scholarly journals The prevalence and consequences of abdominal rectus muscle diastasis among Finnish women: an epidemiological cohort study

Hernia ◽  
2021 ◽  
Author(s):  
R. Tuominen ◽  
T. Jahkola ◽  
T. Saisto ◽  
J. Arokoski ◽  
J. Vironen
Keyword(s):  
Cohort Study ◽  
Back Pain ◽  
Early Pregnancy ◽  
University Hospital ◽  
Normative Values ◽  
Female Population ◽  
Linea Alba ◽  
Nulliparous Women ◽  
Rectus Diastasis ◽  
Abdominal Rectus Muscle

Abstract Purpose Post-pregnancy abdominal rectus diastasis (ARD) has raised attention in the field of surgery in recent years, but there is no consensus about when to consider surgery. Our aim was to find out what is the normal inter-rectus distance in fertile aged, female population in Finland and to examine whether there is a linea alba width that would predispose to diastasis-related problems after pregnancy. Methods For this prospective cohort study, women participating early pregnancy ultrasound in Helsinki University Hospital Department of Obstetrics and Gynecology during 1.1.2018–8.3.2019, were recruited. The width of linea alba was measured by ultrasound during the early pregnancy ultrasound. Symptoms were measured by questionnaire including Health-Related Quality of Life (RAND-36) and Oswestry Disability Index for back symptoms and disability. Results Linea alba width was measured in total of 933 women. The average inter-rectus distance (IRD) among nulliparous women was 1.81 ± 0.72 cm. After one previous pregnancy, the average linea alba width was 2.36 cm ± 0.83 cm and after more pregnancies 2.55 ± 1.09 cm. There was a positive correlation between previous pregnancies and the increased linea alba width (p = 0.00004). We did not perceive any threshold value of linea alba width that would predispose to back pain or movement control problems in this cohort, in which severe diastasis (over 5 cm) was rare. Conclusion Mean inter-rectus distance in parous population exceeds stated normative values. Moderate ARD (3.0–5.0 cm) alone does not seem to explain low back pain or functional disability in population level. Severe post-pregnancy diastasis (over 5.0 cm) is rare.

scholarly journals Impact factors on fetal descent rates in the active phase of labor: a retrospective cohort study

2018 ◽  
Vol 46 (6) ◽  
pp. 579-585 ◽  
Author(s):  
Nina Kimmich ◽  
Jana Juhasova ◽  
Christian Haslinger ◽  
Nicole Ochsenbein-Kölble ◽  
Roland Zimmermann
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Total Duration ◽  
Active Phase ◽  
University Hospital ◽  
Impact Factors ◽  
Nulliparous Women ◽  
Vaginal Deliveries ◽  
Multiparous Women

Abstract Aim: To assess fetal descent rates of nulliparous and multiparous women in the active phase of labor and to evaluate significant impact factors. Methods: In a retrospective cohort study at the University Hospital of Zurich, Switzerland, we evaluated 6045 spontaneous vaginal deliveries with a singleton in vertex presentation between January 2007 and July 2014 at 34 0/7 to 42 0/7 gestational weeks. Median fetal descent rates and their 10th and 90th percentiles were assessed in the active phase of labor and different impact factors were evaluated. Results: Fetal descent rates are exponentially increasing. Nulliparous women have slower fetal descent than multiparous women (P<0.001), ranging from 0 to 5.81 cm/h and from 0 to 15 cm/h, respectively. The total duration of fetal descent in labor is 5.42 h for nulliparous and 2.71 h for multiparous women. Accelerating impact factors are a lower fetal station, multiparity, increasing maternal weight and fetal occipitoanterior position, whereas epidural anesthesia decelerates fetal descent (P<0.001). Conclusions: Fetal descent is a hyperbolic increasing process with faster descent in multiparous women compared to nulliparous women, is highly inter individual and is associated with different impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates as well as on individual evaluation of every parturient.

scholarly journals Clinical risk assessment in early pregnancy for preeclampsia in nulliparous women: A population based cohort study

PLoS ONE ◽  
2019 ◽  
Vol 14 (11) ◽  
pp. e0225716 ◽  
Author(s):  
Anna Sandström ◽  
Jonathan M. Snowden ◽  
Jonas Höijer ◽  
Matteo Bottai ◽  
Anna-Karin Wikström
Keyword(s):  
Risk Assessment ◽  
Cohort Study ◽  
Early Pregnancy ◽  
Population Based ◽  
Clinical Risk ◽  
Nulliparous Women ◽  
Clinical Risk Assessment

scholarly journals Social, biological, behavioural and psychological factors related to physical activity during early pregnancy in the Screening for Pregnancy Endpoints (Cork, Ireland) cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025003 ◽  
Author(s):  
Caragh Flannery ◽  
Darren Dahly ◽  
Molly Byrne ◽  
Ali Khashan ◽  
Sheena McHugh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Early Pregnancy ◽  
Psychological Factors ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
Socioeconomic Background ◽  
Logistic Regression Models ◽  
Nulliparous Women

ObjectiveThe aim of this study was to identify the social, biological, behavioural and psychological factors related to physical activity (PA) in early pregnancy.DesignThis is a secondary analysis of data from a prospective cohort study.SettingThe study was conducted in Cork, Ireland.ParticipantsNulliparous women with singleton pregnancies were recruited and then interviewed at 15±1 weeks’ gestation.Primary and secondary outcomesThe biopsychosocial model identified factors including social (age), biological (body mass index), behavioural (diet) and psychological (anxiety) at 15±1 weeks’ gestation. PA subgroups were identified based on a latent class analysis of their responses to a set of questions about the amount and intensity of activity they were engaging in during the pregnancy. Associations were estimated with multivariable multinomial logistic regression models.ResultsFrom a total of 2579, 1774 (69%) women were recruited; ages ranged from 17 to 45 years. Based on a combination of model fit, theoretical interpretability and classification quality, the latent class analyses identified three PA subgroups:lowPA (n=393),moderatePA (n=960) andhighPA (n=413). The fully adjusted model suggests non-smokers, and consumers of fruit and vegetables were more likely to be in the high PA subgroup (vs low). Women with more than 12 years of schooling and a higher socioeconomic status were more likely to be in the moderate PA subgroup (vs low).ConclusionThe findings highlight potential links between PA, a low education level and a low socioeconomic background. These factors should be considered for future interventions to improve low PA levels during pregnancy.Trial registration numberACTRN 12607000551493.

scholarly journals Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital

2021 ◽  
Vol 18 (14) ◽  
pp. 7528
Author(s):  
Nagham Khanafer ◽  
Philippe Vanhems ◽  
Sabrina Bennia ◽  
Géraldine Martin-Gaujard ◽  
Laurent Juillard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Good Clinical Practice ◽  
University Hospital ◽  
Factors Associated ◽  
Contact Precautions ◽  
Institutional Review ◽  
Virulent Strains ◽  
Scientific Meetings ◽  
Hospital Acquired

Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from C. difficile infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by C. difficile and CDI. Methods and analysis: We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyon, France. All consecutive adult patients admitted on selected units are eligible to participate in the study. Stool samples or rectal swabs for C. difficile testing are obtained on admission, every 3–5 days during hospitalization, at the onset of diarrhea (if applicable), and at discharge. Descriptive and logistic regression analyses will be completed to mainly estimate the proportion of asymptomatic colonization at admission, and to evaluate differences between factors associated with colonization and those related to CDI. Ethics: The study is conducted in accordance with the ethical principles of the Declaration of Helsinki, French law, and the Good Clinical Practice guidelines. The study protocol design was approved by the participating units, the ethics committee and the hospital institutional review board (Comité de protection des personnes et Comission Nationale de l’Informatique et des Libertés; N°: 00009118). Dissemination: The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI.

scholarly journals Changes in physical activity across pregnancy among Chinese women: a longitudinal cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Lü ◽  
Yahui Feng ◽  
Shuai Ma ◽  
Yu Jiang ◽  
Liangkun Ma
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Early Pregnancy ◽  
Chinese Women ◽  
Short Form ◽  
Late Pregnancy ◽  
Population Characteristics ◽  
Central China ◽  
Dominant Form ◽  
Activity Questionnaire

Abstract Background Sufficient physical activity (PA) during pregnancy is beneficial for a woman’s health; however, the PA levels of Chinese women at different pregnancy stages are not clear. The aim of our study was to investigate PA changes during pregnancy and the association of population characteristics with PA change among Chinese women. Methods Data were obtained from 2485 participants who were enrolled in the multicentre prospective Chinese Pregnant Women Cohort Study. PA level was assessed in early pregnancy (mean = 10, 5–13 weeks of gestation) and again in mid-to-late pregnancy (mean = 32, 24–30 weeks of gestation) using the International Physical Activity Questionnaire short form (IPAQ-SF). Sufficient PA (≥ 600 MET min/week) in early pregnancy and insufficient PA in mid-to-late pregnancy indicated decreasing PA. Insufficient PA in early pregnancy and sufficient PA in mid-to-late pregnancy indicated increasing PA. The associations between demographic, pregnancy and health characteristics and PA changes were examined by multivariable logistic regression. Results Total energy expenditure for PA increased significantly from early (median = 396 MET min/week) to mid-to-late pregnancy (median = 813 MET min/week) (P < 0.001), and 55.25% of the participants eventually had sufficient PA. Walking was the dominant form of PA. Women with sufficient PA levels in early pregnancy were more likely to have sufficient PA in mid-to-late pregnancy (OR 1.897, 95% CI 1.583–2.274). Women in West China and those in Central China were most and least likely, respectively, to have increasing PA (OR 1.387, 95% CI 1.078–1.783 vs. OR 0.721, 95% CI 0.562–0.925). Smoking was inversely associated with increasing PA (OR 0.480, 95% CI 0.242–0.955). Women with higher educational levels were less likely to have decreasing PA (OR 0.662, 95% CI 0.442–0.991). Conclusions PA increased as pregnancy progressed, and walking was the dominant form of PA among Chinese women. Further research is needed to better understand correlates of PA change.

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