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Objective: To examine the association between gestational age at birth across the entire gestational age spectrum and special educational needs (SENs) in UK children at 11 years of age.Methods: The Millennium Cohort Study is a nationally representative longitudinal sample of children born in the UK during 2000-2002. Information about the child's birth, health and sociodemographic factors was collected when children were 9 months old. Information about presence and reasons for SEN was collected from parents at age 11. Adjusted relative risks (aRRs) were estimated using modified Poisson regression, accounting for confounders.Results: The sample included 12 081 children with data at both time points. The overall prevalence of SEN was 11.2%, and it was inversely associated with gestational age. Among children born <32 weeks of gestation, the prevalence of SEN was 27.4%, three times higher than among those born at 40 weeks (aRR=2.89; 95% CI 2.02 to 4.13). Children born early term (37-38 weeks) were also at increased risk for SEN (aRR=1.33; 95% CI 1.11 to 1.59); this was the same when the analysis was restricted to births after labour with spontaneous onset. Birth before full term was more strongly associated with having a formal statement of SEN or SEN for multiple reasons.Conclusion: Children born at earlier gestational ages are more likely to experience SEN, have more complex SEN and require support in multiple facets of learning. This association was observed even among children born early-term and when labour began spontaneously. [ABSTRACT FROM AUTHOR]

Objective: To describe ethnic and socioeconomic variation in cause-specific infant mortality of preterm babies by gestational age at birth.Design: National birth cohort study.Setting: England and Wales 2006-2012.Subjects: Singleton live births at 24-36 completed weeks' gestation (n=256 142).Outcome Measures: Adjusted rate ratios for death in infancy by cause (three groups), within categories of gestational age at birth (24-27, 28-31, 32-36 weeks), by baby's ethnicity (nine groups) or area deprivation score (Index of Multiple Deprivation quintiles).Results: Among 24-27 week births (5% of subjects; 47% of those who died in infancy), all minority ethnic groups had lower risk of immaturity-related death than White British, the lowest rate ratios being 0.63 (95% CI 0.49 to 0.80) for Black Caribbean, 0.74 (0.64 to 0.85) for Black African and 0.75 (0.60 to 0.94) for Indian. Among 32-36 week births, all minority groups had higher risk of death from congenital anomalies than White British, the highest rate ratios being 4.50 (3.78 to 5.37) for Pakistani, 2.89 (2.10 to 3.97) for Bangladeshi and 2.06 (1.59 to 2.68) for Black African; risks of death from congenital anomalies and combined rarer causes (infection, intrapartum conditions, SIDS and unclassified) increased with deprivation, the rate ratios comparing the most with the least deprived quintile being, respectively, 1.54 (1.22 to 1.93) and 2.05 (1.55 to 2.72). There was no evidence of socioeconomic variation in deaths from immaturity-related conditions.Conclusions: Gestation-specific preterm infant mortality shows contrasting ethnic patterns of death from immaturity-related conditions in extremely-preterm babies, and congenital anomalies in moderate/late-preterm babies. Socioeconomic variation derives from congenital anomalies and rarer causes in moderate/late-preterm babies. Future research should examine biological origins of extremely preterm birth. [ABSTRACT FROM AUTHOR]

Introduction Maternity Hospital Episode Statistics (HES) data for 2005-2014 were linked to birth registration and birth notification data (previously known as NHS Numbers for Babies or NN4B) to bring together some key demographic and clinical data items not otherwise available at a national level. The linkage algorithm that was previously used to link 2005-2007 data was revised to improve the linkage rate and reduce the number of duplicate HES records. Methods Birth registration and notification linked records from the Office for National Statistics ('ONS birth records') were further linked to Maternity HES delivery and birth records using the NHS Number and other direct identifiers if the NHS Number was missing. Results For the period 2005-2014, over 94% of birth registration and notification records were correctly linked to HES delivery records. Two per cent of the ONS birth records were incorrectly linked to the HES delivery record and 5% of ONS birth records were linked to more than one HES delivery record. Therefore, a considerable amount of time was spent in quality assuring these files. Conclusion The linkage rate for birth registration and notification records to HES delivery records steadily improved from 2005 to 2014 due to improvement in the quality and completeness of patient identifiers in both HES and birth notification data. [ABSTRACT FROM AUTHOR]

The article focuses on findings of a study related to childhood survival in Great Britain, as of October 2010. It states that the Millennium Development Goal of United Nations have significantly helped improve childhood survival in the country by reducing mortality among children under the age of five, and cites the trends in child mortality in Great Britain and Europe. It mentions possible reasons for higher child and adolescent mortality like poverty and socioeconomic inequalities.

Objectives: To explore whether service configuration and obstetric unit (OU) characteristics explain variation in OU intervention rates in 'low-risk' women. Design: Ecological study using funnel plots to explore unit-level variations in adjusted intervention rates and simple linear regression, stratified by parity, to investigate possible associations between unit characteristics/configuration and adjusted intervention rates in planned OU births. Characteristics considered: OU size, presence of an alongside midwifery unit (AMU), proportion of births in the National Health Service (NHS) trust planned in midwifery units or at home and midwifery 'under' staffing. Setting: 36 OUs in England. Participants: 'Low-risk' women with a 'term' pregnancy planning vaginal birth in a stratified, random sample of 36 OUs. Main outcome measures: Adjusted rates of intrapartum caesarean section, instrumental delivery and two composite measures capturing birth without intervention ('straightforward' and 'normal' birth). Results: Funnel plots showed unexplained variation in adjusted intervention rates. In NHS trusts where proportionately more non-OU births were planned, adjusted intrapartum caesarean section rates in the planned OU births were significantly higher (nulliparous: R2=31.8%, coefficient=0.31, p=0.02; multiparous: R2=43.2%, coefficient=0.23, p=0.01), and for multiparous women, rates of 'straightforward' (R2=26.3%, coefficient=−0.22, p=0.01) and 'normal' birth (R2=17.5%, coefficient=0.24, p=0.01) were lower. The size of the OU (number of births), midwifery 'under' staffing levels (the proportion of shifts where there were more women than midwives) and the presence of an AMU were associated with significant variation in some interventions. Conclusions: Trusts with greater provision of non-OU intrapartum care may have higher intervention rates in planned 'low-risk' OU births, but at a trust level this is likely to be more than offset by lower intervention rates in planned non-OU births. Further research using high quality data on unit characteristics and outcomes in a larger sample of OUs and trusts is required. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between low and very low birth weights, mother's age, individual socioeconomic status and area deprivation. Design: Analysis of the incidence of low and very low birth weights by area deprivation, maternal age, social class of household and estimated income. Setting: England 1996-2000. Subjects: 2 894 440 singleton live births and the 10% sample of these births for which parents' individual-level socioeconomic measures were coded. Results: Social class, estimated household income, lone-parenthood and mother's age were all associated with the risk of low and very low birth weight. Even when controlling for these individual level factors, area income deprivation was significantly associated with low and very low birth weight (p<0.00). For low birth weight there was a significant interaction between area income deprivation and mother's age. For very young mothers, the area effect was non-significant (p<0.37). For older mothers, particularly those aged 30-34 years, it was stronger (p<0.00). As a result, mothers aged <18 years, although at relatively high risk of low birth weight irrespective of area income deprivation, were actually at slightly lower risk than mothers aged >40 years in the most deprived areas. Conclusions: For all but very young mothers, there seems to be a negative effect on birth weight from living in areas of income deprivation, whatever their individual circumstances. [ABSTRACT FROM AUTHOR]

Argues that normal birth has become too 'medicalized' and that higher rates of normal birth are associated with beliefs about birth, implementation of evidence based practice, and team working. Belief that the rates of unnecessary medical intervention in childbirth are increasing; Influence of midwives on medicalization; Use of inappropriate electronic fetal monitoring.

Focuses on a study which documented the extent to which maternity data in England are collected and how they are recorded. Identification of problems that may affect the data's availability throughout the National Health Service in Great Britain; Methods; Results; Conclusions.

Presents several issues related to medicine in Great Britain. Estimated rise of caesarean section deliveries; Assessments on the abnormalities in daytime urinary frequencies in children; Methods for the non-operative management of perianeurysmal fibrosis.

Examines the birth rate and perinatal mortality during 1970-76 in England and Wales. Total number of births and still births on each day; Pattern of births in relation to certain periods in a year; Comparison of birth rate variations of other countries.

Comments on several medical issue in Great Britain. Significance of smoke detectors in saving lives; Examination of women with dyskaryortic cervical smears; Diagnosis of gastric cancer by barium meal examination; Skepticism of general practitioners on the risk of HIV infection associated with foreign travel.

Examines the relation between the intended place of delivery among births at home and perinatal mortality. Association between home birth delivery but booked for hospital unit and perinatal delivery; Increase of perinatal mortality in nulliparous women; Suggestion for the low perinatal mortality in home birth for porous women.

The article reports that the U.S. Health and Social Care Act 2012 will replace the administrative structure of the NHS in England and its implications on existing routine data systems and the production of routine statistics. As stated, under the Act, unlike primary care trusts (PCTs), commissioning groups will no longer have responsibility for geographical areas and their practices will be able to recruit patients living anywhere in England. It also states that some health services for which PCTs are responsible will be out of the health service entirely or may be provided under the new public health system.

A letter to the editor is presented in response to the article "NICE promises on infertility and caesarean section are unmet" in the previous issue.

The authors maintain that rates of type 2 diabetes in pregnancy are rising. Pregnant women with type 2 diabetes of various ethnicities and socioeconomic backgrounds may be unfamiliar with the health care system, unidentified as at-risk groups, and not receiving proper care. The editorial discusses the article, "Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study," by Mary C. M. Macintosh, Kate M. Fleming, Jaron A. Bailey, Pat Doyle, Jo Modeler, Dominique Acolet, Shona Golightly and Alison Miller found in the current issue of the "British Medical Journal."

Focuses on the choice and chance of low risk maternity care of women under general practitioner and consultant in Great Britain. Percentage rate of maternity units in district general hospital; Factors affecting choice and chance of maternity care; Comparison between the mortality rate in different types of maternity unit.

Focuses on the rate of infant mortality in Europe. Influence of influenza on the incidence of low birthweight; Fluctuation of perinatal mortality on multiple births; Association between public health problems and infant mortality.

Focuses on the surveys on perinatal mortality in Great Britain. Concerns of the public on infant and perinatal mortality; State of perinatal mortality surveys in the National Health Service; Appropriateness of cut off point for perinatal mortality surveys.

Editorial. Presents maternity or labor statistics as contained in the Maternity Hospital Episode Statistics system delivered by England's Department of Health. Caesarean section rate in the early 1980s; Overall level of operative vaginal deliveries in 1985 and in 1994-1995; Percentage of deliveries coded as `normal deliveries with no antenatal or postnatal complications.'

Argues that the proposed clinical trials in Great Britain regarding the effect of setting on childbirth would not answer the feasibility of home delivery. Call for an improvement in data monitoring during clinical trials; Criticism on the design of the clinical trials proposed in Great Britain; Lack of universal definitions on the comparisons of home and hospital births.

A letter is presented in response to the article "Dismantling the signposts to public health? NHS data under the Health and Social Care Act 2012" by Allyson M. Pollock, Alison Macfarlane and Sylvia Godden in the April 2012 issue; a response by Pollock and colleagues to this letter is also included.

A letter to the editor is presented in response to the article "Study Shows Higher Rates of Neonatal Mortality With Planned Home Births," by S. Mayor, published in the July 2, 2010 issue.

Background The literature on international migration and birth outcomes shows mixed results. This study examined whether low birth weight (LBW) and preterm birth differed between non-migrants and migrant subgroups, defined by race/ethnicity and world region of origin and destination. Methods A systematic review and meta-regression analyses were conducted using three-level logistic models to account for the heterogeneity between studies and between subgroups within studies. Results Twenty-four studies, involving more than 30 million singleton births, met the inclusion criteria. Compared with US-born black women, black migrant women were at lower odds of delivering LBW and preterm birth babies. Hispanic migrants also exhibited lower odds for these outcomes, but Asian and white migrants did not. Sub-Saharan African and Latin-American and Caribbean women were at higher odds of delivering LBW babies in Europe but not in the USA and south-central Asians were at higher odds in both continents, compared with the native-born populations. Conclusions The association between migration and adverse birth outcomes varies by migrant subgroup and it is sensitive to the definition of the migrant and reference groups. [ABSTRACT FROM AUTHOR]

The article presents an obituary for Miles Weatherall, former professor of pharmacology at London University and Josephine Alice Coreen Weatherall, founding project leader of the European Register of Congenital Anomalies and Twins.

Presents a letter to the editor about social class and elective caesareans in the National Health Service (NHS).

Focuses on issues related to the publication of the study 'Triplet and Higher Order Births,' by the British Medical Journal in the 'Independent' journal. Absence of contact address for parents on the publications; Bias of the interview conducted to one of the triplets' mother; Failure of the research to impart information across the media.

Background: There have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years., Methods: We used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100 000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors., Results: Among the 1 226 855 CYP in the cohort, there were 378 402 tests (a rate of 770.8/1000 CYP-years (95% CI 768.4 to 773.3)), 19 005 PCR-confirmed infections (179.4/1000 CYP-years (176.9 to 182.0)) and 346 admissions (29.4/100 000 CYP-years (26.3 to 32.8)). Infants had the highest COVID-19-related admission rates. The presence of chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. Overall, 49% of admitted CYP had at least one chronic condition recorded., Conclusions: Infants and CYP with chronic conditions are at highest risk of admission with COVID-19. Half of admitted CYP had chronic conditions. Studies examining COVID-19 vaccine effectiveness among children with chronic conditions and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)