Births In Hungary Research Articles

Out-of-hospital births in Hungary in the post-COVID-19 era

Bevezetés: Elemzésünkben az intézeten kívüli szülések legfontosabb jellemzőit mutatjuk be Magyarországon. Célkitűzés: Célunk egy leíró statisztikai elemzés készítése, amely bemutatja, hogy COVID–19-et követően mekkora a jelentősége Magyarországon az intézeten kívüli szüléseknek, és ez milyen demográfiai, társadalmi csoportokra jellemző. Módszer: Elemzésünkben a Központi Statisztikai Hivatal népmozgalmi adatbázisát elemezzük. Ez az adatbázis tartalmaz adatot minden magyarországi élve születés esetén a szülés helyéről és arról, hogy a szüléskor jelen volt-e orvos vagy szülésznő. Előnyei ellenére ez az adatbázis alulhasznosított a tudományos, statisztikai elemzésekben. A vizsgált adatok több szempontból összevethetők az intézeten kívüli szülés szakmai szabályairól, feltételeiről és kizáró okairól szóló 35/2011. (III. 21.) Korm. rendelet előírásaival. Eredmények: A COVID–19-járvány kitörését követően Magyarországon jelentősen nőtt az intézményen kívüli születések aránya, a korábbi 0,6%-ról 1% környékére. Az intézeten kívüli szülések között elsősorban azoknak a szüléseknek az aránya nőtt, amelyeknél jelen volt egészségügyi személyzet. Az intézeten kívül szülések nagyobb arányban jellemzőek a fiatal és a viszonylag idős édesanyákra. Az intézeten kívüli szülés esélye párhuzamosan nő a korábbi szülések számával. Átlag alatti arányban szülnek intézeten kívül a középfokú végzettségű nők. A nagy születéskori súlyú és testhosszú újszülöttek között átlag feletti az intézeten kívül születettek aránya. Megbeszélés: Az eredmények szerint a COVID–19-et követő időszakban egyértelműen demográfiailag, társadalmilag polarizálódottnak tekinthető az intézeten kívüli szülések jelensége. A jelenlegi jogi szabályozás által meghatározott kereteken kívül is jelentős számban történnek intézeten kívüli szülések, melyek eredményei arra utalnak, hogy ezek az esetek nem elhanyagolható arányban, minden valószínűség szerint, tervezett, intézeten kívüli szülések. Következtetés: A kapott eredmények felvethetik a több mint egy évtizede változatlan jogi szabályozás és a tényleges gyakorlat közötti diszkrepancia csökkentésének igényét. Orv Hetil. 2024; 165(27): 1044–1052.

EPH154 The Connection Between the Lunar Cycles and the Number of Births in Hungary

EPH154 The Connection Between the Lunar Cycles and the Number of Births in Hungary

Home birth and human rights: Lithuania's turn

After prominent cases concerning home birth in Hungary and Croatia, another case has been brought to the European Court of Human Rights, this time concerning home birth in Lithuania

Distribution of birth weights between 2011 and 2015 and changes in percentile figures between 1996 and 2015. Analyis of the Tauffer database

Introduction and aim: We aimed to provide a current birth weight percentile table for singleton and twin pregnancies stratified by gestational week at delivery and sex using data from all live births in Hungary between 2011 and 2015. In addition, we examined temporal trends in average birth weights in singleton and twin pregnancies by sex in five-year periods between 1996 and 2015. Method: We calculated the 5th, 10th, 25th, 50th, 75th, 90th, and 95th centiles of birth weight for each gestational week by sex for singleton and twin pregnancies using compulsory collected obstetrical data (Tauffer Statistics) in Hungary in 2011-2015. Furthermore, we described changes in birth weights by gestational week between 5-year periods from 1996 to 2015. Results: We present birth weight centiles for live births in both tabular and graphical forms using data from 2011 to 2015. In general, live birth weights in gestational weeks 35-41 were lower in the period of 1996-2005 (the lowest in 1996-2000) and were higher in the period of 2006-2010 compared to the reference period of 2011-2015 (e.g., the average male newborn weighed 3249 g at gestational week 38 in 2011-2015, which is 34.3 [SE at 3.0] g less in 1996-2000, 11.5 [2.9] g less in 2001-2005, and 18.1 [2.9] g more in 2006-2010). Similar trends were not observed in birth weights of twin pregnancies in gestational weeks 35-38. Conclusion: Given the observed substantial change in birth weights during the past 20 years, renewal of the commonly used percentile tables is necessary. Birth weights increased from 1996 to 2010, mainly of mature newborns, followed by a stabilization or slight decrease in the later periods. Orv Hetil. 2019; 160(36): 1426-1436.

Educational hypogamy and second births in Hungary

Recently, a growing body of literature examined the implications of the reversal of gender gap in education end educational hypogamy for family formation. However, less is known about the effect of educational hypogamy on second birth rates. In the present paper, we examine the effect of educational hypogamy on second birth rates in Hungary. Drawing on the economic theory of fertility and available data on sex- and education-specific average wages, we hypothesize that (1) educational hypogamy has a negative effect on second birth rates, and (2) the magnitude of that effect increases with female education. The hypotheses are tested using event history data from the first four waves of the Hungarian Generations and Gender Survey. The analyses are restricted to women born 1951-1980 who were partnered at the time of first birth. We find that educational hypogamy decreases second birth rates, especially among women born between 1971 and 1980. However, we do not find evidence which would support the second hypothesis. Rather, the effect of hypogamy is the largest among women with secondary education, but only in the 1971-1980 cohort. The findings may explain the U-shaped relationship between education and second birth rates.

Centralization of Pediatric Surgery in Hungary.

AbstractSurgical management of the developmental malformations of newborns, infants, and children needs centralization not only from a professional point of view but because of financial reasons, too. During the past 2-3 decades, the reduction in the number of live births in Hungary and the increase in the changing of professional needs have witnessed the centralization of the more expensive, fragmented intensive/surgical care. In a relatively small country, like Hungary, centralization is essential.

Informal cash payments for birth in Hungary: Are women paying to secure a known provider, respect, or quality of care?

BackgroundIn Central and Eastern Europe, many women make informal cash payments to ensure continuity of provider, i.e., to have a “chosen” doctor who provided their prenatal care, be present for birth. High rates of obstetric interventions and disrespectful maternity care are also common to the region. No previous study has examined the associations among informal payments, intervention rates, and quality of maternity care. MethodsWe distributed an online cross-sectional survey in 2014 to a nationally representative sample of Hungarian internet-using women (N = 600) who had given birth in the last 5 years. The survey included items related to socio-demographics, type of provider, obstetric interventions, and experiences of care. Women reported if they paid informally, and how much. We built a two-part model, where a bivariate probit model was used to estimate conditional probabilities of women paying informally, and a GLM model to explore the amount of payments. We calculated marginal effects of the covariates (provider choice, interventions, respectful care). ResultsMany more women (79%) with a chosen doctor paid informally (191 euros on average) compared to 17% of women without a chosen doctor (86 euros). Based on regression analysis, the chosen doctor's presence at birth was the principal determinant of payment. Intervention and procedure rates were significantly higher for women with a chosen doctor versus without (cesareans 45% vs. 33%; inductions 32% vs. 19%; episiotomy 75% vs. 62%; epidural 13% vs. 5%), but had no direct effect on payments. Half of the sample (42% with a chosen doctor, 62% without) reported some form of disrespectful care, but this did not reduce payments. ConclusionDespite reporting disrespect and higher rates of interventions, women rewarded the presence of a chosen doctor with informal payments. They may be unaware of evidence-based standards, and trust that their chosen doctor provided high quality maternity care.

Horváth Gyula szakmai életútja

Regional science is a relatively young field not just in Hungary but also in a global sense. Its definition, classification, methods, institutions and main research topics evolved in the second part of the 20th century. In Hungary, this process started in the 1980s with the foundation of regional science research institutes, studies, university departments, and a journal. The contribution and network of Gyula Horvath, one of the first researchers of the topic in the country, substantially impacted the discipline’s birth in Hungary, the creation and development to which he devoted his whole professional career. His work was acknowledged not only by the Hungarian but also by foreign research institutes, organizations, and communities. He played an important role in developing relationships between international (especially European and Russian) and Hungarian regional science researchers and institutes. He was a regular participant in regional science conferences in the Carpathian Basin and supported Ph.D. students and researchers from the Hungarian minorities in Romania, Serbia, Croatia, Slovakia and Ukraine. Besides his scientific contribution, he also played an important role in the creation and dissemination of regional science courses, and in the development of bachelor and master programs at universities. Several Ph.D. dissertations were written and defended under his supervision. In this paper, I describe his multi-dimensional scientific career, its most significant milestones, publications, research projects and roles by dividing them into three periods. After a short introduction, I start with the summary of the 1970s and the 1980s, I follow with the review of the 1990s and, finally, I finish by outlining the years after 2000.

Forging Ahead: Recollections of the Life and Times of Esther Dartigue by Esther Dartigue and John Dartigue (review)

Forging Ahead: Recollections of Life and Times of Esther Dartigue. By Esther Dartigue and John Dartigue. CreateSpace, 2014. ISBN 1477595902. 482pp. $14.50 paperback.Review by Grace L. Sanders JohnsonIn 1994, educator and activist Esther Dartigue published An Outstanding Haitian, Maurice Dartigue: The Contribution of Maurice Dartigue in Field of Education in Haiti, United Nations, and UNESCO. In so doing, she successfully wrote deceased husband and former Haitian Minister of Education, Maurice Dartigue, into modern history of Haiti. Esther's work has been widely cited in literature on post-US occupation politics, education, and international organizing and has enhanced recent scholarship in field, most notably Millery Polyne's From Douglass to Duvalier: U.S. African Americans, and Panamericanism, 1870-1964 (2010) and Chantalle Verna's forthcoming work and The Uses of America, 1930-1957. In a 2007 article Verna aptly argues, for example, that Maurice Dartigue was the leading educational reformer during two decades following U.S. occupation.1 Much of what we know about Maurice Dartigue's legacy is credited to his wife's tireless combing through his personal papers and related archives in order to bring his vision for to a broader audience. Yet, until now, little has been known about Esther herself-the assiduous mother, scholar and, on select occasions, orator who used historical prose to combine her two great passions, [Maurice] and Haiti (v).Her memoir Forging Ahead: Recollections of Life and Times of Esther Dartigue provides insight into Esther's life, love of Haiti, and contribution to Dartigue family. Esther conceptualized Forging Ahead as a family history for only child, John, and started writing details of childhood, marriage, and first decade and a half of son's life in mid-1990s. However, due to fatigue and illness, she was unable to complete autobiographical project. Inspired by his mother's commitment to their family's genealogy, John Dartigue picked up where his mother left off and narrated final fifty years of life using childhood memories, stories from family and friends, and a meticulous mapping of Esther's personal calendars, letters, and daily notes. Forging Ahead, then, is both a memoir and a biography, with first part primarily written by Esther Dartigue and second part written by John Dartigue. As a companion piece to Esther's first book, Forging Ahead is foremost a family conversation-a love letter to those individuals and places that Esther cared for dearly.Forging Ahead is an unconventionally written collection of remembrances (vii) sometimes connected and other times appearing in tangential and fragmented ways that memories float to and recede from our forethoughts. With a narrative cadence that reads like an oral history, text is not ordinary in structure, scope, or genre, as John Dartigue warns reader from outset. At several points he even suggests that text may not be of interest to a general audience and that some readers may find it useful to skip certain parts. And yet, while a reader who is not familiar with Dartigue family may be tempted to pass over litany of surnames and addresses, readers will likely find themselves continuing to read out of curiosity and expectation that one of those names casually mentioned may be of note: Resia Vincent, Jacques Roumain, Madeleine Sylvain, Jacques Stephen Alexis, or Rafael Trujillo.In this regard, Forging Ahead is at once a genealogical dig, an archival hunt, and a geographical odyssey. The book is divided into fourteen chapters that chronicle near century of Esther Dartigue's life-from birth in Hungary and early adolescence in United States to adulthood in and Central Africa and through death in France. The first three chapters are detailed accounts of Dartigue's poor upbringing in Hungary and young immigrant life with family in Ohio. …

Prevention of neonatal group B streptococcal sepsis in Hungary in 2012. Preliminary data of a nation-wide survey

At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary. The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary. Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary. Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes. The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards.

The effect of education on second births in Hungary

In recent years, several studies have reported a positive effect of women’s education on the transition to second births. This finding contradicts the economic theory of fertility. Three explanations were proposed: the selection, the time-squeeze, and the

Risk factors of preterm birth and low birth weight babies among Roma and non-Roma mothers: a population-based study

In 2009, 8.4% of live births in Hungary were low birth weight (LBW) and 8.7% were preterm (PTB). Roma are disproportionately represented in Northern Hungary where LBW and PTB are highest in the country (10.3% equally). This study evaluates the risk factors for LBW and/or PTB among the Roma and non-Roma populations in two Northern Hungarian counties. We conducted a retrospective cohort study of 5469 non-Roma and 2287 Roma mothers who gave birth in 2009. Women were visited by the Maternal and Child Health Service nurses and completed in-person structured surveys on demographic, socio-economic, cultural and lifestyle factors. These data were combined with biometric data from hospital records. Bivariate statistics and a logistic regression analyses were used to determine risk factors for LBW and PTB. Roma had a higher incidence of PTB and LBW babies compared with non-Roma women (PTB 9.9% vs. 7.1%, LBW 12.2% vs. 6.5% P = 0.001). However, ethnicity was not related to PTB and LBW in multivariable analyses, when controlling for socio-demographic and lifestyle characteristics. Factors associated with LBW and PTB include being underweight, advanced maternal age, and smoking. Strategies that ensure healthy lifestyles must be well integrated in family-based interventions and in the schools, with special consideration for Roma women who have a higher prevalence of deleterious lifestyles and poor birth outcomes. Ensuring a healthy body weight and no smoking has important implications for the mother and foetus.

Home birth: The Czech Republic in the spotlight

British Journal of MidwiferyVol. 20, No. 3 LegalHome birth: The Czech Republic in the spotlightAndrew SymonAndrew SymonSearch for more papers by this authorAndrew SymonPublished Online:16 Aug 2013https://doi.org/10.12968/bjom.2012.20.3.220AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Cameron R (2011a) Home births on trial after boy left with brain damage in botched delivery. Radio Prague, 17 January. http://tinyurl.com/6q3j7xf (accessed 2nd February 2012) Google ScholarCameron R (2011b) Home births under fire as court case highlights family tragedy. Radio Prague, 23 September. http://tinyurl.com/6vp4qks (accessed 9 February 2012) Google ScholarCameron R (2012) Home births back in spotlight as group of pregnant women take their case to European Court of Human Rights. Radio Prague, 17 January. http://tinyurl.com/8a3cy64 (accessed 9 February 2012) Google ScholarCTK (2012) Women entitled to have costs for homebirths covered by health insurance. 27 January. http://tinyurl.com/83uwrau (accessed 9 February 2012) Google ScholarEuropean Court on Human Rights Press Unit (2011) Factsheet - Reproductive rights: Home Birth -Ternovsky v. Hungary (67545/09). http://tinyurl.com/7q7r6jg (accessed 9 February 2012) Google ScholarKenety B (2012) Expectant mums, midwives to sue Czech state in Strasbourg CzechPosition.com, 11 January. http://tinyurl.com/7soea4l (accessed 9 February 2012) Google ScholarRichter J (2012) Prague court delivers landmark ruling in home births advocates' battle with the state. 27 January. http://tinyurl.com/88afvdn (accessed 9 February 2012) Google ScholarRoyal College of Midwives (2011) The Royal College of Midwives Survey of midwives' current thinking about home birth. RCM, London Google ScholarSymon A (2010) Effective ‘criminalization’ of home birth in Hungary? BJM 18 (12): 804–805 Google ScholarSymon A (2011) The Irish Nurses and Midwives Bill: Legal changes and challenges. BJM 19 (3): 193–194 Google Scholar FiguresReferencesRelatedDetailsCited byClemency for Hungarian homebirth midwife Ágnes GerébAmdrew Symon6 September 2018 | British Journal of Midwifery, Vol. 26, No. 9Threatening incarceration for pregnant women who drink alcoholAndrew Symon28 February 2018 | British Journal of Midwifery, Vol. 26, No. 3Never mind the World Cup—Brazil in the obstetric spotlightAndrew Symon1 June 2014 | British Journal of Midwifery, Vol. 22, No. 6 1 March 2012Volume 20Issue 3ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 16 August 2013 Published in print 1 March 2012 Information© MA Healthcare LimitedPDF download

Effective ‘criminalization’ of home birth in Hungary?

Readers may be aware of recent news stories concerning a prominent home birth practitioner in Hungary. A story in The Guardian headlined ‘Midwife Agnes Gereb taken to court for championing home births, (Hill, 2010) has been taken up by a number of websites which have criticized the actions of the Hungarian authorities.

Continued improvement of cardiovascular mortality in Hungary - impact of increased cardio-metabolic prescriptions

BackgroundDuring the last 35 years the poor ranking of Hungary on the list of life expectancy at birth among European countries, has not changed. In 1970 our lag behind the leading European countries was the smallest. The gap was growing between 1970 and 1993 but from 1994 onwards the life expectancy at birth in Hungary has increased continuously and somewhat faster than in other European countries. The aim of this study was to analyze the association between decreasing cardiovascular mortality rates, as a main cause of death and the increase in cardio-metabolic prescriptions and possible changes in lifestyle behavior.MethodsAnalyses were conducted on national data concerning cardiovascular mortality and the number of cardio-metabolic drug prescription per capita. The association between yearly rates of cardiovascular events and changes in antihypertensive, antilipidemic and antidiabetic prescription rates was analyzed. The changes in other cardiovascular risk factors, like lifestyle were also considered.ResultsWe observed a remarkable decline of mortality due to stroke and acute myocardial infarction (AMI). The fall was significantly associated with all prescription rates. The proportion of each treatment type responsible for suppression of specific mortality rates is different. All treatment types comparably improved stroke mortality, while antilipidemic therapy improved AMI outcome.ConclusionsThese results emphasize the importance of a comprehensive strategy that maximizes the population coverage of effective treatments. Hungary appears to be at the beginning of the fourth stage of epidemiologic transition, i.e. it has entered the stage of delayed chronic noninfectious diseases.

Birth Characteristics of Different Ocular Congenital Abnormalities in Hungary

Aims: The aim of the study was to estimate the prevalence at birth of different ocular congenital abnormalities and to describe their birth characteristics in Hungary. Methods: Two data sets were evaluated: the national-based Hungarian Congenital Abnormality Registry and the Hungarian Case-Control Surveillance of Congenital Abnormalities which include cases with ocular abnormalities and patient controls with other (non-ocular) congenital abnormalities, and population controls without abnormalities from the National Birth Registry. Results: Seven hundred twelve cases were found with ocular abnormalities in the data set of the Hungarian Congenital Abnormality Registry (2.62 per 10,000 live births), while that of the Hungarian Case-Control Surveillance of Congenital Abnormalities included 314 cases with ocular defects among 2.7 million live births in Hungary between 1980 and 2002. There was an obvious underascertainment and/or notification of cases with ocular defects because an extra effort to ascertain all cases with ocular abnormalities resulted in a birth prevalence of 6.31 per 10,000 live births in 1999. The main birth characteristics of cases were male excess, shorter mean gestational age and smaller mean birth weight with a larger proportion of preterm birth and low birthweight. Conclusions: Earlier diagnosis of ocular abnormalities is necessary with a more complete notification of these cases to the Hungarian Congenital Abnormality Registry. The birth characteristics of cases with ocular abnormalities may have some associations with the origin of ocular defects; therefore, these variables will require further studies in case-control approach.

Congenital abnormalities associated with limb deficiency defects: a population study based on cases from the Hungarian Congenital Malformation Registry (1975-1984).

Limb deficiency defects (LD) occurring among 1,575,904 births in Hungary during 1975-1984 were reviewed. The overall birth prevalence of LD was 1 in 1,816. This paper discusses the nature and distribution of the limb and other defects in the 275 (32%) children who had structural malformations in other systems. Two main forms of classification were used: morphologic and causal. Additional malformations were most commonly seen in infants with amelia, rudimentary limb (RL), radial/tibial (RT), intercalary or central axis (CA) LD and rarely in those with terminal transverse (TT) or ulnar/fibular (UF) defects. Upper limbs (81%) were involved significantly more often than lower limbs (42%) and there were more right-sided defects (83% vs. 71%) due to an excess of right arm involvement especially with radial ray and split hand anomalies. Single limb involvement was relatively common with amelia (88%), UF (82%), RT (50%), and TT (50%) defects. With other LD, multimelic involvement was more characteristic. This was usually symmetric with intercalary and RL defects but asymmetric with CA anomalies and digital deficiencies (DD). From a causal perspective, 17% of cases had genetic disorders, 52% had recognized associations, anomalies, sequences, environmental causes or patterns of unknown origin, and 31% had unknown patterns of malformations. The commonest entities were amnion disruption sequence (16% of cases) and VACTERL association (8%). Both of these disorders showed unusual temporal distribution. As anticipated, patterns of malformations differed with the type of LD. Amelia and digital amputations were often seen with body wall defects, atypical anencephaly or encephalocele, and cleft lip reflecting amnion disruption. Rudimentary limb was seen with anencephaly, omphalocele, renal agenesis, aberrant genitalia, and imperforate anus, reflecting defects of blastogenesis including the cloacal exstrophy and caudal regression sequences and Schisis association. Radial/tibial defects were associated with different patterns depending on whether the limb defects were unilateral or bilateral. Unilateral defects occurred with anomalies suggesting VACTERL association or the facio-auriculo-vertebral anomaly, while bilateral defects occurred more often in genetic or potentially genetic disorders including VACTERL with hydrocephalus. Central axis defects showed three main patterns of association: one reflecting the ectrodactyly-ectodermal dysplasia-clefting syndrome; one with tongue anomalies representing a variant of oro-mandibular-limb (Hanhart) anomaly, and the last with hydronephrosis indicating a group of "acro-renal" syndromes. Strong associations with other anomalies were not seen in the groups with TT, UF, or intercalary defects.

Urban/Rural Disparities in Male Surmortality in Hungary

Based on data of life expectancy at birth in Hungary, the paper analyses the spatial stability of higher male surmortality in villages than in towns or in Budapest. (In 1987, Hungarian men lived 9,909 years less than women in villages, 7,55 years less in towns or 7,06 years less in Budapest). The paper examines : 1 . To what extent can high male mortality alone "explain" male surmortality in urban and in rural areas (or: does the geographical pattern of male mortality differ from that of male surmortality?); 2. How is male surmortality in large cities affected by their regional location? 3. Is there an "optimal" settlement size group considering male and female mortality both individually and jointly?

Maternal mortality, fetal death, congenital anomalies and infant mortality at an advanced maternal age

Recent economic, technological, and social changes in Hungary have altered the role of women and thus patterns of childbearing. In 1986, 65.9% of births in Hungary involved mothers in the 20-29-year age group--generally regarded as the optimal period for childbearing. The distribution of the remaining births by age group was as follows: 19 years or under, 13.6%; 30-34 years, 15.3%; 35-39 years, 4.5%; and 40-49 years, 0.7%. Advanced maternal age has been a significant risk factor in maternal mortality in Hungary: of the 281 maternal deaths in 1977-86, 41 (14.6%) occurred in the 35-39-year age group and 24 (8.5%) involved women 40-49 years of age. Women in the 30-49-year age group have a 1.4-1.5 times higher risk of stillbirth, a 2.0-2.4 times greater risk of perinatal mortality, and a 2.6-4.3 times higher risk of infant mortality than women 20-29 years old. The risk of spontaneous abortion is 1.7 times higher for those 30-34 years old, 2.8 times higher for mothers 35-39 years of age, and 16.4 times higher for those 40-49 years old than for those in the optimal 20-29-year age range. The distribution of mean birthweight according to maternal age again indicates a detrimental effect of advanced maternal age. Finally, congenital anomalies such as neural tube defect, cleft lip or palate, congenital inguinal hernia, and especially Down's syndrome are more prevalent with increasing maternal age. On the other hand, the majority of these documented risks of birth defects at advanced maternal ages are now preventable through fetal diagnosis and other high-technology prenatal care measures. Most of the deleterious effect of advanced maternal age is a result of social factors (especially educational status) rather than biological factors. As the status of women in Hungary continues to improve, it should become obvious that the 20-29-year age range no longer constitutes the sole period for successful reproduction.

Unexplainable demographic phenomena of multiple births in Hungary.

The decrease trend of multiple births temporarily broke off in Hungary in 1970, with an increase from 18.18‰ (1968) to 20.94‰ (1970), i.e., about 400 cases of excess.The male preponderance in twin births is lower than in single births, and triplets actually show a female excess.There are more boys than girls among the first-born of multiple births.According to the 1959 and 1968 figures, both DZ and MZ twin births were significantly more frequent in mothers aged 16 or less than in mothers aged 17-19 years.The monthly distribution of DZ twins is characteristic, while the monochorial MZ twins did not show seasonal variations.