ABSTRACT
Risk factors during pregnancy and delivery and neurological morbidity of newborns were assessed in a birth cohort in Dominica, the Caribbean. The data were compared with two reference groups, one from Grenada, the Caribbean, and the other from Groningen, the Netherlands. Despite variations in cultural and socio-economic situation, the similarities in obstetrical conditions, neonatal neurological morbidity and perinatal relationships between the three groups were more striking than the differences. The Dominican group showed a significantly higher rate of preterm births than the two other groups. Preterm birth was associated with a significant increase in neurological deviancy. In general motility and muscle tone were found to be lower in the Caribbean region than in the Netherlands.
Subject(s)
Brain Damage, Chronic/epidemiology , Pregnancy Complications/epidemiology , Pregnancy Outcome , Apgar Score , Asphyxia Neonatorum/complications , Asphyxia Neonatorum/epidemiology , Brain Damage, Chronic/diagnosis , Brain Damage, Chronic/etiology , Delivery, Obstetric/methods , Delivery, Obstetric/standards , Female , Fetal Growth Retardation/complications , Fetal Growth Retardation/epidemiology , Humans , Incidence , Infant Mortality , Infant, Newborn , Male , Netherlands/epidemiology , Obstetric Labor, Premature/complications , Obstetric Labor, Premature/epidemiology , Population Surveillance , Pregnancy , Prevalence , Risk Factors , West Indies/epidemiologyABSTRACT
Neonatal morbidity, in particular neurological morbidity is a more relevant measure of the effectiveness of obstetrical care than perinatal mortality. Neurological morbidity was assessed in a birth cohort in Grenada, and appeared to be lower than in a reference group examined in Groningen, the Netherlands, in 1975-1978. Perinatal mortality, however, was higher. The results support the thesis that some children may have died who, if they would have survived, would have been neurologically abnormal. It is concluded that whereas a decrease in perinatal deaths is an essential goal in Grenada, a concomitant increase in morbidity should be carefully avoided.