The epidemiology of low birth weight; changes in incidence in Aberdeen, 1948-72

Changes in the incidence of low birth weight (defined as 2500 gm or less) in Aberdeen, Scotland are explored. The article also focuses on the perinatal mortality rate associated with unexplained low birth weight (LBW). Results, when analysed in terms of age, parity and social class of the mother, showed that in para 0 the incidence was highest in 1948-52. There was very little variation in incidence in each five year group in terms of para 1. The incidence of LBW was most strongly influenced by the socioeconomic climate at the time of the mother's birth. At least in Aberdeen the incidence of LBW in short women was twice that in tall women. The author concludes that the epidemiological characteristics of LBW is very closely associated with the changes in the socioeconomic conditions in Britain in the last decade which have affected health, nutrition and reproductive efficiency.     

Recent trends in contraceptive sterilization in Flanders

Elective sterilization started to spread rather late in Flanders. Despite the sharp increase of this contraceptive method since the end of the 1970s, its frequency is still lower than in many neighbouring countries and much lower than in the US and Canada, mainly due to the lag in male sterilization. Further increase in contraceptive sterilization and a greater participation of men is expected in the near future.     

Some factors in the choice of male or female sterilisation in Aberdeen

In a random sample of 84 men and 167 women, medical considerations, an intransigent attitude of one partner or a fear of adverse effects, were related to the decision on which partner should seek sterilisation. Only 19% of couples felt that they had a real choice between male and female sterilisation.     

Effects of withholding food for 0-72 h on mating, pregnancy rate and pituitary function in female rats

Food was withheld from female rats for 0-72 h at various stages of the oestrous cycle. Withholding food for periods of 24 h ending at 12:00 h on the day of pro-oestrus reduced the mating rate from 61 to 25% (P less than 0.05) but not the pregnancy rate of those rats that mated. Fasting for 24 h ending at 18:00 h on the day of pro-oestrus reduced the pregnancy rate from 82 to 18% (P less than 0.05) without affecting the mating rate and a 48-h fast starting at 12:00 h on the day of pro-oestrus reduced the pregnancy rate from 82 to 25% (P less than 0.05). Withholding food for 23 h ending at 17:00 h on the day of pro-oestrus prevented the LH and prolactin surges normally present at 17:00 h on this day. The treatments had no apparent effect on the ability of the adenohypophysis to release LH in response to injections of GnRH. When ovariectomized female rats fasted for 0-72 h and given 2 injections of oestradiol dibenzoate to test the ability of the hypothalamus to respond to an increasing plasma oestradiol concentration by stimulating the release of LH, a fast for 24 h reduced and a fast for 72 h completely prevented LH release.     

The therapeutic exception: abortion, sterilization and medical necessity in Costa Rica

Based on the case of Rosa, a nine-year-old girl who was denied a therapeutic abortion, this article analyzes the role played by the social in medical practice. For that purpose, it compares the different application of two similar pieces of legislation in Costa Rica, where both the practice of abortion and sterilization are restricted to the protection of health and life by the Penal Code. As a concept subject to interpretation, a broad conception of medical necessity could enable an ample use of the therapeutic exception and a liberal use of both surgeries. The practice of therapeutic sterilization has been generalized in Costa Rica and has become the legitimate way to distribute contraceptive sterilization. In contrast, therapeutic abortion is very rarely practiced. The analysis carried out proposes that it is the difference in social acceptance of abortion and sterilization that explains the different use that doctors, as gatekeepers of social morality, make of medical necessity.