J. Morrison

AN EARLY PREGNANCY FACTOR DETECTED IN HUMAN SERUM BY THE ROSETTE INHIBITION TEST

Modification of maternal lymphocyte activity has been demonstrated early in pregnancy by the rosette inhibition test. Normal human lymphocytes showed a similar depression of activity after incubation in serum from pregnant women, indicating that the response was caused by a serum factor. This early pregnancy factor has been differentiated from other substances which appear later in pregnancy and which may also be involved in the suppression of the maternal response. The results of this investigation suggest that the early pregnancy factor may be necessary for the continued viability of the early embryo.

The mental health of women 6 months after they give birth to an unwanted baby: A longitudinal study

This study reports a longitudinal prospective study of the impact of an unwanted pregnancy on the mental health of the mother. Data are derived from a Brisbane, Australian sample of 8556 mothers who were enrolled at their first clinic visit (mean gestation 18 weeks) and then interviewed again some 3-5 days after the birth and when the baby was 6 months of age. Standard scales of mental health were administered on each of these occasions and mothers whose babies were unwanted were compared with the rest of the sample. The results indicate that mothers of unwanted children have somewhat higher rates of anxiety and depression than the comparison group, but that the magnitude of the mental health differences between the two groups: (a) diminishes over the period of the follow-up, (b) may be partly attributable to the prior poor mental health of women giving birth to an unplanned and unwanted baby, (c) is such that relatively few women who give birth to an unwanted baby experience mental health problems. The paper considers the implications of these results for health planners, notes the absence of contrary data and the need to acknowledge that these results may reflect situational factors which are characteristic of but not necessarily limited to Brisbane.

Information control and the exercise of power in the obstetrical encounter

Interactions between doctor and patient involve participants with unequal power and possibly different interests. While a number of studies have focused upon the doctor/patient relationship, few have examined the utility of the concept of power and its capacity to help us understand the outcome of these interactions. The information sought by pregnant women from their obstetricians is used to provide a case study of one conceptualization and test of the utility of the concept of power. Pregnant women and their obstetricians are found to have different perceptions of the information that should be exchanged during their interactions. Women generally fail to obtain the information they want. Lower social class patients desire more and obtain less information than their higher status counterparts.

Child developmental delay and socio-economic disadvantage in Australia: A longitudinal study

Socio-economic inequalities in adult and child health in Australia have been an issue of national concern. While a large body of data has discussed adult health, there have been relatively few Australian reports of socio-economic inequalities in child health. This occurs in a context where there have been increases in the proportion of Australian children living in poverty and where there has been an increased interest in child developmental delay as an indicator of child health status. This paper reports the result of a longitudinal study of pregnancy outcomes and one indicator of child health, namely child developmental delay. Three indicators of socio-economic status (chronic socio-economic disadvantage, mothers education, family income) were used to predict child developmental delays observed some 5 1/2 years after the study commenced. Mothers who had the lowest socio-economic status (using any of the indicators) had substantially higher rates of children manifesting developmental delays.

Socioeconomic Disadvantage and Child Morbidity: An Australian Longitudinal Study

While an extensive body of literature has demonstrated an association between socioeconomic status and child mortality, there have been relatively few papers which discuss the impact of socioeconomic inequality on child morbidity. This absence of data is partly attributable to methodological problems (need for large samples, the difficulty of assessing morbidity) and partly to the absence of relevant official health statistics. This paper reports results from the Mater-University of Queensland Study of Pregnancy (MUSP) and its outcomes. The sample comprises 8556 consecutive pregnancies, of which over 90% were followed up to birth. Of those mothers giving birth, approx. 70% of children were successfully given a health assessment five years after the birth (mothers report of the childs health using a set of standard indicators). The results indicate a consistent pattern with the children of the most socioeconomically disadvantaged mothers manifesting the worst health. Thus children living in socioeconomic disadvantage have a higher rate of health service utilisation, more chronic health problems and poorer dental health. The paper discusses some social policies for redressing these inequalities.

BIRTH WEIGHT: ANALYSIS OF VARIANCE AND THE LINEAR ADDITIVE MODEL

The normal distribution of birth weight in a Queensland population has been surveyed. A method of analysis is presented which allows for the influence of a number of factors that affect birth weight.

The development of the lower uterine segment.

Summary: The change in position between the lower placental border and the internal cervical os has been measured serially by compound ultrasonic scanning at different stages of gestation in a group of patients with a relatively low insertion of the placenta. These measurements, in conjunction with the clinical estimation as to whether or not placenta praevia was present at delivery, have been used to calculate the normal pattern of development of the lower uterine segment during pregnancy. Factors which apparently interfere with this pattern of development and the value of this knowledge in relation to placental localisation is presented.

The theory, feasibility and accuracy of an ultrasonic method of estimating fetal weight.

We present the theory, method, feasibility and accuracy of estimating fetal weight by measuring the fetal volume using compound ultrasonic scanning. The two parameters had a very high coefficient of correlation (0.9794), and the standard error in one series of 20 patients was only ±106 g. The correlation coefficient achieved by one of us who was new to ultrasound techniques was 0.82, which compared favourably with correlations between fetal weight and biparietal diameter measurements (r = 0.26). A discussion as to the correction factors required to allow for the unknown value of the velocity of ultrasound in fetal tissues, the clinical use of this method, and the possible means by which the accuracy of estimating fetal weight may be further improved is included.

Religious values, practices and pregnancy outcomes: a comparison of the impact of sect and mainstream Christian affiliation.

In this report 6566 women enrolled in the Mater-University of Queensland Study of Pregnancy (MUSP) were separated into three groups; members of religious sects, Christians who attend church frequently and Christians who are infrequent attenders. These three groups, respectively labelled Christian sects, Christian attenders and lukewarm Christians were compared on a number of social background, lifestyle and pregnancy outcome variables. The sect members appeared to have the most favourable health, lifestyles and healthy babies at delivery, though this latter finding appears attributable to specific characteristics of the mother and her lifestyle. On most measures the children of lukewarm Christians appear to manifest the worst health while Christian attenders form a group whose childrens health is between that of sect members and lukewarm Christians.

Poor Antenatal Attendance and Obstetric Performan

Summary: A survey of attendance for antenatal care at a public hospital in Brisbane was carried out.“Poor attenders” were more likely to be young, unmarried, grande multiparous, or aboriginal, and to live in a poorer area of the City. This group comprised 6.5% of the total population, but accounted for 14.6% of all low Apgar scores, 23 % of all low birth weight babies, 23.1 % of all stillbirths, and 18.2% of all neonatal deaths.