Rowland V. Rider

Neurological and intellectual status of prematures at three to five years of age.

Summary The present report compares the neurological and intellectual status of a group of 460 prematurely born children examined at 3 to 5 years of age with that of a matched group of 440 full-term children serving as controls. The findings at this examination are related to similar data pertaining to the same children obtained when they were 40 weeks of age. At both examinations the prematurely born group was found to rate somewhat lower in intellectual status and to have a smaller proportion classed as neurologically normal than the fullterm children. When the prematures were subdivided by birth weight the trend favoring those with larger birth weights was maintained. For example, those in the group with birth weights from 2,001 to 2,500 grams were only slightly different from the controls; those whose birth weights were under 1,501 grams were more seriously handicapped. Consequently, a statement about “prematures” is more useful when details regarding degree of prematurity are available. Also, it was found in comparing the 40 week and the 3 to 5 year results that a childs prognosis for improvement in classification or for maintaining an average or better rating increased with an increase in birth weight. The answer as to whether or not this finding is peculiar to this age interval or to the aspects of development discussed in this paper must await further study. Finally, while the prematurely born group performs less well than the full-term group on the two indices here studied, it should be emphasized that the great majority of those born prematurely fall within the normal range and their distribution of intelligence ratings closely approximates that found for those born at term although somewhat on the lower side.

Proximate determinants of fertility and policy implications in Beijing.

Data from a 1982 sample survey of 3,830 married women below age 50 in a district of Beijing City are applied to the Bongaarts model of the proximate determinants of fertility. A total fertility rate (TFR) of 0.75 births per woman is estimated from the model, compared with a TFR of 1.24 actually observed from the survey. The estimated TFR (0.75) results from the assumed total fecundity (TF) of 15.30 births per woman being inhibited by the indexes of the proximate determinants of fertility, most notably non-marriage (.280), contraception (.315), and induced abortion (.586). The effects of two other proximate determinants, lactational infecundability and spousal separation, were negligible. Comparative data from other countries confirm that the study area has very low levels of fertility and marriage, a very high prevalence of induced abortion, and a small effect of lactational infecundability. The extremely low level of fertility was, thus, achieved through a high level of induced abortion. Future research needs and policy implications associated with the study are discussed.

Oral contraceptives and stroke: A preliminary report on an epidemiologic study in Taiwan, China

To investigate risk of stroke following use of oral contraceptives (OC) in less developed countries, a case‐control study was conducted in Taiwan involving 323 cases hospitalized in 1978–1980, 250 hospital controls, and 646 neighborhood controls matched with cases on several variables. All were alive at interview. For the total sample, no increased risk was found. However, when comparison is with hospital controls, the risk for the recent OC users was increased (OR = 3.93, 95% C.L. 1.21, 5.46). This latter finding is consistent with studies in developed countries.

Menstrual regulation versus contraception in Bangladesh: characteristics of the acceptors.

Menstrual regulation (MR) service was introduced in Bangladesh in 1974 through the Mohammadpur Model Clinic. This study identifies characteristics of the women undergoing MR compared with those of the women accepting contraceptive methods from the clinic. Women in the MR group were a mean of 2 years younger than women in the contraception group. They had an average of 3 more years of education and significantly lower mean gravidity. A significantly higher proportion of women in the MR group desired more children in the future and they traveled significantly farther to attend the clinic. The women in the MR group who reported prior contraceptive practice used less effective methods than the contraception group. The clinics MR services attracted women of early reproductive age: 44% of the women were less than 25 years of age. The study only includes women who had requested and received MR not women who requested and did not receive it; this reflected the clinics choice and might have affected the results. More than 1/2 of the MR users were using some form of contraceptive so that MR appears to provide a backup support to deal with irregular or ineffective contraceptive use.

Age at marriage, family planning practices, and other variables as correlates of fertility in Korea

The relationships between fertility and thirteen variables are examined in three groups of married Korean women, about 400 each from urban, rural, and semi-rural areas. Data were obtained by interview. Age at marriage and family planning practice are the strongest predictors of fertility and account for about 10 percent and 7 percent of the total variance, respectively. Other factors which accounted for lesser fractions of variability are ideal number of children, rural versus urban residence, education, aspiration for daughters, exposure to mass media, and economic status. Most of the relationships appear to be stable over time; others, which are associated with modernization, appear to be changing. The thirteen variables combined can account for a maximum of 40 percent of the variance in fertility.

Continuation of contraception following menstrual regulation–a Bangladesh experience

The study compares the 3 years of birth control practice of 1172 women who underwent early menstrual regulation (MR) and 499 others who accepted contraceptives only (nonMR) from an urban clinic in Bangladesh. About 60% of the women in the sample were followed-up and their all-method continuation rate was analyzed by life-table technique. The 3-year overall continuation rate in the MR group (64%) did not differ from that of the nonMR group (62%). In the age groups 25 and over, the continuation rate was higher in the MR group. Among the women who did not desire any more children, the continuation rate in the MR group was significantly higher than that of the nonMR group (80% versus 68%, P0.05). Of women with parity greater than 2, the MR group had significantly higher continuation rates than the nonMR group. The MR group had higher extended use-effectiveness for IUDs, conventional contraceptives (condom and foam), injectables, and oral contraceptives than the nonMR group. These findings indicated effective contraceptive practice following MR for this urban population. Easy availability of a multimethod service after MR seemed to be important in promoting effective contraception.

Iud retention in West Pakistan and methodology of assessment

In 1967 there was a sample survey of women who had had IUD insertions in West Pakistan during the first 18 months of the Pakistan National Family Planning Program which began in July, 1965. The 12 month retention rate, including reinsertions, per 100 respondents was 56. Certain gross relationships between respondent characteristics and IUD retention were found. Respondents age 35+ and with 5+ living children and respondents who had insertions within two months postpartum had relatively high retention rates. Respondent characteristics associated with low retention rates included: age 35+ with 0–4 living children; reasons other than family planning reported as reasons for insertion; less than one-half hour travel time required to obtain insertion; not informed at time of insertion about side-effects of IUD; and insertion during last six months of 1966. Consistency of response was evaluated by reinterviewing a sample of respondents. The significance of the 43 percent non-response rate was evaluated by making further attempts to interview a sample of non-respondents.