scholarly journals Cost of Illness in Young Children: A Prospective Birth Cohort Study

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 173
Author(s):  
Sarah Kristine Nørgaard ◽  
Nadja Hawwa Vissing ◽  
Bo Lund Chawes ◽  
Jakob Stokholm ◽  
Klaus Bønnelykke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Fish Oil ◽  
Cesarean Delivery ◽  
Cost Of Illness ◽  
Economic Burden ◽  
Geometric Mean ◽  
Childhood Illness ◽  
Costs Of Illness ◽  
The Impact

Childhood illness is extremely common and imposes a considerable economic burden on society. We aimed to quantify the overall economic burden of childhood illness in the first three years of life and the impact of environmental risk factors. The study is based on the prospective, clinical mother–child cohort Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2010) of 700 children with embedded randomized trials of fish-oil and vitamin D supplementations during pregnancy. First, descriptive analyses were performed on the total costs of illness, defined as both the direct costs (hospitalizations, outpatient visits, visit to the practitioner) and the indirect costs (lost earnings) collected from the Danish National Health Registries. Thereafter, linear regression analyses on log-transformed costs were used to investigate environmental determinants of the costs of illness. The median standardized total cost of illness at age 0–3 years among the 559 children eligible for analyses was EUR 14,061 (IQR 9751–19,662). The exposures associated with reduced costs were fish-oil supplementation during pregnancy (adjusted geometric mean ratio (GMR) 0.89 (0.80; 0.98), p = 0.02), gestational age in weeks (aGMR = 0.93 (0.91; 0.96), p < 0.0001), and birth weight per 100 g (aGMR 0.98 (0.97; 0.99), p = 0.0003), while cesarean delivery was associated with higher costs (aGMR = 1.30 (1.15; 1.47), p < 0.0001). In conclusion, common childhood illnesses are associated with significant health-related costs, which can potentially be reduced by targeting perinatal risk factors, including maternal diet during pregnancy, cesarean delivery, preterm birth and low birth weight

scholarly journals Geospatial analysis of determinants of neonatal mortality in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duah Dwomoh
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Neonatal Death ◽  
Reproductive Age ◽  
Multiple Births ◽  
Demographic And Health Surveys ◽  
Neonatal Deaths ◽  
The Impact

Abstract Background Ghana did not meet the Millennium Development Goal 4 of reducing child mortality by two-thirds and may not meet SDG (2030). There is a need to direct scarce resources to mitigate the impact of the most important risk factors influencing high neonatal deaths. This study applied both spatial and non-spatial regression models to explore the differential impact of environmental, maternal, and child associated risk factors on neonatal deaths in Ghana. Methods The study relied on data from the Ghana Demographic and Health Surveys (GDHS) and the Ghana Maternal Health Survey (GMHS) conducted between 1998 and 2017 among 49,908 women of reproductive age and 31,367 children under five (GDHS-1998 = 3298, GDHS-2003 = 3844, GDHS-2008 = 2992, GDHS-2014 = 5884, GMHS-2017 = 15,349). Spatial Autoregressive Models that account for spatial autocorrelation in the data at the cluster-level and non-spatial statistical models with appropriate sampling weight adjustment were used to study factors associated with neonatal deaths, and a p-value less than 0.05 was considered statistically significant. Results Population density, multiple births, smaller household sizes, high parity, and low birth weight significantly increased the risk of neonatal deaths over the years. Among mothers who had multiple births, the risk of having neonatal deaths was approximately four times as high as the risk of neonatal deaths among mothers who had only single birth [aRR = 3.42, 95% CI: 1.63–7.17, p < 0.05]. Neonates who were perceived by their mothers to be small were at a higher risk of neonatal death compared to very large neonates [aRR = 2.08, 95% CI: 1.19–3.63, p < 0.05]. A unit increase in the number of children born to a woman of reproductive age was associated with a 49% increased risk in neonatal deaths [aRR = 1.49, 95% CI: 1.30–1.69, p < 0.05]. Conclusion Neonatal mortality in Ghana remains relatively high, and the factors that predisposed children to neonatal death were birth size that were perceived to be small, low birth weight, higher parity, and multiple births. Improving pregnant women’s nutritional patterns and providing special support to women who have multiple deliveries will reduce neonatal mortality in Ghana.

scholarly journals Low Birth Weight Prevalence in Children Diagnosed with Neurodevelopmental Disorders in Dubai

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110317
Author(s):  
Faisal A. Nawaz ◽  
Meshal A. Sultan
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Mental Disorders ◽  
Low Birth Weight ◽  
Neurodevelopmental Disorders ◽  
Autism Spectrum ◽  
High Birth Weight ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
The Impact

The aim of this study is to evaluate the prevalence of low birth weight and other perinatal risk factors in children diagnosed with neurodevelopmental disorders. This is one of the first studies in the Arabian Gulf region focused on the contribution of these factors toward the development of various disorders such as attention-deficit/hyperactivity disorder, autism spectrum disorder, and other mental disorders. This descriptive study was based on qualitative data analysis. We reviewed retrospective information from the electronic medical records of 692 patients in Dubai, United Arab Emirates. The prevalence of low birth weight in children with mental disorders was significantly higher as compared to the general population (16% vs 6% respectively). Furthermore, other risk factors, including high birth weight and preterm birth were noted to have a significant association with neurodevelopmental disorders. Future research on the impact of perinatal risk factors will contribute to advancement of early intervention guidelines.

scholarly journals Evaluation of the impact of residual anhydramnios following preterm premature rupture of membranes on respiratory distress syndrome

2021 ◽  
Vol 29 (1) ◽  
pp. 13-19
Author(s):  
Erdem Şahin ◽  
Yusuf Madendağ
Keyword(s):  
Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Cesarean Delivery ◽  
Distress Syndrome ◽  
Latency Period ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
The Impact

Objective The aim of the present study was to evaluate the impact of residual anhydramnios following preterm premature rupture of membranes (PPROM) on respiratory distress syndrome (RDS) after the pregnancy was expectantly managed. Methods This study was retrospectively conducted at Erciyes University Medical School, Turkey. It assessed women with singleton pregnancies admitted to the hospital between 2010 and 2020 for expectant management of PPROM between 24th and 28th gestational weeks. The patients were divided into three groups as follows: (1) anhydramnios, (2) oligohydramnios, (3) normal amniotic fluid volume (AFV). Main outcome measure was as follows: The first evaluation was AFV at admission and the primary outcome was a neonatal RDS. Adjusted odds ratios (aOR) and 95% confidence interval (CI) for RDS were calculated for each AFV-at-presentation adjusting for gestational age (GA) at PPROM, GA at delivery, latency period, birth-weight percentile, cesarean birth, and chorioamnionitis. Results Of the 440 women with PPROM, 261 fulfilled the inclusion criteria. There were 125 (47.8%) with normal AFV, 71 (27.3%) with oligohydramnios, and 65 (24.9%) with anhydramnios at admission. The maternal demographic characteristics were similar among the groups. Birth weight was significantly different among the groups. RDS was highest in the anhydramnios group (64.6%). Decreased AFV was not associated with RDS in either oligohydramnios or anhydramnios at presentation. A GA at PPROM, latency period >30 days, and cesarean delivery were co-factors in the outcome. Conclusion Our results indicated that oligohydramnios and anhydramnios were not associated with RDS risk, but GA at PPROM and delivery, latency period, and cesarean delivery were independently associated with the RDS risk.

scholarly journals Economic burden of schizophrenia in Italy: a probabilistic cost of illness analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018359 ◽  
Author(s):  
Andrea Marcellusi ◽  
Gianluca Fabiano ◽  
Raffaella Viti ◽  
Pier Cesare Francesa Morel ◽  
Giuseppe Nicolò ◽  
...  
Keyword(s):  
Cost Of Illness ◽  
Economic Burden ◽  
Indirect Costs ◽  
Direct Costs ◽  
Psychiatric Disease ◽  
Resource Utilisation ◽  
Treatment Pathways ◽  
Specialist Services ◽  
Illness Model ◽  
The Impact

ObjectivesSchizophrenia is a chronic, debilitating psychiatric disease with highly variable treatment pathways and consequent economic impacts on resource utilisation. The aim of the study was to estimate the economic burden of schizophrenia in Italy for both the societal and Italian National Healthcare perspective.MethodsA probabilistic cost of illness model was applied. A systematic literature review was carried out to identify epidemiological and economic data. Direct costs were calculated in terms of drugs, hospitalisations, specialist services, residential and semiresidential facilities. Indirect costs were calculated on the basis of patients’ and caregivers’ loss of productivity. In addition, the impact of disability compensation was taken into account using a database from the Italian National Social Security Institute —Italy (INPS).ResultsOverall, 303 913 prevalent patients with schizophrenia were estimated. Of these, 212 739 (70%) were diagnosed and 175 382 (82%) were treated with antipsychotics. The total economic burden was estimated at €2.7 billion (95% CI €1771.93 to €3988.65), 50.5% due to indirect costs and 49.5% to direct costs. Drugs corresponded to 10% of direct costs and hospitalisations (including residential and semiresidential facilities) accounted for 81%.ConclusionsThis study highlighted that indirect costs and hospitalisations (including residential and semiresidential facilities) play a major role within the expenses associated with schizophrenia in Italy, and this may be considered as a tool for public decision-makers.

scholarly journals Prevalence and Risk Factors For Retinopathy of Prematurity Among Infants in Minilk-II Hospital, Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study, 2020.

2021 ◽  
Author(s):  
Emebet Berhane Woldemariam ◽  
Hana Endale Aliyou ◽  
Yosef Tsige Redi
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Retinopathy Of Prematurity ◽  
Medical Records ◽  
Oxygen Therapy ◽  
Maternal Education ◽  
Cross Sectional ◽  
Childhood Blindness ◽  
Zone Ii ◽  
The Impact

Abstract Background: Retinopathy of prematurity (ROP) is defined as a vaso-proliferative retinal disorder that leads to childhood blindness; and persists as the main cause of preventable childhood blindness. The impact of ROP in developing countries is heavier as term infants can develop ROP because of inadequate awareness of the disease development and the risk factors. Hence, the aim of the study is assessing the prevalence and risk factors for retinopathy of prematurity in the specific study area.Methodology: An institutional based cross-sectional retrospective study was conducted on 301 samples of the pediatrics out-patient eye clinic medical records, at Minilik II referral hospital, from March to April 2020. Study subjects were selected using systematic random sampling method. Data was collected from medical records of all infants visiting the hospital for eye problems from January 2018 to December 2019, using a structured check list. The collected data was entered and cleaned using Epi data 6.4.2.0 and then exported & analyzed using SPSS version 25. Bivariate and multivariate analysis was computed to distinguish the statistically significant factors. Result: The prevalence of ROP among infants in this study showed 39(13%). Of these, more than half (56.4%) were Zone II + Stage 1, followed by Zone II + stage-2, and Stage-5; 12.8% and 10.2% respectively. Birth weight, oxygen therapy and sepsis were the factors significantly associated with ROP [AOR= 39.28; 95% CI: 3.204- 481.658], [AOR= 5.317; 95% CI:1.009- 28.019] and [AOR=9.805; 95% CI:1.592- 60.388] respectively. Conclusions: the prevalence of ROP in the current study is (13%). Birth weight, oxygen therapy and sepsis were the determinant risk factors for development of ROP. Regular ANC, and maternal education may be important to reduce the risk of low-birth weight, and sepsis that results in long-term oxygen therapy leading to childhood blindness.

scholarly journals Is adolescent pregnancy a risk factor for low birth weight?

2013 ◽  
Vol 47 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Alzira Maria D'avila Nery Guimarães ◽  
Heloísa Bettiol ◽  
Luiz De Souza ◽  
Ricardo Q Gurgel ◽  
Maria Luiza Dória Almeida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Birth Weight ◽  
Prenatal Care ◽  
Low Birth Weight ◽  
Adolescent Pregnancy ◽  
Adolescent Mothers ◽  
Northeastern Brazil ◽  
Smoking During Pregnancy ◽  
The Impact

OBJECTIVE: The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW) babies. METHODS: This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS: We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (< 20 years of age). Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS: Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.

scholarly journals A Preconception Paternal Fish Oil Diet Prevents Toxicant-Driven New Bronchopulmonary Dysplasia in Neonatal Mice

Toxics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 7
Author(s):  
Jelonia T. Rumph ◽  
Kayla J. Rayford ◽  
Victoria R. Stephens ◽  
Sharareh Ameli ◽  
Pius N. Nde ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Fish Oil ◽  
Bronchopulmonary Dysplasia ◽  
Toxicant Exposure ◽  
Placental Dysfunction ◽  
Neonatal Mice ◽  
History Of ◽  
Fish Oil Diet

New bronchopulmonary dysplasia is a developmental lung disease associated with placental dysfunction and impaired alveolarization. Risk factors for new BPD include prematurity, delayed postnatal growth, the dysregulation of epithelial-to-mesenchymal transition (EMT), and parental exposure to toxicants. Our group previously reported that a history of paternal toxicant exposure increased the risk of prematurity and low birth weight in offspring. A history of paternal toxicant exposure also increased the offspring’s risk of new BPD and disease severity was increased in offspring who additionally received a supplemental formula diet, which has also been linked to poor lung development. Risk factors associated with new BPD are well-defined, but it is unclear whether the disease can be prevented. Herein, we assessed whether a paternal fish oil diet could attenuate the development of new BPD in the offspring of toxicant exposed mice, with and without neonatal formula feeding. We investigated the impact of a paternal fish oil diet preconception because we previously reported that this intervention reduces the risk of TCDD associated placental dysfunction, prematurity, and low birth weight. We found that a paternal fish oil diet significantly reduced the risk of new BPD in neonatal mice with a history of paternal toxicant exposure regardless of neonatal diet. Furthermore, our evidence suggests that the protective effects of a paternal fish oil diet are mediated in part by the modulation of small molecules involved in EMT.

Analysis of retinopathy of prematurity screening in Tianjin, China

2020 ◽  
Vol 1 (3) ◽  
pp. 173-178
Author(s):  
Mei Han ◽  
◽  
Jun Zheng ◽  
Quan-Hong Han ◽  
Li Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Pulmonary Surfactant ◽  
Demographic Information ◽  
Oxygen Supplementation ◽  
Gestation Age ◽  
Multicenter Retrospective Review ◽  
The Impact

AIM: To analyze the findings of retinopathy of prematurity (ROP) exam in Tianjin, and study the impact of pulmonary surfactant Curosurf and nasal continuous positive airway pressure (NCPAP) in ROP. METHODS: A multicenter retrospective review. 2894 preterm infants (1592 males, 1302 females) from several hospitals in Tianjin were screened from January 2009 to December 2013. Demographic information, ophthalmic outcomes and possible systemic risk factors were recorded. Gestation age, birth weight, oxygen supplementation, Curosurf and NCPAP were used to estimate risk factors for ROP. RESULTS: ROP was found in 448 eyes of 224 patients (7.7%). Among which, severe ROP developed in 98 eyes of 49 patients (21.9%). There was significant statistical difference in RDS, NCPAP, and Curosurf usage between control and ROP groups (P=0.000). Multiple logistic regression analyses of ROP indicated that lower birth weight, younger gestational age, and oxygen supplementation were the risk factors leading to ROP. As the usage rate of Curosurf and NCPAP increased year by year, the usage of oxygen supplementation gradually decreased, the incidence of ROP was also on the decline. CONCLUSION: Low birth weight, young gestational age and oxygen supplementation are associated with ROP. The use of Curosurf and NCPAP may be the factor that reduces the occurrence of ROP.

scholarly journals Marginal cord insertion among singleton births at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hailu Aragie ◽  
Mohammed Oumer
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Delivery ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Perinatal Complications ◽  
Emergency Cesarean ◽  
Intrauterine Contraceptive

Abstract Background Umbilical cord may insert abnormally i.e. marginal insertion to a placenta which can cause different birth and perinatal complications. Despite the increased effort taken by different responsible bodies, the prevalence of birth and perinatal complications are still high, possibly due to anomalous cord insertion. So far, anomalous cord insertion lacks proper attention in different medical settings. Hence, the present study aims to assess the magnitude, risk factors, and adverse birth outcomes of marginal cord insertion among singleton births. Methods An institution-based cross-sectional study design was conducted. A systematic random sampling technique was used to select study participants. Data were collected by using a structured questionnaire and it was entered into epi-data version 3.1 then exported to SPSS version 20 for data cleansing and analysis. Bi-variable and multivariable logistic regressions were employed to identify risk factors and adverse outcomes associated with marginal cord insertions. Crude and adjusted odds ratio (P-value < 0.05) with a 95% confidence interval were calculated. Result The magnitude of marginal cord insertion was 6.4% (95% CI = 4.4–8.8%) in singleton pregnancies. Independent risk factors for marginal cord insertion were advanced maternal age (AOR = 2.24, 95% CI: 1.35–11.08), primiparity (AOR = 1.98, 95% CI: 1.37–8.69), maternal chronic hypertension (AOR = 3.07, 95% CI: 1.66–9.76), previous cesarean delivery (AOR = 2.51, 95% CI: 1.43–10.21), and use of intrauterine contraceptive device before pregnancy (AOR = 2.22, 95% CI: 1.36–12.30). Pregnancies complicated by marginal cord insertion are at higher risk to develop low birth weight (AOR = 2.89, 95% CI: 1.23–6.80), preterm birth (AOR = 4.00, 95% CI: 1.44–11.14), and emergency cesarean delivery (AOR = 3.68, 95% CI: 1.03–13.81). Conclusion and recommendation Marginal cord insertion is a mistreated potential risk for low birth weight, preterm birth, and emergency cesarean delivery. Routine screening of marginal cord insertion should be considered in pregnancies with advanced age, nulliparity, hypertensive disorder, history of cesarean section, and intrauterine contraceptive device usage before pregnancy.

scholarly journals The Active Management of Impending Cephalopelvic Disproportion in Nulliparous Women at Term: A Case Series

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
James M. Nicholson ◽  
Lisa C. Kellar
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Birth Outcome ◽  
Mode Of Delivery ◽  
Case Series ◽  
Active Management ◽  
Optimal Time ◽  
Cephalopelvic Disproportion ◽  
Nulliparous Women ◽  
The Impact

Background. The Active Management of Risk in Pregnancy at Term (AMOR-IPAT) protocol has been associated in several studies with significant reductions of group cesarean delivery rate. Present within each of these studies were nulliparous women with risk factors for cephalopelvic disproportion. Risk factors for cephalopelvic disproportion in nulliparous women are especially important because they represent the precursors for the most common indication for primary cesarean delivery.Cases. Three examples of exposure of urban nulliparous women to the AMOR-IPAT protocol are presented. Each woman's risk factor profile for Cephalopelvic Disproportion (CPD) was used to estimate her Upper Limit of Optimal Time of Vaginal Delivery for CPD (UL-OTDcpd). Labor management and clinical outcomes for each case are presented. A simple table summarizing induction rates and birth outcome rates of exposed versus nonexposed nulliparous women is also presented.Conclusion. Because the mode of delivery of the first birth substantially impacts birth options in later pregnancies, the impact of AMOR-IPAT on nulliparous patients is particularly important. Determining the UL-OTDcpd in nulliparous patients, and carefully inducing each patient who has not entered labor by her UL-OTDcpd, may be an effective way of lowering rates of cesarean delivery in nulliparous women.

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