scholarly journals Risk of Stillbirth after Infertility Treatment in the United States: 2014-2017

2020 ◽  
Vol 9 (1) ◽  
pp. 149-152
Author(s):  
Deepa Dongarwar ◽  
Hamisu Mohammed Salihu
Keyword(s):  
United States ◽  
Regression Models ◽  
Fetal Death ◽  
The United States ◽  
Infertility Treatment ◽  
Reproductive Technology ◽  
Creative Commons ◽  
Hazard Ratios ◽  
The Us ◽  
Open Access Article

To estimate the risk of stillbirth following infertility treatment in the United States (US), we analyzed data from the US Natality and Fetal Death files from 2014 to 2017. We built Cox proportional regression models to generate adjusted hazard ratios (HR) for the risk of stillbirth among women who utilized various modalities of infertility treatment within the study period. Women who used any infertility treatment and, specifically, assisted reproductive technology (ART), had an elevated risk of stillbirth (HR: 1.21, 95% CI:1.09 -1.33) compared to women who did not use ART. We concluded that in this population, the risk of stillbirth was elevated among women using infertility treatment. Key words: • ART • Infertility treatment • Fertility enhancing drugs • Stillbirth in US   Copyright © 2020 Dongarwar and Salihu. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Stillbirths among Advanced Maternal Age Women in the United States: 2003-2017

2020 ◽  
Vol 9 (1) ◽  
pp. 153-156
Author(s):  
Deepa Dongarwar ◽  
Anjali Aggarwal ◽  
Kenneth Barning ◽  
Hamisu Mohammed Salihu
Keyword(s):  
United States ◽  
Maternal Age ◽  
Regression Models ◽  
Original Work ◽  
Fetal Death ◽  
Advanced Maternal Age ◽  
The United States ◽  
Population Based ◽  
Population Based Study ◽  
Open Access Article

The aim of the study was to evaluate the association between fetal stillbirth and advanced maternal age in the United States (US). This was a population-based study using the Natality and Fetal Death datasets for the years 2003-2017. We built Cox proportional regression models to examine the likelihood of stillbirth among women aged ?40 years. Out of a total of 57,273,305 births, stillbirth was observed in 302,522, yielding a stillbirth rate of 5 per 1000. After adjusting for confounders, women of advanced age (?40 years) had a 40-50% greater risk of stillbirth compared to women 20-29 years of age. Keywords: • Advanced maternal age • Stillbirth • Cox proportional regression • United State   Copyright © 2020 Dongarwar et al. This is an open-access article distributed under the terms of the Creative Com - mons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Nativity Status and Poly Tobacco Use among Young Adults in the United States

2021 ◽  
Author(s):  
Peace C. Okpala ◽  
Carrie Rosario ◽  
Melissa J. Dupont-Reyes ◽  
Michelle Y. Martin Romero ◽  
Md Towfiqul Alam ◽  
...  
Keyword(s):  
United States ◽  
Young Adults ◽  
Tobacco Use ◽  
Regression Models ◽  
The United States ◽  
Foreign Born ◽  
Tobacco Products ◽  
Targeted Interventions ◽  
Nativity Status ◽  
The Us

Introduction: Young adults are the second largest segment of the immigrant population in the United States (US). Given recent trends in later age of initiation of tobacco use, we examined variation in use of tobacco products by nativity status for this population group. Methods: Our study included young adults 18-30 years of age sampled in the National Health Interview Survey (2015-2019), a nationally representative sample of the US population. We calculated prevalence of use of any and 2 or more tobacco products (cigarettes, cigars, pipes, e-cigarettes, and smokeless tobacco) for foreign-born (n=3,096) and US-born (n=6,811) young adults. Logistic regression models adjusted for age, sex, race-ethnicity, education, and poverty, while accounting for the complex survey design. Results: Foreign-born young adults were significantly less likely to use any tobacco product (Cigarette = 7.3% vs 10.7%; Cigar= 1.8% vs 4.8%; E-cigarette= 2.3% vs 4.5%, respectively; p<0.01) or poly tobacco use (1.9% vs. 4.2%; p<0.01) than US-born young adults. Adjusted regression models showed lower odds of poly tobacco use among the foreign-born than their US-born counterparts (Odds Ratio = 0.41, (95% Confidence Interval: 0.26-0.63)). Conclusion: Findings highlight the importance of targeted interventions by nativity status and further tobacco prevention efforts needed for the US-born.

scholarly journals US-China trade conflict: causes and consequences

2020 ◽  
Keyword(s):  
United States ◽  
Foreign Trade ◽  
Regression Models ◽  
Bilateral Trade ◽  
Negative Impact ◽  
The United States ◽  
Economic Relations ◽  
Stage Of Development ◽  
The Us ◽  
The Usa

At the present stage of development of international economic relations special attention is paid to the study of the relations between the countries that are the world leaders in terms of GDP and foreign trade – the USA and China. This is due to the fact that in recent years the US have introduced a number of measures to counteract the growth of Chinese exports, which has led to backlash from China. The subject of the study is the foreign trade relations of the USA and China. The goal is to analyze the influence of protectionist measures applied by the US and China on the development of their foreign economic relations. The following objectives are set: to determine the level of economic interdependence of the USA and the PRC, to investigate their impact on mutual trade flows and to analyze the dynamics of bilateral trade of countries under restrictive measures. The following methods are: comparative analysis, systematization and generalization, construction of regression models. The results of the analysis revealed that the US and PRC current accounts show reverse dynamics: the United States demonstrates stable deficit, while China has had surplus for many years. Moreover, the structures of the current accounts do differ a lot as well: the US is totally services-oriented country, whereas China is a major exporter of goods. It can be observed that both countries have experienced a recession of foreign economic activity since 2018, as far as their current account balances decreased substantially, which is likely to be the consequence of tariff barriers imposed by the US and PRC. Furthermore, due to trade confrontation, bilateral trade between these countries declines significantly as well, so that now China and the United States are forced to look for new export markets. The results of the regression models allow concluding that import from China is indeed having a negative impact on US exports, which has led to the US restrictions on imports from China. However, the introduction of mutual restrictions did not lead to an improvement of the US foreign trade.

scholarly journals 855. Persistence on F/TAF versus F/TDF for HIV Pre-Exposure Prophylaxis: A Real-World Evidence Analysis in the United States

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S518-S519
Author(s):  
Li Tao ◽  
Valentina Shvachko ◽  
Moupali Das ◽  
Christoph C Carter ◽  
Jared Baeten ◽  
...  
Keyword(s):  
United States ◽  
Real World ◽  
The United States ◽  
Odds Ratios ◽  
Preexposure Prophylaxis ◽  
Hazard Ratios ◽  
Real World Evidence ◽  
The Us ◽  
Evidence Analysis ◽  
Exposure Prophylaxis

Abstract Background Persistence to preexposure prophylaxis (PrEP) is an important determinant of its efficacy, but evidence on real-world persistence is lacking. This study assesses adherence to F/TDF and F/TAF for PrEP both in terms of discontinuation and re-initiation patterns. Methods We identified HIV-negative individuals in the United States who initiated F/TDF or F/TAF for PrEP between October 2019 and December 2020 from a de-identified prescription claims database; users taking generic F/TDF were excluded. Non-persistence was defined as a prescription fill gap of >30 days; discontinuation included switch from F/TDF to F/TAF or F/TAF to F/TDF. We used survival analyses to estimate persistence, Cox regressions to compare the hazard ratios (HR) of discontinuation, and logistic regression to compare the odds ratios of re-initiation after discontinuation. Results Among F/TAF users (N=82,402) median age at PrEP initiation was 35 years (interquartile range [IQR] 28−47) and median PrEP persistence was 4 months (IQR 1.8-8.9), compared to 31 years (IQR 25−40) and 2 months (IQR 1.0-3.8) for F/TDF users (N=48,501). PrEP persistence at 60 and 90 days was higher among F/TAF users than F/TDF users (Figure). F/TDF users were 2.5 times more likely to discontinue than F/TAF users, with more marked differences in older users than that in younger users (p for interaction between discontinuation and age group < 0.01, Table). We also observed a higher rate of discontinuation of F/TDF versus F/TAF if PrEP was prescribed by internal medicine or infectious disease physicians than by family medicine physicians (data not shown). After discontinuation, F/TAF users were 1.7 times more likely than F/TDF users to re-initiate PrEP; the association was not different by age. Persistence rates of F/TAF and F/TDF for PrEP by time of PrEP initiation Hazard ratios (HR) and corresponding 95% confidence intervals (CI) of non-persistence and odds ratios (OR) of re-initiation after discontinuation for users of F/TAF and F/TDF for PrEP in the US, Oct 2019 – Dec 2020 Conclusion In this real-world analysis, the F/TAF for PrEP regimen was associated with higher persistence and re-initiation than F/TDF for PrEP. These findings underscore the dynamic nature of PrEP utilization in the real-world and the importance of interventions aimed at improving PrEP persistence and re-initiation in people who would benefit from PrEP. Disclosures Li Tao, MD, PhD, Gilead Sciences Inc (Employee, Shareholder) Valentina Shvachko, MS, Gilead Sciences Inc (Employee, Shareholder) Moupali Das, MD, Gilead Sciences Inc. (Employee, Shareholder) Christoph C. Carter, MD, Gilead Sciences Inc. (Employee, Shareholder) Jared Baeten, MD, PHD, Gilead Sciences Inc. (Employee, Shareholder) David Magnuson, PharmD, Gilead Sciences Inc (Employee, Shareholder)

scholarly journals Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys

BMJ ◽  
2019 ◽  
pp. l2219 ◽  
Author(s):  
David Hammond ◽  
Jessica L Reid ◽  
Vicki L Rynard ◽  
Geoffrey T Fong ◽  
K Michael Cummings ◽  
...  
Keyword(s):  
United States ◽  
Regression Models ◽  
Smoking Prevalence ◽  
The United States ◽  
Close Monitoring ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Nicotine Concentration ◽  
The Past ◽  
The Us

Abstract Objective To examine differences in vaping and smoking prevalence among adolescents in Canada, England, and the United States. Design Repeat cross sectional surveys. Setting Online surveys in Canada, England, and the US. Participants National samples of 16 to 19 year olds in 2017 and 2018, recruited from commercial panels in Canada (n=7891), England (n=7897), and the US (n=8140). Main outcome measures Prevalence of vaping and smoking was assessed for use ever, in the past 30 days, in the past week, and on 15 days or more in the past month. Use of JUUL (a nicotine salt based electronic cigarette with high nicotine concentration) and usual vaping brands were also assessed. Logistic regression models examined differences in vaping and smoking between countries and over time. Results The prevalence of vaping in the past 30 days, in the past week, and on 15 days or more in the past month increased in Canada and the US between 2017 and 2018 (P<0.001 for all), including among non-smokers and experimental smokers, with no changes in England. Smoking prevalence increased in Canada (P<0.001 for all measures), with modest increases in England, and no changes in the US. The percentage of ever vapers who reported more frequent vaping increased in Canada and the US (P<0.01 for all), but not in England. The use of JUUL increased in all countries, particularly the US and Canada—for example, the proportion of current vapers in the US citing JUUL as their usual brand increased threefold between 2017 and 2018. Conclusions Between 2017 and 2018, among 16 to 19 year olds the prevalence of vaping increased in Canada and the US, as did smoking in Canada, with little change in England. The rapidly evolving vaping market and emergence of nicotine salt based products warrant close monitoring.

P–773 Infertility treatment and the risk of small for gestational age births: a population-based study in the United States

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Glatthorn ◽  
M Sauer ◽  
J Brandt ◽  
C Ananth
Keyword(s):  
United States ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
The United States ◽  
Infertility Treatment ◽  
Unmeasured Confounding ◽  
Live Births ◽  
The Us ◽  
Infertility Treatments ◽  
The Impact

Abstract Study question What is the association between infertility treatments and small for gestational age (SGA) births? Summary answer Women who conceived pregnancies with any infertility treatment had a decreased risk of SGA &lt;10th, &lt;5th and &lt;3rd percentiles compared to naturally conceived pregnancies. What is known already Assisted reproductive technology (ART) and other infertility treatments have long been associated with an increased risk of SGA births, which confers a greater risk of perinatal morbidity and mortality compared to appropriate for gestational age births. Study design, size, duration This is a cross-sectional study of 16,836,228 births in the United States (US) between 2015–2019. The exposure group included women who underwent any infertility treatment, including ART and prescribed fertility enhancing medications. The comparison group included those who had naturally conceived pregnancies. The primary outcome was SGA birth, defined as sex-specific birthweight &lt;10th percentile for gestational age. Secondary outcomes included SGA &lt;5th and &lt;3rd percentile births. Participants/materials, setting, methods Pregnant subjects (n = 16,836,228) in the US who delivered non-malformed, singleton live births between 24–44 weeks’ gestational age. We estimated risk of SGA births in relation to any infertility treatment from fitting log-linear Poisson regression models with robust variance. Risk ratios (RR) and 95% confidence intervals (CI) were estimated as the effect measure before and after adjusting for confounders. We also performed a sensitivity analysis to correct for potential non-differential exposure misclassification and unmeasured confounding biases. Main results and the role of chance During the study period, 1.4% (n = 231,177) of non-malformed singleton live births resulted from infertility treatments (0.8% ART and 0.6% fertility enhancing medications). Of these, 9.4% (n = 21,771) of pregnancies conceived with infertility treatment were complicated by SGA &lt;10th percentile compared to 11.9% (n = 1,755,925) of naturally conceived pregnancies. For pregnancies conceived with infertility treatment versus naturally conceived pregnancies, the adjusted RR for SGA &lt;10th percentile was 1.07 (95% CI 1.06, 1.08). However, after correction for misclassification bias and unmeasured confounding, infertility treatment was found to be protective for SGA and conferred a 27% reduced risk of SGA &lt;10th percentile (bias-corrected RR 0.73, 95% CI 0.53, 0.85). These trends were similar for analyses stratified by exposure to ART and fertility enhancing medications and secondary SGA outcomes, including SGA &lt;5th and &lt;3rd percentile. Limitations, reasons for caution All information collected on infertility treatment relies on self-reporting by patients and recording by hospital staff at the time of delivery, which likely resulted in underreporting of infertility treatments. Additionally, we cannot determine the impact of interventions that were not recorded, such as intrauterine insemination (IUI). Wider implications of the findings: Compared to naturally conceived pregnancies, exposure to infertility treatment is associated with reduction in the risk of SGA births. These findings, which are contrary to some published reports, likely reflect changes in the modern practice of infertility care in the US, and importantly, robust analysis of the national data. Trial registration number Not applicable

scholarly journals Temporal Trends in the Rates of Singletons, Twins and Higher-order Multiple Births Over Five Decades Across Racial Groups in the United States

2020 ◽  
Vol 9 (3) ◽  
pp. 257-259
Author(s):  
Liye Wang ◽  
Deepa Dongarwar ◽  
Hamisu M. Salihu
Keyword(s):  
Global Health ◽  
Temporal Trends ◽  
The United States ◽  
Vital Statistics ◽  
Higher Order ◽  
Racial Groups ◽  
Creative Commons ◽  
The Us ◽  
Work First ◽  
Open Access Article

We analysed Natality data obtained from the National Vital Statistics System from 1971 through 2018. Overall, the rates of singletons declined among all racial groups over the five decades of the study. However, the rates of twins and higher-order multiples increased over the same period although for the past two decades, the rates of higher-order multiples had substantially plummeted. The global health implication of these findings is that policy changes in the US in the form of professional practice guidelines have succeeded in reducing the birth of vulnerable populations (i.e., higher-order multiples) who are predominantly created using assisted reproductive technology. Key words: • Trends in Multiple Gestations • US • Black • White • Singletons • Twins • Higher-order multiples   Copyright © 2020 Wang et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

Smoker Suicide Rates and Risks in the United States and Frankfurt, Germany

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
B. Leistikow ◽  
K. Petronis ◽  
M. Kettner ◽  
N. Willits ◽  
B. Schneider
Keyword(s):  
United States ◽  
General Population ◽  
Census Data ◽  
Smoking Status ◽  
The United States ◽  
Suicide Rates ◽  
Hazard Ratios ◽  
The Us ◽  
Never Smokers ◽  
Rate Ratios

Background:Suicide and smoking are immense, growing, associated global problems. Recent general population suicide rates and ratios by smoking status are unknown though in past reports, smokers had near three-fold hazard ratios of suicide among health professionals. So we assessed recent suicide rates and rate ratios in the general population of the United States (US) and Frankfurt, Germany.Methods:US National Health Interview Survey interviewees from 1987, 1988, and 1990-94 with near complete follow up through 2002 (representing the US adult non-institutionalized population) and all suicides in 1999-2000 among adult residents of Frankfurt, their proxy respondents, control subjects, and census data were studied using survival time methods. Age was categorized in both samples as 18-30, 31-60 and 61+ years.Results:The respective US versus Frankfurt crude suicide rates per 100,000 were 13.8 (95% confidence interval (CI) 12.4-15.5) versus 17.7 (CI 15.0-20.5) overall, 7.9 (CI 6.4-9.9) versus 12.0 (CI 9.2-14.7) in never smokers, and 22.9 (CI 19.5-27.0) versus 32.0 (CI 24.5-39.6) in current smokers. Smoker suicide rate ratios relative to never smokers ranged from 2.1 (males) to 4.2 (females) in US groups and 1.5 (ages 61+ years) to 3.7 (ages 31-60 years) in Frankfurt groups (each p< 0.05).Discussion:In both the US and Frankfurt, Germany, large absolute and relative excesses of suicide are seen in smokers. Reducing the prevalence of smoking might greatly reduce suicide rates, especially in young and middle-aged adults and US females.Acknowledgements:This study was funded by Pfizer, Inc.

The United States and the Iranian Nuclear Programme

2018 ◽  
Author(s):  
Steven Hurst
Keyword(s):  
United States ◽  
Decision Making ◽  
Domestic Politics ◽  
The United States ◽  
Nixon Administration ◽  
Comprehensive Plan ◽  
The Us ◽  
Nuclear Issue ◽  
The Relationship

The United States, Iran and the Bomb provides the first comprehensive analysis of the US-Iranian nuclear relationship from its origins through to the signing of the Joint Comprehensive Plan of Action (JCPOA) in 2015. Starting with the Nixon administration in the 1970s, it analyses the policies of successive US administrations toward the Iranian nuclear programme. Emphasizing the centrality of domestic politics to decision-making on both sides, it offers both an explanation of the evolution of the relationship and a critique of successive US administrations' efforts to halt the Iranian nuclear programme, with neither coercive measures nor inducements effectively applied. The book further argues that factional politics inside Iran played a crucial role in Iranian nuclear decision-making and that American policy tended to reinforce the position of Iranian hardliners and undermine that of those who were prepared to compromise on the nuclear issue. In the final chapter it demonstrates how President Obama's alterations to American strategy, accompanied by shifts in Iranian domestic politics, finally brought about the signing of the JCPOA in 2015.

‘To see oursels as ithers see us’: Reflections on Scottish Independence from the United States

2014 ◽  
Vol 23 (3) ◽  
pp. 381-388 ◽  
Author(s):  
Euan Hague ◽  
Alan Mackie
Keyword(s):  
United States ◽  
The United States ◽  
The Us ◽  
Scottish Independence ◽  
The Uk ◽  
Scottish Diaspora

The United States media have given rather little attention to the question of the Scottish referendum despite important economic, political and military links between the US and the UK/Scotland. For some in the US a ‘no’ vote would be greeted with relief given these ties: for others, a ‘yes’ vote would be acclaimed as an underdog escaping England's imperium, a narrative clearly echoing America's own founding story. This article explores commentary in the US press and media as well as reporting evidence from on-going interviews with the Scottish diaspora in the US. It concludes that there is as complex a picture of the 2014 referendum in the United States as there is in Scotland.

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