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Accidental out-of-hospital births in Finland: incidence and geographical distribution 1963-1995.

https://arctichealth.org/en/permalink/ahliterature202145
Source
Acta Obstet Gynecol Scand. 1999 May;78(5):372-8
Publication Type
Article
Date
May-1999
Author
K. Viisainen
M. Gissler
A L Hartikainen
E. Hemminki
Author Affiliation
STAKES (National Research and Development Centre for Welfare and Health), University of Helsinki, Department of Public Health, Finland.
Source
Acta Obstet Gynecol Scand. 1999 May;78(5):372-8
Date
May-1999
Language
English
Publication Type
Article
Keywords
Adult
Birth weight
Delivery Rooms - statistics & numerical data
Delivery, obstetric - statistics & numerical data
Female
Finland
Gestational Age
Hospitals - standards
Hospitals, Maternity - statistics & numerical data
Humans
Incidence
Infant, Newborn
Obstetrics and Gynecology Department, Hospital - statistics & numerical data
Parity
Pregnancy
Prenatal Care
Rural Health Services - statistics & numerical data
Urban Health Services - statistics & numerical data
Abstract
The study aims to describe the incidence and geographical distribution of accidental out-of-hospital births (accidental births) in Finland in relation to the changes in the hospital network, and to compare the perinatal outcomes of accidental births and all hospital births.
Data for the incidence and distribution analyses of accidental births were obtained from the official statistics between 1962 and 1973 and from the national Medical Birth Registry (MBR) in 1992-1993. The infant outcomes were analyzed for the MBR data in 1991-1995.
Between 1963 and 1975 the central hospital network expanded and by 1975 they covered 72% of births. The number of small maternity units has decreased since 1963. The incidence of accidental births decreased between 1963 and 1973, from 1.3 to 0.4 per 1000 births, and rose by the 1990s to 1/1000. In the 1990s the parity adjusted risk of an accidental birth was higher for residents of northern than of southern Finland, OR 2.51 (CI 1.75-3.60), and for residents of rural compared to urban municipalities, OR 3.26 (CI 2.48-4.27). The birthweight adjusted risk for a perinatal death was higher in accidental births than in hospital births, OR 3.11 (CI 1.42-6.84).
A temporal correlation between closing of small hospitals and an increase in accidental birth rates was detected. Due to the poor infant outcomes of accidental births, centralization policies should include measures to their prevention.
PubMed ID
10326879 View in PubMed
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Amount of antenatal care and infant outcome.

https://arctichealth.org/en/permalink/ahliterature217840
Source
Eur J Obstet Gynecol Reprod Biol. 1994 Jul;56(1):9-14
Publication Type
Article
Date
Jul-1994
Author
M. Gissler
E. Hemminki
Author Affiliation
National Research and Development Centre for Welfare and Health, Helsinki, Finland.
Source
Eur J Obstet Gynecol Reprod Biol. 1994 Jul;56(1):9-14
Date
Jul-1994
Language
English
Publication Type
Article
Keywords
Birth weight
Cesarean Section
Female
Finland
Gestational Age
Humans
Pregnancy
Pregnancy outcome
Prenatal Care
Registries
Regression Analysis
Time Factors
Abstract
The connection between the amount of antenatal care and pregnancy outcome was studied using the 1987 Finnish Medical Birth Registry. A total of 57,108 women were included in the analysis. The timing of initiation of antenatal care and the relative number of antenatal visits (adjusted by gestation length), were used as measures of amount of antenatal care. Nine outcome variables measuring infant health and interventions were studied. Logistic regression was used to adjust for differences in maternal background characteristics. Women beginning antenatal care after the 16th week of gestation had the poorest outcome. Early attending multiparous women had a higher risk of low birthweight, premature infants, caesarean section and instrumental delivery than did those with average timing of their first attendance. For primigravidas, the increased risk was of prematurity only. A U-shaped curve was found for most of the outcome variables in regard to relative number of visits. The women with many visits had the poorest outcome, and also the highest rates of caesarean section and induction of labour. One reason for the unexpectedly high risks for early attenders may be connected with the content of antenatal care. In Finland, it might be possible to reduce the total number of antenatal visits without having any negative effect on infant health.
PubMed ID
7982522 View in PubMed
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Asthma and atopic dermatitis in children born moderately and late preterm.

https://arctichealth.org/en/permalink/ahliterature283894
Source
Eur J Pediatr. 2016 Jun;175(6):799-808
Publication Type
Article
Date
Jun-2016
Author
P. Haataja
P. Korhonen
R. Ojala
M. Hirvonen
M. Paassilta
M. Gissler
T. Luukkaala
O. Tammela
Source
Eur J Pediatr. 2016 Jun;175(6):799-808
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Asthma - epidemiology - therapy
Child
Dermatitis, Atopic - epidemiology - therapy
Female
Finland - epidemiology
Gestational Age
Hospitalization
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - epidemiology
Male
Mothers - statistics & numerical data
Pregnancy
Premature Birth - economics
Prevalence
Registries
Risk factors
Abstract
This national register study aimed to evaluate the need of asthma medication reimbursement and hospitalization due to asthma and atopic dermatitis up to 7 years of age in moderately preterm (MP) (32-33 weeks) and late preterm (LP) (34-36 weeks) children compared to very preterm (VP) (
PubMed ID
26898703 View in PubMed
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Birth dimensions of offspring, premature birth, and the mortality of mothers.

https://arctichealth.org/en/permalink/ahliterature196160
Source
Lancet. 2000 Dec 16;356(9247):2066-7
Publication Type
Article
Date
Dec-16-2000
Author
G D Smith
E. Whitley
M. Gissler
E. Hemminki
Source
Lancet. 2000 Dec 16;356(9247):2066-7
Date
Dec-16-2000
Language
English
Publication Type
Article
Keywords
Birth weight
Body Height
Breast Neoplasms - mortality
Cardiovascular Diseases - mortality
Female
Finland - epidemiology
Humans
Infant, Newborn
Infant, Premature
Mothers
Pregnancy
Proportional Hazards Models
Smoking
Abstract
A person's birthweight is inversely related to their cardiovascular disease (CVD) mortality risk, and preliminary data suggest that the birthweights of offspring are also inversely related to parental CVD mortality risk. In a cohort of pregnant Finnish women, we assessed the relation between birth dimensions of the offspring and maternal characteristics, and subsequent mortality. Maternal CVD mortality was inversely related to the birthweight of offspring and women having premature deliveries were also at increased CVD risk. Breast-cancer mortality was positively associated with ponderal index of offspring.
Notes
Comment In: Lancet. 2001 Oct 13;358(9289):1268; author reply 126911675086
PubMed ID
11145495 View in PubMed
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Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland.

https://arctichealth.org/en/permalink/ahliterature121150
Source
Hum Reprod. 2012 Nov;27(11):3315-20
Publication Type
Article
Date
Nov-2012
Author
R. Klemetti
M. Gissler
M. Niinimäki
E. Hemminki
Author Affiliation
National Institute for Health and Welfare (THL), PO Box 30, 00271 Helsinki, Finland.
Source
Hum Reprod. 2012 Nov;27(11):3315-20
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Abortion, Induced - adverse effects
Adult
Developed Countries
Female
Finland - epidemiology
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Very Low Birth Weight
Male
Parity
Patient Education as Topic
Pregnancy
Pregnancy outcome
Pregnancy Trimester, First
Premature Birth - epidemiology - etiology
Registries
Reoperation - adverse effects
Risk factors
Young Adult
Abstract
Is the perinatal health of first-born children affected by the mother's previous induced abortion(s) (IAs)?
Prior IAs, particularly repeat IAs, are correlated with an increased risk of some health problems at first birth; even in a country with good health care quality.
A positive association between IA and risk of preterm birth or a dose-response effect has been found in some previous studies. Limited information and conflicting results on other infant outcomes are available.
Nationwide register-based study including 300 858 first-time mothers during 1996-2008 in Finland.
All the first-time mothers with a singleton birth (obtained from the Medical Birth Register) in the period 1996-2008 (n = 300 858) were linked to the Abortion Register for the period 1983-2008.
Of the first-time mothers, 10.3% (n = 31 083) had one, 1.5% had two and 0.3% had three or more IAs. Most IAs were surgical (88%) performed before 12 weeks (91%) and carried out for social reasons (97%). After adjustment, perinatal deaths and very preterm birth (
PubMed ID
22933527 View in PubMed
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Birth outcomes by level of obstetric care in Finland: a catchment area based analysis.

https://arctichealth.org/en/permalink/ahliterature217647
Source
J Epidemiol Community Health. 1994 Aug;48(4):400-5
Publication Type
Article
Date
Aug-1994
Author
K. Viisainen
M. Gissler
E. Hemminki
Author Affiliation
Department of Public Health University of Helsinki, Finland.
Source
J Epidemiol Community Health. 1994 Aug;48(4):400-5
Date
Aug-1994
Language
English
Publication Type
Article
Keywords
Catchment Area (Health)
Cross-Sectional Studies
Delivery, Obstetric - standards
Female
Finland - epidemiology
Hospitals, Maternity - standards
Humans
Infant mortality
Infant, Low Birth Weight
Infant, Newborn
Obstetrics - standards
Pregnancy
Pregnancy outcome
Reproductive history
Risk factors
Abstract
To study whether hospitals of different levels are equally safe places to give birth in a regionalised system of care.
This was a population based, cross sectional survey comparing birth outcomes in nationwide catchment areas of different levels of hospital care. All women and low risk women were examined separately.
The study population comprised all women who gave birth in Finland in 1987-88. The data were obtained from the Finnish Medical Registry, complemented by official data.
No statistically significant differences were found in crude or birthweight specific perinatal mortality rates between the catchment areas, nor did the other outcomes studied favour tertiary care compared with other levels of care in the area based analysis.
In a regionalised system of birth care with a proper referral system, small local hospitals are as safe places to give birth as tertiary care hospitals.
Notes
Cites: N Engl J Med. 1982 Jul 15;307(3):149-557088051
Cites: J Epidemiol Community Health. 1993 Jun;47(3):242-78350040
Cites: Am J Obstet Gynecol. 1985 Jul 1;152(5):517-244014345
Cites: Scand J Soc Med. 1985;13(3):113-84040649
Cites: Lancet. 1985 Aug 24;2(8452):429-322863454
Cites: Acta Paediatr Scand. 1986 Jan;75(1):10-63953264
Cites: Br J Obstet Gynaecol. 1986 Jul;93(7):675-833524667
Cites: Br J Obstet Gynaecol. 1986 Jul;93(7):690-33730338
Cites: J Rural Health. 1988 Jul;4(2):101-1710288967
Cites: Community Health Stud. 1988;12(4):386-933243073
Cites: Am J Obstet Gynecol. 1989 Jul;161(1):86-912750825
Cites: Int J Health Serv. 1990;20(2):221-322332261
Cites: J Nurse Midwifery. 1991 Nov-Dec;36(6):327-331757818
Cites: Qual Assur Health Care. 1992 Jun;4(2):133-91511147
Cites: Int J Epidemiol. 1992 Aug;21(4):720-41521976
Cites: Med Care. 1983 Dec;21(12):1131-436656337
PubMed ID
7964341 View in PubMed
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Births by younger and older mothers in a population with late and regulated childbearing: Finland 1991.

https://arctichealth.org/en/permalink/ahliterature213603
Source
Acta Obstet Gynecol Scand. 1996 Jan;75(1):19-27
Publication Type
Article
Date
Jan-1996
Author
E. Hemminki
M. Gissler
Author Affiliation
National Research and Development Centre for Welfare and Health, University of Helsinki, Finland.
Source
Acta Obstet Gynecol Scand. 1996 Jan;75(1):19-27
Date
Jan-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Apgar score
Birth weight
Educational Status
Female
Finland - epidemiology
Health status
Humans
Maternal Age
Middle Aged
Obstetric Labor Complications - epidemiology
Parity
Pregnancy
Pregnancy Complications - epidemiology
Prenatal Care
Rural Population
Social Class
Urban Population
Abstract
The aims of this study were: first, to ascertain the characteristics of younger and older mothers in the Finnish population; second, to assess the health conditions pertaining to births and newborns according to maternal age groups.
The data, 26,373 primiparous and 38,895 multiparous women, came from the 1991 nationwide Finnish birth register, and was completed using death and education registers. The younger (
PubMed ID
8560992 View in PubMed
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Births in Finland and Estonia from 1992 to 1996: convergent differences?

https://arctichealth.org/en/permalink/ahliterature199441
Source
BJOG. 2000 Feb;107(2):179-85
Publication Type
Article
Date
Feb-2000
Author
M. Gissler
H. Karro
A. Tellmann
E. Hemminki
Author Affiliation
National Research and Development Centre for Welfare and Health, Medical Birth Registry and Health Services Research Unit, Helsinki, Finland.
Source
BJOG. 2000 Feb;107(2):179-85
Date
Feb-2000
Language
English
Publication Type
Article
Keywords
Abortion, Spontaneous - epidemiology
Birth rate
Estonia - epidemiology
Female
Finland - epidemiology
Health status
Humans
Infant mortality
Infant, Newborn
Maternal Health Services - statistics & numerical data
Maternal mortality
Pregnancy
Pregnancy outcome
Prenatal Care - statistics & numerical data
Registries
Abstract
To describe the differences in childbearing, in prenatal and obstetrical practices, and in perinatal health outcome in Finland and Estonia.
Registry study using the data from the Finnish and Estonian medical birth registries for years 1992 to 1996 (in total 324,021 and 74,297 newborns, respectively).
In 1992 the birth rates were 51 per 1,000 women aged 15 to 49 in Finland and 48 per 1,000 in Estonia. The birth rate declined in the study period in both countries, but the decline was more rapid in Estonia (-26%) than in Finland (-6%). In the same period the rates of induced abortion declined in both countries (-34% and -6%, respectively), but the rate in 1996 was still much higher in Estonia (46/1,000) than in Finland (8/1,000). Compared with Finnish mothers, Estonian mothers were younger, had fewer multiple births, less prenatal care and fewer interventions during pregnancy and delivery. The intervention rates increased in both countries during the study period, but this increase was more rapid in Estonia. The infant outcomes were poorer in Estonia, but the differences between Estonia and Finland decreased during the 1990's.
The differences in prenatal and maternal care and in induced abortion rates have decreased between Estonia and Finland. Changes in maternal backgrounds, improved referral system for complicated pregnancies, improvements in prenatal care and in availability of appropriate equipment and technology may have caused improved maternal and infant health in Estonia, but this should be further investigated.
PubMed ID
10688501 View in PubMed
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The danger of overmatching in studies of the perinatal mortality and birthweight of infants born after assisted conception.

https://arctichealth.org/en/permalink/ahliterature210782
Source
Eur J Obstet Gynecol Reprod Biol. 1996 Nov;69(2):73-5
Publication Type
Article
Date
Nov-1996
Author
M. Gissler
E. Hemminki
Author Affiliation
STAKES (National Research and Development Centre for Welfare and Health), Helsinki, Finland. mika.gissler@helsinki.fi
Source
Eur J Obstet Gynecol Reprod Biol. 1996 Nov;69(2):73-5
Date
Nov-1996
Language
English
Publication Type
Article
Keywords
Birth weight
Female
Fertilization in Vitro - adverse effects
Finland
Gestational Age
Humans
Infant mortality
Infant, Newborn
Mothers
Odds Ratio
Pregnancy
Pregnancy, Multiple - ethnology - statistics & numerical data
Prospective Studies
Technology Assessment, Biomedical
Abstract
To examine the impact of gestation length and plurality on short-term outcome of in vitro fertilization (IVF)-children.
A register study using the Finnish Medical Birth Register for 1991-1993 (N = 194 383 newborns, of which 1335 were IVF-newborns).
For IVF-newborns, a high proportion of multiple births (27%, odds ratio (OR) 19.67 compared with non-IVF births), low birth weight infants (30%, OR 7.94), and perinatal deaths (2.9%, OR 4.17) was found. The mothers' background did not explain the increased risks. After adjusting for gestation length and/or plurality, the odds ratios decreased significantly.
Because of the high risk of plurality and premature births, matching the control group by gestation length and/or the number of multiples births may yield misleading results on the total health impact of IVF, and therefore it should be avoided.
PubMed ID
8902436 View in PubMed
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Data quality after restructuring a national medical registry.

https://arctichealth.org/en/permalink/ahliterature215678
Source
Scand J Soc Med. 1995 Mar;23(1):75-80
Publication Type
Article
Date
Mar-1995
Author
M. Gissler
J. Teperi
E. Hemminki
J. Meriläinen
Author Affiliation
National Research and Development Centre for Welfare and Health (STAKES), Department of Public Health, University of Helsinki.
Source
Scand J Soc Med. 1995 Mar;23(1):75-80
Date
Mar-1995
Language
English
Publication Type
Article
Keywords
Abstracting and Indexing as Topic
Birth Certificates
Data Collection - methods - standards
Female
Finland
Forms and Records Control
Humans
Infant, Newborn
Male
Quality Control
Registries
Reproducibility of Results
Abstract
The validity of the 1991 Finnish Medical Birth Registry data was assessed, with special emphasis on the effects of changes made to the data collection form in 1990. Data abstracted from medical records for all births occurring in 49 hospitals during a five-day sample period (n = 865) were compared to the register information. Good or satisfactory validity was found for 32 of 33 variables, when minor error was tolerated in variables with continuous scales. For diagnoses and procedures, recorded in check-box format, satisfactory validity was found for 10 of 45 variables. Validity could not be assessed for 18 variables because of insufficient number of cases (13 items) or definition problems (5 items). When the results were compared to a 1987 data quality study, many of the variables that had been changed to the check-box format showed improvement in validity. In addition, in some cases a small change in question alternatives or instructions caused a noticeable change in validity.
PubMed ID
7784857 View in PubMed
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29 records – page 1 of 3.