Bronchopulmonary Dysplasia and Risk of Developmental Delay: An EPIPAGE-2 Cohort Study

Neonatology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Ludovic Tréluyer ◽  
Pierre-Henri Jarreau ◽  
Laetitia Marchand-Martin ◽  
Valerie Benhammou ◽  
Alexandra Nuytten ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Developmental Delay ◽  
Bronchopulmonary Dysplasia ◽  
Prospective Cohort ◽  
Odds Ratio ◽  
Preterm Children ◽  
Respiratory Management ◽  
Postmenstrual Age ◽  
Study Population

<b><i>Background:</i></b> Overall and respiratory management of preterm children are constantly evolving, which might have changed both the pathophysiology and neurodevelopmental consequences of bronchopulmonary dysplasia (BPD). <b><i>Objectives:</i></b> The objective of this study is to determine whether the previously shown association between BPD and risk of developmental delay persists. <b><i>Methods:</i></b> The study population was children born before 32 weeks’ gestation from the French prospective cohort EPIPAGE-2. The exposure was BPD assessed at 36 weeks’ postmenstrual age. The main outcome was risk of developmental delay defined by an Age &amp; Stages Questionnaires (ASQ) score below threshold at 24 months’ corrected age. <b><i>Results:</i></b> The analyzed population included 2,706 children. Among those with available ASQ score, 196/1,587 had BPD and 671/1,587 had an ASQ score below threshold. BPD was associated with an ASQ score below threshold (odds ratio 1.52, 95% confidence interval 1.11–2.08; <i>p</i> = 0.008). <b><i>Conclusions:</i></b> BPD was strongly associated with risk of developmental delay.

scholarly journals Effects of Contact Precautions on Patient Perception of Care and Satisfaction: A Prospective Cohort Study

2013 ◽  
Vol 34 (10) ◽  
pp. 1087-1093 ◽  
Author(s):  
Preeti Mehrotra ◽  
Lindsay Croft ◽  
Hannah R. Day ◽  
Eli N. Perencevich ◽  
Lisa Pineles ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patient Satisfaction ◽  
Confidence Interval ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Odds Ratio ◽  
Coordination Of Care ◽  
Primary Analysis ◽  
Contact Precautions ◽  
Standardized Interview

Objective.Contact precautions decrease healthcare worker-patient contact and may impact patient satisfaction. To determine the association between contact precautions and patient satisfaction, we used a standardized interview for perceived issues with care.Design.Prospective cohort study of inpatients, evaluated at admission and on hospital days 3, 7, and 14 (until discharged). At each point, patients underwent a standardized interview to identify perceived problems with care. After discharge, the standardized interview and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were administered by telephone. Responses were recorded, transcribed, and coded by 2 physician reviewers.Participants.A total of 528 medical or surgical patients not admitted to the intensive care unit.Results.A total of 528 patients were included in the primary analysis, of whom 104 (20%) perceived some issue with their care. On multivariable logistic regression, contact precautions were independently associated with a greater number of perceived concerns with care (odds ratio, 2.05 [95% confidence interval, 1.31–3.21]; P<.01), including poor coordination of care (P = .02) and a lack of respect for patient needs and preferences (P = .001). Eighty-eight patients were included in the secondary analysis of HCAHPS. Patients under contact precautions did not have different HCAHPS scores than those not under contact precautions (odds ratio, 1.79 [95% confidence interval, 0.64–5.00]; P = .27).Conclusions.Patients under contact precautions were more likely to perceive problems with their care, especially poor coordination of care and a lack of respect for patient preferences.

scholarly journals Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection

2019 ◽  
Vol 09 (03) ◽  
pp. e298-e301
Author(s):  
Emily Gregory ◽  
Craig V. Towers ◽  
Jaclyn van Nes ◽  
Kristina Shumard ◽  
Kim B. Fortner ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Cesarean Delivery ◽  
Prospective Cohort Study ◽  
Study Design ◽  
Prospective Cohort ◽  
Odds Ratio

Abstract Objective To evaluate fetomaternal bleeding following routine cesarean delivery compared with cesarean delivery involving transplacental transection. Study Design A prospective cohort study evaluating cesarean delivery in which the placenta was transected (cases) versus controls (placenta not transected) from January 2016 to April 2018. A maternal Kleihauer–Betke's (KB) test and newborn hematocrit were performed shortly after delivery. Results The rate of a positive KB test was not significantly different between cases (n = 31) and controls (n = 61) (19 vs. 14%; odds ratio [OR]: 1.44; 95% confidence interval [CI]: 0.46–4.49; p = 0.74). Median neonatal hematocrits were not different. However, the rate of newborn hematocrits <40% at delivery was higher in cases compared with controls (23 vs. 3%; OR: 8.90; 95% CI: 1.72–45.90; p = 0.005). Conclusion A cesarean requiring transplacental transection to accomplish delivery does not significantly increase the rate of fetomaternal bleeding but is associated with a higher likelihood of newborn hematocrit <40% at delivery.

scholarly journals Type D personality and periodontal disease in university students: A prospective cohort study

2016 ◽  
Vol 23 (5) ◽  
pp. 754-762 ◽  
Author(s):  
Shinsuke Mizutani ◽  
Daisuke Ekuni ◽  
Mayu Yamane-Takeuchi ◽  
Tetsuji Azuma ◽  
Ayano Taniguchi-Tabata ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Periodontal Disease ◽  
University Students ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Odds Ratio ◽  
Type D Personality ◽  
Japanese University ◽  
Type D

The purpose of this prospective cohort study was to investigate whether Type D personality was related to periodontal disease in Japanese university students. Among students ( n = 600) who were interested in receiving oral health examinations, logistic regression analysis showed that the risk of developing periodontal disease during a 3-year period was associated with body mass index ⩾ 25 (odds ratio: 2.543; 95% confidence interval: 1.297–4.989; p = 0.007) and Type D personality (odds ratio: 1.473; 95% confidence interval: 1.027–2.111; p = 0.035). In this short-term prospective cohort study, a significant association between periodontal disease and Type D personality was observed in Japanese university students.

scholarly journals Association between functional mitral regurgitation and recurrence of paroxysmal atrial fibrillation following catheter ablation: a prospective cohort study

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110143
Author(s):  
Fusheng Ke ◽  
Yinhui Huang ◽  
Zhexiu Jin ◽  
Lei Huang ◽  
Qiang Xiong ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Cohort Study ◽  
Catheter Ablation ◽  
Mitral Regurgitation ◽  
Confidence Interval ◽  
Paroxysmal Atrial Fibrillation ◽  
Prospective Cohort ◽  
Radiofrequency Catheter Ablation ◽  
Functional Mitral Regurgitation

Objective The present study aimed to investigate the effect of functional mitral regurgitation (FMR) on recurrence of paroxysmal atrial fibrillation (PAF) in patients undergoing radiofrequency catheter ablation. Methods This prospective cohort study comprised 107 patients with PAF. The patients were divided into the FMR and non-FMR groups. FMR was assessed by Doppler echocardiography before index ablation. All patients initially underwent circumferential pulmonary vein isolation (CPVI) and were followed up for 12 months after ablation. PAF, atrial tachycardia, or atrial flutter served as the endpoint indicator. Results The median duration of PAF was 24 (3–60) months. Binary logistic univariate and multivariate analyses showed that FMR was not a risk factor for recurrence of catheter ablation for PAF (hazard ratio=0.758, 95% confidence interval: 0.191–3.004; hazard ratio=0.665, 95% confidence interval: 0.134–3.300, respectively). Kaplan–Meier analysis showed no significant difference in the recurrence rate between the groups. Fifteen (15/107, 14%) cases of PAF were triggered by the pulmonary vein. Three (3/107, 2.8%) cases of PAF were triggered by the superior vena cava. Conclusions FMR is not an independent risk factor for predicting recurrence of catheter ablation for PAF. FMR does not affect patients undergoing radiofrequency catheter ablation for PAF.

Lung Ultrasound in Bronchopulmonary Dysplasia: Patterns and Predictors in Very Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Victoria Aldecoa-Bilbao ◽  
Mar Velilla ◽  
Marta Teresa-Palacio ◽  
Carla Balcells Esponera ◽  
Ana Herranz Barbero ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Lung Ultrasound ◽  
Respiratory Support ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Pleural Line ◽  
Respiratory Management ◽  
Postmenstrual Age ◽  
Severity Of The Disease

<b><i>Introduction:</i></b> Lung ultrasound (LUS) is useful for respiratory management in very preterm infants (VPI), but little is known about the echographic patterns in bronchopulmonary dysplasia (BPD), the relation between the image findings, and the severity of the disease and its long-term outcomes. We aimed to describe LUS patterns in BPD and analyze the accuracy of LUS to predict the need for respiratory support at 36 weeks postmenstrual age (PMA) in VPI. <b><i>Methods:</i></b> Preterm infants ≤30.6 weeks of gestational age were recruited. LUS was performed at admission, at 7th, and 28th day of life (DOL) with a standardized protocol (6 zones: anterior, lateral, and posterior fields). Clinical data, respiratory outcomes, and image findings were recorded. <b><i>Results:</i></b> Eighty-nine patients were studied. Infants with BPD had significantly higher LUS score at admission, at 7th, and 28th DOL. Patients with BPD exhibited more consolidations and pleural line abnormalities at 7th and 28th DOL than those without BPD (<i>p</i> &#x3c; 0.001), regardless of the definition used for BPD. LUS at 7th DOL predicted <i>NICHD 2001-BPD</i> with <i>R</i><sup>2</sup> = 0.522; AUC = 0.87 (0.79–0.94), <i>p</i> &#x3c; 0.001, and <i>Jensen 2019-BPD</i> with <i>R</i><sup>2</sup> = 0.315 (AUC = 0.80 [0.70–0.90], <i>p</i> &#x3c; 0.001). A model including mechanical ventilation &#x3e;5 days, oxygen therapy for 7 days and LUS score at 7th DOL accurately predicted the need for respiratory support at 36 weeks PMA (<i>R</i><sup>2</sup> = 0.655, <i>p</i> &#x3c; 0.001) with an AUC = 0.90 (0.84–0.97), <i>p</i> &#x3c; 0.001. <b><i>Conclusion:</i></b> LUS score, pleural line abnormalities, and consolidations can be useful to diagnose BPD in VPI and to predict its severity after the first week of life.

scholarly journals Association between maternal gluten intake and type 1 diabetes in offspring: national prospective cohort study in Denmark

BMJ ◽  
2018 ◽  
pp. k3547 ◽  
Author(s):  
Julie C Antvorskov ◽  
Thorhallur I Halldorsson ◽  
Knud Josefsen ◽  
Jannet Svensson ◽  
Charlotta Granström ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cohort Study ◽  
Confidence Interval ◽  
Prospective Cohort Study ◽  
Food Frequency Questionnaire ◽  
Prospective Cohort ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Food Frequency

Abstract Objective To examine the association between prenatal gluten exposure and offspring risk of type 1 diabetes in humans. Design National prospective cohort study. Setting National health information registries in Denmark. Participants Pregnant Danish women enrolled into the Danish National Birth Cohort, between January 1996 and October 2002, Main outcome measures Maternal gluten intake, based on maternal consumption of gluten containing foods, was reported in a 360 item food frequency questionnaire at week 25 of pregnancy. Information on type 1 diabetes occurrence in the participants’ children, from 1 January 1996 to 31 May 2016, were obtained through registry linkage to the Danish Registry of Childhood and Adolescent Diabetes. Results The study comprised 101 042 pregnancies in 91 745 women, of whom 70 188 filled out the food frequency questionnaire. After correcting for multiple pregnancies, pregnancies ending in abortions, stillbirths, lack of information regarding the pregnancy, and pregnancies with implausibly high or low energy intake, 67 565 pregnancies (63 529 women) were included. The average gluten intake was 13.0 g/day, ranging from less than 7 g/day to more than 20 g/day. The incidence of type 1 diabetes among children in the cohort was 0.37% (n=247) with a mean follow-up period of 15.6 years (standard deviation 1.4). Risk of type 1 diabetes in offspring increased proportionally with maternal gluten intake during pregnancy (adjusted hazard ratio 1.31 (95% confidence interval 1.001 to 1.72) per 10 g/day increase of gluten). Women with the highest gluten intake versus those with the lowest gluten intake (≥20 v <7 g/day) had double the risk of type 1 diabetes development in their offspring (adjusted hazard ratio 2.00 (95% confidence interval 1.02 to 4.00)). Conclusions High gluten intake by mothers during pregnancy could increase the risk of their children developing type 1 diabetes. However, confirmation of these findings are warranted, preferably in an intervention setting.

Household Bird Ownership is Associated with Respiratory Illness among Young Children in Urban Bangladesh (CHoBI7 Program)

2022 ◽  
Author(s):  
Tahmina Parvin ◽  
Elizabeth D. Thomas ◽  
Kelly Endres ◽  
Daniel Leung ◽  
Bhuyian Sazzadul ◽  
...  
Keyword(s):  
Cohort Study ◽  
Young Children ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Odds Ratio ◽  
Respiratory Symptoms ◽  
Respiratory Illness ◽  
Middle Income ◽  
The Past ◽  
Difficulty Breathing

There is limited evidence on the association between animal ownership and respiratory illness among young children in low- and middle-income countries. In this study, we examined the association between animal ownership and respiratory illness among children younger than 5 years of age enrolled in a prospective cohort study in urban Bangladesh. This prospective cohort study enrolled 884 participants younger than 5 years of age in Dhaka, Bangladesh. At baseline, trained research assistants administered caregivers of children younger than 5 years of age a questionnaire on household animal ownership. Animal ownership was defined as owning chickens, birds other than chickens, cats, and dogs. Respiratory surveillance was conducted monthly for children based on caregiver-reported coughing, rapid breathing, and difficult breathing in the past 2 weeks during the 12-month study period. At baseline, 48% of children (424 of 884) had reports of coughing, 5% (40 of 884) had difficulty breathing, 3% (25 of 884) had rapid breathing, and 49% (431 of 884) had reports of any of these three respiratory symptoms. Seventeen percent of children (151 of 884) resided in a household that owned an animal. Children residing in households reporting bird ownership had a significantly greater odds of coughing (odds ratio, 1.14; 95% CI, 1.02–1.28) and any of the three respiratory symptoms in the past 2 weeks (odds ratio, 1.14; 95% CI, 1.02–1.28). Household bird ownership was associated with respiratory illness in young children. These findings suggest that interventions aiming at reducing young children’s exposure to domestic animals should extend to include birds other than chickens.

β-Blockers, Tachycardia, and Survival Following Sepsis: An Observational Cohort Study

2021 ◽  
Author(s):  
Dmitri Guz ◽  
Shira Buchritz ◽  
Alina Guz ◽  
Alon Ikan ◽  
Tania Babich ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cohort Study ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Internal Medicine Wards ◽  
Β Blockers

Abstract Background Sepsis is associated with excessive release of catecholamines, which causes tachycardia and is correlated with poor clinical outcome. β-Blockers (BBs) may blunt this effect on heart rate (HR). The objective of this study is to assess whether long-term BB therapy is associated with better clinical outcomes in patients with sepsis admitted to internal medicine wards. Methods We performed a single-center, observational cohort study. We included adult patients who were hospitalized in medicine departments due to sepsis. A propensity score model for BB therapy was used to match patients. The primary outcome was the 30-day all-cause mortality rate. A multivariate analysis was performed to identify risk factors for an adverse outcome. Patients were stratified according to absolute tachycardia (HR ≥100/min) or relative tachycardia at presentation (tachycardia index above the third quartile, with tachycardia index defined as the ratio of HR to temperature). Results A total of 1186 patients fulfilled the inclusion criteria. In the propensity-matched cohort patients given BB treatment were younger (median age [interquartile range], 74 [62–82] vs 81 [68–87] years; P ≤ .001). BB treatment was associated with reduction in 30-day mortality rates for patients with absolute tachycardia (odds ratio, 0.406; 95% confidence interval, .177–.932). Final model with interaction variable of BB treatment with HR was associated with short-term survival (odds ratio, 0.38; 95% confidence interval, .148–.976). Selective BB therapy had a stronger protective effect than nonselective BB therapy. Conclusions Long-term BB therapy was associated with decreased mortality rate in patients hospitalized with sepsis in internal medicine wards exhibiting absolute and relative tachycardia.

scholarly journals Incidence of VTE in asymptomatic children with deficiencies of antithrombin, protein C, and protein S: a prospective cohort study

2020 ◽  
Vol 4 (21) ◽  
pp. 5442-5448
Author(s):  
Daniela Tormene ◽  
Elena Campello ◽  
Chiara Simion ◽  
Giacomo Turatti ◽  
Michelangelo Marobin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Protein C ◽  
Protein S ◽  
Healthy Children ◽  
Thrombotic Risk ◽  
Asymptomatic Children ◽  
Risk Period

Abstract Although antithrombin, protein C, and protein S defects are well-recognized inherited risk factors for venous thromboembolism (VTE) in adults, whether they predispose children to these vascular disorders as well is undefined. In a prospective cohort study, we assessed the incidence of spontaneous and risk period–related VTE in children who were family members of adults who, after an episode of symptomatic VTE, had then been identified as carriers of these abnormalities. A total of 134 children from 87 families were enrolled. Seventy (51.5%) of these children were carriers of an inherited defect, and the remaining 64 were not; the mean observation period was 4 years (range, 1-16 years) and 3.9 years (range, 1-13), respectively. Sixteen risk periods were experienced by carriers, and 9 by noncarriers. Six VTE occurred in the 70 carriers during 287 observation-years, accounting for an annual incidence of 2.09% patient-years (95% confidence interval, 0.8-4.5), compared with none in the 64 noncarriers during 248 observation-years. Of the 14 children with thrombophilia who experienced a risk period for thrombosis, 4 (28.6%) developed a VTE episode. The overall incidence of risk-related VTE was 25% per risk period (95% confidence interval, 6.8-64). In conclusion, the thrombotic risk in otherwise healthy children with severe inherited thrombophilia does not seem to differ from that reported for adults with the same defects. Screening for thrombophilia in children who belong to families with these defects seems justified to identify those who may benefit from thromboprophylaxis during risk periods for thrombosis.

A Prospective Cohort Study of Load and Wellness (Sleep, Fatigue, Soreness, Stress, and Mood) in Elite Junior Australian Football Players

2019 ◽  
Vol 14 (6) ◽  
pp. 829-840 ◽  
Author(s):  
Timothy J.H. Lathlean ◽  
Paul B. Gastin ◽  
Stuart V. Newstead ◽  
Caroline F. Finch
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Perceived Exertion ◽  
Training Session ◽  
Load Ratio ◽  
Rating Of Perceived Exertion ◽  
Football Players ◽  
Australian Football

Purpose:To investigate associations between load (training and competition) and wellness in elite junior Australian Football players across 1 competitive season.Methods:A prospective cohort study was conducted during the 2014 playing season in 562 players from 9 teams. Players recorded their training and match intensities according to the session-rating-of-perceived-exertion (sRPE) method. Based on sRPE player loads, a number of load variables were quantified, including cumulative load and the change in load across different periods of time (including the acute-to-chronic load ratio). Wellness was quantified using a wellness index including sleep, fatigue, soreness, stress, and mood on a Likert scale from 1 to 5.Results:Players spent an average of 85 (21) min in each match and 65 (31) min per training session. Average match loads were 637 (232) arbitrary units, and average training loads were 352 (233) arbitrary units. Over the 24 wk of the 2014 season, overall wellness had a significant linear negative association with 1-wk load (B = −0.152; 95% confidence interval, −0.261 to −0.043;P = .006) and an inverseU-curve relationship with session load (B = −0.078; 95% confidence interval, 0.143 to 0.014;P = .018). Mood, stress, and soreness were all found to have associations with load.Conclusions:This study demonstrates that load (within a session and across the week) is important in managing the wellness of elite junior Australian Football players. Quantifying loads and wellness at this level will help optimize player management and has the potential to reduce the risk of adverse events such as injury.

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