Perinatal outcome of pregnancies in women aged 40 and over.

Perinatal outcome of pregnancies at forty and over was analyzed starting from the diagnosis of pregnancy to seven days following delivery. Retrospectively, pre-gestational health and reproduction status were dealt with, as well as the course of pregnancy, deliveries, and newborn children (study group). The control group was composed of pregnant women aged 20 to 29, who were identical to study group in terms of parity. Statistical data processing was done by means of chi2-test, and contingency 2 x 2 tables. The difference was significant if p < 0.05. Out of 2,099 diagnosed wanted pregnancies at forty and over, 415 (19.8%) had a miscarriage, in 33 (1.6%) an artificial abortion was performed after determining the fetus karyotype and 1,651 (78.2%) of pregnant women delivered. In 66.2% of pregnancies the fetus karyotype was determined and in 33 (2.5%) fetuses chromosomal abnormalities were found Incidence of deliveries at 40 and over is 1.38%, which is a 35.6-percent increase in the last ten years. Nullipara and pluripara had an increase, and multipara had a decrease. Pre-gestational health and reproduction status in study group is lower than in control group. Complications during pregnancy: threatened abortion, EPH gestosis, placenta praevia, gestational diabetes, late fetal death are more frequent than in control group (p < 0.05). In intrapartal terms, more frequent were induction of delivery, meconium-stained amniotic fluid, fetal distress, operative vaginal deliveries, and Cesarean section (p < 0.05). In neonatal outcome there are more premature infant, there are more VLBW, LBW, SGA, newborn with low Apgar index values, and the total perinatal death is greater than in the control group (p < 0.05). In perinatal terms, (from the diagnosis to the seventh day following delivery) 1,617 children survived (77.0%), meaning that perinatal loss was 482 (23.0%). Authors conclude that pregnancy at 40 and over is a high-risk pregnancy. There is a high risk of pre-gestational and gestational complications, and perinatal loss is high. Therefore, those pregnancies are not desirable from the medical point of view.

[Twin pregnancies in maternity wards in Cakovec, Sisak and Sibenik in 1998]. / Blizanacke trudnoce u rodilistima Cakovec, Sisak i Sibenik u 1998. godini.

This study shows the frequency of twin births in maternity wards where a pilot study of the use of child health cards was undertaken during 1998 (Cakovec, Sisak, Sibenik), the months in the year when twin births are more common, their characteristics in terms of the mother's age and parity, gestational age and the sex of the twins. In the three maternity wards mentioned, 3.582 children were born in 1998, of which 38 births were of twins, which is an average of 1.03%. There is no statistically significant difference between the three hospitals in terms of the frequency of twin births (p > 0.05). The most twins were born in May (23.6%). The average age of the mothers who gave birth to twins was 29.5 +/- 10.8 years. In terms of parity, twins were most often (in 55.3% cases) born to women who had already had 2 to 4 babies. In terms of the gestational age of twins, 20 pairs of twins (52.6%) were born at term, 18 pairs (47.4%) were born prematurely, 39 boys were born (51.3%), and 37 girls (48.7%), that is 13 pairs of boy twins, 13 pairs of girl-boy twins and 12 pairs of girls twins. The authors consider that the child health card, along with all its uses relating to the monitoring of the growth and development of children, may also serve in the monitoring of perinatal factors of twin pregnancies.

Influence of father's weight and height on weight of male and female newborns.

The study included 1,596 newborns and their parents living in Sibenik County, Croatia. All newborns are born between 37 and 42 weeks of gestation, with no congenital anomalies and from a single pregnancy. Fathers and mothers of male babies are older than those of girl babies (p < 0.01). Mean values for weight, height, BMI in parents and the woman's parity are equal (p = 0.05). Pregnancy with male baby lasts longer and the babies are heavier (p < 0.05). Where the fathers weight between 70 and 79 kg and 80 to 89 kg, and where the fathers are 175 to 179 cm or 180 to 184 cm tall with normal BMI the male babies are heavier than the females at birth (p < 0.05). Increased weight, height and BMI in the father increase the birth weight of both male and female babies (p < 0.00001). The authors concludes that the parents (father and/or mother) of male babies are older than those of girls, that pregnancy for males babies lasts longer and that male babies are born heavier than girls. With increased weight, and height and BMI in the father, the birth weight of both male and female babies increases.

The effect of high birth weight (400 g or more) on the weight and height of adult men and women.

Three hundred and twenty eight examined adult men and 346 examined adult women were macrosomic at birth (4000 g or over). The control group consisted of 564 adult men and 749 adult women with birth weights of 2500 to 3999 g. Both male and female macrosomic babies achieve greater weights and heights in adulthood than those in the control group. There are more overweight and obese men in the macrosomic group than in the control group and the same is true of the women (p < 0.001). The mean values of the BMI (body mass index) for the macrosomic adults are greater than those for the control group (p < 0.001). Fetal macrosomia is a good predictor of the weight and height of adult men and women.

Influence of 1991-1995 war on breast-feeding in Croatia: questionnaire study.

AIM: To investigate the influence of 1991-1995 war on the prevalence, duration, and practice of breast-feeding Croatian children up to 5 years of age. METHOD: In 1996, interviews were conducted in households with children up to 2 years of age (757 children) and 2-5 years of age (1,180 children). Data for war-free areas, war-affected areas, and areas liberated after several years of occupation were analyzed separately. RESULTS: In 1996, 94.6% of mothers started breast-feeding, which lasted for an average of 3.4+/-2.9 months. The proportion of mothers who started breast-feeding did not vary with respect to either war-related or geographic areas of the country. Breast-feeding was significantly longer in war-free than in war-affected areas (3.7+/-3.1 vs. 2.7+/-2.1 months, respectively; p=0.015). The duration of breast-feeding in Croatia's geographic regions, Istria, Hrvatsko Primorje, and Gorski Kotar, was significantly longer than in Slavonia (3.9+/-3.4 vs. 3.4+/-3.0, respectively; p=0.037). On the country level, 49.4% of babies were fed on demand and 43.3% according to a daily schedule. The percent of children who were not breast-fed was significantly higher (p=0. 002) in the older age group (2-5 years of age, 9.3%) than in the younger age group (up to 2 years of age, 5.4%). CONCLUSIONS: The war decreased the prevalence and duration of breast-feeding, which might be related to regular humanitarian donations of infant food and mother's milk substitutes, especially in the war-affected areas. UNICEF breast-feeding campaign, which started in 1993, appeared to be effective.