ANNUAL REPORT BY IVAN KRSTITELJ ANDRIANIC, THE CITY SURGEON OF THE SANITARY REGION OF CRIKVENICA FOR YEAR I859

This paper presents and comments on an annual report by lvan Krstitelj Andriani6, the chief physician of the sanitary region of Crikvenica (North-Croatian littoral) for the year 1859 . Beside interesting and very precise medico-historical data, the report is an excellent source for demographic, ethnographic, and cultural-anthropological considerations within this particular time and space frame

NEWBORNS OF MOTHERS WITH EPILEPSY

Cilj rada. Na temelju izabranih parametara usporediti novorođenčad majki s epilepsijom i novorođenčad rođenu od zdravih majki te utvrditi utječe li i u kojoj mjeri epilepsija na rani neonatalni ishod. Metode. Retrospektivnim istraživanjem u razdoblju od deset godina izdvojeno je 869 novorođenčadi. Ispitivanu skupinu sačinjavalo je 175 novorođenčadi majki oboljelih od epilepsije, a kontrolnu skupinu 694 novorođenčadi zdravih majki. Analizirani su gestacijska dob kod poroda, način dovršenja poroda, porodna težina, porodna duljina, opseg glave, Apgar ocjena u 1. i 5. minuti, ­postojanje prirođenih anomalija, postupci primijenjeni u okviru postnatalnog prihvata i skrbi novorođenčeta te eventualne bolesti u novorođenčeta. Rezultati. Novorođenčad kojih su majke bolovale od epilepsije nije se statistički značajno razlikovala od novorođenčadi rođenih od zdravih majki ni u jednom promatranom parametru. Zaključak. Rezultati našeg istraživanja pokazuju da uz odgovarajuću antenatalnu skrb, prihvat i opskrbu novorođenčeta, žene oboljele od epilepsije mogu roditi zdravo dijeteObjective. To compare specific parameters in children born to mothers with epilepsy and children born to healthy mothers. The aim is to determine possible differences among groups and to establish whether and in which degree mother\u27s disorder affects the neonates. Methods. Retrospective study of children born to mothers with epilepsy and ­children born to healthy mothers at the University Hospital of Rijeka, Department of Obstetrics and Gynecology, over ­period of ten years. Statistical evaluation of the hospital records data. Compared parameters were gestational age, mode of delivery (vaginal delivery/ caesarean section), birth weight, birth length, head circumference, Apgar scores in first and fifth minute, the presence of congenital anomalies, performed postnatal procedures (divided in two groups: more and less invasive procedures) and the neonatal health condition. Neonatal disorders were grouped in five diagnostic categories: breathing disorders, birth damages (with the exception of brain damages), brain damages and convulsions, icterus, infections and skin diseases. A total of 869 neonates have been studied. Among them, 175 children were born to mothers with epilepsy. The control group consisted of 694 children born to healthy mothers. Multiple pregnancies and still-born ­children were not taken into the consideration. Results. A total of 869 neonates have been evaluated and their corresponded parameters compared. The mean gestational ages, birth lengths, birth weight, head circumferences, mode of ­delivery and Apgar scores, as well as the evaluation of performed postnatal procedures and existence of the disorders ­presented no statistically significant differences among groups. The appearances of congenital disorders within specific groups measured in percentages show that the incidence is about twice as high in the group of children born to mothers with epilepsy, compared to the group of children born to healthy mothers (6,28% and 3,03%, respectively). There is, ­however, no statistically significant difference between the groups (2= 3,82; p=0,05). Conclusion. There are no statistically significant differences between children born to mothers with epilepsy compared to those born to healthy mothers. Evaluation of the mean birth weights among groups shows that the values are within the referent borders. Obtained results oppose to current findings that suggest low birth weight is seen about twice as often in infants of mothers with epilepsy. Our results confirm the fact that the risk for congenital malformations in children born to mothers with epilepsy is about twice that for the general population. Lack of statistically significant difference in the rate of congenital anomalies ­between the group of children born to mothers with epilepsy and those born to healthy mothers could be explained by the retrospective design of the study and the fact that the information were taken from the hospital records (instead of being collected specifically for the purpose of the study). Such results urge for prospective follow up of women with epilepsy and their offspring and for development of registries of pregnant women with epilepsy and their children which would ­ensure recognition and register of congenital malformations. Obtained results show that, with adequate antenatal and postnatal medical care of mothers and neonates, women with epilepsy can fulfill their reproductive function and give birth to a healthy child

NEWBORNS OF MOTHERS WITH EPILEPSY

Cilj rada. Na temelju izabranih parametara usporediti novorođenčad majki s epilepsijom i novorođenčad rođenu od zdravih majki te utvrditi utječe li i u kojoj mjeri epilepsija na rani neonatalni ishod. Metode. Retrospektivnim istraživanjem u razdoblju od deset godina izdvojeno je 869 novorođenčadi. Ispitivanu skupinu sačinjavalo je 175 novorođenčadi majki oboljelih od epilepsije, a kontrolnu skupinu 694 novorođenčadi zdravih majki. Analizirani su gestacijska dob kod poroda, način dovršenja poroda, porodna težina, porodna duljina, opseg glave, Apgar ocjena u 1. i 5. minuti, ­postojanje prirođenih anomalija, postupci primijenjeni u okviru postnatalnog prihvata i skrbi novorođenčeta te eventualne bolesti u novorođenčeta. Rezultati. Novorođenčad kojih su majke bolovale od epilepsije nije se statistički značajno razlikovala od novorođenčadi rođenih od zdravih majki ni u jednom promatranom parametru. Zaključak. Rezultati našeg istraživanja pokazuju da uz odgovarajuću antenatalnu skrb, prihvat i opskrbu novorođenčeta, žene oboljele od epilepsije mogu roditi zdravo dijeteObjective. To compare specific parameters in children born to mothers with epilepsy and children born to healthy mothers. The aim is to determine possible differences among groups and to establish whether and in which degree mother\u27s disorder affects the neonates. Methods. Retrospective study of children born to mothers with epilepsy and ­children born to healthy mothers at the University Hospital of Rijeka, Department of Obstetrics and Gynecology, over ­period of ten years. Statistical evaluation of the hospital records data. Compared parameters were gestational age, mode of delivery (vaginal delivery/ caesarean section), birth weight, birth length, head circumference, Apgar scores in first and fifth minute, the presence of congenital anomalies, performed postnatal procedures (divided in two groups: more and less invasive procedures) and the neonatal health condition. Neonatal disorders were grouped in five diagnostic categories: breathing disorders, birth damages (with the exception of brain damages), brain damages and convulsions, icterus, infections and skin diseases. A total of 869 neonates have been studied. Among them, 175 children were born to mothers with epilepsy. The control group consisted of 694 children born to healthy mothers. Multiple pregnancies and still-born ­children were not taken into the consideration. Results. A total of 869 neonates have been evaluated and their corresponded parameters compared. The mean gestational ages, birth lengths, birth weight, head circumferences, mode of ­delivery and Apgar scores, as well as the evaluation of performed postnatal procedures and existence of the disorders ­presented no statistically significant differences among groups. The appearances of congenital disorders within specific groups measured in percentages show that the incidence is about twice as high in the group of children born to mothers with epilepsy, compared to the group of children born to healthy mothers (6,28% and 3,03%, respectively). There is, ­however, no statistically significant difference between the groups (2= 3,82; p=0,05). Conclusion. There are no statistically significant differences between children born to mothers with epilepsy compared to those born to healthy mothers. Evaluation of the mean birth weights among groups shows that the values are within the referent borders. Obtained results oppose to current findings that suggest low birth weight is seen about twice as often in infants of mothers with epilepsy. Our results confirm the fact that the risk for congenital malformations in children born to mothers with epilepsy is about twice that for the general population. Lack of statistically significant difference in the rate of congenital anomalies ­between the group of children born to mothers with epilepsy and those born to healthy mothers could be explained by the retrospective design of the study and the fact that the information were taken from the hospital records (instead of being collected specifically for the purpose of the study). Such results urge for prospective follow up of women with epilepsy and their offspring and for development of registries of pregnant women with epilepsy and their children which would ­ensure recognition and register of congenital malformations. Obtained results show that, with adequate antenatal and postnatal medical care of mothers and neonates, women with epilepsy can fulfill their reproductive function and give birth to a healthy child