Start
nshd_47_ss
Supplementary Questionnaire for Inquiry into Prematurity
ROYAL COLLEGE OF OBSTETRICIANS AND GYNAECOLOGISTS POPULATION INVESTIGATION COMMITTEE and INSTITUTE OF CHILD HEALTH At the LONDON SCHOOL OF ECONOMICS
intro i

Name

Generic text
intro ii

Address (in 1946)

Long text
intro iii

Where delivered

Generic text
intro iv

Actual date of delivery

Generic date
NOTE-1. The 1946 survey provided only limited information about pregnancy, confinement and the subsequent care of the baby. In order to make a satisfactory study of prematurity the Joint Committee are most anxious to obtain the supplementary information asked for in this questionnaire. Each premature baby has been matched with a mature one of the same sex, the same position in the family and of the same social and economic group. It is hoped that the information asked for below can be supplied for the mature "controls" as well as for the premature babies.
2. To save time in filling in this questionnaire, the majority of questions have been "pre-coded." The answers should be shown by putting a ring with a soft pencil round the code number or letter opposite the correct answer. If the answer to any question cannot be obtained, put a ring round "X" for unknown.
3. These questions refer throughout to the pregnancy ending in, and the baby born in, March 1946.
DETAILS OF PREGNANCY AND CONFINEMENT ENDING IN MARCH, 1946.
1

What was the expected date of delivery?

Generic date
2 a

Did the mother during her pregnancy have : A blood pressure of 150/100 or higher?

1
Yes
2
No
X
Unknown
2 b

Did the mother during her pregnancy have : Albuminuria?

1
Yes
2
No
X
Unknown
2 c

Did the mother during her pregnancy have : Any other signs of toxaemia?

*
Yes, namely
2
No
X
Unknown
Generic text
3

Was there any haemorrhage before the beginning of labour?

1
Yes
2
No
X
Unknown
(If "yes")
qc_3 == 1
3 a

At what week of pregnancy did it occur? ... week.

Number of weeks
3 b

What was the cause of the haemorrhage?

Generic text
4

Was labour induced?

1
Yes
2
No
X
Unknown
(If "Yes.")
qc_4 == 1
4 a

What method of induction was used?

1
Medical
2
Surgical
X
Unknown
4 b

Why was labour induced?

Generic text
5

Was any other reason brought forward for premature delivery?

1
Yes
2
No
X
Unknown
(If "Yes.")
qc_5 == 1
5 a

Please state reason

Generic text
6

Was the baby delivered by caesarean section?

1
Yes
2
No
X
Unknown
(If "Yes.")
qc_6 == 1
6 a

What was the reason for caesarean section?

Generic text
If not delivered by caesarean section.
qc_6 == 2
7

What was the presentation at birth?

Generic text
8

Were forceps used?

1
Yes
2
No
X
Unknown
(If "Yes.")
qc_8 == 1
8 a

Why were they used?

Generic text
9

Was episiotomy performed?

1
Yes
2
No
X
Unknown
10

Did the baby have any birth injury or suspected birth injury?

1
Yes
2
No
X
Unknown
(If "Yes.")
qc_10 == 1
10 a

Please give full details

Generic text
11

What was the condition of the baby at birth?

1
Vigorous
2
Feeble
3
Needing Resuscitation
4
Regaining good colour
5
Continuing poor colour
*
Other, namely
X
Unknown
Other
CARE OF THE BABY BORN IN MARCH, 1946.
If baby born at home.
12

Was he admitted to a hospital or nursing home during the first month of life?

1
Yes
2
No
X
Unknown
13

Where was he admitted?

1
Children's hospital
2
Maternity hospital
3
General hospital
4
Nursing home
X
Unknown
14 a

For what reason was he admitted? Condition of the infant, namely

Generic text
14 b

For what reason was he admitted? Condition of home, namely

Generic text
14 c

For what reason was he admitted? Other reason, namely

Other
15

On what date was he admitted?

Generic date
16

Was the mother admitted as well?

1
Yes
2
No
X
Unknown
If baby remained at home.
qc_12 == 2
17

Was special nursing care provided?

1
Yes
2
No
X
Unknown
(If "Yes.")
qc_17 == 1
17 a

Please give full details

Generic text
18

Was a doctor in charge of the case?

1
Yes
2
No
X
Unknown
If baby born in hospital or admitted to hospital.
qc_12 == 1
19

Where was he nursed?

1
In ward with mother
2
Ordinary children's ward
3
Ordinary babies' nursery
4
Special premature baby unit
*
Elsewhere, namely
X
Unknown
20

How many other babies or children were there in the same ward or unit?

How many
21

Was this baby isolated in a single cubicle?

1
Yes
2
No
X
Unknown
22

Was an incubator used?

1
Yes
2
No
X
Unknown
(If "Yes")
qc_22 == 1
22 a

For how many days? ... days

Days
23

Was an Oxygen tent used?

1
Yes
2
No
X
Unknown
(If "Yes")
qc_23 == 1
23 a

For how many days? ... days

Days
24

Had the sister or nurse in charge of this baby any responsibility for adult patients, or was she solely in charge of babies?

1
Solely in charge of babies
2
Also in charge of adults
X
Unknown
25

How long was the baby kept in hospital? ... days

Days
26

What was his weight on discharge? ... lbs ... ozs.

lbs
ozs
For all babies whether nursed at home or in hospital.
27

Were there any special complications?

1
Yes
2
No
X
Unknown
(If "Yes.")
qc_27 == 1
27 a

Please give full details.

Generic text
End

nshd_47_ss

s_intro_i
Supplementary Questionnaire for Inquiry into Prematurity
s_intro_ii
ROYAL COLLEGE OF OBSTETRICIANS AND GYNAECOLOGISTS POPULATION INVESTIGATION COMMITTEE and INSTITUTE OF CHILD HEALTH At the LONDON SCHOOL OF ECONOMICS
intro i
Name
Generic text
intro ii
Address (in 1946)
Long text
intro iii
Where delivered
Generic text
intro iv
Actual date of delivery
Generic date
s_note_1
NOTE-1. The 1946 survey provided only limited information about pregnancy, confinement and the subsequent care of the baby. In order to make a satisfactory study of prematurity the Joint Committee are most anxious to obtain the supplementary information asked for in this questionnaire. Each premature baby has been matched with a mature one of the same sex, the same position in the family and of the same social and economic group. It is hoped that the information asked for below can be supplied for the mature "controls" as well as for the premature babies.
s_note_2
2. To save time in filling in this questionnaire, the majority of questions have been "pre-coded." The answers should be shown by putting a ring with a soft pencil round the code number or letter opposite the correct answer. If the answer to any question cannot be obtained, put a ring round "X" for unknown.
s_note_3
3. These questions refer throughout to the pregnancy ending in, and the baby born in, March 1946.

DETAILS OF PREGNANCY AND CONFINEMENT ENDING IN MARCH, 1946.

1
What was the expected date of delivery?
Generic date
2 a
Did the mother during her pregnancy have : A blood pressure of 150/100 or higher?
1
Yes
2
No
X
Unknown
2 b
Did the mother during her pregnancy have : Albuminuria?
1
Yes
2
No
X
Unknown
2 c
Did the mother during her pregnancy have : Any other signs of toxaemia?
*
Yes, namely
2
No
X
Unknown
Generic text
3
Was there any haemorrhage before the beginning of labour?
1
Yes
2
No
X
Unknown
3 a
At what week of pregnancy did it occur? ... week.
Number of weeks
(If "yes")
3 b
What was the cause of the haemorrhage?
Generic text
(If "yes")
4
Was labour induced?
1
Yes
2
No
X
Unknown
4 a
What method of induction was used?
1
Medical
2
Surgical
X
Unknown
(If "Yes.")
4 b
Why was labour induced?
Generic text
(If "Yes.")
5
Was any other reason brought forward for premature delivery?
1
Yes
2
No
X
Unknown
5 a
Please state reason
Generic text
(If "Yes.")
6
Was the baby delivered by caesarean section?
1
Yes
2
No
X
Unknown
6 a
What was the reason for caesarean section?
Generic text
(If "Yes.")
7
What was the presentation at birth?
Generic text
If not delivered by caesarean section.
8
Were forceps used?
1
Yes
2
No
X
Unknown
8 a
Why were they used?
Generic text
(If "Yes.")
9
Was episiotomy performed?
1
Yes
2
No
X
Unknown
10
Did the baby have any birth injury or suspected birth injury?
1
Yes
2
No
X
Unknown
10 a
Please give full details
Generic text
(If "Yes.")
11
What was the condition of the baby at birth?
1
Vigorous
2
Feeble
3
Needing Resuscitation
4
Regaining good colour
5
Continuing poor colour
*
Other, namely
X
Unknown
Other

CARE OF THE BABY BORN IN MARCH, 1946.

12
Was he admitted to a hospital or nursing home during the first month of life?
1
Yes
2
No
X
Unknown
If baby born at home.
13
Where was he admitted?
1
Children's hospital
2
Maternity hospital
3
General hospital
4
Nursing home
X
Unknown
If baby born at home.
14 a
For what reason was he admitted? Condition of the infant, namely
Generic text
If baby born at home.
14 b
For what reason was he admitted? Condition of home, namely
Generic text
If baby born at home.
14 c
For what reason was he admitted? Other reason, namely
Other
If baby born at home.
15
On what date was he admitted?
Generic date
If baby born at home.
16
Was the mother admitted as well?
1
Yes
2
No
X
Unknown
If baby born at home.
17
Was special nursing care provided?
1
Yes
2
No
X
Unknown
If baby born at home.
If baby remained at home.
17 a
Please give full details
Generic text
If baby born at home.
If baby remained at home.
(If "Yes.")
18
Was a doctor in charge of the case?
1
Yes
2
No
X
Unknown
If baby born at home.
If baby remained at home.
19
Where was he nursed?
1
In ward with mother
2
Ordinary children's ward
3
Ordinary babies' nursery
4
Special premature baby unit
*
Elsewhere, namely
X
Unknown
If baby born in hospital or admitted to hospital.
20
How many other babies or children were there in the same ward or unit?
How many
If baby born in hospital or admitted to hospital.
21
Was this baby isolated in a single cubicle?
1
Yes
2
No
X
Unknown
If baby born in hospital or admitted to hospital.
22
Was an incubator used?
1
Yes
2
No
X
Unknown
If baby born in hospital or admitted to hospital.
22 a
For how many days? ... days
Days
If baby born in hospital or admitted to hospital.
(If "Yes")
23
Was an Oxygen tent used?
1
Yes
2
No
X
Unknown
If baby born in hospital or admitted to hospital.
23 a
For how many days? ... days
Days
If baby born in hospital or admitted to hospital.
(If "Yes")
24
Had the sister or nurse in charge of this baby any responsibility for adult patients, or was she solely in charge of babies?
1
Solely in charge of babies
2
Also in charge of adults
X
Unknown
If baby born in hospital or admitted to hospital.
25
How long was the baby kept in hospital? ... days
Days
If baby born in hospital or admitted to hospital.
26
What was his weight on discharge? ... lbs ... ozs.
lbs
ozs
If baby born in hospital or admitted to hospital.
s_q27
For all babies whether nursed at home or in hospital.
27
Were there any special complications?
1
Yes
2
No
X
Unknown
27 a
Please give full details.
Generic text
(If "Yes.")
Name

1947 Supplementary Questionnaire for Inquiry into Prematurity