scholarly journals Neonatal abstinence syndrome and early childhood morbidity and mortality in Washington state: a retrospective cohort study

2017 ◽  
Vol 37 (10) ◽  
pp. 1124-1129 ◽  
Author(s):  
C E Witt ◽  
K E Rudd ◽  
P Bhatraju ◽  
F P Rivara ◽  
S E Hawes ◽  
...  
Keyword(s):  
Early Childhood ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Washington State ◽  
Morbidity And Mortality ◽  
Neonatal Abstinence Syndrome ◽  
Abstinence Syndrome ◽  
Childhood Morbidity

Obstetric outcomes of pregnancy complicated by urolithiasis: a retrospective cohort study

2021 ◽  
Vol 49 (1) ◽  
pp. 54-59
Author(s):  
Emily K. Clennon ◽  
Bharti Garg ◽  
Brian D. Duty ◽  
Aaron B. Caughey
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Preterm Delivery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Gestational Hypertension ◽  
Neonatal Abstinence Syndrome ◽  
Obstetric Outcomes ◽  
Abstinence Syndrome ◽  
Increased Risk

AbstractObjectivesEvaluate the association between urolithiasis during pregnancy and obstetric outcomes outside the context of urological intervention.MethodsWe conducted a retrospective cohort study of singleton, non-anomalous gestations delivered at 23–42 weeks in California from 2007 to 2011. Maternal outcomes (preterm delivery [early (<32 weeks) and late (<37 weeks)], preeclampsia, gestational diabetes, cesarean deliveries, urinary tract infection [UTI] at delivery, chorioamnionitis, endomyometritis, and maternal sepsis) and newborn outcomes (seizure, respiratory distress syndrome, hypoglycemia, jaundice, and neonatal abstinence syndrome [NAS]) were compared using χ2-tests and multivariable logistic regression.ResultsA total of 2,013,767 pregnancies met inclusion criteria, of which 5,734 (0.28%) were complicated by urolithiasis. Stone disease during pregnancy was associated with 30% greater odds of each early (aOR 1.30; 95% CI 1.19–1.43) and late (aOR 1.29; 95% CI 1.18–1.41) preterm delivery. Cesarean delivery, UTI at delivery, gestational hypertension, gestational diabetes, preeclampsia, and sepsis were all significantly positively associated with urolithiasis. Odds of NAS (aOR 2.11; 95% CI 1.27–3.51) and jaundice were significantly greater in the neonates of stone-forming patients (aOR 1.08; 95% CI 1.01–1.16).ConclusionsUrolithiasis during pregnancy was associated with 30% greater odds of preterm delivery and increased risk of myriad metabolic, hypertensive, and infectious disorders of gestation. Neonates born to stone-forming patients were more than twice as likely to develop neonatal abstinence syndrome but did not have significantly greater odds of complications of prematurity.

scholarly journals Impact of the COVID-19 pandemic on the outcome, morbidity, and mortality of acute care surgery patients: A retrospective cohort study

2021 ◽  
Vol 28 ◽  
pp. 50-55
Author(s):  
Chonlada Krutsri ◽  
Pongsasit Singhatas ◽  
Preeda Sumpritpradit ◽  
Tharin Thampongsa ◽  
Samart Phuwapraisirisan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Acute Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Morbidity And Mortality ◽  
Acute Care Surgery ◽  
Care Surgery

scholarly journals Morbidity and mortality outcomes of COVID-19 patients with and without hypertension in Lagos, Nigeria: A retrospective cohort study

2020 ◽  
Author(s):  
Akin Osibogun ◽  
Akin Abayomi ◽  
Oluchi Kanma-Okafor ◽  
Jide Idris ◽  
Abimbola Bowale ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critical Illness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Outcome Data ◽  
Morbidity And Mortality ◽  
P Value ◽  
Hypertensive Patients ◽  
Increased Risk

Abstract Background: The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described.Methods: In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 6 2020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred. Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher’s exact tests were used in determining associations between variables. Kaplan–Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders. P-value ≤0.05 was considered statistically significant.Results: A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of an additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P<0.001). After adjustment for confounders (age and sex), severe COVID-19and death were higher for hypertensives {severe/critical illness: HR=2.41, P=0.001, 95%CI=1.4–4.0, death: HR=2.30, P=0.001, 95%CI=1.2–4.6, for those with hypertension only} {severe/critical illness: HR=3.76, P=0.001, 95%CI=2.1–6.4, death: crude HR=6.63, P=0.001, 95%CI=3.4–1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities. Conclusion: The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.

scholarly journals Drug use disorder following early life exposure to tetrachloroethylene (PCE)-contaminated drinking water: a retrospective cohort study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ann Aschengrau ◽  
Alexandra Grippo ◽  
Michael R. Winter ◽  
Margaret G. Shea ◽  
Roberta F. White ◽  
...  
Keyword(s):  
Early Childhood ◽  
Drinking Water ◽  
Cohort Study ◽  
Drug Use ◽  
Diagnostic Criteria ◽  
Retrospective Cohort Study ◽  
Early Life ◽  
Retrospective Cohort ◽  
Contaminated Drinking Water ◽  
Drug Use Disorder

Abstract Background Many studies of adults with occupational exposure to solvents such as tetrachloroethylene (PCE) have shown adverse effects on cognition, mood and behavioral problems. Much less is known about neurotoxic effects in early life at lower exposure levels seen in community settings. We recently reported that illicit drug use was more frequent among adults from Cape Cod, Massachusetts who were exposed to PCE-contaminated drinking water during gestation and early childhood than their unexposed counterparts. Using newly collected data from this population-based retrospective cohort study, the current analysis examines whether early life PCE exposure is also associated with drug use disorder over the life course. Methods Three-hundred and sixty-three subjects with prenatal and early childhood PCE exposure and 255 unexposed subjects were studied. These individuals (median age: 40–41 years) completed self-administered questionnaires on the eleven established diagnostic criteria for drug use disorder and confounding variables. A validated leaching and transport model was used to estimate exposure to PCE-contaminated water. Results Overall, 23.3% of subjects reported having at least one criterion for drug use disorder over their lifetime. Early life PCE exposure was associated with a modest increase in the lifetime presence of one or more diagnostic criteria for drug use disorder (adjusted RR: 1.4, 95% CI: 1.0–1.8). Compared to unexposed subjects, PCE-exposed subjects were more likely to report having most diagnostic criteria of drug use disorder, including neglecting major roles due to drug use, physical and psychological problems related to drug use, and giving up activities due to drug use. No dose-response relationships were observed with increasing levels of PCE exposure. Conclusions These results suggest that exposure to PCE-contaminated drinking water during early life modestly increases the risk of developing diagnostic criteria for drug use disorder later in life. Because this study has several limitations, these findings should be confirmed in follow-up investigations of other exposed populations with more diverse racial and socioeconomic characteristics.

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