JAMA : the journal of the American Medical Association
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Although uterine perforation is a potentially life-threatening complication of curettage abortion, little is known about the risk factors associated with uterine perforation or how to prevent it. Using linear logistic regression, we analyzed 67,175 curettage abortions performed at 13 institutions in the United States from 1975 through 1978. The overall incidence of confirmed perforation was 0.9 per 1,000 abortions. ⋯ Use of Laminaria for dilation had a protective effect, although this effect was not statistically significant (relative risk, 0.17; 95% confidence interval, 0.02 to 1.2). Among factors beyond the control of the physician, advancement of gestational age and previous delivery were significant risk factors. Use of Laminaria and performance of the abortion by an attending physician considerably lowered the risk of uterine perforation.
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Analysis of US Natality Statistics using a bivariate (birth weight-gestational age) approach shows that trends among term-low-birth-weight infants (less than or equal to 2,500 g; greater than or equal to 37 weeks, term low birth weight) and preterm-low-birth-weight infants (less than or equal to 2,500 g; less than 37 weeks, preterm low birth weight) have different patterns over time and by race. Between 1970 and 1980 the incidence of preterm low birth weight for all races declined 7.1%, while the term-low-birth-weight incidence declined almost three times as much (20.9%). ⋯ The reduction in the overall low-birth-weight incidence for both populations is principally caused by reduction in the incidence of term-low-birth-weight infants. Term- and preterm-low-birth-weight infants reflect different etiologic insults and require different intervention strategies for prevention.