scholarly journals The risk of preterm birth in combinations of mental disorder and socioeconomic position among Danish women

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C K Knudsen ◽  
A M S Christensen ◽  
S Heuckendorff ◽  
K Fonager ◽  
C Overgaard

Abstract Background Inequality in preterm birth is a public health challenge requiring identification of pregnant women at particularly high risk of preterm birth. Therefore, the aim was to estimate the risk of preterm birth in women with different combinations of mental health conditions and socioeconomic position. Methods Based on Danish registries, we conducted a nationwide cohort study including all first-time mothers giving birth to a singleton liveborn infant in Denmark between 2000 through 2016. We examined the risk of preterm birth (<37 weeks of gestation) in different combinations of mental health conditions (no, minor, and moderate/severe) and educational level (high, intermediate, and low) in three age strata (<25, 25-30, and >30 years). The relative risk of preterm birth was estimated using Poisson regression with a robust error variance. We measured the attributable proportion to assess additive interaction between the effects of exposures. Results Of the 415,523 included first time mothers, 29,069 (7,0%) gave birth preterm. The risk of preterm birth increased in combinations of higher degree of mental health conditions, lower degree of educational level, and increasing age. Women aged>30 years with moderate/severe mental health conditions and low educational level had the highest risk of preterm birth (13.7%). The analysis of additive interaction revealed only a limited additional effect of being exposed to mental health conditions and lower educational levels in each age strata. However, positive additive interaction was found between age>30 year and combinations of mental health conditions and educational level. Conclusions Substantial inequality in preterm birth remains with increasing risk in women with combinations of higher degree of mental health conditions and lower degree of educational level. In the prevention of inequality in preterm birth special attention on women aged>30 years exposed to mental health conditions and lower educational levels is essential

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Camilla Klinge Knudsen ◽  
Amanda Marie Somer Christesen ◽  
Signe Heuckendorff ◽  
Kirsten Fonager ◽  
Martin Nygård Johansen ◽  
...  

Abstract Background Inequality in preterm birth is a world-wide challenge that has proved difficult for maternity care services to meet. Reducing the inequality requires identification of pregnant women at particularly high risk of preterm birth in order to target interventions. Therefore, the aim was to estimate the risk of preterm birth in women with different combinations of socioeconomic position, mental health conditions, and age. Methods In this nationwide register-based cohort study, we included all first-time mothers that gave birth to a singleton liveborn infant in Denmark between 2000 and 2016. The absolute and relative risk of preterm birth (< 37 weeks of gestation) was examined in different combinations of educational level (high, intermediate, and low) and mental health conditions (no, minor, and moderate/severe) in three age strata (≤23, 24–30, and ≥ 31 years). We estimated the relative risk using Poisson regression with a robust error variance. As additive interaction can help identify subgroups where limited resources can be of best use, we measured the attributable proportion to assess the risk that is due to interaction of the different exposures. Results Of the 415,523 included first-time mothers, 6.3% gave birth prematurely. The risk of preterm birth increased with decreasing educational level and increasing severity of mental health conditions in all age strata, but most in women aged ≥31 years. The highest absolute risk was 12.9% [95% CI: 11.2;14.8%] in women aged ≥31 years with low education and moderate/severe mental health conditions resulting in a relative risk of 2.23 [95% CI: 1.93–2.58] compared to the unexposed reference group in that age strata. We found positive additive interaction between low education and mental health conditions in women aged 24–30 and ≥ 31 years and between age ≥ 31 years and combinations of mental health conditions and educational levels. Conclusion The inequality in preterm birth increased with increasing age. To reduce inequality in preterm birth focused attention on women with higher age further combined with lower educational levels and mental health conditions is essential.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 70-LB
Author(s):  
ALEJANDRA M. WIEDEMAN ◽  
YING FAI NGAI ◽  
AMANDA M. HENDERSON ◽  
CONSTADINA PANAGIOTOPOULOS ◽  
ANGELA M. DEVLIN

2020 ◽  
Author(s):  
Huiting Xie

BACKGROUND Many people are affected by mental health conditions, yet its prevalence in certain populations are not well documented. OBJECTIVE The aim of this study is to describe the attributes of people with mental health conditions in U.S and SG in terms of: perception of mental health recovery and its correlates such as strengths self-efficacy, resourcefulness and stigma experience. With the findings, not only could the knowledge base for mental health recovery in both countries be enhanced but interventions and policies relating to self-efficacy, resourcefulness and de-stigmatization for mental health recovery could be informed. METHODS A A cross-sectional, descriptive study with convenience sample of 200 community dwelling adults were selected, 100 pax from the United States (U.S) and 100 pax from Singapore (SG). Adults with serious mental illnesses without substance abuse impacting on their recovery were recruited. Participants completed self-administered questionaires measuring their mental health recovery, strengths self-efficacy, resourcefulness and stigma experience. RESULTS This study offered the unique opportunity to examine mental health recovery as well as its correlates such as strengths self-efficacy, resourcefulness and stigma experience from both the United States and Singapore. While the perception of mental health recovery and positive attributes like strengths self-efficacy and resourcefulness remained strong in participants with serious mental illnesses across both countries, people with serious mental illnesses in both countries still experienced negative perception like stigma. The findings would not only inform strategies to promote mental health recovery but also enhance the focus on correlates such as strengths self-efficacy and resourcefulness across both countries. CONCLUSIONS The findings would not only inform strategies to promote mental health recovery but also enhance the focus on correlates such as strengths self-efficacy and resourcefulness across both countries.


2021 ◽  
pp. 145507252098596
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Sagi Alagem-Iversen ◽  
Birgitte Thylstrup

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.


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