Registered nurses are at increased risk of hospitalization for infectious diseases and perinatal complications: A population-based observational study

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.

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Association between hyperinsulinemia and increased risk of cancer death in nonobese and obese people: A population-based observational study

International Journal of Cancer ◽

10.1002/ijc.30729 ◽

2017 ◽

Vol 141 (1) ◽

pp. 102-111 ◽

Cited By ~ 40

Author(s):

Tetsuro Tsujimoto ◽

Hiroshi Kajio ◽

Takehiro Sugiyama

Keyword(s):

Observational Study ◽

Population Based ◽

Cancer Death ◽

Obese People ◽

Increased Risk ◽

Risk Of Cancer

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Association between same day discharge total knee and total hip arthroplasty and risks of cardiac/pulmonary complications and readmission: a population-based observational study

BMJ Open ◽

10.1136/bmjopen-2019-031260 ◽

2019 ◽

Vol 9 (12) ◽

pp. e031260 ◽

Cited By ~ 5

Author(s):

Jiabin Liu ◽

Nabil Elkassabany ◽

Jashvant Poeran ◽

Alejandro Gonzalez Della Valle ◽

David H Kim ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Observational Study ◽

Hip Arthroplasty ◽

Population Based ◽

Pulmonary Complications ◽

Unplanned Readmission ◽

Total Hip ◽

Increased Risk ◽

Same Day Discharge ◽

Total Knee

ObjectiveTo determine if same-day discharge total knee arthroplasty (TKA) or total hip arthroplasty (THA) is not associated with increased risk of unplanned readmission and adverse outcomes within 30 days of surgery.DesignThis is a population-based observational study.SettingPatients from 708 participating institutions who underwent primary TKA or primary THA between 2011 and 2017 were divided into three groups by length of stay (LOS 0, 1 and 2–3 days). All patients with LOS>3 days were excluded from the current study. Regression analysis and propensity score matching were performed.Data sourcesAmerican College of Surgeons—National Surgical Quality Improvement Programme database.Main outcomes and measuresPrimary outcomes included unplanned readmission and cardiac/pulmonary complications within 30 days of surgery.ResultsWe identified 226 481 TKA (LOS 0=3118, LOS 1=31 404, and LOS 2–3=1 91 959) and 140 557 THA patients (LOS 0=2652, LOS 1=29 617, and LOS 2–3=1 08 288). There were no differences in 30-day mortality. After adjusting for relevant covariates, LOS 0 (compared with LOS 1) was associated with higher odds of cardiac/pulmonary complications in both TKA (OR 1.95, 95% CI 1.20 to 3.16; 0.67% vs 0.37%) and THA (OR 1.96, 95% CI 1.05 to 3.64; 0.57% vs 0.26%). There were no statistical differences in unplanned readmissions between LOS 0 and LOS 1 groups in TKA (2.41% vs 2.31%) and THA (1.62% vs 2.04%).ConclusionsLOS 0 discharge after TKA and THA was associated with higher odds of cardiac/pulmonary complications compared with LOS 1 discharge. While the overall burden of complications is relatively low, until future studies can confirm or challenge our findings, a measured approach is advisable when recommending discharge of patients on the same day of surgery.

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Immune-Related and Inflammatory Conditions Likely Play a Role in the Development of Lymphoplasmacytic Lymphoma/Waldenström’s Macroglobulinemia

Blood ◽

10.1182/blood.v112.11.3758.3758 ◽

2008 ◽

Vol 112 (11) ◽

pp. 3758-3758

Author(s):

Sigurdur Y Kristinsson ◽

Magnus Bjorkholm ◽

Jill Koshiol ◽

Lynn R. Goldin ◽

Mary L. McMaster ◽

...

Keyword(s):

Infectious Diseases ◽

Large Population ◽

Population Based ◽

Birth Date ◽

Prior History ◽

Hospital Inpatient ◽

Lymphoplasmacytic Lymphoma ◽

Inflammatory Conditions ◽

Increased Risk ◽

History Of

Abstract Introduction: Certain autoimmune and infectious conditions are associated with increased risks of subtypes of non-Hodgkin lymphomas (NHL). A few prior studies suggest that chronic immune stimulation may particularly elevate risk for the NHL subtype lymphoplasmacytic lymphoma (LPL)/Waldenström’s macroglobulinemia (WM). To improve our understanding on the role of immune-related and inflammatory conditions in LPL/WM pathogenesis, we conducted a large population-based study including close to 2,500 LPL/WM patients diagnosed in Sweden and almost 10,000 matched controls. Methods: Using both the central Cancer registry and local hospital-based registries, we identified all LPL/WM patients diagnosed in Swedish hospitals 1958–2005. From the Swedish Population Registry we identified four matched controls per LPL/WM patient. Through data linkage with the central Inpatient registry, we gathered information on hospital inpatient discharges that listed autoimmune-, infectious-, and other inflammatory/allergic diseases present at least 1 year prior to LPL/WM. Using Poisson regression, we calculated rate ratios (RR) and 95% confidence intervals (CI) adjusted for categorical year of birth, date of diagnosis, gender, and county. Results: A total of 2,470 LPL/WM patients (647 LPL and 1,823 WM), and 9,698 population-based matched controls were included in the study. We found an increased risk of developing LPL/WM among individuals with a prior history of systemic sclerosis (RR=4.7; 1.4–15.3), Sjögren’s syndrome (RR=12.1; 3.3–45.0), autoimmune hemolytic anemia (AIHA) (RR=24.2; 5.4–108.2), polymyalgia rheumatica (RR=2.9; 1.6–5.2), and temporalis arteritis (RR=8.3; 2.1–33.1). We also found excess risk of LPL/WM among persons with a history of pneumonia (RR=1.4; 1.1–1.7), septicaemia (RR=2.4; 1.2–4.3), pyelonephritis (RR=1.7; 1.1–2.5), sinusitis (RR=2.7; 1.4–4.9), herpes zoster (RR=3.4; 2.0–5.6), and influenza (RR=2.9; 1.7–5.0). Importantly, when we assessed the associations by latency (time between immune-related or inflammatory conditions and LPL/WM), for most autoimmune- and infectious diseases the excess LPL/WM risk remained significant at >5 years latency. We found no significant increased risk for LPL/WM among individuals with prior chronic inflammatory or allergic conditions. Conclusions: In the largest investigation of risk factors for LPL/WM to date, we found a personal history of certain autoimmune and infectious diseases to be associated with excess LPL/WM risk. Immune-related conditions might act as potential LPL/WM triggers or they could represent premalignant immune disruptions preceding LPL/WM. Our results provide novel insights into the as yet unclear pathogenesis of LPL/WM.

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Prenatal and Perinatal Factors Associated with Isolated Oral Clefting

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2002_039_0370_papfaw_2.0.co_2 ◽

2002 ◽

Vol 39 (3) ◽

pp. 370-375 ◽

Cited By ~ 8

Author(s):

Diego F. Wyszynski ◽

Tianxia Wu

Keyword(s):

Gestational Age ◽

Large Population ◽

Fetal Monitoring ◽

Hyaline Membrane Disease ◽

Population Based ◽

Assisted Ventilation ◽

Perinatal Complications ◽

Increased Risk ◽

Electronic Fetal Monitoring ◽

Potential Risk Factors

Objective: To describe medical service utilization and maternal morbid conditions of women who carry offspring with oral clefts (OCs), to describe maternal and offspring complications during birth, and to evaluate postnatal characteristics of their newborns with isolated OCs. Methods: Two thousand four hundred thirty-seven patients with isolated OCs and 4871 unaffected matched controls meeting inclusion criteria were selected from the U.S. Natality database for 1997. Matching variables were mother's and father's race and child's race, sex, county of birth, and month of birth. Patients and controls were compared in terms of maternal demographic characteristics, gestational complications, physical characteristics of the newborns, maternal exposure to potential risk factors, and adequacy of prenatal care. Results: Although the quality of care was very good in both groups, low gestational age, low birth weight, and low 5-minute Apgar score are more frequent among newborns with OCs than in unaffected controls. Mothers of offspring with OCs are at increased risk, compared with mothers of controls, of having hydramnios or oligohydramnios, eclampsia, and abruptio placenta. Obstetric procedures, such as amniocentesis, electronic fetal monitoring, induction of labor, tocolysis, and ultrasound, and repeat cesarean deliveries are more frequent among mothers of patients than those of controls. At birth, new-borns with isolated OCs are at risk of having hyaline membrane disease and of requiring assisted ventilation, independently of gestational age. Conclusion: The results of this large population-based, case-control study suggest that the presence of an OC in the offspring is associated with increased risk for prenatal and perinatal complications in the mother.

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Perinatal Outcomes of Women Aged 50 Years and Above

American Journal of Perinatology ◽

10.1055/s-0039-1700859 ◽

2019 ◽

Vol 37 (01) ◽

pp. 079-085 ◽

Cited By ~ 1

Author(s):

Erez Maoz-Halevy ◽

Gali Pariente ◽

Eyal Sheiner ◽

Tamar Wainstock

Keyword(s):

Cesarean Delivery ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Medical Center ◽

Perinatal Outcomes ◽

Population Based ◽

Perinatal Complications ◽

Apgar Scores ◽

Logistic Regression Models ◽

Increased Risk

Abstract Objective Pregnancies among women aged 40 and above are increasing in frequency. Nevertheless, little is known about the perinatal outcomes of women aged 50 years and above. The purpose of the study was to evaluate pregnancy outcomes in women at an extremely advanced maternal age of 50 years or above. Study Design In a population-based cohort study, perinatal outcomes of women aged 50 years and above were compared with pregnancies in women according to maternal age. All singleton deliveries that occurred between the years 1991 and 2014 in a tertiary medical center were included. We excluded fetuses with congenital anomalies and chromosomal abnormality. Logistic regression models were used to control for confounders. Results During the study period, 242,771 deliveries were included, of which 234,824 (96.7%) occurred in women aged < 40 years, 7,321 (3.0%) in women aged 40 to 44 years, 558 (0.2%) in women aged 45 to 49 years, and 68 (0.03%) in women aged 50 years and above. Maternal age of 50 years and above was noted as an independent risk factor for gestational diabetes mellitus (GDM), low Apgar scores, and cesarean delivery. Nevertheless, among pregnancies of women aged 50, pregnancy outcomes including GDM, preterm delivery, cesarean delivery, lower Apgar scores at 5 minutes (<7), and perinatal mortality were not significantly different than pregnancy outcomes of women aged 40 to 49 years. Conclusion Pregnancy at the maternal age of 50 years and older is independently associated with higher rates of GDM, cesarean delivery, and lower Apgar scores at 5 minutes; however, most perinatal complications were not higher compared with pregnant women aged 40 to 49 years. These findings suggest that while there is an increased risk of perinatal complications in pregnancies of women aged 40 years or above compared with younger women, there are no significant increased risks in women aged over 50 years.

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Maternal Smoking during Pregnancy and the Risk for Childhood Infectious Diseases in the Offspring: A Population-Based Cohort Study

American Journal of Perinatology ◽

10.1055/s-0039-1695773 ◽

2019 ◽

Cited By ~ 1

Author(s):

Nadav Dan ◽

Eyal Sheiner ◽

Tamar Wainstock ◽

Kyla Marks ◽

Roy Kessous

Keyword(s):

Infectious Diseases ◽

Maternal Smoking ◽

Cohort Analysis ◽

Population Based ◽

Upper Respiratory Tract ◽

Smoking During Pregnancy ◽

Infectious Morbidity ◽

Increased Risk ◽

Maternal Smoking During Pregnancy

Objective Infectious diseases account for up to 43% of childhood hospitalizations. Given the magnitude of infection-related hospitalizations, we aimed to evaluate the effect of maternal smoking during pregnancy on the risk for long-term childhood infectious morbidity. Study Design This is a population-based cohort analysis comparing the long-term risk for infectious diseases, in children born to mothers who smoked during pregnancy versus those who did not. Infectious diseases were predefined based on International Classification of Diseases, Ninth Revision codes. Deliveries occurred between the years 1991 and 2014. Results A total of 246,854 newborns met the inclusion criteria; 2,986 (1.2%) were born to mothers who smoked during pregnancy. Offspring of smokers had significantly higher risk for several infectious diseases during childhood (upper respiratory tract, otitis, viral infections, and bronchitis) as well as increased risk for total infection-related hospitalizations (odds ratio = 1.5, 95% confidence interval [CI]: 1.3–1.7; p = 0.001). Cumulative incidence of infection-related hospitalizations was significantly higher in offspring of smokers (log-rank test, p = 0.001). Controlling for maternal age, diabetes, hypertensive disorders, and gestational age at index delivery, smoking remained an independent risk factor for infectious diseases during childhood (adjusted hazard ratio = 1.5, 95% CI: 1.3–1.6; p = 0.001). Conclusion Intrauterine exposure to maternal smoking may create an environment leading to an increased future risk for long-term pediatric infectious morbidity of the offspring.

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