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In Brazil, hospital birth care is available to all, but there are important differences between hospitals in the public and private sectors, geographical regions and capitals/inland cities, resulting in inequalities of infant health. To assess the hospital structure for birth care in Brazil and analyze hospital adequacy to care for newborns according to levels of risk. Data were collected as part of a nationwide hospital-based cohort study, 'Birth in Brazil'. The hospitals were classified according to whether they had a neonatal intensive care unit and divided into two models of governance: public and private financing. Three structure domains were assessed: human resources, medications and equipment for post-natal women and newborn emergency care. Newborns were classified according to the obstetric risk. There are more NICUs in private hospitals and they cater mostly for low obstetric risk newborns; the public sector serves 50% of at-risk patients in hospitals without an NICU. The differences between hospital service structures according to geographic region and capital/inland cities were evident. Hospitals in less developed regions and inland cities had poorer adequacy in the three domains. The distribution of neonatal care to Brazilian infants varied between the public and private sectors. The public sector offered less complex services for newborns at risk, and infants without obstetric risk were born in facilities with an NICU, creating the possibility of unnecessary intervention, especially in the private sector. [ABSTRACT FROM AUTHOR]

Objective. To determine maternal indicators and adverse perinatal outcomes among late-preterm infants during birth hospitalization in a low-income country. Methods. Cross-sectional study of late-preterm and term survivors in a tertiary maternity hospital in southwest Nigeria using multivariable logistic regression analysis and population attributable risk (PAR) percentage. Adjusted odds ratios (OR) and 95%% confidence intervals (CI) of significant factors are stated. Results. Of 4176 infants enrolled, 731 (17.5%%) were late preterm and 3445 (82.5%%) were full-term. Late-preterm delivery was independently associated with mothers who were unmarried (OR: 1.71, CI: 1.06-2.75), lacked formal education (OR: 1.75, CI: 1.06-2.89), human immunodeficiency virus positive (OR: 1.61, CI: 1.17-2.20), with hypertensive disorders (OR: 3.07, CI: 2.32-4.08), antepartum hemorrhage (OR: 3.66, CI: 1.97-6.84), and were unlikely to have induced labor (OR: 0.010, CI: 0.01-0.69). Hypertensive disorders and antepartum hemorrhage had a combined PAR of 48.4%%. Infants born late preterm were more likely to have low 5-min Apgar scores (OR: 1.70, CI: 1.01-2.83), sepsis (OR: 1.62, CI: 1.05-2.50), hyperbilirubinemia (OR: 1.56, CI: 1.05-2.33), admission into special care baby unit (OR: 1.85, CI: 1.38-2.48), and nonexclusive breast-feeding (OR: 1.49, CI: 1.49, CI: 1.18-1.89). Conclusions. These findings suggest that late-preterm infants in low-resource settings are at risk of severe morbidity and suboptimal feeding. Education and close monitoring of high-risk mothers are warranted to prevent avoidable late-preterm delivery and facilitate the proactive management of unavoidable late-preterm births. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare maternal and midwifery manpower effects of policies for induction of labour (IOL) postdates, using a retrospective cohort design, in a level two maternity unit in a district hospital in South-West England. Primary outcome measures included mode of delivery, admission--delivery interval, midwifery manpower use. Group I consisted of 124 women who underwent IOL at 40++10. Group II were 104 women who underwent IOL at 42 weeks' gestation and 123 women who laboured spontaneously between 40++10 and 42 weeks' gestation. The nulliparous women had a shorter admission--delivery interval when induction was planned for 42 weeks, compared with 40++10 ( p == 0.003), and required less frequent use of syntocinon ( p == 0.04) and of continuous fetal monitoring ( p == 0.02). The caesarean rate was higher in Group I than in Group II ( p == 0.04) for nulliparous women only. The earlier induction policy was associated with a higher midwifery manpower requirement for nulliparae ( p == 0.002). For parous women, the only difference was the greater use of oxytocin in labour. There was no difference between the groups in duration of labour, analgesia, Apgar scores, admission to neonatal care and meconium aspiration. In conclusion, delaying planned induction by three days was associated with lower medicalisation of labour and manpower needs for nulliparous women. [ABSTRACT FROM AUTHOR]

Females pregnant out of wedlock who chose to bear their children in a maternity home situation were compared with females who chose abortion as their option. Maternity home pregnants were younger, less educated, more regular church attenders, less aware of abortion, less sexually premissive, in poorer relationship with the putative father, and less likely to be satisfied with their pregnancy decision than their abortion choice counterparts. [ABSTRACT FROM AUTHOR]

This concludes the study, the first part of which appeared in vol. II, no. I of Population Studies. The present section deals with such collective schemes as free confinement services for all mothers, maternity and infant homes, free admittance to maternity and infant welfare clinics, non-residential child welfare. institutions, free school meals and free travel for mothers and children. The chief measure in Swedish population policy is the child allowance granted to all children in all families. Children of invalids, widows, unmarried mothers, etc., receive supplementary grants. Provisions aiming to overcome man-power difficulties in industry and in the home are discussed including immigration, the rationalization of house-hold work, home helps service, etc. The proposal for a Population Institute is considered and the cost of the various measures of Swedish population policy is estimated. [ABSTRACT FROM AUTHOR]