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The Work of the National Perinatal Epidemiology Unit: One Example of Technology Assessment in Perinatal Care

Published online by Cambridge University Press:  10 March 2009

Lain Chalmers
Affiliation:
National Perinatal Epidemiology UnitOxford

Abstract

This article describes one approach to assessing the effects of perinatal care–that adopted by the National Perinatal Epidemiology Unit in Oxford, England. The unit's research has been based primarily on a combination of simple, descriptive analyses of observational data and statistically robust analyses of evidence derived from randomized controlled trials.

Type
Special Section: Obstetric Technology: A Future Perspective
Copyright
Copyright © Cambridge University Press 1991

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References

1.Black, N., & Macfarlane, A. J.Methodological kit: Monitoring perinatal mortality statistics in a health district. Community Medicine, 1982, 4, 2533.Google ScholarPubMed
2.Botting, B. J., MacDonald Davies, I., & Macfarlane, A. J.Recent trends in the incidence of multiple births and associated mortality. Archives of Disease in Childhood, 1987, 62, 941–50.CrossRefGoogle ScholarPubMed
3.Botting, B., & Macfarlane, A. J. Geographic variation in infant mortality in relation to birthweight 1983–1985. In Office of Population Censuses and Surveys, Mortality and Geography. London: Her Majesty's Stationery Office, 1990, 4756.Google Scholar
4.Botting, B. J., Macfarlane, A. J., & Price, F. V.Three, four and more. A study of triplet and higher order births. London: Her Majesty's Stationery Office, 1990.Google Scholar
5.British Association of Perinatal Medicine Working Group. Referrals for neonatal medical care in the United Kingdom over one year. British Medical Journal, 1989, 298, 169–72.CrossRefGoogle Scholar
6.Brown, I., Elbourne, D., & Mutch, L.Standard national perinatal data: A suggested minimum data set. Community Medicine, 1981, 3, 298306.Google Scholar
7.Campbell, M. J., Rodrigues, L., Macfarlane, A. J., & Murphy, M. F. G.Sudden infant deaths and cold weather: Was the rise in infant mortality in 1986 in England and Wales due to the weather? Paediatric and Perinatal Epidemiology, 1991, 5, 93100.CrossRefGoogle ScholarPubMed
8.Campbell, R., Davies, I. M., & Macfarlane, A. J.Perinatal mortality and place of delivery. Population Trends, 1982, 28, 912.Google Scholar
9.Campbell, R., Macdonald Davies, I., Macfarlane, A. J., & Beral, V.Home births in England and Wales 1979: Perinatal mortality according to intended place of delivery. British Medical Journal, 1984, 289, 721–24.CrossRefGoogle ScholarPubMed
10.Campbell, R., & Macfarlane, A. J.Place of delivery: A review. British Journal of Obstetrics and Gynaecology, 1986, 93, 675–83.CrossRefGoogle ScholarPubMed
11.Campbell, R., & Macfarlane, A. J.Where to be born? The debate and the evidence. Oxford, U.K.: National Perinatal Epidemiology Unit, 1987.Google Scholar
12.Carmody, F., Grant, A., & Somchiwong, M.Vacuum extraction: A randomized controlled comparison of the New Generation cup with the original BIRD cup. Journal of Perinatal Medicine, 1986, 14, 95100.CrossRefGoogle ScholarPubMed
13.Chalmers, I. Perinatal epidemiology: Strengths, limitations and possible hazards. In Beard, R. W. & Campbell, S. (eds.), Current status of fetal monitoring and ultrasound. London: Royal College of Obstetricians and Gynaecologists, 1978, 1225.Google Scholar
14.Chalmers, I. Implications of the current debate on obstetric practice. In Kitzinger, S. & Davis, J. (eds.), The place of birth. Oxford, U.K.: Oxford University Press, 1978, 4453.Google Scholar
15.Chalmers, I.Perinatal health: The search for indices. Lancet, 1979, ii, 1063–65.CrossRefGoogle Scholar
16.Chalmers, I.Intensive or extensive care in perinatal health services? Community Medicine, 1980, 2, 279–81.Google Scholar
17.Chalmers, I. Evaluation of perinatal practice: The limitations of audit by death. In Chester, R., Diggory, P., & Sutherland, M. B. (eds.), Changing patterns of childbearing and child rearing. London: Academic Press, 1981, 3956.Google Scholar
18.Chalmers, I.Enquiry into perinatal death: A report on national perinatal surveillance. Report submitted to DHSS. Oxford, U.K.: National Perinatal Epidemiology Unit, 12 1984.Google Scholar
19.Chalmers, I.Short, Black, Baird, Himsworth and social class differences in fetal and neonatal mortality rates. British Medical Journal, 1985, 291, 231–33.CrossRefGoogle ScholarPubMed
20.Chalmers, I.Minimizing harm and maximizing benefit during innovation in health care: Controlled or uncontrolled experimentation? Birth, 1986, 13, 155–64.CrossRefGoogle ScholarPubMed
21.Chalmers, I. Evaluating the effects of perinatal care. In Chalmers, I., Enkin, M., & Keirse, M. J. N. C. (eds.), Effective care in pregnancy and childbirth. Oxford, U.K.: Oxford University Press, 1989, 338.Google Scholar
22.Chalmers, I.Under-reporting research is scientific misconduct. Journal of the American Medical Association, 1990, 263, 1405–08.CrossRefGoogle Scholar
23.Chalmers, I. (ed.). Oxford Database of Perinatal Trials, version 1.2, disk issue 6. Oxford U.K.: Oxford University Press, 08 1991.Google Scholar
24.Chalmers, I., Enkin, M., & Keirse, M. J. N. C. (eds.). Effective care in pregnancy and childbirth. Oxford, U.K.: Oxford University Press, 1989.Google Scholar
25.Chalmers, I., Hetherington, J., Newdick, M., et al. The Oxford Database of Perinatal Trials: Developing a register of published reports of controlled trials. Controlled Clinical Trials,1986, 7, 306-24.CrossRefGoogle ScholarPubMed
26.Chalmers, I., & Macfarlane, A. J. Interpretation of perinatal statistics. In Wharton, B. (ed.), Topics in perinatal medicine. London: Pitman Medical, 1980, 111.Google Scholar
27.Chalmers, I., & Macfarlane, J. A.Towards defensive obstetrics [letter], Lancet, 1979, i, 53.CrossRefGoogle Scholar
28.Chalmers, I., & Mcllwaine, G. (eds.). Perinatal audit and surveillance. London: Royal College of Obstetricians and Gynaecologists, 1980.Google Scholar
29.Chalmers, I., & Mutch, L.Are current trends in perinatal practice associated with an increase or a decrease in handicapping conditions? Lancet, 1981, i, 1415.CrossRefGoogle Scholar
30.Chalmers, I., & Mutch, L.Investment in neonatal intensive care and the “handicapped survivor bogey” [letter]. Lancet, 1984, ii, 469.CrossRefGoogle Scholar
31.Chalmers, I., Oakley, A., & Macfarlane, J. A.Perinatal health services: An immodest proposal. British Medical Journal, 1980, 1, 842–45.CrossRefGoogle Scholar
32.CLASP Collaborative Group. MRC collaborative low-dose aspirin study in pregnancy (CLASP). Proceedings of Silver Jubilee British Congress of Obstetrics and Gynaecology, London, 07 4–7, 1989, 143.Google Scholar
33.Cochrane, A. L.Effectiveness and efficiency: Random reflections on health services. London: Nuffield Provincial Hospitals Trust, 1971 (republished 1989).Google Scholar
34.Committee on Child Health Services (chairman, Professor S. D. M. Court). Fit for the future, cmnd 6684. London: Her Majesty's Stationery Office, 1976.Google Scholar
35.Dennis, J., & Chalmers, I.Very early neonatal seizure rate: A possible epidemiological indicator of the quality of perinatal care. British Journal of Obstetrics and Gynaecology, 1982, 89, 418–26.CrossRefGoogle Scholar
36.Dickersin, K., Hewitt, P., Mutch, L., et al. Comparison of MEDLINE searching with a perinatal trials database. Controlled Clinical Trials, 1985, 6, 306–17.CrossRefGoogle ScholarPubMed
37.Elbourne, D., & Mutch, L.Archive of locally based perinatal surveys. Oxford, U.K.: National Perinatal Epidemiology Unit, 1981.Google Scholar
38.Elbourne, D., & Mutch, L.Archive of locally based perinatal surveys. Oxford, U.K.: National Perinatal Epidemiology Unit, 1984.Google Scholar
39.Elbourne, D., Pritchard, C., & Dauncey, M.Perinatal outcomes and related factors: Social class differences within and between geographical areas. Journal of Epidemiology and Community Health, 1986, 40, 301–08.CrossRefGoogle ScholarPubMed
40.Elbourne, D., Richardson, M., Chalmers, I., et al. The Newbury Maternity Care Study: A randomized controlled trial to assess a policy of women holding their own obstetric records. British Journal of Obstetrics and Gynaecology, 1987, 94, 612–19.CrossRefGoogle ScholarPubMed
41.Enkin, M., & Chalmers, I. (eds.). Effectiveness and satisfaction in antenatal care. Clinics in Developmental Medicine Nos. 81/82. London: Spastics International Medical Publications/William Heinemann Medical Books, 1982.Google Scholar
42.Enkin, M., Keirse, M. J. N. C., & Chalmers, I.A guide to effective care in pregnancy and childbirth. Oxford, U.K.: Oxford University Press, 1989.Google Scholar
43.Evans, P., Johnson, A., Mutch, L., & Alberman, E.Report of a meeting on the standardization of the recording and reporting of cerebral palsy. Developmental Medicine and Child Neurology, 1986, 28, 547–48.CrossRefGoogle ScholarPubMed
44.Evans, P., Johnson, A., Mutch, L., & Alberman, E.A standard form for recording clinical findings in children with a motor deficit of central origin. Developmental Medicine and Child Neurology, 1989, 31, 119–27.Google Scholar
45.Everett, C. B., Ashurst, H., & Chalmers, I.Reported management of threatened miscarriage by general practitioners in Wessex. British Medical Journal, 1987, 295, 583–86.CrossRefGoogle ScholarPubMed
46.Garcia, J. Women's views on antenatal care. In Enkin, M. & Chalmers, I. (eds.), Effectiveness and satisfaction in antenatal care. Clinics in Developmental Medicine Nos. 81/82. London: Spastics International Medical Publications/William Heinemann Medical Books, 1982, 8191.Google Scholar
47.Garcia, J.The role and structure of the Maternity Service Liaison Committee. Health Trends, 1987, 19, 1719.Google ScholarPubMed
48.Garcia, J.Getting consumers’ views of maternity care: Examples of how the OPCS Survey manual can help. London: Department of Health, 1989.Google Scholar
49.Garcia, J., Anderson, J., Vacca, A., et al. Views of women and their medical and midwifery attendants about instrumental delivery using vacuum extraction and forceps. Journal of Psychosomatic Obstetrics and Gynaecology, 1985, 4, 19.CrossRefGoogle Scholar
50.Garcia, J., Blondel, B., & Saurel-Cubizolles, M. J. The needs of childbearing families: Social policies and the organization of health care. In Chalmers, I., Enkin, M., & Keirse, M. J. N. C. (eds.), Effective care in pregnancy and childbirth. Oxford, U.K.: Oxford University Press, 1989, 205–20.Google Scholar
51.Garcia, J., Corry, M., MacDonald, D., et al. Mothers’ views of continuous electronic fetal heart monitoring and intermittent auscultation in a randomized controlled trial. Birth, 1985, 12, 7985.CrossRefGoogle ScholarPubMed
52.Garcia, J., & Elbourne, D. Future research on work in pregnancy. In Chamberlain, G. (ed.), Pregnant women at work. London: Royal Society of Medicine/Macmillan Press, 1984, 273–87.CrossRefGoogle Scholar
53.Garcia, J., & Garforth, S.Labour and delivery routines in English consultant maternity units. Midwifery, 1989, 5, 155–62.CrossRefGoogle ScholarPubMed
54.Garcia, J., Garforth, S., & Ayers, S.The policy and practice of midwifery study: Introduction and methods. Midwifery, 1987, 3, 29.CrossRefGoogle Scholar
55.Garcia, J., Kilpatrick, R., & Richards, M. (eds.). The politics of maternity care. Oxford, U.K.: Oxford University Press, 1990.Google Scholar
56.Garforth, S., & Garcia, J.Admitting — A weakness or a strength? Routine admission of a woman in labour. Midwifery, 1987, 3, 1024.CrossRefGoogle ScholarPubMed
57.Garforth, S., & Garcia, J.Breastfeeding policies in practice — “No wonder they get con fused.” Midwifery, 1989, 5, 7583.CrossRefGoogle Scholar
58.Graham, H., & Oakley, A. Competing ideologies of reproduction: Medical and maternal perspectives on pregnancy. In Roberts, H. (ed.), Women, health and reproduction. London: Routledge and Kegan Paul, 1981, 5074.Google Scholar
59.Grant, A. Equipment and services. In Chamberlain, G. V. P. & Gunn, P. (eds.), Birthplace. Chichester, U.K.: John Wiley & Sons Ltd, 1987, 50100.Google Scholar
60.Grant, A. European collaborative trials in perinatal medicine. The need for a ‘Perinatal Trials Service.’ In Breart, G. & Buekens, P. (eds.), Evaluation of perinatal care. Methodology and research proposals. Paris: Copedith, 1987, 6168.Google Scholar
61.Grant, A. The relationship between obstetrically preventable intrapartum asphyxia, abnormal neonatal neurological signs and subsequent motor impairment in babies born at or after term. In Kubli, F. & Patel, N. (eds.), International Workshop on Perinatal Events and Cerebral Handicap. Berlin: Springer-Verlag, 1987, 149–59.Google Scholar
62.Grant, A. Collaborative randomized trial of dexamethasone in neonatal chronic lung disease. In Hot Topics ‘89 in Neonatology. Report of Ross Laboratories Special Conference, Washington, DC, 1989.Google Scholar
63.Grant, A., Elbourne, D., Valentin, L., & Alexander, S.The effect of a policy of formal fetal movement counting on the risk of antepartum late death among normally-formed singleton fetuses. Lancet, 1989, ii, 345–49.CrossRefGoogle Scholar
64.Grant, A., Elbourne, D., Mireh, L., & Krog, J. Osiris Surfactant Trial. First Osiris News letter. No. 1. Osiris Trials Office. Oxford, U.K.: National Perinatal Epidemiology Unit, 07 1990.Google Scholar
65.Grant, A., & Hepburn, M.Merits of an individualized approach to fetal movement counting compared with fixed–time and fixed–number methods. British Journal of Obstetrics and Gynaecology, 1984, 91, 1087–90.CrossRefGoogle ScholarPubMed
66.Grant, A., O'Brien, N., Joy, M., et al. Cerebral palsy among children born during the Dublin randomized trial of intrapartum monitoring. Lancet, 1989, ii, 1233–36.CrossRefGoogle Scholar
67.Grant, A., Sleep, J., Ashurst, H., & Spencer, J. A. D.Dyspareunia associated with the use of glycerol–impregnated catgut to repair perineal — trauma Report of a three year followup study. British Journal of Obstetrics and Gynaecology, 1989, 96, 741–43.CrossRefGoogle Scholar
68.Grant, A., Sleep, J., Mclntosh, J., & Ashurst, H.Ultrasound and pulsed electromagnetic energy treatment for perineal trauma. A randomized placebo-controlled trial. British Journal of Obstetrics and Gynaecology, 1989, 96, 434–39.CrossRefGoogle ScholarPubMed
69.Harding, J. E., Elbourne, D. R., & Prendiville, W. J.Views of mothers and midwives participating in the Bristol randomized, controlled trial of active management of the third stage of labor. Birth, 1989, 16, 16.CrossRefGoogle ScholarPubMed
70.Hare, E. H., Moran, P. A. P., & Macfarlane, A. J.The changing seasonality of infant deaths in England and Wales 1912–1978 and its relation to seasonal temperature. Journal of Epidemiology and Community Health, 1981, 35, 7782.CrossRefGoogle Scholar
71.Hetherington, J., Dickersin, K., Chalmers, I., & Meinert, C. L.Retrospective and prospective identification of unpublished controlled trials: Lessons from a survey of obstetricians and pediatricians. Pediatrics, 1989, 84, 374–80.CrossRefGoogle ScholarPubMed
72.House of Commons Official Report (Hansard), 1978, 07 5.Google Scholar
73.Houston, M. J. R., & Field, P. A.Practices and policies of the initiation of breastfeeding. Journal of Obstetric, Gynecological and Neonatal Nursing, 1988, 17, 418–24.CrossRefGoogle ScholarPubMed
74.Johnson, A.Screening tests for hearing and visual impairment: How and when are they done? Health Visitor, 1986, 59, 140–42.Google Scholar
75.Johnson, A., & Ashurst, H.Is popliteal angle measurement useful in early identification of cerebral palsy? Developmental Medicine and Child Neurology, 1989, 31, 457–65.CrossRefGoogle ScholarPubMed
76.Johnson, A., & Ashurst, H.Screening for sensrineural deafness by health visitors. Archives of Disease in Childhood, 1990, 65, 841–45CrossRefGoogle ScholarPubMed
77.Johnson, A., Goddard, O., & Ashurst, H.Is late walking a marker of morbidity? Archives of Disease in Childhood, 1990, 65, 486–88.CrossRefGoogle ScholarPubMed
78.Johnson, A., & King, R.A regional register of early childhood impairments: A discussion paper. Community Medicine, 1989, 11, 352–63.Google ScholarPubMed
79.Johnson, M. A., & Macfarlane, A. J.Neonatal intensive care: Trends in morbidity. Lancet, 1988, ii, 168.CrossRefGoogle Scholar
80.Johnson, A., Stayte, M., & Wortham, C.Vision screening at 8 and 18 months. British Medical Journal, 1989, 299, 545–49.CrossRefGoogle ScholarPubMed
81.Kaufman, K. J., & Houston, M. J. R.Midwives, nurses, and clinical excellence. Recent Advances in Nursing, 1988, 21, 6381.Google Scholar
82.Klein, M., Elbourne, D., & Lloyd, I. A prospective study comparing the experiences of low risk women booked for delivery in 2 systems of maternity care. Royal College of General Practitioners Occasional Paper 31, 04 1985.Google Scholar
83.Levin, J. B., Macfarlane, A. J., & Bennett, S.The comparison of trends in perinatal mortality in small areas. International Journal of Epidemiology, 1990, 19, 7889.CrossRefGoogle ScholarPubMed
84.MacDonald, D., Grant, A., Sheridan-Pereira, M., et al. The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring. American Journal of Obstetrics and Gynecology, 1985, 152, 524–39.CrossRefGoogle ScholarPubMed
85.Macfarlane, A. J.Birth, death and handicap: Saving money, spending lives. Science for People, 1981, 48, 913.Google Scholar
86.Macfarlane, A. J. Seasonal variation in postneonatal mortality. In Studies in sudden infant deaths. Studies on medical and population subjects no. 45. London: Her Majesty's Stationery Office, 1982, 917.Google Scholar
87.Macfarlane, A. J.A time to die? International Journal of Epidemiology, 1984,13, 3844.CrossRefGoogle ScholarPubMed
88.Macfarlane, A. J. Trends in maternity care. In OPCS, DHSS, Welsh Office, Hospital inpatient enquiry maternity tables 1977–1981. Series MB4 no. 19. London: Her Majesty's Stationery Office, 1986, 925.Google Scholar
89.Macfarlane, A. J., & Chalmers, I.Birth and infant mortality statistics. Paper presented at the Statistics Users Conference, 12 1980.Google Scholar
90.Macfarlane, A. J., & Chalmers, I. Problems in the interpretation of perinatal mortality statistics. In Hull, D. (ed.), Recent advances in paediatrics. London: Churchill Livingstone, 1981, 112.Google Scholar
91.Macfarlane, A. J., Chalmers, I., & Adelstein, A. M.The role of standardization in the interpretation of perinatal mortality rates. Health Trends, 1980, 3, 4550.Google Scholar
92.Macfarlane, A. J., Cole, S., & Hey, E.Comparisons of data from regional perinatal mortality surveys. British Journal of Obstetrics and Gynaecology, 1986, 93, 1224–32.CrossRefGoogle ScholarPubMed
93.Macfarlane, A., Cole, S., Johnson, A., & Botting, B.Epidemiology of birth before 28 weeks of gestation. British Medical Bulletin, 1988, 44, 861–93.CrossRefGoogle ScholarPubMed
94.Macfarlane, A. J., & McPherson, C. K.The quality of official health statistics. Journal of the Royal Statistical Society, Series A, 1988, 151, 342–54.CrossRefGoogle Scholar
95.Macfarlane, A. J., & Mugford, M.Birth counts: Statistics of pregnancy and childbirth. London: Her Majesty’s Stationery Office, 1984.Google Scholar
96.Macfarlane, A. J., & Mugford, M.Framework for information systems: Comments on Working Paper II and accompanying documents. Oxford, U.K.: National Perinatal Epidemiology Unit, 1990.Google Scholar
97.Medical Research Council Working Party on Cervical Cerclage. Interim report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists multicentre randomised controlled trial of cervical cerclage. British Journal of Obstetrics and Gynaecology, 1988, 95, 437–45.CrossRefGoogle Scholar
98.Minchom, P., Niswander, K., Chalmers, I., et al. Antecedents and outcome of very early neonatal seizures in infants born at or after term. British Journal of Obstetrics and Gynaecology, 1987, 94, 431–39.CrossRefGoogle ScholarPubMed
99.MIRIAD. Annual report of the Midwifery Research Database (MIRIAD). Oxford, U.K.: National Perinatal Epidemiology Unit, 1990.Google Scholar
100.Mohamed, K., Grant, A., Ashurst, H., & James, D.The Southmead perineal suture study: A randomized comparison of suture materials and suturing techniques for repair of perineal trauma. British Journal of Obstetrics and Gynaecology, 1989, 96, 1272–80.CrossRefGoogle Scholar
101.Mugford, M.A comparison of reported differences in definitions of vital events and statistics. WHO Statistics Quarterly, WHO Geneva, 1983, 36, 201–12.Google ScholarPubMed
102.Mugford, M. Maternity unit profiles. In Chamberlain, G. V. P. & Gunn, P. (eds.), Birthplace. Chichester, U.K.: John Wiley & Sons Ltd., 1987, 283–86.Google Scholar
103.Mugford, M., Kingston, J., & Chalmers, I.Reducing the incidence of infection after caesarean section: Implications of prophylaxis with antibiotics for hospital resources. British Medical Journal, 1989, 299, 1003–06.CrossRefGoogle ScholarPubMed
104.Mugford, M., Mutch, L., & Elbourne, D.Standard perinatal data: Suggestions for regular review of facilities for perinatal care within a regional health authority. Community Medicine, 1985, 7, 157–68.Google ScholarPubMed
105.Mugford, M., Piercy, J., & Chalmers, I.Cost implications of different approaches to the prevention of respiratory distress syndrome. Archives of Disease in Childhood, 1991, 66, 757–64.CrossRefGoogle Scholar
106.Mugford, M., Somchiwong, M., & Waterhouse, I.Treatment of umbilical cords: A randomized trial to assess the effect of treatment methods on the work of midwives. Midwifery, 1986, 2, 177–86.CrossRefGoogle ScholarPubMed
107.Mugford, M., & Stilwell, J. Maternity services: How well have they done and could they do better? and Profiling maternity services: How do English regions and Wales compare? In Harrison, A. & Gretton, J. (eds.), Health care U.K. 1986. Cambridge, U.K.: Burlington Press, 1986, 5364 and 115–19.Google Scholar
108.Mugford, M., Szczepura, A., Lodwick, A., & Stilwell, J.Factors affecting the outcome of maternity care II. Neonatal outcomes and resources beyond the hospital of birth. Journal of Epidemiology and Community Health, 1988, 42, 170–76.CrossRefGoogle ScholarPubMed
109.Murphy, J. E, Dauncey, M., Gray, O. P., & Chalmers, I.Planned and unplanned deliveries at home: Implications of a changing ratio. British Medical Journal, 1984, 288, 1429–32.CrossRefGoogle ScholarPubMed
110.Murphy, J. F., Dauncey, M., Newcombe, R., et al. Employment in pregnancy: Prevalence, maternal characteristics, perinatal outcome. Lancet, 1984, i, 1163–66.CrossRefGoogle Scholar
111.Murphy, K., Grieg, V., Garcia, J., et al. Maternal considerations in the use of pelvic examinations in labour. Midwifery, 1986, 2, 9397.CrossRefGoogle ScholarPubMed
112.Mutch, L.Archive of locally based perinatal surveys. Oxford, U.K.: National Perinatal Epidemiology Unit, 04 1986.Google Scholar
113.Mutch, L., & Elbourne, D.Standard national perinatal data: A suggested common core of tabulations. Community Medicine, 1983, 5, 251–59.Google Scholar
114.Mutch, L., & Elbourne, D.Archive of locally based perinatal surveys. Oxford, U.K.: National Perinatal Epidemiology Unit, 1983.Google Scholar
115.Mutch, L. M. M., Johnson, M. A., & Morley, R.Follow-up studies: Design, organisation and analysis. Archives of Disease in Childhood, 1989, 64, 13941402.CrossRefGoogle ScholarPubMed
116.Mutch, L. M. M., Newdick, M., Lodwick, A., & Chalmers, I.Secular changes in rehospitalisation of very low birthweight infants. Pediatrics, 1986, 78, 164–71.CrossRefGoogle Scholar
117.National Perinatal Epidemiology Unit. A classified bibliography of controlled trials in perinatal medicine 1940–1984. Oxford, U.K.: Oxford University Press, 1985.Google Scholar
118.Niswander, K., Henson, G., Elbourne, D., et al. Adverse outcome of pregnancy and the quality of obstetric care. Lancet, 1984, ii, 827–31.CrossRefGoogle Scholar
119.Oakley, A.Women confined: Towards a sociology of childbirth. London: Martin Robertson, 1980.Google Scholar
120.Oakley, A.Subject women. Oxford, U.K.: Martin Robinson, 1981.Google Scholar
121.Oakley, A. Obstetric practice — Cross-cultural comparisons. In Stratton, P. (ed.), Psychobiology of the human newborn. London: John Wiley and Sons, 1982, 297313.Google Scholar
122.Oakley, A.Social consequences of obstetric technology: How to measure ‘soft’ outcomes. Birth, 1983, 10, 99108.CrossRefGoogle ScholarPubMed
123.Oakley, A. Women and health policy. In Lewis, J. (ed.), Women's welfare, women's rights. London: Croom Helm 1983, 103–29.Google Scholar
124.Oakley, A. The effect of the mother's work on the infant. In Chamberlain, G. (ed.), Pregnant women at work. London: Royal Society of Medicine/Macmillan Press, 1984,117–32.CrossRefGoogle Scholar
125.Oakley, A.The captured womb. Oxford, U.K.: Blackwell Scientific Publications, 1984.Google Scholar
126.Oakley, A., Macfarlane, J. A., & Chalmers, I. Social class, stress and reproduction. In Rees, A. R. & Purcell, H. (eds.), Disease and the environment. Chichester, U.K.: John Wiley and Sons, 1982, 1150.Google Scholar
127.Oakley, A., McPherson, A., & Roberts, H.Miscarriage. London: Fontana, 1984.Google Scholar
128.Oakley, A., Rajan, L., & Grant, A.Social support and pregnancy outcome. British Journal of Obstetrics and Gynaecology, 1990, 97, 155–62.CrossRefGoogle ScholarPubMed
129.Prendiville, W. J., Harding, J. E., Elbourne, D. R., & Stirrat, G. M.The Bristol third stage trial: Active versus physiological management of third stage of labour. British Medical Journal, 1988, 297, 1295–300.CrossRefGoogle ScholarPubMed
130.Proud, J., & Grant, A.Third trimester placental grading by ultrasonography as a test of fetal wellbeing. British Medical Journal, 1987, 294, 1641–44.CrossRefGoogle ScholarPubMed
131.Quam, L.Improving clinical effectiveness in the NHS: An alternative to the white paper. British Medical Journal, 1989, 299, 448–50.CrossRefGoogle Scholar
132.Renfrew, M. J. Developing midwifery research: The role of the midwife researcher at the National Perinatal Epidemiology Unit. In 1988 Research and the Midwife Conference, Glasgow and London. Manchester, U.K.: University of Manchester, 1989.Google Scholar
133.Renfrew, M. J.Ethics and morality in midwifery research. Midwives Chronicle and Nursing Notes, 1989, 102, 198202.Google ScholarPubMed
134.Renfrew, M. J., Fisher, C., & Arms, S.Bestfeeding: Getting breastfeeding right for you. Berkeley, CA: Celestial Arts, 1990.Google Scholar
135. Saurel-Cubizolles, M.-J., & Garcia, J. Activité professionnelle pendant la grossesse en France et en Grande-Bretagne: Principes et realités. Revue Frangaise des Affaires Sociales, 1983, 177–87.Google Scholar
136.Sleep, J. & Grant, A.Pelvic floor exercises in post-natal care. Midwifery, 1987, 3,158–64.CrossRefGoogle Scholar
137.Sleep, J., & Grant, A.Effects of salt and Savlon bath concentrate postpartum. Nursing Times, 1988, 84, 5557.Google ScholarPubMed
138.Sleep, J., & Grant, A.Relief of perineal pain following childbirth. A survey of midwifery practice. Midwifery, 1988, 4, 118–22.CrossRefGoogle ScholarPubMed
139.Sleep, J., Grant, A., Garcia, J., et al. West Berkshire perineal management trial. British Medical Journal, 1984, 289, 587–90.CrossRefGoogle ScholarPubMed
140.Social Services Committee. Perinatal and neonatal mortality, vol. 1. London: Her Majesty's Stationery Office, 1980.Google Scholar
141.Spencer, J., Grant, A., Elbourne, D., et al. A randomized comparison of glycerol-impregnated chromic catgut with untreated chromic catgut for the repair of perineal trauma. British Journal of Obstetrics and Gynaecology, 1986, 93, 426–30.CrossRefGoogle ScholarPubMed
142.Stayte, M., Johnson, A., & Wortham, C.Ocular and vision defects in a geographically defined population of 2 year old children. British Journal of Ophthalmology, 1990, 74, 465–68.CrossRefGoogle Scholar
143.Stilwell, J., Szczepura, A., & Mugford, M.Factors affecting the outcome of maternity care I. The relationship between staffing and perinatal deaths at the hospital of birth. Journal of Epidemiology and Community Health, 1988, 42, 157–69.CrossRefGoogle ScholarPubMed
144.Szczepura, A., Mugford, M., & Stilwell, J. A.Information for managers in hospitals: Representing maternity unit statistics graphically. British Medical Journal, 1987, 294, 875–80.CrossRefGoogle ScholarPubMed
145.Tarnow-Mordi, W. O., Elbourne, D., Grant, A., et al., & the OCTAVE Study Group. Randomised trial of high versus low frequency positive pressure ventilation in 346 newborn infants in 6 centres. Proceedings of the 61st Annual Meeting of the British Paediatric Association, York, U.K., 1989.Google Scholar
146.Vacca, A., Grant, A., Wyatt, G., & Chalmers, I.Portsmouth operative delivery trial: A comparison of vacuum extraction and forceps delivery. British Journal of Obstetrics and Gynaecology, 1983, 90, 1107–12.CrossRefGoogle Scholar
147.Ventriculomegaly Trial Group. Randomised trial of early tapping in neonatal posthaemorrhagic ventricular dilatation. Archives of Disease in Childhood, 1990, 65, 310.CrossRefGoogle Scholar
148.Weale, A. (ed.). Cost and choice in health care: The ethical dimension. London: King Edward's Hospital Fund for London, 1988, 4853.Google Scholar
149.Working Group on the very low birthweight infant. European Community collaborative study of outcome of pregnancy between 22 and 28 weeks’ gestation. Lancet, 1990, ii, 782–84.Google Scholar