In attempting to determine the causes of umbilical hernia in the Negro it was noticed that there was a definite relationship between variations in the incidence of hernia, birth rate, average birth weight, prematurity and deaths during the first week of life. Seasonal variations occurring consistently in each study strongly suggest the importance of the preconceptional and early prenatal periods and give some indications as to possible causes.
Since syphilis might influence some of these conditions, all cases in which either the mother or the infant showed a positive Wassermann reaction were excluded.
There were 5,564 live Negro births in Atlanta during 1930, 1931 and 1932. There was an average of 491 infants born during the winter quarter, 458 in spring, 454 in summer, and 440 in the fall. The low rate of 440 in the fall corresponds to the group conceived during the winter quarter and the
BIVINGS L. PRECONCEPTIONAL AND PRENATAL INFLUENCES AFFECTING THE NEW-BORN. JAMA. 1933;101(22):1703–1705. doi:10.1001/jama.1933.02740470017004
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