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Sonia S. Anand - One of the best experts on this subject based on the ideXlab platform.
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A qualitative investigation of optimal Perinatal Health: the perspectives of south Asian grandmothers living in southern Ontario, Canada
BMC pregnancy and childbirth, 2020Co-Authors: Sujane Kandasamy, Gita Wahi, Rebecca Anglin, Leila Gaind, Dipika Desai, Milan Gupta, Sonia S. AnandAbstract:Perinatal Health-seeking behaviours are influenced by various factors, including personal beliefs. South Asian women, who often live within a wide kinship system, can be influenced by the advice and guidance of their mothers and/or mothers-in-law. To explore the cultural Health perceptions of South Asian grandmothers within this context, we used constructivist grounded theory to sample and interview 17 South Asian grandmothers who reside in Southern Ontario, Canada. Interviews were audio-recorded, transcribed verbatim, and coded/analyzed by three independent coders. Many grandmothers emphasized that the preconception phase should focus on building Healthy habits around nutrition, physical activity, and mental wellness; the pregnancy period should encompass an enriched environment (positive relationships, Healthy routines, nutritional enhancement); and the postpartum phase should emphasize healing and restoration for both the mother and newborn (self-care, bonding, rebuilding Healthy habits). Many of the grandmothers conceptualized these stages as a cyclical relationship where healing and restoration transitions gradually to re-establishing Healthy habits before having a subsequent child. They also expressed responsibility in supporting their daughters and/or daughters-in-law with their family units and encouraging the transfer of Perinatal Health information. South Asian grandmothers are involved in supporting the family units of their children and involving them in Perinatal Health programming can be an effective way to translate Health knowledge to South Asian women.
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A Case Study of a Methodological Approach to Cocreating Perinatal Health Knowledge Between Western and Indigenous Communities
International Journal of Qualitative Methods, 2017Co-Authors: Sujane Kandasamy, Meredith Vanstone, Mark Oremus, Trista Hill, Gita Wahi, Julie Wilson, A. Darlene Davis, Ruby Jacobs, Rebecca Anglin, Sonia S. AnandAbstract:This article describes the methods taken to create an understanding of the Perinatal Health beliefs of elder Indigenous women of the Six Nations of the Grand River in Ontario, Canada. Our study pai...
Elina Hemminki - One of the best experts on this subject based on the ideXlab platform.
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SP6-1 Mothers' abortion history and Perinatal Health at first birth
Journal of Epidemiology & Community Health, 2011Co-Authors: Elina Hemminki, Reija Klemetti, Mika GisslerAbstract:Introduction We studied Perinatal Health of first born children by mother9s abortion history in Finland with good abortion and birth services and relatively few abortions. Methods Nationwide registers covering all births and induced abortions were used. All first time mothers in Birth Register (1996–2008) were linked to Abortion Register (1983–2008). The Perinatal Health of children was compared by the number of mother9s abortions adjusting by logistic regression for mothers9 age, civil status, socioeconomic status, urbanity and smoking. Results Of the 300 858 mothers, 22 860 (7.6%) had one, 2681 (0.9%) two, 542 (0.2%) three or more abortions. Of abortions, 88% were surgical, 91% were made Conclusions One previous abortion did not increase Perinatal problems at first birth, but three or more did; two were in between. This may be due to mothers9 characteristics not controlled for or due to sequel of repeated abortions.
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Perinatal Health in the Nordic countries - current challenges
Scandinavian journal of public health, 2009Co-Authors: Elina HemminkiAbstract:Perinatal Health refers to the Health of a baby at the time of birth and immediately after. It is measured by various indicators, either predicting or describing Health, such as pre-term (too early) birth, low birth weight, small for gestational age (poor growth), large for gestational age, malformations, diseases and Perinatal mortality (stillbirths and deaths in the first week of life). With the exception of birth weight, these indicators suffer problems with definition and measurement. Due in large part to a lack of other available data, it has been traditional to make surveillance and place/time comparisons using Perinatal mortality or birth weight as indicators. The time in a mother’s womb is an important determinant for Health in later life. It is obvious for babies who have congenital anomalies, other developmental handicaps or brain injury. But the theory of programming, supported by a number of epidemiological studies, suggests a broader Health impact. In international comparisons Perinatal Health indicators in the Nordic countries show good Health. For example, in 2004 Finland, Norway and Sweden were among the countries having low early neonatal mortality (two per 1,000 live births or less), and only Denmark was among the high-rate countries (three or more per 1,000) [1]. The proportion of low birth weight infants of all live births was less than 5% in Finland, Norway and Sweden, and in Denmark it was 5.3. In the rest of Europe the proportions were typically around 7% or more. This may explain why Nordic interest in Perinatal Health research has focused on risk factors, and studies from a population Health perspective have been less in evidence. Internationally the importance of the fetal period to later Health has been the focus of much recent discussion and may have contributed to the growing interest, even in the Nordic countries, in studying the level and determinants of and variation in Perinatal Health. Furthermore, new Health challenges for childbearing women (and the fathers of the babies to be born) have been identified. These new challenges include older age in childbearing, alcohol and other intoxicant use, mothers’ obesity, and migrant women who often have different Health habits and Health status. Furthermore, increasing use of medical technology before and during pregnancy and birth, such as assisted reproduction techniques, fetal screening and caesarean section, has raised concern. A Nordic research group, NorCHASE, which was supported by the Nordic Council of Ministers, has collected from four Nordic countries (excluding Iceland) an impressive database on Perinatal Health indicators available from birth registers and linked it to parents’ social background as available from population registers. The Nordic countries have a unique research possibility for linking at the individual level Health indicators to population registers, including information on demography, socioeconomic conditions, education, income etc. Country comparisons showed that in 1981 to 2000, neonatal deaths, and infant deaths as a whole, decreased in all countries; there was an inverse association between maternal education and risk of death, and the strength of the association varied by time and country [2]. Infant mortality declined over time, but was notably higher in Denmark and Norway (in the 1980s over seven per 1,000 births and at the end of 1990s over four in Denmark) than in Finland and Sweden (less than six in the 1980s and less than four in the 1990s). In all countries and at all times boys had a higher mortality than girls [3].
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Trends in Socioeconomic Differences in Finnish Perinatal Health 1991-2006
Journal of epidemiology and community health, 2009Co-Authors: Mika Gissler, Anne-marie Nybo Andersen, Ossi Rahkonen, Annett Arntzen, Sven Cnattingius, Elina HemminkiAbstract:Background: Socioeconomic differences in Perinatal Health decreased in Finland in the late 1990s. Whether the decreasing socioeconomic differences in Perinatal Health observed in Finland in the late 1990s have continued in 2000–6 was studied. Methods: The data were based on 965 443 births and 931 285 singletons recorded between 1991 and 2006 in the Finnish Medical Birth Register. Information on socioeconomic position was based on maternal occupation. Perinatal Health was measured with six different indicators. Results: The proportions of preterm, low birthweight and SGA (small-for-gestational-age) births remained stable during the study period, but decreased for LGA (large-for-gestational-age) births and Perinatal death. After adjustment for maternal background variables, the socioeconomic differences in preterm and low-birthweight births decreased in the late 1990s and remained low thereafter. In 2003–6, blue-collar workers had a 14% (95% CI 7% to 22%) higher risk for preterm birth and a 25% (95% CI 16% to 34%) higher risk for low birthweight than upper white-collar workers. For SGA, the socioeconomic differences remained unchanged, and the excess risk for blue-collar workers was 44% (95% CI 31% to 58%) in 2003–6. For LGA, the socioeconomic differences increased, and the highest excess risks were obtained among lower white-collar (23%, 95% CI 15% to 33%) and blue-collar workers (24%, 95% CI 14% to 36%). The differences in Perinatal mortality decreased until the late 1990s, but increased thereafter. In 2003–6, lower white-collar and blue-collar workers had the highest excess risks: 46% (95% CI 20% to 77%) and 44% (95% CI 13% to 83%), respectively. Conclusions: The trends in social inequality in Perinatal Health outcomes were diverging by indicator. The positive trend on diminishing socioeconomic differences found in the 1990s seems to have come to an end.
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Register based monitoring shows decreasing socioeconomic differences in Finnish Perinatal Health
Journal of epidemiology and community health, 2003Co-Authors: Mika Gissler, Jouni Meriläinen, E Vuori, Elina HemminkiAbstract:Study objective: Several studies on differences in infant outcome by socioeconomic position have been done, but these have usually been based on ad hoc data linkages. The aim of this paper was to investigate whether socioeconomic differences in Perinatal Health in Finland could be regularly monitored using routinely collected data from one single register. Design and setting: Since October 1990, the Finnish Medical Birth Register (MBR) has included data on maternal occupation. A special computer program that converted the occupation name into an occupational code and into a socioeconomic position was prepared. Perinatal Health was measured with five different indicators. The Finnish MBR data for years 1991 to 1999 (n=565 863 newborns) were used in the study. The study period was divided into three, three year periods to study time trends. Results: An occupational code was derived for 95% of women, but it was not possible to define a socioeconomic position for 22% of women, including, for example, students and housewives (the group "Others"). For the rest, the data showed socioeconomic differences in all Perinatal Health indicators. Maternal smoking explained up to half of the excess risk for adverse Perinatal outcome in the lowest socioeconomic group. The socioeconomic differences narrowed during the 1990s: infant outcome improved in the lowest socioeconomic group, but remained at the same level or even deteriorated in other groups. When comparing the lowest group with the highest group, the odds ratios (OR) adjusted for maternal background characteristics at least halved for prematurity (from 1.32 (95% confidence intervals 1.24 to 1.43) in 1991–1993 to 1.16 (1.08 to 1.25) in 1997–1999), for low birth weight (from 1.49 (1.36 to 1.63) to 1.25 (1.17 to 1.40)), and for Perinatal mortality (from 1.79 (1.44 to 2.21) to 1.33 (1.07 to 1.66)). Conclusions: Social inequality in Perinatal Health outcomes exists in Finland, but seems to have diminished in the 1990s. These data showed that routinely collected birth register data provide a good source for studies on socioeconomic Health differences in the Perinatal period, but that uncertainty, mainly attributable to the large group of women with difficult to classify socioeconomic status, remains.
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Can children's Health be predicted by Perinatal Health?
International journal of epidemiology, 1999Co-Authors: Mika Gissler, Ossi Rahkonen, Marjo-riitta Järvelin, Pekka Louhiala, Elina HemminkiAbstract:While Perinatal mortality has been widely used as an indicator to measure the standard of Health care and to identify risk groups its value has been questioned because of definition problems and decreasing Perinatal mortality rates in industrialized countries. Finnish Health register data were used to assess how well childrens Health until age 7 years can be predicted by Perinatal outcome using routine Health registers. Specifically data came from the 1987 Finnish Medical Birth Register 6 other national registers and education registers of 1 county. 60192 children were traced up to age 7 years through record linkages with personal identification numbers. All Perinatal Health indicators were strongly correlated with subsequent Health: 85% of children who were Healthy in the Perinatal period reported no Health problems during early childhood and 91% of children Healthy in early childhood had also been Healthy in the Perinatal period. However poor Health outcome could not be predicted: 76% of the children with reported Perinatal problems were Healthy in early childhood and 87% of the children with long-term morbidity during childhood had no Perinatal problems. These findings suggest that when assessing risk factors and Health care technology it is not enough to only monitor Perinatal Health status. Rather long-term follow-ups are also needed.
Mika Gissler - One of the best experts on this subject based on the ideXlab platform.
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Pregnancy, obstetric, and Perinatal Health outcomes in eating disorders.
American journal of obstetrics and gynecology, 2014Co-Authors: Milla S. Linna, Anu Raevuori, Jari Haukka, Jaana Suvisaari, Jaana T. Suokas, Mika GisslerAbstract:OBJECTIVE: The purpose of this study was to assess pregnancy, obstetric, and Perinatal Health outcomes and complications in women with lifetime eating disorders. STUDY DESIGN: Female patients (n ¼ 2257) who were treated at the Eating Disorder Clinic of Helsinki University Central Hospital from 19952010 were compared with unexposed women from the population (n ¼ 9028). Register-based information on pregnancy, obstetric, and Perinatal Health outcomes and complications were acquired for all singleton births during the follow-up period among women with broad anorexia nervosa (AN; n ¼ 302 births), broad bulimia nervosa (BN; n ¼ 724), bingeeatingdisorder(BED;n ¼52),andunexposedwomen(n ¼6319). RESULTS: Women with AN and BN gave birth to babies with lower birthweight compared with unexposed women, but the opposite was observed in women with BED. Maternal AN was related to anemia, slow fetal growth, premature contractions, short duration of the first stage of labor, very premature birth, small for gestational age, low birthweight, and Perinatal death. Increased odds of premature contractions, resuscitation of the neonate, and very low Apgar score at 1 minute were observed in mothers with BN. BED was associated positively with maternal hypertension, long duration of the first and second stage of labor, and birth of large-for-gestational-age infants. CONCLUSION: Eating disorders appear to be associated with several adverse Perinatal outcomes, particularly in offspring. We recommend close monitoring of pregnant women with either a past or current eating disorder. Attention should be paid to children who are born to these mothers.
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SP6-1 Mothers' abortion history and Perinatal Health at first birth
Journal of Epidemiology & Community Health, 2011Co-Authors: Elina Hemminki, Reija Klemetti, Mika GisslerAbstract:Introduction We studied Perinatal Health of first born children by mother9s abortion history in Finland with good abortion and birth services and relatively few abortions. Methods Nationwide registers covering all births and induced abortions were used. All first time mothers in Birth Register (1996–2008) were linked to Abortion Register (1983–2008). The Perinatal Health of children was compared by the number of mother9s abortions adjusting by logistic regression for mothers9 age, civil status, socioeconomic status, urbanity and smoking. Results Of the 300 858 mothers, 22 860 (7.6%) had one, 2681 (0.9%) two, 542 (0.2%) three or more abortions. Of abortions, 88% were surgical, 91% were made Conclusions One previous abortion did not increase Perinatal problems at first birth, but three or more did; two were in between. This may be due to mothers9 characteristics not controlled for or due to sequel of repeated abortions.
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Perinatal Health monitoring in Europe: results from the EURO-PERISTAT project.
Informatics for health & social care, 2010Co-Authors: Mika Gissler, Nicholas Lack, Béatrice Blondel, Alison Macfarlane, Ashna D. Mohangoo, James D. Chalmers, Aldona Gaizauskiene, Miriam Gatt, Luule Sakkeus, Jennifer ZeitlinAbstract:Data about deliveries, births, mothers and newborn babies are collected extensively to monitor the Health and care of mothers and babies during pregnancy, delivery and the post-partum period, but there is no common approach in Europe. We analysed the problems related to using the European data for international comparisons of Perinatal Health. We made an inventory of relevant data sources in 25 European Union (EU) member states and Norway, and collected Perinatal data using a previously defined indicator list. The main sources were civil registration based on birth and death certificates, medical birth registers, hospital discharge systems, congenital anomaly registers, confidential enquiries and audits. A few countries provided data from routine Perinatal surveys or from aggregated data collection systems. The main methodological problems were related to differences in registration criteria and definitions, coverage of data collection, problems in combining information from different sources, missing data and random variation for rare events. Collection of European Perinatal Health information is feasible, but the national Health information systems need improvements to fill gaps. To improve international comparisons, stillbirth definitions should be standardised and a short list of causes of fetal and infant deaths should be developed.
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Trends in Socioeconomic Differences in Finnish Perinatal Health 1991-2006
Journal of epidemiology and community health, 2009Co-Authors: Mika Gissler, Anne-marie Nybo Andersen, Ossi Rahkonen, Annett Arntzen, Sven Cnattingius, Elina HemminkiAbstract:Background: Socioeconomic differences in Perinatal Health decreased in Finland in the late 1990s. Whether the decreasing socioeconomic differences in Perinatal Health observed in Finland in the late 1990s have continued in 2000–6 was studied. Methods: The data were based on 965 443 births and 931 285 singletons recorded between 1991 and 2006 in the Finnish Medical Birth Register. Information on socioeconomic position was based on maternal occupation. Perinatal Health was measured with six different indicators. Results: The proportions of preterm, low birthweight and SGA (small-for-gestational-age) births remained stable during the study period, but decreased for LGA (large-for-gestational-age) births and Perinatal death. After adjustment for maternal background variables, the socioeconomic differences in preterm and low-birthweight births decreased in the late 1990s and remained low thereafter. In 2003–6, blue-collar workers had a 14% (95% CI 7% to 22%) higher risk for preterm birth and a 25% (95% CI 16% to 34%) higher risk for low birthweight than upper white-collar workers. For SGA, the socioeconomic differences remained unchanged, and the excess risk for blue-collar workers was 44% (95% CI 31% to 58%) in 2003–6. For LGA, the socioeconomic differences increased, and the highest excess risks were obtained among lower white-collar (23%, 95% CI 15% to 33%) and blue-collar workers (24%, 95% CI 14% to 36%). The differences in Perinatal mortality decreased until the late 1990s, but increased thereafter. In 2003–6, lower white-collar and blue-collar workers had the highest excess risks: 46% (95% CI 20% to 77%) and 44% (95% CI 13% to 83%), respectively. Conclusions: The trends in social inequality in Perinatal Health outcomes were diverging by indicator. The positive trend on diminishing socioeconomic differences found in the 1990s seems to have come to an end.
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PERISTAT: indicators for monitoring and evaluating Perinatal Health in Europe.
European journal of public health, 2003Co-Authors: Jennifer Zeitlin, Sophie Alexander, Béatrice Blondel, Mika Gissler, Katherine Wildman, Gérard Bréart, Henrique Barros, Simone Buitendijk, Alison MacfarlaneAbstract:Background: The PERISTAT project aimed to develop an indicator set for monitoring and describing Perinatal Health in Europe. The challenge was to define indicators that cover common concerns and have the same meaning within the different European Health care systems. Methods: PERISTAT included i) a review of existing recommendations on Perinatal Health indicators, ii) a DELPHI consensus process with a scientific advisory committee composed of a clinician and an epidemiologist or statistician from each European member state as well as with a panel of midwives, and iii) a study of the availability of national statistics to construct recommended indicators. This article describes the first two components. Results: The review identified 10 international and 13 national recommended indicator sets. It also included indicators routinely compiled by WHO, EUROSTAT and OECD. Because of the methodological limits to using existing indicators for European comparisons, a high priority was placed on improving indicators already collected. Using the DELPHI method based on the results of the review, the scientific committee achieved a consensus on ten core and 23 recommended indicators, including 12 requiring further development. Conclusions: The PERISTAT project was successful in identifying a set of indicators, which drew on and consolidated previous work. Consensus was not achieved on precise indicators in areas where uncertainty about appropriate indicators was high, although areas were targeted for future development. Finally, the feasibility study, which is in progress, is an essential part of the project, since it will enable member states to evaluate their capacity to produce these indicators.
E. A. P. Steegers - One of the best experts on this subject based on the ideXlab platform.
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Addressing Perinatal Health inequities in Dutch municipalities: Protocol for the Healthy Pregnancy 4 All-3 programme
Health policy (Amsterdam Netherlands), 2020Co-Authors: Lisa S. Barsties, Leonie A. Daalderop, Jacqueline Lagendijk, Frank Van Steenbergen, Jasper V. Been, Loes C.m. Bertens, Adja J M Waelput, Hanneke Van Zoest, Derk Loorbach, E. A. P. SteegersAbstract:Background: Health inequities are already present at birth and affect individuals’ Health and socioeconomic outcomes across the life course. Addressing these inequities requires a cross-sectoral approach, covering the first 1,000 days of life. We believe that - in the Dutch context - municipal governments can be the main responsible actor to drive such an approach, since they are primarily responsible for organising adequate public Health. Therefore, we aim to identify and develop transformative change towards the implementation of Perinatal Health into municipal approaches and policies concerning Health inequities. Methods: A transition analysis will be combined with action research in six Dutch municipalities. Interviews and interactive group sessions with professionals and organisations that are relevant for the institutional embedding of Perinatal Health into approaches and policies regarding Health inequities, will be organised in each municipality. As a follow-up, a questionnaire will be administered among all participants one year after completion of the group sessions. Discussion: We expect to gain insights into the role of municipalities in addressing Perinatal Health inequities, learn more about the interaction between different key stakeholders, and identify barriers and facilitators for a cross-sectoral approach to Perinatal Health. This knowledge will serve to inform the development of approaches to Perinatal Health inequities in areas with relatively poor Perinatal Health outcomes, both in the Netherlands and abroad.
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Societal Valorisation of New Knowledge to Improve Perinatal Health: Time to Act
Paediatric and perinatal epidemiology, 2016Co-Authors: E. A. P. Steegers, Mary Barker, Régine P.m. Steegers-theunissen, Michelle A. WilliamsAbstract:Academics have a public duty to use their research to promote improvements in patient care and Health. Here, we argue that there is an imperative to translate recent compelling evidence demonstrating the importance of the periconceptional period in determining the Health of future generations, into improvements in pregnancy‐related care and Perinatal Health. Taking this action has the potential to interrupt cycles of deprivation and to reduce inequalities in Health. These are among the biggest challenges in Health care today.
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An Urban Perinatal Health Programme of Strategies to Improve Perinatal Health
Maternal and Child Health Journal, 2012Co-Authors: S. Denktaş, G. J. Bonsel, E. J. Weg, A. J. J. Voorham, H. W. Torij, J. P. Graaf, H. I. J. Wildschut, I. A. Peters, E. Birnie, E. A. P. SteegersAbstract:Promotion of a Healthy pregnancy is a top priority of the Health care policy in many European countries. Perinatal mortality is an important indicator of the success of this policy. Recently, it was shown that the Netherlands has relatively high Perinatal death rates when compared to other European countries. This is in particular true for large cities where Perinatal mortality rates are 20–50% higher than elsewhere. Consequently in the Netherlands, there is heated debate on how to tackle these problems. Without the introduction of measures throughout the entire Perinatal Health care chain, pregnancy outcomes are difficult to improve. With the support of Health care professionals, the City of Rotterdam and the Erasmus University Medical Centre have taken the initiative to develop an urban Perinatal Health programme called ‘Ready for a Baby’. The main objective of this municipal 10-year programme is to improve Perinatal Health and to reduce Perinatal mortality in all districts to at least the current national average of l0 per 1000. Key elements are the understanding of the mechanisms of the large Health differences between women living in deprived and non-deprived urban areas. Risk guided care, orientation towards shared-care and improvement of collaborations between Health care professionals shapes the interventions that are being developed. Major attention is given to the development of methods to improve risk-selection before and during pregnancy and methods to reach low-educated and immigrant groups.
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Urban Perinatal Health inequalities
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine the Federation of Asia and , 2010Co-Authors: Jashvant Poeran, S. Denktaş, G. J. Bonsel, E. Birnie, E. A. P. SteegersAbstract:Objective. Large urban areas have higher Perinatal mortality rates. In attaining a better understanding, we conducted an analysis on a neighborhood level in Rotterdam, the second largest city of The Netherlands.Methods. Perinatal outcome of all single pregnancies (50,000) was analyzed for the period of 2000–2006. The prevalences of Perinatal mortality and Perinatal morbidity were determined for every neighborhood.Results. Large Perinatal Health inequalities exist between neighborhoods in the city of Rotterdam with Perinatal mortality rates as high as 37 per 1000 births. The highest risks were observed in deprived neighborhoods.Conclusion. We observed high levels of Perinatal Health inequalities in the city of Rotterdam which have not been previously described in the Western world. Accumulation of medical risk factors as well as socioeconomic and urban risk factors seems to be a likely contributor.
Jennifer Zeitlin - One of the best experts on this subject based on the ideXlab platform.
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Perinatal Health monitoring in Europe: results from the EURO-PERISTAT project.
Informatics for health & social care, 2010Co-Authors: Mika Gissler, Nicholas Lack, Béatrice Blondel, Alison Macfarlane, Ashna D. Mohangoo, James D. Chalmers, Aldona Gaizauskiene, Miriam Gatt, Luule Sakkeus, Jennifer ZeitlinAbstract:Data about deliveries, births, mothers and newborn babies are collected extensively to monitor the Health and care of mothers and babies during pregnancy, delivery and the post-partum period, but there is no common approach in Europe. We analysed the problems related to using the European data for international comparisons of Perinatal Health. We made an inventory of relevant data sources in 25 European Union (EU) member states and Norway, and collected Perinatal data using a previously defined indicator list. The main sources were civil registration based on birth and death certificates, medical birth registers, hospital discharge systems, congenital anomaly registers, confidential enquiries and audits. A few countries provided data from routine Perinatal surveys or from aggregated data collection systems. The main methodological problems were related to differences in registration criteria and definitions, coverage of data collection, problems in combining information from different sources, missing data and random variation for rare events. Collection of European Perinatal Health information is feasible, but the national Health information systems need improvements to fill gaps. To improve international comparisons, stillbirth definitions should be standardised and a short list of causes of fetal and infant deaths should be developed.
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Migration and Perinatal Health surveillance: an international Delphi survey.
European journal of obstetrics gynecology and reproductive biology, 2010Co-Authors: Anita J. Gagnon, Meg Zimbeck, Jennifer ZeitlinAbstract:Abstract Objective While the Perinatal Health of migrants has been identified as a priority by many governments, there is no consensus on indicators for monitoring migration and Perinatal Health. The Reproductive Outcomes and Migration international research collaboration and the EURO-PERISTAT project convened an expert panel to recommend migration indicators for national and international monitoring of migration and Perinatal Health. Study design A Delphi consensus process involved 38 Perinatal clinicians, epidemiologists, and experts in Health information systems from 22 countries who completed one or more questionnaires. Panel members ranked migration indicators from a list inventoried from the published literature. Results Country of birth was considered ‘essential’ or ‘recommended’ for routine collection by 100% of respondents, followed by length of time in country (88%), language fluency (70%), immigration status (67%), and ethnicity as defined by maternal parents’ place of birth (55%). Feasibility with ‘minor’ or ‘no modifications’ to current data collection systems was highest for country of birth (69%), followed by length of time in country (61%). Other indicators were judged to be less feasible. In respect to migration, the Perinatal Health indicators considered to be ‘essential’ by 94% of respondents included fetal, neonatal, and infant mortality. A smaller proportion (73%) considered maternal mortality to be ‘essential’. Conclusions A strong consensus was achieved for including country of birth in core Perinatal Health indicator sets. Length of time in country was also recommended as a second indicator for routine data collection. Specific studies should be undertaken to complement routine data collection on: immigration status, language fluency, and ethnicity as defined by maternal parents’ place of birth.
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The European Perinatal Health report: delivering comparable data for examining differences in maternal and infant Health
European journal of obstetrics gynecology and reproductive biology, 2009Co-Authors: Meagan Zimbeck, Ashna D. Mohangoo, Jennifer ZeitlinAbstract:In December 2008, the first-ever European Perinatal Health Report was released by EURO-PERISTAT. Part of the EU Health Programme for Health surveillance and reporting, this landmark report presents indicators of Perinatal Health and care derived from routine statistical data in 25 EU Member States and Norway. It also includes chapters from three other European projects with Perinatal data: SCPE on cerebral palsy, EUROCAT on congenital anomalies and EURONEOSTAT on very preterm babies admitted to intensive care. © 2009 Elsevier Ireland Ltd. All rights reserved.
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Migration to western industrialised countries and Perinatal Health: a systematic review.
Social science & medicine (1982), 2009Co-Authors: Anita J. Gagnon, M. Zimbeck, Jennifer ZeitlinAbstract:Influxes of migrant women of childbearing age to receiving countries have made their Perinatal Health status a key priority for many governments. The international research collaboration Reproductive Outcomes And Migration (ROAM) reviewed published studies to assess whether migrants in western industrialised countries have consistently poorer Perinatal Health than receiving-country women. A systematic review of literature from Medline, Health Star, Embase and PsychInfo from 1995 to 2008 included studies of migrant women/infants related to pregnancy or birth. Studies were excluded if there was no cross-border movement or comparison group or if the receiving country was not western and industrialised. Studies were assessed for quality, analysed descriptively and meta-analysed when possible. We identified 133 reports (>20,000,000 migrants), only 23 of which could be meta-analysed. Migrants were described primarily by geographic origin; other relevant aspects (e.g., time in country, language fluency) were rarely studied. Migrants' results for preterm birth, low birthweight and Health-promoting behaviour were as good or better as those for receiving-country women in >or=50% of all studies. Meta-analyses found that Asian, North African and sub-Saharan African migrants were at greater risk of feto-infant mortality than 'majority' receiving populations, and Asian and sub-Saharan African migrants at greater risk of preterm birth. The migration literature is extensive, but the heterogeneity of the study designs and definitions of migrants limits the conclusions that can be drawn. Research that uses clear, specific migrant definitions, adjusts for relevant risk factors and includes other aspects of migrant experience is needed to confirm and understand these associations.
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Methodological difficulties in the comparison of indicators of Perinatal Health across Europe.
European journal of obstetrics gynecology and reproductive biology, 2003Co-Authors: Nicholas Lack, Jennifer Zeitlin, Lone Krebs, Wolfgang Künzel, Sophie AlexanderAbstract:The main purpose of this article is to point out common pitfalls that can confuse comparative analyses of indicators of Perinatal Health and to discuss ways to overcome or minimize these difficulties. The challenge is to distinguish 'real' variations in the value of an indicator from variations due to differences in registration practices and definitions and from random variation. The first section presents the major properties that are desirable in indicators of Perinatal Health status and Perinatal Health care in Europe to be used for comparative purposes. The second section provides specific examples of the types of methodological difficulties encountered in European cross-country comparisons due to variations in the definition, measurement and construction of indicators. The conclusion discusses the PERISTAT project's responses to these difficulties and how these methodological constraints impact on the selection of an appropriate indicator set for Europe today.