[The influence on the outcome of pregnancies of sociologic and medical changes during 1963--1972. II. Special section: prenatal dystrophy, diabetogenic fetal disease, the impact of previous miscarriages and twins (author's transl)].

Analysis of 16 486 obstetric and neonatal case histories of the years 1963--1972. 30.7% of all neonates of Austrian (A) mothers showed one or more signs of placentar insufficiency. Pronounced prenatal dystrophy (p.d.) occurs in similar numbers in women with or without EPH gestosis, but has other important causes as well. In p.d. excentric umbilical cord insertion is more common than in neonates without dystrophy (56.4 : 52.4). Very young mothers often have neonates with p.d. During the ten year period p.d. increased considerably until 1967. After that it decreased slightly but not to the numbers at the start. These changes in frequency apply to all maternal age groups equally. Pronounced and highgrade p.d. in foreign workers' (f.w.) children is significantly more common than with A mothers (p 0.0001). Cushing's syndrome as a symptom of fetal disease due to diabetes has become rarer by over 50% owing to more intensive preventive measures; at the same time still-births of those weighing 4000 g or more have disappeared. The frequency of Cushing's syndrome rises according to the age of the mother from 0.8% to 3.5%. In Austrian mothers the number of previous abortions has decreased during these 10 years, just as has the number of births. The chances of actual pregnancies are the worse the higher the number of previous abortions. In f.w. mothers previous artificial abortions are far more numerous, but the outcome of pregnancy does not deteriorate with an increase in previous abortions. In A mothers the effects of previous premature or still births are the same as after abortions but much more pronounced. The percentage of normal births following premature births has fallen somewhat in A mothers during the ten year period, also after one miscarriage from 86% to 71%, probably owing to effective prevention of late abortions. Of 173 pairs of twins the first-born was heavier than the second in 71 instances. It is confirmed that the second twin is still-born almost twice as often as the first-born and this in twins of whom the second is heavier than the first. 11% of individual twins weith more than 3000 g and 28% between 2501 and 3000 g. The heavier the twins the lower the average age of the mother (from 30.8 to 26.6). The mothers whose first twin weighs more than 2500 g, the second less, appear to be younger than those with an inverse ratio (27.6 : 30.7).