Shining a light on historical neonatal health
The weight of a baby is an important indicator of their health, and may to an extent reflect the living standards of the mother and their own health during pregnancy. We spoke to Dr Kaspar Staub about his work in analysing detailed records from a Lausanne hospital over the period
between 1905-25, aiming to gain deeper insights into the factors which affect neonatal health.
The Spanish flu pandemic began in the Summer of 1918, a time when the ongoing First World War was leading to food shortages and an increase in cases of malnutrition, even in neutral countries. As Principal Investigator of an SNSF-funded project based at the University of Zurich, Dr Kaspar Staub and his team are investigating the impact of these challenging circumstances on neonatal health, looking at data gathered from the main maternity hospital in Lausanne before, during and after the 1918-1920 pandemic. “We have data from the moment a mother arrives in hospital to give birth up until they leave, after ten days in most cases,” he outlines. These records are highly detailed, providing information on the health of both the mother and the child; Dr Staub is particularly interested in the weight of the baby, although there are also other indicators of neonatal health. “We can look at premature birth rates and data about the size of the baby, such as head circumference, birth length and placental weight for example,” he explains.
in numbers of children, in income,” he says. “We can see clusters of inequality in cities today, and this was strongly apparent in Lausanne in the early 20 th century.”
The majority of the women giving birth were from Lausanne, but the records also
“It is impressive to see how sensitively the health of newborns reflected times of crisis and inequality back then”
Health inequalities
This research covers the period between 1905-25, over which time Switzerland gradually grew wealthier, on its way towards becoming the prosperous country it is today. In the late 19 th century it was more common for women to give birth at home, but this began to change around the early part of the following century. “By 1910 we pick up roughly 40 percent of all births in or around Lausanne with our maternity hospital data, and by the end of the First World War we are up to 70 percent,” says Dr Staub. This is partly attributable to a greater proportion of women from higher socio-economic strata giving birth in hospital, a topic of deep interest to Dr Staub, who is looking into the impact of inequalities in maternal living standards on neonatal health. “We can look at inequality from various perspectives. We see it in housing, in nutrition, in family size,
show a significant proportion of women came from surrounding areas, as this was the main hospital in the city and the wider Canton. The hospital remains the primary maternity facility serving the Canton today, and Dr Staub is looking to collaborate with clinicians there, exploring any possible parallels between the Spanish flu and the Covid-19 pandemic. “Do we see the same effects on neonatal health in the children of infected mothers? At what stage during pregnancy were they infected, and how severely? How does that affect neonatal health outcomes?” he outlines. The depth of the records means there is vast scope for further investigation. “It’s really amazing how closely maternal and neonatal health was documented, we have data on a lot of women,” continues Dr Staub. “In the records there are detailed responses from mothers about their health during pregnancy.”
This provides an invaluable record and a rich source of data for further analysis. However, with the project into its final year, Dr Staub’s attention is currently focused more on exploring some specific points. “One is the determinants of neonatal health. There we specifically look at maternal height, the importance of which is underestimated. We are also interested in the impact of other maternal infections than flu, such as syphilis,” he says. “And we are looking at these spatial clusters within the city, this spatial, health geography approach within the city. Who lived where? Do we see clusters?”
Birth weights and other anthropometrics of neonates as a mirror of (maternal) living standards in Lausanne, 1905-1925. This project is funded by The Swiss National Science Foundation (SNSF)
PD Dr. Kaspar Staub, Head of Anthropometrics & Historical Epidemiology Group Institute Manager Institute of Evolutionary Medicine (IEM) University of Zurich Winterthurerstrasse 190 CH-8057 Zurich, Switzerland
T: +41 44 635 05 13
E: kaspar.staub@iem.uzh.ch
: https://twitter.com/KasparStaub
W: https://www.iem.uzh.ch/en/research/ group_staub.html
Kaspar Staub is a historian and epidemiologist who leads the Anthropometry and Historical Epidemiology research group at the Institute of Evolutionary Medicine at the University of Zurich. His research interests include changes in human body shape over the last 200 years and historical and present-day epidemics.
