Maternal and child health problems in the USSR

Article Abstract:

The problems of maternal and child health services in the USSR are discussed by A. A. Baranov, the Deputy Minister of Health of the USSR. Funds for obstetric and pediatric services have not been confirmed, and the goal of eliminating the duplication of services within geographic regions has been delayed, further compromising available resources. In addition, central funding for specific needs in maternal and child health services, such as family planning, genetic counselling, and vitamin administration, has not been established. Changes in the health care system have been blocked by the inability to consider radical changes in investment policies. Only a small percentage of the new health care units have been allocated to pediatric and obstetric care, despite the fact that there is a shortage of pediatric hospital beds in most regions of the country. Pediatric and obstetric care units lack adequate medical equipment and drugs. A recent meeting adopted resolutions to increase funding for mother and child services; extend diagnostic units to investigate maternal and child health problems; and increase labor and newborn beds, nutritional funding, and the number of diseases qualifying for free drug treatment. Recent changes in health policies have led to more laboratories, additional resuscitation equipment and rehydration supplies, and decreased infant mortality. However, there have been increases in the death rates of mothers and full-term newborns, suggesting poor supervision before and after delivery and unsatisfactory organization of newborn care. Other serious problems concerning maternal and child care include the excessive number of abortions, lack of modern contraceptives, and poor health care in rural regions. The government of the USSR is taking initiatives to resolve the numerous problems facing maternal and child health care services. (Consumer Summary produced by Reliance Medical Information, Inc.)

Finance, Pediatrics, Medical policy, Health policy, Soviet Union, Maternal health services, Child health services

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Effects of newborn screening of cystic fibrosis on reported maternal behaviour

Article Abstract:

Cystic fibrosis is an inherited disease of the exocrine glands and affects the pancreas, respiratory system, and sweat glands. The disease usually develops in infancy and is characterized by chronic respiratory infection, impaired function of the pancreas, and increased levels of electrolytes, or charged salts, in the sweat. Although several procedures have been developed to detect cystic fibrosis in the newborn, programs to screen the newborn for cystic fibrosis remain a controversial issue. The procedure, effectiveness, and ethical aspects of cystic fibrosis screening of newborns are issues of extensive debate. Newborn screening may cause mothers to become overprotective of their child. Issues concerning cystic fibrosis screening of newborns and maternal overprotection include: (1) effectiveness of screening in decreasing the diagnostic delay, defined as the period from initial concern about cystic fibrosis-related symptoms and a definite diagnosis; (2) relation between length of diagnostic delay, absence of cystic fibrosis-related symptoms, and extent to which a mother is overprotective of her child; and (3) relation between onset of symptoms after diagnosis of cystic fibrosis and mother's denial of her child's illness. The strength of overprotective child rearing attitudes of 29 mothers whose children were screened were compared with those of 29 mothers whose children were diagnosed after the development of symptoms. Cystic fibrosis screening of newborns did not increase the tendency of a mother to overprotect her child, and actually decreased this tendency in some cases. A delay in diagnosis in the absence of screening was shown to cause frequent and considerable distress in mothers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Testing, Telecommunications systems, Medical screening, Health screening, Cystic fibrosis

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Effects of maternal iodine supplementation during pregnancy

Article Abstract:

Iodine deficiency causes goiter in adults and cretinism, a congenital syndrome of physical and mental retardation, in infants. These iodine deficiency disorders are effectively treated by iodine supplements. However, cretinism can only be prevented by supplementation before conception, as damage occurs early in fetal development. The poor development seen in cretinism is likely due to low maternal levels of thyroxine, a thyroid hormone. However, excessive iodine supplements may inhibit thyroid gland production of thyroxine, leading to risk of cretinism, and this has raised concerns about national iodine supplementation programs. The follow-up in 1978 and 1982 of pregnancies occurring during a 1966 study of single-dose iodine supplementation in New Guinea is described in this article. Only five of the original 27 villages could be reevaluated, due to logistics. In 1978, there were no differences in motor (movement) performance between 12 children in the iodine-treated group and 18 children in the control group (the children were 11 years old). In 1982, with slightly fewer children available (aged 15 years), there were no significant differences in either mental or physical performance. The study indicates that no subsequent risk was associated with widespread supplementation of the population with iodine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Complications and side effects, Pregnancy, Iodine, Iodine (Chemical element), Iodine deficiency diseases, Thyroid diseases, Cretinism

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