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INFLUENCE OF METEOROLOGICAL FACTORS ON PREMATURE RUPTURE OF FETAL MEMBRANES
435
rising to 3-9 and 5-0 kPa mmol-1 min on the 7th and 14th days, respectively of steroid therapy. The prednisolone dose could be reduced to 10 mg/day over the ensuing 2 months. The patient denied any exposure to budgerigars, pigeons, or hens. The sequence of events in this case strongly incriminates the influenza vaccine in the initiation of the diffuse pulmonary disease. The most likely component of the vaccine to result in an allergic reaction is the chicken embryo. Before coeliac disease developed the patient had had several similar influenza vaccines without ill-effects. Active coeliac disease, with its associated "leaky mucosa", permits the absorption of dietary antigens and the resultant development of antibodies in serum/ We suggest that this patient’s antibodies to chicken were the result of his diseased intestinal mucosa and that these antibodies may have resulted in an immune-complex reaction with the chicken embryo in the vaccine, the pulmonary microvasculature bearing the brunt of the reaction. We would be interested to hear of any other cases of similar reaction to vaccines produced in chicken embryo in patients with adult coeliac disease, childhood coeliac disease, or other "leaky mucosa" diseases.
Glasgow G21 3UW
K. E. L. MCCOLL G. J. ADDIS T. J. THOMSON
Department of Immunology, Western Infirmary, Glasgow
E. M. KIRKWOOD
University Department of Materia Medica, Stobhill General Hospital,
Correlation of mean daily barometric pressure (mm Hg) with daily percentage of cases of premature rupture of the membranes in spontaneous labour.
n=23; r=-0.444;p<0-OS.
Blacks it was more frequent in April and less in September.5 How meteorological factors impose their effects requires an
explanation. INFLUENCE OF METEOROLOGICAL FACTORS ON PREMATURE RUPTURE OF FETAL MEMBRANES
SIR,-Premature rupture of the fetal membranes occurs in 2.7-17% of all pregnancies and is largely unexplained.1 The observation that meteorological factors influence the incidence of eclampsia2prompted us to investigate the relationship between meteorological factors and premature rupture of the membranes. We studied pregnant women (gestational age >24 weeks) resident in Athensand its environs who were seen at our clinic between Jan. 1 and Dec. 31, 1977, because of spontaneous rupture of the membranes and who had no signs of onset of labour. The lowest mean daily barometric pressure and relative humidity in the area of Athens and environs for 1977 (the National Observatory of Athens Meteorological Institute) were748 mm Hg and 27% respectively, and the highest were 772 mm Hg and 90%. There were 4494 spontaneous labours during the year (labours induced by oxytocin and csesarean sections were excluded). Cases of premature rupture of the membranes numbered 1593. The daily percentage of cases of premature rupture in spontaneous labours was compared with the daily mean barometric pressure and relative humidity. There was no significant correlation with humidity (r=0-110; p>0-4) but there was a significant correlation with barometric
p<0-05) (see figure). Meteorological factors appear to influence several aspects of human reproductive biology. In addition to the effects on eclampsia,2 data from Great Britain suggested that anencephaly and spina bifida occurred more often during the winter (conception from March to August) with a shorter duration of pregnancy and a greater mean weight of the embryo than in summer (conception from September to February).4 In Hungary conceptions were more frequent in the summer, and in the U.S.A., Australia, South Africa, and southern hemisphere as a whole conception in Whites was more frequent in March, and less in November; in
pressure (r=0-444;
5. Hodgson, H. J. F., Davies, R. J., Gent, A. E., ibid. 1976, i, 115. 1. Gunn, G., Mishell, D., Morton, D. Am. J. Obstet. Gynec. 1970, 2. Louros, N., Panayotou, P. Zentr. Gynæc. 1938, 62, 1078. 3. Neutra, R. J. Obst. Gynæc. Brit. Comm. 1974, 81, 833. 4. Leck, I., Record, R. G. Br. J.prev. soc. Med. 1966, 20, 67.
106, 469.
Department of Obstetrics and Gynæcology, "Alexandra" Maternity Hospital, University of Athens, Athens
(6II), Greece
S. MILINGOS I. MESSINIS D. DIAKOMANOLIS D. ARAVANTINOS D. KASKARELIS
"A-Z PREGNANCY AND BABYCARE"
SIR,—A number of statements have appeared recently in the press to the effect that the Royal Society of Medicine does not support this publication wholeheartedly and, by inference, that it lacks confidence in Health Care Periodicals Ltd and in its managing director, Mr J. Scott-Clark. It should, therefore, be put on record first, that the decision that the Society should engage more actively in health education and in publishing, both for members of the medical profession and for the lay public, was taken by council more than two years ago and has repeatedly been reaffirmed by it and by the scientific and executive committee; second, that the honorary editors of the Society who, under the by-laws are given such authority, approved the publicationof the A-Z Pregnancy and Babycare in February, 1977; third, that its editorin-chief, Dr Hugh Jolly, was invited to accept that position by the honorary editors and did so in order to assist the Society; and fourth, that the Society stands fully behind Health Care Periodicals Ltd in the publication and distribution of the book. It should also be known that, for some years, the Society’s open section has accommodated members from many walks of life and has arranged meetings for the discussion of subjects of common concern to the medical profesion and the general public ; that some of its principal lectures are addressed to the laity; and that it has organised lunch-time lectures by its fellows on medical subjects for lay audiences as a contribution to health care. These activities continue, and they were forerunners of the enlarged publications programme of which the A-Z Pregnancy and Babycare is but one part. The Royal Society of Medicine, 1 Wimpole Street, London W1M 8AE 5. Erhardt, C. L., Nelson, F. G., Pakter, G.
SMITH President
Am. J. publ. Hlth, 1971, 61, 246.
rising to 3-9 and 5-0 kPa mmol-1 min on the 7th and 14th days, respectively of steroid therapy. The prednisolone dose could be reduced to 10 mg/day over the ensuing 2 months. The patient denied any exposure to budgerigars, pigeons, or hens. The sequence of events in this case strongly incriminates the influenza vaccine in the initiation of the diffuse pulmonary disease. The most likely component of the vaccine to result in an allergic reaction is the chicken embryo. Before coeliac disease developed the patient had had several similar influenza vaccines without ill-effects. Active coeliac disease, with its associated "leaky mucosa", permits the absorption of dietary antigens and the resultant development of antibodies in serum/ We suggest that this patient’s antibodies to chicken were the result of his diseased intestinal mucosa and that these antibodies may have resulted in an immune-complex reaction with the chicken embryo in the vaccine, the pulmonary microvasculature bearing the brunt of the reaction. We would be interested to hear of any other cases of similar reaction to vaccines produced in chicken embryo in patients with adult coeliac disease, childhood coeliac disease, or other "leaky mucosa" diseases.
Glasgow G21 3UW
K. E. L. MCCOLL G. J. ADDIS T. J. THOMSON
Department of Immunology, Western Infirmary, Glasgow
E. M. KIRKWOOD
University Department of Materia Medica, Stobhill General Hospital,
Correlation of mean daily barometric pressure (mm Hg) with daily percentage of cases of premature rupture of the membranes in spontaneous labour.
n=23; r=-0.444;p<0-OS.
Blacks it was more frequent in April and less in September.5 How meteorological factors impose their effects requires an
explanation. INFLUENCE OF METEOROLOGICAL FACTORS ON PREMATURE RUPTURE OF FETAL MEMBRANES
SIR,-Premature rupture of the fetal membranes occurs in 2.7-17% of all pregnancies and is largely unexplained.1 The observation that meteorological factors influence the incidence of eclampsia2prompted us to investigate the relationship between meteorological factors and premature rupture of the membranes. We studied pregnant women (gestational age >24 weeks) resident in Athensand its environs who were seen at our clinic between Jan. 1 and Dec. 31, 1977, because of spontaneous rupture of the membranes and who had no signs of onset of labour. The lowest mean daily barometric pressure and relative humidity in the area of Athens and environs for 1977 (the National Observatory of Athens Meteorological Institute) were748 mm Hg and 27% respectively, and the highest were 772 mm Hg and 90%. There were 4494 spontaneous labours during the year (labours induced by oxytocin and csesarean sections were excluded). Cases of premature rupture of the membranes numbered 1593. The daily percentage of cases of premature rupture in spontaneous labours was compared with the daily mean barometric pressure and relative humidity. There was no significant correlation with humidity (r=0-110; p>0-4) but there was a significant correlation with barometric
p<0-05) (see figure). Meteorological factors appear to influence several aspects of human reproductive biology. In addition to the effects on eclampsia,2 data from Great Britain suggested that anencephaly and spina bifida occurred more often during the winter (conception from March to August) with a shorter duration of pregnancy and a greater mean weight of the embryo than in summer (conception from September to February).4 In Hungary conceptions were more frequent in the summer, and in the U.S.A., Australia, South Africa, and southern hemisphere as a whole conception in Whites was more frequent in March, and less in November; in
pressure (r=0-444;
5. Hodgson, H. J. F., Davies, R. J., Gent, A. E., ibid. 1976, i, 115. 1. Gunn, G., Mishell, D., Morton, D. Am. J. Obstet. Gynec. 1970, 2. Louros, N., Panayotou, P. Zentr. Gynæc. 1938, 62, 1078. 3. Neutra, R. J. Obst. Gynæc. Brit. Comm. 1974, 81, 833. 4. Leck, I., Record, R. G. Br. J.prev. soc. Med. 1966, 20, 67.
106, 469.
Department of Obstetrics and Gynæcology, "Alexandra" Maternity Hospital, University of Athens, Athens
(6II), Greece
S. MILINGOS I. MESSINIS D. DIAKOMANOLIS D. ARAVANTINOS D. KASKARELIS
"A-Z PREGNANCY AND BABYCARE"
SIR,—A number of statements have appeared recently in the press to the effect that the Royal Society of Medicine does not support this publication wholeheartedly and, by inference, that it lacks confidence in Health Care Periodicals Ltd and in its managing director, Mr J. Scott-Clark. It should, therefore, be put on record first, that the decision that the Society should engage more actively in health education and in publishing, both for members of the medical profession and for the lay public, was taken by council more than two years ago and has repeatedly been reaffirmed by it and by the scientific and executive committee; second, that the honorary editors of the Society who, under the by-laws are given such authority, approved the publicationof the A-Z Pregnancy and Babycare in February, 1977; third, that its editorin-chief, Dr Hugh Jolly, was invited to accept that position by the honorary editors and did so in order to assist the Society; and fourth, that the Society stands fully behind Health Care Periodicals Ltd in the publication and distribution of the book. It should also be known that, for some years, the Society’s open section has accommodated members from many walks of life and has arranged meetings for the discussion of subjects of common concern to the medical profesion and the general public ; that some of its principal lectures are addressed to the laity; and that it has organised lunch-time lectures by its fellows on medical subjects for lay audiences as a contribution to health care. These activities continue, and they were forerunners of the enlarged publications programme of which the A-Z Pregnancy and Babycare is but one part. The Royal Society of Medicine, 1 Wimpole Street, London W1M 8AE 5. Erhardt, C. L., Nelson, F. G., Pakter, G.
SMITH President
Am. J. publ. Hlth, 1971, 61, 246.