[Male and female fertility too late? Effect of parental age at conception on the health and mortality of children]. / Une fécondite féminine et masculine trop tardive? Effet des ages parentaux a la conception sur la santé et la mortalité des enfants.

After recalling that maternal and paternal fertility, and in particular the first birth, are occurring later and later in life in all developed countries, the paper examines the relation between parental ages at childbearing on the one hand and morbidity and mortality of the child on the other hand. Age of mother at childbearing has an impact on child mortality and morbidity. Similarly, a late paternal age at childbearing, controlling for mother's age, has a statistically significant impact on neonatal mortality and on late foetal mortality, as well as on the risk for the child of suffering from various congenital anomalies.

[Evaluation of the vaccine coverage of the general practitioners in the French Community]. / Evaluation de la couverture vaccinale des médecins généralistes en Communauté Française et en Région de Bruxelles-Capitale.

The present inter-University study aims to analyze the vaccine statute of the Belgian French-speaking general practionners and the reasons of their possible non-vaccination. A questionnaire with an exhaustive list of vaccines was sent by postal way to a random sample of thousand two hundred and twenty general practitioners. The results were analyzed via SPSS 13. The rate of answer is 60.83%. Two thirds of the doctors (67%) considered themselves in order of vaccination anti-influenza. A majority of doctors (59.7%) is vaccinated systematically each year. The majority of the doctors (83%) considered themselves in antitetanus order of vaccination. Two thirds (67%) think that the vaccine protects from 5 to 10 years. Nearly 73% of the doctors considered themselves in order of vaccination against hepatitis B. More than 50% of the doctors received a vaccine HBV since less than 10 years. The majority of the doctors (79.2%) made a blood control of their protection after vaccination HBV Almost half of the doctors thinks that the vaccine protect for life, 23% from 10 to 20 years and 14% from 5 to 10 years. Two thirds (67%) of the doctors did not make a vaccine against rubella. In 80% of the cases vaccination dated from more than 20 years. In nearly two thirds of the cases the doctors did not make blood control of their protection. Nearly 60% of the questioned doctors think that vaccination offers a protection to life. About half of the doctors did not consider themselves in order of vaccination against the whooping-cough. In three quarter of the cases last vaccination dated from more than 20 years. The two principal durations of protection of the vaccine are with life and between 10 and 20 years. Three quarters of the questioned doctors are considered in order of vaccination against the poliomyelitis. However in 62% of the cases the last vaccine goes up with more than 20 years. More two thirds of the doctors think than the vaccine protects with life or from 10 to 20 years. Two thirds of doctors considered themselves in order of vaccination against the diphteria. For a third of the doctors the vaccine dated from less than 5 years, in more than one quarter of the cases to more than 20 years like between 5 and 10 years. About half of the doctors said they were vaccinated against other pathologies: hepatitis A (34.5%), the yellow fever (21.1%), the thyphoid fever (12.5%), the BCG (8.9%), the pneumococcus (6.6%), meningitis and variola (5%). In the French Community, the vaccine coverage of the general practitioners against the influenza (67%), tetanus (83%) and hepatitis B (73%) is, in this study, higher or equal to the other Belgian and international studies but remains insufficient. A bad vaccine coverage is observed concerning rubella, the whooping-cough, the poliomyelitis. The answers over the durations of protection of the vaccines are rather disparate and show a bad knowledge of these durations and diagrams of vaccination. An update of this knowledge could be carried out during the continuous medical trainings.

Foetal mortality, infant mortality, and age of parents. An overview.

This review article examines the relationship between late foetal and infant mortality, and age of parents. The highest risks are observed at older maternal ages for foetal mortality and at both extremes of reproductive ages for infant mortality. For infant morbidity, the role of intermediate variables is discussed. Increasing paternal age seems to be related to higher foetal and neonatal mortality.

Infant health and mortality indicators: their accuracy for monitoring the socio-economic development in the Europe of 1994.

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