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Objectives. Although more fetal deaths than neonatal deaths occur, routinely collected fetal death data are seldom used for perinatal epidemiologic research because of data quality concerns. We developed a strategy for identifying and correcting errors in birthweight and gestational age in fetal death records. Methods. Using data from Georgia for 1989 and 1990, we detected singleton fetal death records having improbable or missing birthweight or gestational age by comparing these values with referent values. To verify the questionable values, we contacted 100 reporting hospitals in 1992. Results. In 817 of 2226 records, values were either improbable (60.1%) or missing (39.9%). We were able to contact the hospitals to verify data for 716 (88%) of these records. Verification resulted in corrections to 405 (57%) records, and 48% of unreported birthweights were obtained. Conclusions. Many errors in recorded gestational age and birthweight were identified by this method. Rather than deleting or imputing problem data for analyses, researchers should consider efforts to verify them. Efforts to improve this information should include improved reporting, strict quality assurance, and procedures for routine verification and correction of records. (Am J Public Health. 1997:87:1323-1327)

Several studies suggest that toxic chemicals in hair products may be absorbed through the scalp in sufficient amounts to increase the risks of adverse health effects in women or their infants. This case-control study of 525 Black women from three counties in North Carolina who had delivered a singleton, liveborn infant examined whether exposure to chemicals used in hair straightening and curling increased the odds that the infant was preterm or low birth weight. Cases consisted of 188 preterm and 156 low birth weight births (for 123 women, their infant was both low birth weight and preterm). Controls were 304 women who delivered term and normal birth weight infants. Women who used a chemical hair straightener at any time during pregnancy or within 3 months prior to conception had an adjusted odds ratios (OR) of 0.7 (95% confidence interval (Cl) 0.4−1.1) for preterm birth and 0.6 (95% Cl 0.4−1.1) for low birth weight. Exposure to chemical curl products was also not associated with preterm delivery (adjusted OR = 0.9, 95% Cl 0.5−1.8) or low birth weight (adjusted OR = 1.0, 95% Cl 0.5−1.9). Despite this failure to find an association, continued search for risk factors to which Black women are uniquely exposed is warranted. Am J Epidemiol 1999; 149: 712−16. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to examine the relation between maternal depressive symptoms and spontaneous preterm birth. From 1991 to 1993, pregnant, African-American women were prospectively enrolled at four hospital-based clinics in Baltimore, Maryland, that serve low-income areas of the city. The Center for Epidemiologic Studies Depression (CES-D) Scale was used to assess depressive symptoms. Multiple logistic regression analysis estimated the independent contribution of maternal depressive symptoms to spontaneous preterm birth, controlling for behavioral, clinical, and demographic variables. Among the 1,399 women in the sample, 117 (8.4%) had a spontaneous preterm delivery. Spontaneous preterm birth occurred among 12.7% of those with a CES-D score in the upper 10th percentile and among 8.0% of those with a lower score (relative risk = 1.59). The adjusted odds ratio for an elevated CES-D score was 1.96 (95% confidence interval: 1.04, 3.72); hence, maternal depressive symptoms in this sample of African-American women were independently associated with spontaneous preterm birth. Effective treatment of depression in pregnant women could ultimately result in a reduction of spontaneous preterm births.