Prenatal and postnatal risk factors for infantile pneumonia in a representative birth cohort

2011 ◽  
Vol 140 (7) ◽  
pp. 1277-1285 ◽  
Author(s):  
C. H. CHEN ◽  
H. J. WEN ◽  
P. C. CHEN ◽  
S. J. LIN ◽  
T. L. CHIANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family Environment ◽  
Large Population ◽  
Multivariate Logistic Regression Analysis ◽  
Antibiotic Use ◽  
Population Based ◽  
Study Cohort ◽  
Mortality And Morbidity ◽  
Smoking During Pregnancy ◽  
Maternal Overweight

SUMMARYPneumonia is an important cause of mortality and morbidity in infants. However, information of risk factors for pneumonia in children aged <6 months is limited. This study aimed to evaluate the risk factors and their contribution to infantile pneumonia in a large population-based survey. Of 24 200 randomly sampled main caregivers invited, 21 248 (87·8%) participated in this study. A structured questionnaire was used to interview the main caregivers. Information regarding whether hospitalization was required, family environment, and medical history were obtained. The prevalence of pneumonia was 0·62% in our study cohort. Multivariate logistic regression analysis showed that preterm birth, congenital cardiopulmonary disease, antibiotic use during pregnancy, maternal overweight, daily prenatal exposure to environmental tobacco smoke, maternal smoking during pregnancy, and visible mould on walls at home are risk factors associated with infantile pneumonia. Further study is warranted to investigate the causality and mechanisms of these novel factors.

scholarly journals Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5865
Author(s):  
Salma Younes ◽  
Muthanna Samara ◽  
Rana Al-Jurf ◽  
Gheyath Nasrallah ◽  
Sawsan Al-Obaidly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Population Based ◽  
Incidence Rates ◽  
Large For Gestational Age ◽  
Mortality And Morbidity ◽  
Early Term ◽  
Incidence Risk

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.

scholarly journals Adjuvant Hormonotherapy and Cardiovascular Risk in Post-Menopausal Women with Breast Cancer: A Large Population-Based Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2254
Author(s):  
Matteo Franchi ◽  
Roberta Tritto ◽  
Luigi Tarantini ◽  
Alessandro Navazio ◽  
Giovanni Corrao
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Adjuvant Therapy ◽  
Large Population ◽  
Positive Association ◽  
Population Based ◽  
Study Cohort ◽  
Increased Risk ◽  
Post Menopausal ◽  
New Diagnosis

Background: Whether aromatase inhibitors (AIs) increase the risk of cardiovascular (CV) events, compared to tamoxifen, in women with breast cancer is still debated. We evaluated the association between AI and CV outcomes in a large population-based cohort of breast cancer women. Methods: By using healthcare utilization databases of Lombardy (Italy), we identified women ≥50 years, with new diagnosis of breast cancer between 2009 and 2015, who started adjuvant therapy with either AI or tamoxifen. We estimated the association between exposure to AI and CV outcomes (including myocardial infarction, ischemic stroke, heart failure or any CV event) by a Cox proportional hazard model with inverse probability of treatment and censoring weighting. Results: The study cohort included 26,009 women starting treatment with AI and 7937 with tamoxifen. Over a median follow-up of 5.8 years, a positive association was found between AI and heart failure (Hazard Ratio = 1.20, 95% CI: 1.02 to 1.42) and any CV event (1.14, 1.00 to 1.29). The CV risk increased in women with previous CV risk factors, including hypertension, diabetes and dyslipidemia. Conclusions: Adjuvant therapy with AI in breast cancer women aged more than 50 years is associated with increased risk of heart failure and combined CV events.

scholarly journals A population-based exposure assessment of risk factors associated with gastrointestinal pathogens: a Campylobacter study

2012 ◽  
Vol 141 (5) ◽  
pp. 976-986 ◽  
Author(s):  
L. A. MacRITCHIE ◽  
C. J. HUNTER ◽  
N. J. C. STRACHAN
Keyword(s):  
Risk Factors ◽  
Population Density ◽  
Exposure Assessment ◽  
Disease Incidence ◽  
Univariate Analysis ◽  
Age Groups ◽  
Multivariate Logistic Regression Analysis ◽  
Environmental Water ◽  
Population Based ◽  
Elevated Exposure

SUMMARYA questionnaire survey was undertaken to determine the exposure of a study population to campylobacteriosis source risk factors (environmental, water, food) and results were stratified by age, population density and deprivation. Data were gathered using an exposure assessment carried out by telephone in the Grampian region of Scotland. Univariate analysis showed that children aged 5–14 years, living in low population density (0–44·4 persons/km2) and affluent areas had elevated exposure to environmental and water risk factors. Multivariate logistic regression analysis revealed that younger age groups and lower population density were significant indicators for most environmental risk factors. The results compared to reported disease incidence in Grampian showed that greater exposure to risk factors does not necessarily coincide with greater disease incidence for age groups, particularly for the 0–4 years age group. Further research is required to explain the relationship between exposure and disease incidence.

scholarly journals Primary Care Consultations after Hospitalisation for Pneumonia: A Large Population-based Cohort Study

2020 ◽  
pp. BJGP.2020.0890
Author(s):  
Vadsala Baskaran ◽  
Fiona Pearce ◽  
Rowan H Harwood ◽  
Tricia McKeever ◽  
Wei Shen Lim
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Large Population ◽  
Significant Proportion ◽  
Antibiotic Use ◽  
Population Based ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Respiratory Disorder ◽  
The Impact

Background: Up to 70% of patients report ongoing symptoms four weeks after hospitalisation for pneumonia, and the impact on primary care is poorly understood. Aim: To investigate the frequency of primary care consultations after hospitalisation for pneumonia, and the reasons for consultation. Design: Population-based cohort study. Setting: UK primary care database of anonymised medical records (Clinical Practice Research Datalink, CPRD) linked to Hospital Episode Statistics (HES), England. Methods: Adults with the first ICD-10 code for pneumonia (J12-J18) recorded in HES between July 2002-June 2017 were included. Primary care consultation within 30 days of discharge was identified as the recording of any medical Read code (excluding administration-related codes) in CPRD. Competing-risks regression analyses were conducted to determine the predictors of consultation and antibiotic use at consultation; death and readmission were competing events. Reasons for consultation were examined. Results: Of 56,396 adults, 55.9% (n=31,542) consulted primary care within 30 days of discharge. The rate of consultation was highest within 7 days (4.7 per 100 person-days). The strongest predictor for consultation was a higher number of primary care consultations in the year prior to index admission (adjusted sHR 8.98, 95% CI 6.42-12.55). The commonest reason for consultation was for a respiratory disorder (40.7%, n=12,840), 12% for pneumonia specifically. At consultation, 31.1% (n=9,823) received further antibiotics. Penicillins (41.6%, n=5,753) and macrolides (21.9%, n=3,029) were the commonest antibiotics prescribed. Conclusion: Following hospitalisation for pneumonia, a significant proportion of patients consulted primary care within 30 days, highlighting the morbidity experienced by patients during recovery from pneumonia.

Abstract 16663: Premature Ventricular Contractions and Incident Heart Failure: Identifying Risk Factors via Interaction Analyses

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Vratika Agarwal ◽  
Eric Vittinghoff ◽  
Isaac R Whitman ◽  
Thomas A Dewland ◽  
Jonathan Dukes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Case Reports ◽  
Large Population ◽  
Premature Ventricular Contraction ◽  
Fold Increase ◽  
Population Based ◽  
P Value ◽  
Premature Ventricular Contractions ◽  
Younger Patients

Introduction: Premature ventricular contraction (PVC)-induced cardiomyopathy is a potentially reversible cause of heart failure (HF). The association between PVCs and HF has been limited to case reports and small observational studies. Our objective was to leverage a large population-based database to examine interactions that might prove clinically useful in risk stratification. Methods: We included adult patients free of structural heart disease in the California Healthcare Cost and Utilization Project (HCUP) database from 2005-2009. After excluding patients with prevalent cardiomyopathy or heart failure, we identified patients with a diagnosis of PVCs. The primary outcome was incident systolic HF. Results: Among 16.8 million patients experiencing 48.1 million hospitalizations, 35,817 (0.2%) had a PVC diagnosis, and 198,818 (1.2%) developed systolic HF during study follow-up. After adjustment for age, sex, race, income & known HF risk factors, PVCs were an independent predictor of systolic HF [Hazard Ratio (HR) 1.57, 95% CI 1.51-1.63, p-value<0.001]. Interaction analyses revealed that relationship between PVCs and incident systolic HF was especially strong among younger patients and in those without coronary artery disease (CAD), hypertension (HTN), diabetes mellitus (DM) or atrial fibrillation (AF) [Table 1]. In patients <65 years without HTN, DM, CAD or AF, a PVC diagnosis was associated with an over 6-fold increase in incident HF risk (HR 6.5, 95% CI 5.5-7.7, p<0.001). Conclusion: Using a large population-based database, we found that a diagnosis of PVCs predicts incident systolic HF even after adjusting for conventional risk factors. This effect is most pronounced in younger patients, and those without HTN, DM, CAD or AF, suggesting that PVCs impart the greatest risk for heart failure when other cardiac comorbidities are absent.

Incidence and risk factors for dysglycaemia in Asian-Indians: a 10-year population-based prospective cohort study

2021 ◽  
pp. postgradmedj-2021-141243
Author(s):  
Rahul Gupta ◽  
Satyam Singh Jayant ◽  
Ashu Rastogi ◽  
Sanjay K Bhadada ◽  
Anil Bhansali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Asian Indians ◽  
Sedentary Lifestyle ◽  
Population Based ◽  
Incidence Rates ◽  
Study Cohort ◽  
Family History Of Diabetes ◽  
High Incidence ◽  
History Of ◽  
East Asia Region

BackgroundDiabetes prevalence estimates suggest an increasing trend in South-East Asia region, but studies on its incidence are limited. The current study aims to estimate the incidence of type 2 diabetes and pre-diabetes in a population-based cohort from India.MethodsA subset of Chandigarh Urban Diabetes Study cohort (n=1878) with normoglycaemia or pre-diabetes at baseline was prospectively followed after a median of 11 (0.5–11) years. Diabetes and pre-diabetes were diagnosed as per WHO guidelines. The incidence with 95% CI was calculated in 1000 person-years and Cox proportional hazard model was used to find the association between the risk factors and progression to pre-diabetes and diabetes.ResultsThe incidence of diabetes, pre-diabetes and dysglycaemia (either pre-diabetes or diabetes) was 21.6 (17.8–26.1), 18.8 (14.8–23.4) and 31.7 (26.5–37.6) per 1000 person-years, respectively. Age (HR 1.02, 95% CI 1.01 to 1.04), family history of diabetes (HR 1.56, 95% CI 1.09 to 2.25) and sedentary lifestyle (HR 1.51, 95% CI 1.05 to 2.17) predicted conversion from normoglycaemia to dysglycaemia, while obesity (HR 2.43, 95% CI 1.21 to 4.89) predicted conversion from pre-diabetes to diabetes.ConclusionA high incidence of diabetes and pre-diabetes in Asian-Indians suggests a faster conversion rate to dysglycaemia, which is partly explained by sedentary lifestyle and consequent obesity in these individuals. The high incidence rates call for a pressing need for public health interventions targeting modifiable risk factors.

Abstract P302: Ethnic Difference of Cardiorespiratory Fitness and Related to Factors in Young Adults: The Nhanes 1999-2004

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Hong Seok LEE ◽  
Zhiwei Zhang ◽  
Karen Xu ◽  
Yong-Moon Park
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiorespiratory Fitness ◽  
Mexican Americans ◽  
Mexican American ◽  
Population Based ◽  
Cardiopulmonary Fitness ◽  
Mortality And Morbidity ◽  
Fitness Level

Background: Cardiorespiratory fitness is a distinct health characteristic that relates to the ability to perform physical activity. Higher cardiorespiratory fitness was reported to have reverse relationship with overall mortality and morbidity rates due to various chronic disease. The assessment of cardiorespiratory fitness was measured by maximal oxygen uptake (VO2max; mL/kg/minute) on a submaximal treadmill test. This study was aimed to examine cardiorespiratory fitness among U.S. adults 20-49 years of age, to describe the distribution of cardiorespiratory fitness and cardiovascular risk factors depends on different ethnicity for without physical limitations or indications of cardiovascular disease. Method: Data from the 1999-2004, National Health and Nutrition Examination Survey were used to describe the distribution of cardiorespiratory fitness for adults 20-49 years of age. 8324 out of 31126 subjects have valid values of cardiopulmonary fitness in the dataset with 5391 in low category of cardiorespiratory fitness (VO 2 max < 27), 2606 in medium category (37.1 > VO 2 max ≥27) and 327 in high category (37.1 ≥ VO 2 max). The risk factors for cardiopulmonary fitness was assessed by using logistic regression after adjusting all cardiovascular risk factors. All data were analyzed using SAS Ver. 9.4. Result: Overall, there is no significant association of cardiorespiratory fitness with ethnicity ( P =0.08). 65.9% of study population was male in all races. Among, non-Hispanic whites, those with 25 m 2 /kg > BMI had better cardiorespiratory fitness (more than 37.1 mL/kg/minute) than those with BMI ≥ 35 [Odds ratio (OR): 0.496, Confidence Interval (CI): 0.258-0.957]. A similar pattern was observed for Mexican Americans. Non-Hispanic black with 25 m 2 /kg > BMI had better cardiorespiratory fitness than ones with BMI ≥ 35 m 2 /kg [OR:0.137, CI:0.059-0.318], 35 m 2 /kg > BMI≥30 m 2 /kg [OR:0.269, CI:0.124-0.583], 30 m 2 /kg > BMI≥25 m 2 /kg [OR: 0.241,0.123-0.318]. Non-Hispanic white with higher diastolic blood pressure over 90 mmHg had tendency to have lower cardiorespiratory fitness. Among metabolic panel, only Mexican American with LDL<100 mg/dl has higher cardiorespiratory fitness [OR:0.559, CI:0.319-0.981]. Discussion: Our findings on cardiorespiratory fitness level among non-Hispanic blacks, non-Hispanic whites and Mexican Americans are similar to previously reported studies, however, non-Hispanic black had different risk factors related to cardiorespiratory fitness, especially significant benefit from lower BMI less than 25 m 2 /kg since other ethnicities with BMI less than 25 m 2 /kg had benefit only compared to BMI> 35 m 2 /kg. These results can be used to improve cardiorespiratory fitness level for future population based on ethnicities. The different risk factors in fitness status can also be used to develop health policies and targeted educational campaigns.

Socioeconomic Status and Orofacial Clefts in Scotland, 1989 to 1998

2003 ◽  
Vol 40 (5) ◽  
pp. 481-485 ◽  
Author(s):  
J. D. Clark ◽  
P. A. Mossey ◽  
L. Sharp ◽  
J. Little
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Cleft Lip ◽  
Population Based ◽  
Orofacial Clefts ◽  
Smoking During Pregnancy ◽  
Live Births ◽  
Strong Positive Relationship ◽  
The Relationship ◽  
Deprived Areas

Objective The purpose of this study was to investigate the association between socioeconomic status and orofacial clefts (OFC) in Scotland. Design Study of prevalence at birth over a 10-year period using an area-based measure of material deprivation. Setting Population-based study throughout Scotland. Participants Eight hundred thirty-four live births with OFC born between January 1, 1989, and December 31, 1998, ascertained from the nationwide register of the Cleft Service in Scotland, compared with the total 603,825 live births in Scotland in this period. Results There was a strong positive relationship whereby the prevalence of OFC at birth increased with increasing deprivation. This trend was statistically significant for cleft lip and/or palate (CL[P]: p = .016) but not for cleft palate (CP; p = .078). For each type of cleft, the relative risk among those resident in the most deprived areas, compared with those resident in the least deprived areas, was 2.33. Conclusions The association between OFC and socioeconomic status is consistent with a report for an earlier period in a smaller part of Scotland. Unlike the earlier study, this pattern appears to be stronger for CL(P) than for CP. These observations do not appear to be an artifact of recording. It is possible that they reflect the association between deprivation and risk factors for OFC, most likely tobacco smoking during pregnancy. Because the relationship between OFC and socioeconomic status appears to have been virtually unstudied in other populations, it would be valuable to investigate this relationship elsewhere and determine whether known risk factors account for the relationship.

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