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1.
Matern Child Health J ; 3(4): 177-87, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10791358

ABSTRACT

OBJECTIVES: To compare maternal characteristics and birth outcomes of Mexico-born and native-born mothers in the United States and those of North African mothers living in France and Belgium to French and Belgian nationals. METHODS: We examined information from single live birth certificates for 285,371 Mexico-born and 3,131,632 U.S.-born mothers (including 2,537,264 U.S.-born White mothers) in the United States, 4,623 North African and 103,345 Belgian mothers in Belgium, and a French national random sample consisting of 632 North African and 11,185 French mothers. The outcomes were mean birthweight, low birthweight, and preterm births. Differences between native/nationals and foreign-born mothers in each country were assessed in bivariate and multivariate analyses controlling for maternal risk factors. RESULTS: The adjusted odds for low birthweight were lower for immigrants than native/nationals by 32% in the United States, by 32% in Belgium, and by 30% in France. The adjusted odds for preterm births were lower for immigrants compared with native/nationals by 11% in the United States and by 23% in Belgium. In France, the odds for preterm births were comparable for immigrants and naturalized mothers. Infants of immigrant mothers also had higher mean birthweights in all three countries. CONCLUSION: Despite their disadvantaged status, Mexico-born and North African-born women residing in the United States, France, and Belgium show good birth outcomes. These cannot be explained solely by traditional risk factors. Protective factors and selective migration may offer further clues.


Subject(s)
Black or African American/statistics & numerical data , Emigration and Immigration/statistics & numerical data , Mexican Americans/statistics & numerical data , Pregnancy Outcome/ethnology , Pregnancy Outcome/epidemiology , Residence Characteristics/statistics & numerical data , Adolescent , Adult , Africa, Northern/ethnology , Analysis of Variance , Belgium/epidemiology , Birth Certificates , Birth Weight , Black People , Female , France/epidemiology , Humans , Infant, Newborn , Odds Ratio , Population Surveillance , Pregnancy , Risk Factors , United States/epidemiology , White People/statistics & numerical data
2.
Am J Public Health ; 88(5): 808-11, 1998 May.
Article in English | MEDLINE | ID: mdl-9585752

ABSTRACT

OBJECTIVES: This study examined birthweights of North African immigrants in Belgium. METHODS: Analyses focused on Belgian single live birth certificates from 1981 to 1988. RESULTS: Low-birthweight (< 2500 g) rates were 3.1% among 34,686 newborns of North African origin and 4.8% among 804,286 newborns of Belgian origin. The entire North African birthweight distribution was shifted toward higher birthweights than the Belgian distribution. Low frequencies of low birthweights among North Africans were still observed after marital status, occupation of the father, and parity had been taken into account. CONCLUSIONS: Despite their low socioeconomic status, North African immigrants have high birthweights.


Subject(s)
Birth Weight , Africa, Northern/ethnology , Belgium , Emigration and Immigration , Female , Humans , Infant Mortality , Infant, Newborn , Male , Marital Status , Parity , Social Class
3.
Paediatr Perinat Epidemiol ; 9(3): 273-80, 1995 Jul.
Article in English | MEDLINE | ID: mdl-7479276

ABSTRACT

Belgium is known to have a lesser low birthweight rate and a lower infant mortality rate than the United States. We used previously unpublished data to show that beneath this comparison lies a more complicated picture. Singleton live birth certificates for 1986-87 were analysed. Despite a lower mean birthweight in Belgium (3360 g) than in the United States (3420 g), Belgium had fewer (4.9%) low birthweight infants than the US (5.9%) because of fewer preterm births (4.4 vs. 9.3%). Consistent with the excess of preterm births in the US, the residual distribution of birthweight was smaller in Belgium (2.2% vs. 3.1%). Whereas neonatal mortality was 4.8/1000 in Belgium and 5.6/1000 in the US, birthweight-specific neonatal mortality was higher in Belgium. The challenge for Belgium is to improve the survival of newborns regardless of their birthweight. In the US, the task is to eliminate the excess of small preterm infants.


Subject(s)
Infant Mortality , Infant, Low Birth Weight , Infant, Premature , Obstetric Labor, Premature/epidemiology , Belgium/epidemiology , Bias , Birth Weight , Causality , Data Interpretation, Statistical , Female , Gestational Age , Humans , Infant, Newborn , Pregnancy , United States/epidemiology
4.
Eur J Popul ; 11(1): 63-84, 1995.
Article in English | MEDLINE | ID: mdl-12158978

ABSTRACT

PIP: The ability of infant mortality and health indicators to monitor health conditions in early infancy and their broader use as indicators of the general level of socioeconomic development was discussed from three points of view: 1) the increasing impact of differences in legal definitions of live and stillbirths on the comparability of the infant mortality figures produced by vital statistics; 2) the validity of mortality measures to monitor health; and 3) the comparability of social inequalities in infant health and mortality over time and across countries. The infant mortality rate is defined as the risk of a live born child dying before its first birthday and is known as one of the most sensitive indicators of socioeconomic development of the population. Infant mortality rates consist of postneonatal early days or hours of life, early neonatal during the first week, late fetal or stillbirths, and perinatal mortality. Regarding live and stillbirth comparability all over Europe, legal definitions of vital events are significant: stillbirths, live births, and deaths. The problems of definition also impact the lack of international comparability of perinatal and infant mortality figures, whereby collapsing of stillbirths and early neonatal deaths may bias comparisons over time. Therefore, these two rates should be separated. The question also arises whether mortality measures health as a negative indicator. With respect to birth weight and gestational age, very low birth weight (1500 g) tends to replace the concept of low birth weight (2500 g). Another issue is birth weight specific mortality rates, which could enable the comparison of infant mortality levels to eliminate discrepancies derived from underregistration. The sociodemographic characteristics routinely included in vital registration beginning in the 1970s have shown that the children of unmarried, less educated, and unemployed mothers are at higher risk of perinatal mortality with a relative risk of 1.5 from the lowest to the highest social class.^ieng


Subject(s)
Child Welfare , Evaluation Studies as Topic , Infant Mortality , Mortality , Socioeconomic Factors , Vital Statistics , Demography , Developed Countries , Economics , Europe , Health , Population , Population Characteristics , Population Dynamics , Research
5.
Bull World Health Organ ; 73(4): 449-60, 1995.
Article in English | MEDLINE | ID: mdl-7554016

ABSTRACT

International comparisons of the perinatal mortality data derived from vital registration statistics can be made in different ways. In this article we examine the legal and administrative definitions of vital events (live births and stillbirths) in the 27 European countries that participated in an in-depth survey conducted in 1991 by the Institute of Demography, University of Louvain, Belgium. The impact of the various definitions in use on the comparability of vital event data over time and in different countries is illustrated by discussing some of the anomalies exhibited by published data (e.g., age at death in different European countries and the trends in infant mortality or stillbirth rate in selected countries). Analysed is the potential for vital registration systems to produce standardized perinatal mortality data that satisfy WHO recommendations for international comparisons, taking into account the contents of the vital registration forms and the data processing (record linkage) methods useful in different countries.


Subject(s)
Infant Mortality , Vital Statistics , Europe , Fetal Death/epidemiology , Humans , Infant , Infant Mortality/trends , Infant, Newborn , Medical Record Linkage , Registries
8.
Cah Que Demogr ; 23(2): 297-340, 1994.
Article in French | MEDLINE | ID: mdl-12291398

ABSTRACT

"Tendencies in foetal-infant mortality in countries characterized by very low overall mortality rates should be set forth in terms of health. First with respect to physical health, greater use of technology in reproductive matters is translated by an increase in both survival rates of very low birth weight infants and, in certain countries, in multiple deliveries. Next concerning social health, given the persistence and potential deepening of social inequalities, it is unlikely that overall rates have reached a peak. Several indicators can be developed with vital statistics, including incidence of low and very low birth weight, specific risks by birth weight, and differential risks by social characteristics of the parents. These phenomena can be monitored and, to a certain extent, compared in [Canada and] a large number of European countries." (SUMMARY IN ENG AND SPA)


Subject(s)
Fetal Death , Health , Infant Mortality , Social Welfare , Socioeconomic Factors , Americas , Canada , Demography , Developed Countries , Economics , Europe , Longevity , Mortality , North America , Population , Population Dynamics , Research , Survival Rate
9.
Am J Public Health ; 83(1): 31-6, 1993 Jan.
Article in English | MEDLINE | ID: mdl-8417603

ABSTRACT

OBJECTIVES: We sought to describe prenatal care use in the United States and in three European countries where accessibility to prenatal care has been reported to be better than it is in the United States. METHODS: We analyzed the 1980 US National Natality Survey, the 1981 French National Natality Survey, a 1979 sample of Danish births, and a survey performed from 1979 to 1980 in one Belgian province. RESULTS: The proportion of women who began prenatal care late (after 15 weeks) is highest in the United States (21.2%) and lowest in France (4.0%). This contrasts with the median number of visits, which is greater in the United States (11) than in Denmark (10) or in France (7). Across all maternal ages, parities, and educational levels, late initiation of prenatal care is more frequent in the United States, and median number of visits in the United States is equal to or higher than that in the other countries. CONCLUSIONS: In countries that offer nearly universal access to prenatal care, women begin care earlier during pregnancy and have fewer visits than women in the United States.


Subject(s)
Health Services Accessibility/statistics & numerical data , Prenatal Care/statistics & numerical data , Adult , Educational Status , Europe , Female , Humans , Marital Status , Odds Ratio , Pregnancy , Regression Analysis , Transients and Migrants/statistics & numerical data , United States
10.
Biol Neonate ; 55(1): 42-9, 1989.
Article in English | MEDLINE | ID: mdl-2650744

ABSTRACT

In spite of an overall sharp decrease in the infant mortality level since the very beginning of the 20th century, one still observes a persistance of social inequalities, even in perinatal mortality, almost everywhere in Europe. International comparisons or trends are rather difficult to establish due to methodological and conceptual shortcomings. In the years 1979-1980, a comprehensive survey was conducted in one of the Belgian provinces, Hainaut, where information on the mothers' behavior during pregnancy, including everyday life habits, was collected together with the usual identification factors. It appears that future research needs must be based on a new definition of the social gradients, shifting from the usual father's socioeconomic reference to a more sociocultural integration gradient, taking also maternal and family characteristics into account in order to improve the understanding of the phenomenon.


Subject(s)
Infant Mortality , Socioeconomic Factors , Belgium , Europe , Humans , Infant Mortality/trends , Infant, Low Birth Weight , Infant, Newborn , Maternal Behavior , Surveys and Questionnaires
11.
Int J Epidemiol ; 16(4): 612-8, 1987 Dec.
Article in English | MEDLINE | ID: mdl-3440673

ABSTRACT

Morbidity registration by a network of sentinel general practitioners (SGPs) in Belgium raises a number of problems related to possible biases in the network procedure, such as unequal geographical distribution, non-participation of a segment of the target population of practitioners and difficulties in the estimation of the denominator population at risk for the health problems under study. Through the application of two hierarchical clustering procedures, the initial number of 43 districts in the country has been reduced to 15 homogeneous district clusters. These represent the new geographical framework from which the geographical spread of the network is checked. This network is subsequently corrected for such socio-demographic parameters as age, sex and occupation in order to match more closely the total population of Belgian general practitioners (GPs). The population covered by the network is estimated on the basis of the annual number of patient contacts. Application of the described procedures should result in a network allowing valid estimations for a number of health issues as seen by Belgian GPs.


Subject(s)
Epidemiologic Methods , Family Practice , Population Surveillance , Adult , Age Factors , Aged , Belgium , Female , Humans , Male , Middle Aged , Sex Factors
15.
Genus ; 38(3-4): 19-37, 1982 Dec.
Article in French | MEDLINE | ID: mdl-12266011

ABSTRACT

PIP: After 1st stressing the complexity of explaining child mortality, a short overview of the various approaches to the problem is given. Included in the overview is research undertaken in different areas directly or indirectly concerned--particularly epidemiology and demography, but also in medical sciences, medical sociology, and anthropology. The purpose of this review is to point out the lack of coherence and shortcomings of research. Are they really explanatory or merely descriptive? Do they use the relevant techniques of observation and statistical analysis according to the objectives: Are they well integrated, without ambiguity, into the framework of a methodologically coherent thought? To many of these questions, the answer is often negative. To the partitioning of the different sciences concerning child mortality, this paper opposes the absolute necessity of a multidisciplinary approach, which should at the same time carry on the theoretical reflection on the cause of this complex phenomenon, and elaborate all research programs on the matter. (author's modified)^ieng


Subject(s)
Cohort Studies , Demography , Developing Countries , Epidemiologic Methods , Evaluation Studies as Topic , Health Services Research , Infant Mortality , Mortality , Research , Anthropology, Cultural , Population , Population Dynamics , Social Sciences , Sociology
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