scholarly journals Pregnancy and delivery after pelvic fracture in fertile-aged women: A nationwide population-based cohort study in Finland

Author(s):  
Matias Vaajala ◽  
Ilari Kuitunen ◽  
Lauri Nyrhi ◽  
Ville Ponkilainen ◽  
Maiju Kekki ◽  
...  
2017 ◽  
Vol 76 (11) ◽  
pp. 1809-1814 ◽  
Author(s):  
Katarina Remaeus ◽  
Kari Johansson ◽  
Johan Askling ◽  
Olof Stephansson

ObjectivesReports on pregnancy outcomes among women with juvenile onset arthritis (JIA) have been few and small. The aim of this study was to assess pregnancy outcomes in a large and contemporary cohort of women diagnosed with JIA.MethodsIn a nationwide Swedish population-based cohort study between 1992 and 2011, we identified 1807 births among women with JIA and 1 949 202 control births. Since JIA is a heterogenic condition, births to women with JIA was divided into JIA paediatric only (n=1169) and JIA persisting into adulthood (n=638). ORs and 95% CIs were estimated with generalised estimating equations.ResultsWomen with JIA were at increased risk of preterm birth, especially medically indicated, in both subgroups: adjusted OR (aOR) 1.74 (1.35–2.67) for JIA paediatric and aOR 4.12 (2.76–6.15) for JIA persisting into adulthood. JIA persisting into adulthood was associated with very preterm birth (aOR 3.14, 1.58–6.24), spontaneous preterm birth (aOR 1.63, 1.11–2.39), small for gestational age birth (aOR 1.84, 1.19–2.85), early-onset pre-eclampsia (aOR 6.28, 2.68–13.81) and late-onset pre-eclampsia (aOR 1.96, 1.31–2.91). Women with JIA paediatric only were at increased risk of delivery by caesarean section (aOR 1.42, 1.66–1.73) and induction of labour (aOR 1.45, 1.18–1.77).ConclusionsWe found increased risks of both maternal and infant complications among women with JIA confined to childhood and in women with JIA persistent into adulthood as compared with population controls. Pregnancies in women with JIA should thus be subject to increased surveillance during pregnancy and delivery.


Author(s):  
Tyrone G. Harrison ◽  
Shannon M. Ruzycki ◽  
Matthew T. James ◽  
Paul E. Ronksley ◽  
Kelly B. Zarnke ◽  
...  

2021 ◽  
Vol 184 (1) ◽  
pp. 19-28
Author(s):  
Alexander A Leung ◽  
Janice L Pasieka ◽  
Martin D Hyrcza ◽  
Danièle Pacaud ◽  
Yuan Dong ◽  
...  

Objective Despite the significant morbidity and mortality associated with pheochromocytoma and paraganglioma, little is known about their epidemiology. The primary objective was to determine the incidence of pheochromocytoma and paraganglioma in an ethnically diverse population. A secondary objective was to develop and validate algorithms for case detection using laboratory and administrative data. Design Population-based cohort study in Alberta, Canada from 2012 to 2019. Methods Patients with pheochromocytoma or paraganglioma were identified using linked administrative databases and clinical records. Annual incidence rates per 100 000 people were calculated and stratified according to age and sex. Algorithms to identify pheochromocytoma and paraganglioma, based on laboratory and administrative data, were evaluated. Results A total of 239 patients with pheochromocytoma or paraganglioma (collectively with 251 tumors) were identified from a population of 5 196 368 people over a period of 7 years. The overall incidence of pheochromocytoma or paraganglioma was 0.66 cases per 100 000 people per year. The frequency of pheochromocytoma and paraganglioma increased with age and was highest in individuals aged 60–79 years (8.85 and 14.68 cases per 100 000 people per year for males and females, respectively). An algorithm based on laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal) closely approximated the true frequency of pheochromocytoma and paraganglioma with an estimated incidence of 0.54 cases per 100 000 people per year. Conslusion The incidence of pheochromocytoma and paraganglioma in an unselected population of western Canada was unexpectedly higher than rates reported from other areas of the world.


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