTIVE To assess antibiotic use and other factors associated with death rates in beef feedlots in 3 regions of the US over a 10-year period. SAMPLE Data for 186,297 lots (groups) of finished cattle marketed between 2010 and 2019 were obtained from a database representing feedlots in the central, high, and north plains of the US. PROCEDURES Descriptive statistics were generated. Generalized linear mixed models were used to estimate lot death rates for each region, sex (steer or heifer), and cattle origin (Mexico or the US) combination. Death rate was calculated as the (number of deaths/number of cattle placed in the lot) × 100. Lot antibiotic use (TotalActiveMG/KGOut) was calculated as the total milligrams of active antibiotics assigned to the lot per live weight (in kilograms) of cattle marketed from the lot. Rate ratios were calculated to evaluate the respective associations between lot death rate and characteristics of cattle and antibiotic use. RESULTS Mean death rate increased during the 10-year period, peaking in 2018. Mean number of days on feed also increased over time. Mean TotalActiveMG/KGOut was greatest in 2014 and 2015, lowest in 2017, and moderated in 2018 and 2019. Death rate was positively associated with the number of days on feed and had a nonlinear association with TotalActiveMG/KGOut. Feeding medicated feed articles mitigated death rate. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a balance between disease prevention and control in feedlots for cattle with various risk profiles. Additional data sources are needed to assess TotalActiveMG/KGOut across the cattle lifetime.

scholarly journals Population based cohort study of fetal deaths, and neonatal and perinatal mortality at term within a Somali diaspora

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephen Contag ◽  
Rahel Nardos ◽  
Irina A. Buhimschi ◽  
Jennifer Almanza
Keyword(s):  
Cohort Study ◽  
Black Women ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Neonatal Death ◽  
Fetal Death ◽  
Hispanic Women ◽  
Place Of Birth ◽  
Death Rates ◽  
Somali Women

Abstract Background Somali women deliver at greater gestational age with limited information on the associated perinatal mortality. Our objective is to compare perinatal mortality among Somali women with the population rates. Methods This is a retrospective cohort study from all births that occurred in Minnesota between 2011 and 2017. Information was obtained from certificates of birth, and neonatal and fetal death. Data was abstracted from 470,550 non-anomalous births ≥37 and ≤ 42 weeks of gestation. The study population included U.S. born White, U.S. born Black, women born in Somalia or self-identified as Somali, and women who identified as Hispanic regardless of place of birth (377,426). We excluded births < 37 weeks and > 42 weeks, > 1 fetus, age < 18 or > 45 years, or women of other ethnicities. The exposure was documented ethnicity or place of birth, and the outcomes were live birth, fetal death, neonatal death prior to 28 days, and perinatal mortality rates. These were calculated using binomial proportions with 95% confidence intervals and compared using odds ratios adjusted (aOR) for diabetes, hypertension and maternal body mass index. Results The aOR [95%CI] for stillbirth rate in the Somali cohort was greater than for U.S. born White (2.05 [1.49–2.83]) and Hispanic women (1.90 [1.30–2.79]), but similar to U.S. born Black women (0.88 [0.57–1.34]). Neonatal death rates were greater than for U.S. born White (1.84 [1.36–2.48], U.S. born Black women (1.47 [1.04–2.06]) and Hispanic women (1.47 [1.05–2.06]). This did not change after analysis was restricted to those with spontaneous onset of labor. When analyzed by week, at 42 weeks Somali aOR for neonatal death was the same as for U.S. born White women, but compared against U.S. born Black and Hispanic women, was significantly lower. Conclusions The later mean gestational age at delivery among women of Somali ethnicity is associated with greater overall risk for stillbirth and neonatal death rates at term, except compared against U.S. born Black women with whom stillbirth rates were not different. At 42 weeks, Somali neonatal mortality decreased and was comparable to that of the U.S. born White population and was lower than that of the other minorities.

Calculating Age-Standardized Death Rates Among People With HIV Comparable Across Jurisdictions and Over Time

2021 ◽  
Vol 111 (1) ◽  
pp. 121-126
Author(s):  
Qiang Xia ◽  
Ying Sun ◽  
Chitra Ramaswamy ◽  
Lucia V. Torian ◽  
Wenhui Li
Keyword(s):  
United States ◽  
New York ◽  
New York City ◽  
York City ◽  
Death Rate ◽  
Age Distribution ◽  
The United States ◽  
Local Health ◽  
Death Rates ◽  
Over Time

The Centers for Disease Control and Prevention (CDC) and local health jurisdictions have been using HIV surveillance data to monitor mortality among people with HIV in the United States with age-standardized death rates, but the principles of age standardization have not been consistently followed, making age standardization lose its purpose—comparison over time, across jurisdictions, or by other characteristics. We review the current practices of age standardization in calculating death rates among people with HIV in the United States, discuss the principles of age standardization including those specific to the HIV population whose age distribution differs markedly from that of the US 2000 standard population, make recommendations, and report age-standardized death rates among people with HIV in New York City. When we restricted the analysis population to adults aged between 18 and 84 years in New York City, the age-standardized death rate among people with HIV decreased from 20.8 per 1000 (95% confidence interval [CI] = 19.2, 22.3) in 2013 to 17.1 per 1000 (95% CI = 15.8, 18.3) in 2017, and the age-standardized death rate among people without HIV decreased from 5.8 per 1000 in 2013 to 5.5 per 1000 in 2017.

scholarly journals Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 149S-157S
Author(s):  
Benedict I. Truman ◽  
Ramal Moonesinghe ◽  
Yolanda T. Brown ◽  
Man-Huei Chang ◽  
Jonathan H. Mermin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Rate Of Change ◽  
Fiscal Year ◽  
Death Rates ◽  
Black Residents ◽  
Race Ethnicity ◽  
Hiv Funding ◽  
Racial Ethnic ◽  
Hispanic White

Objective Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. Methods We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant ( P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. Results Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was −9.4% (95% CI, −10.9% to −7.8%) for Hispanic residents, −7.8% (95% CI, −9.0% to −6.6%) for non-Hispanic black residents, −6.7% (95% CI, −9.3% to −4.0%) for non-Hispanic white residents, and −5.2% (95% CI, −7.8% to −2.5%) for non-Hispanic API+AI/AN residents. Conclusions Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

Epidemiology of congenital malformations of the central nervous system in (a) Aberdeen and (b) Scotland

1974 ◽  
Vol 6 (2) ◽  
pp. 113-137 ◽  
Author(s):  
Dugald Baird
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Death Rate ◽  
Perinatal Death ◽  
Social Classes ◽  
Stillbirth Rate ◽  
Sequence Of Events ◽  
Perinatal Death Rate ◽  
The Central Nervous System ◽  
Cns Malformations

SummaryThe incidence of anencephalus and other malformations of the central nervous system (CNS) is much higher in the United Kingdom than in other countries of Western Europe which were not industrialized to the same extent. In the UK the incidence is highest in the unskilled manual occupational group, especially in the large cities of the North of England, Scotland and Northern Ireland. Standards of living have been low in these areas for many years and deteriorated sharply at the time of the worldwide industrial depression from 1928 to 1934. The population tended to be stunted in stature and to show other signs of chronic malnutrition.The cohort of women born in these years had an unusually high stillbirth rate from anencephalus (and from all other CNS malformations) from about 1946 onwards. It was highest in the early 1960s when these women were at the peak of their reproductive activity. This suggests that the severe malnutrition to which they were subjected before and soon after birth resulted in severe damage, which reduced their reproductive efficiency as demonstrated by the unusually high perinatal death rate from all CNS malformations. Not surprisingly the death rate rose sooner, lasted longer and reached a higher level in social classes IV and V than in social classes I and II. Other evidence of damage was an increase in the incidence of low birth weight babies with a corresponding increase in the perinatal death rate from this cause.In Scotland the stillbirth rate from anencephalus was approximately 2·1 per 1000 in 1948–49, 3·4 at its highest point between 1961 and 1963 and 2·1 in 1968, by which time the women born in the years of the depression had completed their childbearing. A teratogen acting during a particular period of time could not provide a satisfactory explanation for this sequence of events.

scholarly journals Incidence of SARs-CoV-2 (Dikos-Ntsaaigii-19) Among Navajo Nation Children

2021 ◽  
Author(s):  
Joseph Angel De Soto ◽  
Babatunde Ojo
Keyword(s):  
Infection Rate ◽  
Death Rate ◽  
Signal Transduction Pathway ◽  
The United States ◽  
Vaccination Rate ◽  
Transduction Pathway ◽  
Bureau Of Indian Affairs ◽  
Infection Rates ◽  
Navajo Nation ◽  
Death Rates

On March 17, 2020 the SARs-CoV-2 virus was first reported on the Navajo Reservation. Today, the Navajo Nation has a 147% higher infection rate and a 450% higher death rate than the national average. Despite this tragedy, a glaring question remains, what is happening among the Navajo children. The study found that Navajo children had an infection rate 220% higher than the general population and a death rate from COVID 1,400% greater than non-Navajo in the United States. This occurs even though of Navajo children having a much higher vaccination rate of 68% compared to about 25% of children Nationwide. The introduction of SARs-CoV variants such as the alpha and omicron variants did not seem to play a role in these findings. The higher infection rates suggest a genetic predisposition among the Navajo to SARs-CoV-2 via the ACE-2 receptor and signal transduction pathway while the increased death rates may also suggest inferior care provided by the Bureau of Indian Affairs Hospitals.

scholarly journals Characteristics overview of mother with perinatal death at Dr. Soetomo Hospital in 2015

2017 ◽  
Vol 24 (3) ◽  
pp. 105
Author(s):  
Yulisa Haslinda ◽  
Budi Prasetyo
Keyword(s):  
Birth Weight ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Pregnancy Complications ◽  
Maternal Age ◽  
Perinatal Death ◽  
Descriptive Study ◽  
Perinatal Deaths ◽  
Maternal Characteristic ◽  
Characteristic Features

Objectives: to determine the frequency distribution of perinatal mortality and maternal characteristic features in terms of age, parity, gestational age and pregnancy complications in Dr.Soetomo Hospital Surabaya in 2015. Materials and Methods: A descriptive study conducted by collecting data on patients who experienced perinatal mortality of infants born from January to December 2015 in Dr. Soetomo, Hospital Surabaya. Samples were collected using total sampling. The samples must meet the following criteria: mothers of infants with perinatal mortality in Dr. Soetomo Hospital, Surabaya, from January to December 2015.Results: There were 206 perinatal deaths out of 1018 births in Dr. Soetomo during 2015, of which 58% was live birth and 42% was stillbirth. Most of perinatal mortality found in the preterm gestational age as much as 78%, and gestational age 28-<37 weeks (58%). Most of perinatal mortality occured in infants with less than 1500 grams birth weight, which was as much as 53% of all perinatal deaths and infant whose birth weight from1500 to 2500 grams was about 29%. Most perinatal mortality found in multigravida (54%) and in infants whose mothers experienced preeclampsia in pregnancy complications (35%), followed by infant mortality in women with non-obstetric complications (23%).Conclusion: Perinatal mortality in Dr. Soetomo Hospital was mostly found in multigravida mothers, 16-35 years old maternal age, 28-37 weeks gestational age and those with complications of preeclampsia.

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