scholarly journals Previous Preterm Birth and Current Maternal Complications as a Risk Factor of Subsequent Stillbirth

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Boubakari Ibrahimou ◽  
Cynthia Anozie ◽  
Cara de la Cruz ◽  
Hamisu Salihu
Keyword(s):  
Risk Factor ◽  
Preterm Birth ◽  
Previous History ◽  
Significant Risk ◽  
Obstetric Care ◽  
Significant Risk Factor ◽  
Population Based ◽  
Public Health Issue ◽  
Maternal Complications ◽  
Singleton Pregnancies

Purpose. To examine the association between previous preterm birth and the risk of stillbirth. Methods. This population-based retrospective cohort study analyzed live births and stillbirth records in Missouri (1989–1997). The main outcome of interest was stillbirth occurrence while the exposures were prior preterm birth. Adjusted odds ratios and 95% confidence intervals were computed using logistic regression. Results. Women who had a previous preterm birth have 63% increased odds of stillbirth in singleton pregnancies and 75% increased odds in twins as compared to those who did not have a preterm birth in a prior pregnancy (AOR = 1.63, 95% CI = 1.41–1.88 and AOR = 1.75, 95% CI = 1.20–2.56), respectively. The most significant risk factor for stillbirth in singleton pregnancies was uterine bleeding (AOR = 5.89, 95% CI = 5.13–6.76). In twin pregnancies, it was the condition hydramnios/oligohydramnios (AOR = 4.72, 95% CI = 3.70–6.02). Eclampsia was associated with a heightened risk of stillbirth in singletons (AOR = 2.45, 95% CI = 1.41–4.12), but not in twins (AOR = 0.96, 95% CI = 0.13–7.00). Black mothers were more likely than white to experience stillbirth (AOR = 2.10, 95% CI = 1.99–2.22 for singletons and AOR = 1.51, 95% CI = 1.27–1.79 for twins). Conclusion. Stillbirth is a vital public health issue and its etiology is not well understood. Previous history of preterm birth was found to be associated with future stillbirth. Targeted early medical and obstetric care and interventions among women with preterm birth history may potentially reduce the likelihood of stillbirth.

Abstract 13889: The Influence of Depression on Dementia Risk in Patients With Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
T Jared Bunch ◽  
Tami L Bair ◽  
Stacey Knight ◽  
Benjamin A Steinberg ◽  
Jeffrey L Anderson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Population Based ◽  
Late Life Depression ◽  
Adjusted Risk ◽  
Relative Risks ◽  
History Of ◽  
History Of Depression

Background: Atrial Fibrillation (AF) is a significant risk factor for multiple forms of dementia. Although late-life depression may be a manifestation of dementia, earlier-life depression is a risk factor for dementia. The influence of earlier-life depression in patients with AF as a risk factor for dementia is unknown. Methods: AF patients (January 1, 1990-August 8, 2016) with no history of dementia and at least 3 years of follow-up derived from the Intermountain Healthcare Registry were included. Patients were compared by the presence or absence of depression at baseline. The primary endpoints were the development of dementia (total)imer’s disease. Results: Among 132,703 AF patients, 19,757 (14.9%) had a history of depression. Of these, 10,044 (50.8%) had SSRI use prior to AF diagnosis. The mean time from depression diagnosis to AF diagnosis was 5.0±4.8 years. AF patients with a history of depression were younger, more often female, and had higher rates of hypertension, diabetes, and heart failure. Patients with depression had a significantly higher multivariable-adjusted risk of dementia at 3 years (HR: 1.74 (1.59, 1.90), p<0.0001) and 5 years (HR: 1.73 (1.61, 1.86), p<0.0001), independent of the length of time between depression and AF diagnosis. Landmark analysis showed patients with depression and AF have much higher rates of dementia after 3 years (HR 1.51 (1.40, 1.63), p<0.0001) and after 5 years (HR 1.47 (1.34, 1.61), p<0.0001), Figure. These relative risks with depression are greater than composite risks of AF and dementia alone (HR 1.36) derived from multiple population-based studies. Conclusions: Patients with a history of depression prior to AF diagnosis have much higher rates of dementia after the onset of the arrhythmia. The presence of earlier-life depression should be recognized as an important risk factor for dementia in AF patients and may represent a therapeutic target to lower risk of cognitive decline.

scholarly journals Effects of Dietary Patterns during Pregnancy on Preterm Birth: A Birth Cohort Study in Shanghai

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2367
Author(s):  
Zhengyuan Wang ◽  
Shenglu Zhao ◽  
Xueying Cui ◽  
Qi Song ◽  
Zehuan Shi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Dietary Patterns ◽  
Significant Risk ◽  
Binary Logistic Regression ◽  
Significant Risk Factor ◽  
Birth Cohort Study ◽  
Female Ratio ◽  
Animal Food

The objective of this study was to analyse representative dietary patterns during pregnancy in Shanghai and explore the effects of dietary patterns during pregnancy on preterm birth. Data were derived from the ‘Iodine Status in Pregnancy and Offspring Health Cohort’ (ISPOHC) study. Multistage, stratified random sampling was used to select survey participants from 16 districts in Shanghai, which were divided into five sampling areas; 40–70 pregnant women were selected from each area. A total of 4361 pregnant women and their offspring were involved in the study. The male-to-female ratio of the babies was 1.04:1, and the incidence of single preterm birth was 4.2%. Three dietary patterns were extracted by factor analysis: a ‘Vegetarian Pattern’, an ‘Animal Food Pattern’ (AFP), and a ‘Dairy and Egg Pattern’. These patterns explained 40.511% of the variance in dietary intake. Binary logistic regression, which was used to analyse the association between birth outcomes and scores measuring maternal dietary patterns, found only the AFP was a significant risk factor for preterm birth. Higher AFP scores were positively associated with preterm birth (Q2 vs. Q1 OR = 1.487, 95% CI: 1.002–2.207; Q3 vs. Q1 OR = 1.885, 95% CI: 1.291–2.754). After adjusting for other potential contributors, a higher AFP score was still a significant risk factor for preterm birth (Q2 vs. Q1 OR = 1.470, 95% CI: 0.990–2.183; Q3 vs. Q1 OR = 1.899, 95% CI: 1.299–2.776). The incidence of preterm birth was 4.2%. A higher score of AFP was significantly associated with a higher risk of preterm birth. The animal food intake of pregnant women should be reasonably consumed during pregnancy.

Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Crisis ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 330-337 ◽  
Author(s):  
Cun-Xian Jia ◽  
Lin-Lin Wang ◽  
Ai-Qiang Xu ◽  
Ai-Ying Dai ◽  
Ping Qin
Keyword(s):  
Risk Factor ◽  
Family Income ◽  
Rural China ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Health Condition ◽  
Physical Illness ◽  
Rural Residents ◽  
Increased Risk ◽  
Study Population

Background: Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. Aims: To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. Method: In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. Results: The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ2 = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85–5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Conclusion: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

scholarly journals Higher premature atrial complex burden from the Holter examination predicts poor cardiovascular outcome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ting-Chun Huang ◽  
Po-Tseng Lee ◽  
Mu-Shiang Huang ◽  
Pei-Fang Su ◽  
Ping-Yen Liu
Keyword(s):  
Risk Factor ◽  
Dose Response ◽  
Cox Model ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cardiovascular Death ◽  
Specific Model ◽  
Distribution Model ◽  
All Cause Mortality ◽  
Quartile Group

AbstractPremature atrial complexes (PACs) have been suggested to increase the risk of adverse events. The distribution of PAC burden and its dose–response effects on all-cause mortality and cardiovascular death had not been elucidated clearly. We analyzed 15,893 patients in a medical referral center from July 1st, 2011, to December 31st, 2018. Multivariate regression driven by ln PAC (beats per 24 h plus 1) or quartiles of PAC burden were examined. Older group had higher PAC burden than younger group (p for trend < 0.001), and both genders shared similar PACs distribution. In Cox model, ln PAC remained an independent risk factor for all-cause mortality (hazard ratio (HR) = 1.09 per ln PAC increase, 95% CI = 1.06‒1.12, p < 0.001). PACs were a significant risk factor in cause-specific model (HR = 1.13, 95% CI = 1.05‒1.22, p = 0.001) or sub-distribution model (HR = 1.12, 95% CI = 1.04‒1.21, p = 0.004). In ordinal PAC model, 4th quartile group had significantly higher risk of all-cause mortality than those in 1st quartile group (HR = 1.47, 95% CI = 1.13‒1.94, p = 0.005), but no difference in cardiovascular death were found in competing risk analysis. In subgroup analysis, the risk of high PAC burden was consistently higher than in low-burden group across pre-specified subgroups. In conclusion, PAC burden has a dose response effect on all-cause mortality and cardiovascular death.

Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

2020 ◽  
pp. 1-7
Author(s):  
Stephanie M. Cabral ◽  
Katherine E. Goodman ◽  
Natalia Blanco ◽  
Surbhi Leekha ◽  
Larry S. Magder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Risk Adjustment ◽  
Community Hospital ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Bivariate Analysis ◽  
Patient Admissions ◽  
Clostridioides Difficile ◽  
Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

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