Bernard G. Greenberg

Maternal, fetal, and environmental factors in prematurity☆

Abstract This study of certain factors associated with premature births included 2,521 prematures among 29,561 deliveries at three hospitals in North Carolina during the years 1954 through 1961. Using four broad socioeconomic classes, it was observed that the incidence of prematurity was considerably higher in women under 20 years of age and in the less favored socioeconomic classes. Birth order per se did not exert a significant influence on the incidence of prematurity. On the other hand, maternal height did correlate with prematurity, the shorter women having higher rates. Selected complications during pregnancy occurred progressively more frequently from the most favored to the least favored socioeconomic group. In general, the complications studies were associated with an increase in the incidence of prematurity so that both socioeconomic status and complications affected premature rates.

Parental, fetal, and environmental factors in perinatal mortality☆

Abstract The parental, fetal, and environmental factors associated with 279 perinatal deaths and 398 controls have been examined. From the data it is quite evident that socioeconomic factors are of primary importance in perinatal mortality. The difference in perinatal mortality between the white and non-white groups disappeared when adjusted for socioeconomic factors. The fathers occupation and the mothers education showed significant differences in relation to perinatal mortality even when adjusted for race, age, and parity. The fathers occupation and mothers education were considered as indices of the socioeconomic status of the family. The mothers age was found to be a highly significant factor in perinatal mortality even when adjusted for race, age, and parity. The technique used in obtaining the data for the present study did not yield reliable information in regard to the nutritional status of the mother. Birth interval, parity, previous obstetric complications, and previous perinatal mortality did not appear to be significant in relation to perinatal mortality when adjusted for race, age, and parity. No correlation was noted between the level of the maternal hemoglobin and perinatal mortality. Certain complications of pregnancy such as toxemia, premature separation of the placenta, placenta previa, and other antepartum bleeding were associated with extremely high perinatal mortality rates. In this study the type of delivery appeared to have no relationship to perinatal mortality when other variables were considered.

Spontaneous premature rupture of the membranes.

Abstract A sample of cases of spontaneous premature rupture of the membranes associated with the delivery of approximately 7,500 infants weighing 400 grams and above is presented. The over-all incidence of premature rupture of the membranes was 15.8 per cent. The incidence of premature rupture of the membranes among the fetal and neonatal deaths was 26.7 per cent. Premature rupture of the membranes occurred in association with a sizable number of major obstetrical complications. Infection was the principal lethal factor in the infant deaths which were primarily due to premature rupture. It occurred more frequently among the non-white and less educated mothers, and was tolerated less well by the older mothers from lower socioeconomic groups, whether the classification was based upon the mothers education, race, or the fathers occupation. Premature rupture of the membranes is a major obstetrical complication which requires additional study.