scholarly journals Adolescent Pregnancy Outcomes Among Sisters and Mothers: A Population-Based Retrospective Cohort Study Using Linkable Administrative Data

2017 ◽  
Vol 133 (1) ◽  
pp. 100-108 ◽  
Author(s):  
Elizabeth Wall-Wieler ◽  
Leslie L. Roos ◽  
Nathan C. Nickel
Keyword(s):  
Adolescent Pregnancy ◽  
Adolescent Girls ◽  
Adolescent Mothers ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adolescent Mother ◽  
Administrative Databases ◽  
Logistic Regression Models ◽  
Targeted Interventions ◽  
Adolescent Pregnancies

Objectives: Female family members affect both the likelihood of adolescent pregnancy and the outcome of that pregnancy. We examined the degree to which an older sister’s adolescent reproductive outcomes affect her younger sister’s reproductive behavior, and whether relationships in adolescent pregnancy among sisters born to adolescent mothers differ from those born to nonadolescent mothers. Methods: We followed a birth cohort in Manitoba, Ontario, Canada, to age 20 using linkable administrative databases housed at the Manitoba Centre for Health Policy. The cohort consisted of 12 391 girls born in Manitoba between April 1, 1984, and March 31, 1996, who had 1 older sister. We used logistic regression models to examine the relationships among familial adolescent pregnancy outcomes. Results: Compared with adolescent girls whose older sister did not have an adolescent pregnancy, adolescent girls whose older sister had an adolescent pregnancy were more likely to have a pregnancy (adjusted odds ratio [aOR] = 2.57), regardless of whether that pregnancy was completed (aOR = 2.56) or terminated (aOR = 2.59). Relationships in adolescent pregnancy among sisters were much stronger for those born to nonadolescent mothers (aOR = 3.16 [older sister completed adolescent pregnancy] and 3.18 [older sister terminated adolescent pregnancy]) than to adolescent mothers (aOR = 1.65 [older sister completed adolescent pregnancy] and 1.77 [older sister terminated adolescent pregnancy]). For younger sisters having an adolescent pregnancy, the odds of her completing the pregnancy were reduced if her older sister had terminated an adolescent pregnancy and her mother had not been an adolescent mother (aOR = 0.38). Conclusions: Younger sisters of adolescents who had a pregnancy may benefit from targeted interventions to reduce their likelihood of adolescent pregnancies.

scholarly journals The Cycle of Child Protection Services Involvement: A Cohort Study of Adolescent Mothers

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Elizabeth Wall-Wieler ◽  
Marni Brownell ◽  
Deepa Singal ◽  
Nathan Nickel ◽  
Leslie Roos
Keyword(s):  
Cohort Study ◽  
Adolescent Girls ◽  
Adolescent Mothers ◽  
Child Protection ◽  
Regression Models ◽  
Population Based ◽  
Child Protection Services ◽  
Logistic Regression Models ◽  
First Child ◽  
Intergenerational Cycle

IntroductionAdolescent girls in care of child protection services are more likely to become pregnant than adolescent girls not in care, and mothers who were in care are more likely to have their children placed in care. Objectives and ApproachLinkable administrative data were used to determine whether adolescent mothers in care are at greater risk of having their child placed in care before age two. A population-based cohort of adolescent mothers whose first child was born in Manitoba, Canada between April 1, 1998, and March 31, 2013 (n = 5,942) was used. Adjusted odds ratios (AOR) of having that first child taken into care before their second birthday were compared between mothers who were in care (n = 576) and mothers who were not in care (n = 5, 366) at the birth of their child using logistic regression models. ResultsAdolescent mothers who were in care had greater odds of having their child taken into care before the child’s second birthday (AOR = 7.53; 95% CI = 6.19-9.14). Specifically, their children had higher odds of being taken into care in their first week of life (AOR = 11.64; 95% CI = 8.83-15.34), between one week and their first birthday (AOR = 3.63; 95% CI = 2.79-4.71)., and between their first and second birthday (AOR = 2.21; 95% CI = 1.53-3.19). Conclusion/ImplicationsFindings support an intergenerational cycle of involvement with child protection services. More and better services are required for adolescent mothers who give birth while in care of child protection services.

Social Determinants of Health and Adverse Outcomes in Adolescent Pregnancies

2021 ◽  
Author(s):  
S. Amjad ◽  
M. Adesunkanmi ◽  
J. Twynstra ◽  
J.A. Seabrook ◽  
M.B. Ospina
Keyword(s):  
Social Determinants Of Health ◽  
Adolescent Pregnancy ◽  
Birth Outcomes ◽  
Adolescent Mothers ◽  
Social Determinants ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Determinants Of Health ◽  
Adolescent Pregnancies ◽  
Adverse Pregnancy

AbstractThe association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated with substantial risk of long-term morbidities for the young mother and their newborns. Multiple levels of social disadvantage have been related to adverse pregnancy outcomes among adolescent mothers. Patterns of cumulative social adversity define the most marginalized group of adolescents at the highest risk of experiencing adverse maternal and birth outcomes. Using a social determinants of health (SDOH) framework, we present an overview of the current scientific evidence on the influence of these conditions on adolescent pregnancy outcomes. Multiple SDOH such as residence in remote areas, low educational attainment, low socioeconomic status, and lack of family and community support have been linked with increased risk of adverse pregnancy outcomes among adolescents. Based on the PROGRESS-Plus equity framework, this review highlights some SDOH aspects that perinatal health researchers, clinicians, and policy makers should consider in the context of adolescent pregnancies. There is a need to acknowledge the intersectional nature of multiple SDOH when formulating clinical and societal interventions to address the needs of the most marginalized adolescent in this critical period of life.

scholarly journals Variation in the Practice of Preoperative Medical Consultation for Major Elective Noncardiac Surgery

2012 ◽  
Vol 116 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Duminda N. Wijeysundera ◽  
Peter C. Austin ◽  
W. Scott Beattie ◽  
Janet E. Hux ◽  
Andreas Laupacis
Keyword(s):  
Population Based ◽  
Noncardiac Surgery ◽  
Medical Consultation ◽  
Administrative Databases ◽  
Logistic Regression Models ◽  
Medical Consultations ◽  
Teaching Status ◽  
Procedure Volume ◽  
The Individual ◽  
Individual Hospital

Background Patients scheduled for major elective noncardiac surgery frequently undergo preoperative medical consultations. However, the factors that determine whether individuals undergo consultation and the extent of interhospital variation remain unclear. Methods The authors used population-based administrative databases to conduct a cohort study of patients, aged 40 yr or older, who underwent major elective noncardiac surgery in Ontario, Canada, between April 2004 and February 2009. Multilevel logistic regression models were used to identify patient- and hospital-level predictors of consultation. Results Within the cohort of 204,819 patients who underwent surgery at 79 hospitals, 38% (n = 77,965) underwent preoperative medical consultation. Although patient- and surgery-level factors did predict consultation use, they explained only 5.9% of variation in consultation rates. Differences in rates across hospitals were large (range, 10-897 per 1,000 procedures), were not explained by surgical procedure volume or hospital teaching status, and persisted after adjustment for patient- and surgery-level factors. The median odds of undergoing consultation were 3.51 times higher if the same patient had surgery at one randomly selected hospital as opposed to another. Conclusions One-third of surgical patients undergo preoperative medical consultation. Although patient- and surgery-level factors are weak predictors of consultation use, the individual hospital is the major determinant of whether patients undergo consultation. Additional research is needed to better understand the basis for this substantial interhospital variation and to determine which patients benefit most from preoperative consultation.

scholarly journals Presentations to emergency departments for chronic obstructive pulmonary disease in Alberta: a population-based study

CJEM ◽  
2010 ◽  
Vol 12 (06) ◽  
pp. 500-508 ◽  
Author(s):  
Rhonda J. Rosychuk ◽  
Donald C. Voaklander ◽  
Ambikaipakan Senthilselvan ◽  
Terry P. Klassen ◽  
Thomas J. Marrie ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Older Adults ◽  
Pulmonary Disease ◽  
Population Based ◽  
Administrative Databases ◽  
Chronic Obstructive ◽  
Population Based Study ◽  
Obstructive Pulmonary Disease ◽  
Targeted Interventions ◽  
Ed Visits

ABSTRACTObjective:Chronic obstructive pulmonary disease (COPD) is a widespread illness with an increasing prevalence in older adults; exacerbations resulting in visits to the emergency department (ED) are common. We sought to determine the epidemiology of COPD presentations to EDs by older adults in Alberta.Methods:Administrative databases were used to examine all ED encounters for COPD from April 1999 to March 2005 in Alberta. Data included demographics of patients and timing of ED visits. Data analysis included descriptive summaries and age–sex directly standardized visit rates (DSVRs).Results:There were 85 330 ED visits for acute COPD made by 38 638 patients 55 years of age or older during the study period. More men (53.2%) presented, and the mean age at presentation was 72 years. The age–sex DSVRs remained stable from 2000/01 (24.4/1000) to 2004/05 (25.6/1000). Presentation rates differed among population subgroups. Overall, 67% of visits resulted in discharge from the ED.Conclusion:Chronic obstructive pulmonary disease is a common presentation in Alberta EDs; however, the rates of presentation were stable during the study period, and monthly and hourly trends exhibited similar patterns for each year. Disparities based on age, sex, and socio-economic and cultural statuses were identified. Targeted interventions could be implemented to reduce future ED visits for COPD.

scholarly journals Higher breakfast glycaemic load is associated with increased metabolic syndrome risk, including lower HDL-cholesterol concentrations and increased TAG concentrations, in adolescent girls

2014 ◽  
Vol 112 (12) ◽  
pp. 1974-1983 ◽  
Author(s):  
Analise Nicholl ◽  
Mary du Heaume ◽  
Trevor A. Mori ◽  
Lawrence J. Beilin ◽  
Wendy H. Oddy ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Adolescent Girls ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Glycaemic Load ◽  
The Metabolic Syndrome ◽  
Almost All ◽  
Metabolic Syndrome Components

Almost all previous studies examining the associations between glycaemic load (GL) and metabolic syndrome risk have used a daily GL value. The daily value does not distinguish between peaks of GL intake over the day, which may be more closely associated with the risk of the metabolic syndrome. The aim of the present study was to investigate the cross-sectional associations between daily and mealtime measures of GL and metabolic syndrome risk, including metabolic syndrome components, in adolescents. Adolescents participating in the 14-year follow-up of the Western Australian Pregnancy Cohort (Raine) Study completed 3 d food records and metabolic assessments. Breakfast GL, lunch GL, dinner GL and a score representing meal GL peaks over the day were determined in 516 adolescents. Logistic regression models were used to investigate whether GL variables were independent predictors of the metabolic syndrome in this population-based cohort (3·5 % prevalence of the metabolic syndrome). Breakfast GL was found to be predictive of the metabolic syndrome in girls (OR 1·15, 95 % CI 1·04, 1·27; P <0·01), but not in boys. Other meal GL values and daily GL were found to be not significant predictors of the metabolic syndrome. When breakfast GL was examined in relation to each of the components of the metabolic syndrome in girls, it was found to be negatively associated with fasting HDL-cholesterol concentrations (P= 0·037; β = − 0·004; 95 % CI − 0·008, − 0·002) and positively associated with fasting TAG concentrations (P= 0·008; exp(β) = 1·002; 95 % CI 1·001, 1·004). The results of the present study suggest that there may be an association between breakfast composition and metabolic syndrome components in adolescent girls. These findings support further investigation into including lower-GL foods as part of a healthy breakfast in adolescence, particularly for girls.

scholarly journals Trends in the prevalence and incidence of anxiety and depressive symptoms in Iran: findings from KERCADRS

2021 ◽  
Vol 9 (3) ◽  
pp. e000937
Author(s):  
Hamid Najafipour ◽  
Mohadeseh Shojaei Shahrokhabadi ◽  
Ghodsyeh Banivaheb ◽  
Abdolreza Sabahi ◽  
Mitra Shadkam ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Young Adults ◽  
Incidence Rate ◽  
Disease Risk ◽  
Common Mental Disorders ◽  
Household Survey ◽  
Population Based ◽  
Logistic Regression Models ◽  
Targeted Interventions

ObjectivesAnxiety and depression (A&D) are common mental disorders with high economical and health burdens. This study aimed to investigate the prevalence and the incidence rate of A&D symptoms and their relationship with sociodemographic and other risk factors and comorbidities in adults living in southeastern Iran.DesignA population-based cohort study with random cluster household survey sampling method.SettingSecond round of Kerman Coronary Artery Disease Risk Factors Study (KERCADRS) (2014–2018) performed in Southeastern, Iran.ParticipantsWe recruited 9997 participants (15–80 years) in the second round of the study, from whom 2820 persons were the people who also participated in the first round of KERCADRS in 2009–2012. The age-standardised A&D prevalence was measured among all participants, and the 5-year A&D incidence rate was measured in those who were free from A&D in the first round in 2009–2012 and were at risk of A&D in the follow-up. The relationship between A&D and demographic characteristics, smoking, opium use, obesity and physical activity was assessed by logistic regression models.ResultsOverall, the prevalence of anxiety (48.1% to 16.4%, p<0.001) and depression (5.9% to 1.3%, p<0.001) decreased between the two rounds. The highest prevalence of anxiety was among widowed (31.4%), unemployed (21.3%), obese (19.4%), and opium users (17.4%). Young adults, women, those divorced or widowed, and those with obesity and low physical activity had a higher chance of developing anxiety. The 5-year incidence rate (person/1000 person-years) was 15.0 for anxiety and 3.9 for depression.ConclusionDespite the overall decrease in the prevalence of A&D symptoms in last 5 years in the area, young adults, women, unemployed, opium users, people with low physical activity and those with obesity had a higher chance of developing anxiety and are in need of more targeted interventions.

Comparing trends of perinatal mortality in two rural areas of Matlab, Bangladesh

2020 ◽  
Vol 35 (1) ◽  
pp. 39-50 ◽  
Author(s):  
Aminur Rahman ◽  
Anne Austin ◽  
Iqbal Anwar ◽  
Surasak Taneepanichskul
Keyword(s):  
Adolescent Pregnancy ◽  
Adolescent Mothers ◽  
Rural Areas ◽  
Maternal Education ◽  
Perinatal Death ◽  
Diarrhoeal Disease ◽  
Adolescent Mother ◽  
Age At First Birth ◽  
Content Type ◽  
Service Areas

PurposeSixteen million adolescents give birth each year, constituting 11% of all births worldwide. Adverse adolescent pregnancy outcomes are well-documented. Available data on adolescent pregnancies have mainly relied on self-reported age and retrospective survey data, which might not capture adolescent births accurately. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes in Matlab, Bangladesh, using data from the Matlab Heath and Demographic System (HDSS) which precisely documents maternal age.Design/methodology/approachThe study was conducted in the rural subdistrict of Matlab in Bangladesh. HDSS data were used to examine trends in adolescent motherhood (10–19 years) in the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) service areas (ISA) and government service areas (GSA) between 2007 and 2015. A total of 4,996 adolescent mothers were included in the analysis. Chi-square testing and binary logistic regression were used to document adolescent pregnancy trends and the differences in and causes of perinatal death.FindingsThe fertility rate was 27 per 1000 adolescent mothers in ISA and 20 per 1000 adolescent mothers in GSA, during the 9 years of the study period. The adjusted odd of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. Significant determinants of perinatal death among adolescent mothers included maternal education, paternal education, mother’s age at first birth, asset score and distance from the nearest health facility.Originality/valueThis paper documents the real trend of adolescent pregnancy by capturing the accurate age at pregnancy for the first time in Bangladesh.

Perinatal Outcomes of Women Aged 50 Years and Above

2019 ◽  
Vol 37 (01) ◽  
pp. 079-085 ◽  
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.

Epidemiology of pheochromocytoma and paraganglioma: population-based cohort study

2021 ◽  
Vol 184 (1) ◽  
pp. 19-28
Author(s):  
Alexander A Leung ◽  
Janice L Pasieka ◽  
Martin D Hyrcza ◽  
Danièle Pacaud ◽  
Yuan Dong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Administrative Data ◽  
Laboratory Data ◽  
Population Based ◽  
Incidence Rates ◽  
Primary Objective ◽  
Administrative Databases ◽  
Secondary Objective ◽  
True Frequency ◽  
Clinical Records

Objective Despite the significant morbidity and mortality associated with pheochromocytoma and paraganglioma, little is known about their epidemiology. The primary objective was to determine the incidence of pheochromocytoma and paraganglioma in an ethnically diverse population. A secondary objective was to develop and validate algorithms for case detection using laboratory and administrative data. Design Population-based cohort study in Alberta, Canada from 2012 to 2019. Methods Patients with pheochromocytoma or paraganglioma were identified using linked administrative databases and clinical records. Annual incidence rates per 100 000 people were calculated and stratified according to age and sex. Algorithms to identify pheochromocytoma and paraganglioma, based on laboratory and administrative data, were evaluated. Results A total of 239 patients with pheochromocytoma or paraganglioma (collectively with 251 tumors) were identified from a population of 5 196 368 people over a period of 7 years. The overall incidence of pheochromocytoma or paraganglioma was 0.66 cases per 100 000 people per year. The frequency of pheochromocytoma and paraganglioma increased with age and was highest in individuals aged 60–79 years (8.85 and 14.68 cases per 100 000 people per year for males and females, respectively). An algorithm based on laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal) closely approximated the true frequency of pheochromocytoma and paraganglioma with an estimated incidence of 0.54 cases per 100 000 people per year. Conslusion The incidence of pheochromocytoma and paraganglioma in an unselected population of western Canada was unexpectedly higher than rates reported from other areas of the world.

Sign in / Sign up

Export Citation Format

Share Document