Association of antinuclear antibody seropositivity with inhaled environmental exposures in patients with interstitial lung disease

BackgroundInterstitial lung diseases (ILD) are diffuse parenchymal lung disorders that cause substantial morbidity and mortality. In patients with ILD, elevated antinuclear antibody (ANA) titers may be a sign of an autoimmune process. Inhalational exposures contribute to ILD pathogenesis and affect prognosis and may trigger autoimmune disease. The association of inhalational exposures with ANA seropositivity in ILD patients is unknown.MethodsThis was a retrospective cohort study of adult ILD patients from five US centers. Exposures to tobacco, inhaled organic antigens, and inhaled inorganic particles were extracted from medical records. A multivariable logistic regression model was used to analyse the effects of confounders including age, ILD diagnosis, gender, and exposure type on ANA seropositivity.ResultsAmong 1,265 patients with ILD, there were more ANA seropositive (58.6%, n=741) than ANA seronegative patients (41.4%, n=524). ANA seropositive patients had lower total lung capacity (69% versus 75%, p<0.001) and forced vital capacity (64% versus 70%, p<0.001) than patients who were ANA seronegative. Amongst patients with tobacco exposure, 61.4% (n=449) were ANA positive compared to 54.7% (n=292) of those without tobacco exposure. In multivariable analysis tobacco exposure remained independently associated with increased ANA seropositivity (OR=1.38, 95%CI=1.12–1.71). This significant difference was similarly demonstrated among patients with and without a history of inorganic exposures (OR=1.52, 95%CI=1.12–2.07).ConclusionPatients with ILD and inhalational exposure had significantly higher prevalence of ANA seropositivity than those without reported exposures across ILD diagnoses. Environmental and occupational exposures should be systematically reviewed in patients with ILD, particularly those with ANA seropositivity.

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ASXL1/SRSF2 Co-Mutated Acute Myeloid Leukemia (AML): A Rare but Distinct Subpopulation with Dismal Outcomes

Blood ◽

10.1182/blood-2019-122929 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 2598-2598

Author(s):

Daniel R. Richardson ◽

David M Swoboda ◽

Anastasia Ivanova ◽

Steven M Johnson ◽

Jonathan Galeotti ◽

...

Keyword(s):

Research Funding ◽

Multivariable Analysis ◽

Prior History ◽

Treatment Intensity ◽

Cell Transplant ◽

Myeloid Neoplasm ◽

Significant Difference ◽

History Of ◽

Baseline Characteristics

Background: Advances in the understanding of the genetic determinants of AML and the widespread use of next-generation sequencing (NGS) have led to the refinement of prognostically distinct molecular subgroups. Mutations in ASXL1 and SRSF2, which are common in myelodysplastic syndrome (MDS) and myeloproliferative neoplasms (MPNs), rarely co-occur in patients (pts) with AML. The largest reported cohort (n=15) of ASXL1/SRSF2 co-mutated AML had no long-term survivors (Papaemmanuil et al. NEJM 2016). It remains unknown how clinical factors such as prior history of a myeloid neoplasm or intensity of treatment influence outcomes. We sought to assess the clinical characteristics and analyze outcomes in a larger cohort of pts with ASXL1/SRSF2 co-mutated AML. We hypothesized that this profile may be a genomic footprint of prior myeloid neoplasia. Methods: We conducted a multi-institutional retrospective analysis of newly diagnosed adult AML pts with both ASXL1 and SRSF2 mutations at the University of North Carolina and at Moffitt Cancer Center from 2011-2018. NGS was performed on DNA using the Illumina TruSight Myeloid 54-gene sequencing panel. The primary endpoint was overall survival (OS) defined as time from diagnosis of AML to death. Pts were stratified by secondary AML (s-AML), defined as having a documented history of MDS/MPN. Secondary outcomes included rates of complete remission (CR) and CR with incomplete hematologic recovery (CRi). Multivariable analysis was performed with baseline characteristics. Results: Forty-six pts were identified and included. The median age of pts was 72 years (range 42 - 85). Sixty-seven percent (28/42) had normal cytogenetics; 88% (37/42) were intermediate risk cytogenetics by current ELN guidelines. Sixty-one percent (n=28) were classified as having s-AML. One pt had therapy-related AML without preexisting MDS/MPN and was therefore not included in s-AML. The Figure illustrates co-existing mutations and individual responses to upfront therapy stratified by s-AML and non-s-AML. The median number of mutations was 5 (range 2 - 7). The most common co-occurring mutations were TET2 (52%), RUNX1 (35%), IDH2 (15%), and STAG2 (15%). Median OS was 7.0 months (m) (CI 5.3, 15.4). Median OS for pts with s-AML (n=28) and non-s-AML (n=18) was 6.1 and 15.4 m (p=0.05), respectively. There was no significant difference in median OS between s-AML and non-s-AML on multivariable analysis (hazard ratio (HR) = 2.56, p=0.07). Median OS did not differ by age (Age <65 years v. older, p=0.54), total # of mutations (≥ 5 v. less, p=0.73), or etiology of s-AML (MDS v. MPN, p=0.66). Twenty-two (47%) pts received upfront intensive induction chemotherapy (IC), 17 (37%) received hypomethylating agents (HMAs), and 7 pts (15%) received no AML-directed chemotherapy. Median OS did not significantly differ between pts receiving upfront IC and HMAs (15.3 v. 7.04 m, p=0.21). Among non-s-AML pts, median OS was longer in those receiving IC (n=10) versus HMAs (n=7) (15.4 v. 3.5 m, p=0.01). Among all pts receiving IC, median OS was longer in non-s-AML pts (n=10) versus s-AML pts (n=12) (15.4 v. 5.9 m, p=0.01). Median OS did not differ by treatment intensity for s-AML pts (IC v. HMA: 5.9 v. 9.9 m, p=0.38). Six pts underwent allogeneic hematopoietic cell transplant (HCT) with a median OS NR (median follow-up 15.6 m). Overall rate of CR/CRi was 35% and was similar between pts receiving IC and HMAs (45% v. 21%, p=0.29). Among pts with non-s-AML, CR/CRi rates with IC and HMAs were 70% and 29%, respectively (p=0.11). Among pts with s-AML, CR/CRi rates with IC and HMAs were 42% and 20%, respectively (p=0.38). On multivariable analysis of baseline characteristics, only ECOG performance status (PS) was significantly associated with OS (HR 2.25, p=0.01). ECOG PS remained significant (HR 2.65, p=0.03) after adjusting for HCT and treatment intensity. Conclusions: ASXL1/SRSF2 co-mutated AML represents a rare but distinct genotype with most pts having pre-existing myeloid neoplasms and associated co-mutations commonly seen in MDS/MPNs. OS is dismal regardless of age, number of mutations, treatment intensity, or prior history of myeloid neoplasm. HCT may mitigate these poor outcomes and lead to long-term survival. This represents the largest reported cohort to date of pts with ASXL1/SRSF2 co-mutated AML. Further study is warranted to inform risk stratification and prognosis of pts with ASXL1/SRSF2-mutated AML. Disclosures Foster: Bellicum Pharmaceuticals, Inc: Research Funding; Daiichi Sankyo: Consultancy; MacroGenics: Research Funding; Celgene: Research Funding. Coombs:Octopharma: Honoraria; Pharmacyclics: Honoraria; Medscape: Honoraria; Abbvie: Consultancy; Loxo: Honoraria; Cowen & Co.: Consultancy; Dedham Group: Consultancy; H3 Biomedicine: Honoraria; Covance: Consultancy. Sallman:Celyad: Membership on an entity's Board of Directors or advisory committees. Zeidner:Agios: Honoraria; Celgene: Consultancy, Honoraria, Research Funding; Daiichi Sankyo: Honoraria; Tolero: Honoraria, Research Funding; Pfizer: Honoraria; AsystBio Laboratories: Consultancy; Merck: Research Funding; Takeda: Research Funding; AbbVie: Honoraria.

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Prognostic Impact of Sarcopenia and Radiotherapy in Patients With Advanced Gastric Cancer Treated With Anti-PD-1 Antibody

Frontiers in Immunology ◽

10.3389/fimmu.2021.701668 ◽

2021 ◽

Vol 12 ◽

Author(s):

Nalee Kim ◽

Jeong Il Yu ◽

Do Hoon Lim ◽

Jeeyun Lee ◽

Seung Tae Kim ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Negative Impact ◽

Multivariable Analysis ◽

Immune Checkpoint Blockade ◽

Prognostic Impact ◽

Skeletal Muscle Index ◽

Entire Cohort ◽

Significant Difference ◽

History Of

BackgroundWe explored the combined effects of sarcopenia (SAR) and radiotherapy (RT) on outcomes in patients with advanced gastric cancer (AGC) treated with immune-checkpoint blockade (ICB).MethodsAmong 185 patients with AGC treated with ICB, we defined SAR as skeletal muscle index <49 cm2/m2 for men and <31 cm2/m2 for women; 93 patients met criteria. We defined high neutrophil-to-lymphocyte ratio (hNLR) as NLR≥3. Palliative RT was performed in 37 patients (20%) before ICB.ResultsWe frequently observed hNLR in patients with SAR (53% vs. 35%, p = 0.02). The median overall survival (OS) for the entire cohort was 5 months. Stratification by risk factors of SAR or hNLR revealed a significant difference in median OS (0 [N = 60] vs. 1 [N = 76] vs. 2 [N = 49]: 7.6 vs. 6.4 vs. 2.2 months, p < 0.001). Patients with microsatellite instability-high (MSI-H, N = 19) or Epstein-Barr virus (EBV)-positive tumors (N = 13) showed favorable outcomes compared to those with microsatellite stable (MSS, N = 142) tumors (median OS, not reached vs. 16.8 vs. 3.8 months, respectively). The benefit of RT was evident in patients with both SAR and hNLR (median OS, 3.1 vs. 1.3 months, p = 0.02) and MSS/EBV-negative tumor (median OS, 6.5 vs. 3.5 months, p = 0.03), but outcomes after RT in MSI-H tumor were not significantly different. In multivariable analysis, SAR/hNLR, molecular subtypes, and a history of RT were associated with OS (all p < 0.05).ConclusionsWe demonstrated the negative predictive value of SAR/hNLR on outcomes after ICB for AGC, and the history of RT could overcome the negative impact of SAR/hNLR and the MSS/EBV-negative subtype.

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Intracerebral hemorrhage: who gets tested for methamphetamine use and why might it matter?

BMC Neurology ◽

10.1186/s12883-020-01967-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sahar Osman ◽

Zhu Zhu ◽

Mark Farag ◽

Leonid Groysman ◽

Cyrus Dastur ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Racial Bias ◽

External Ventricular Drain ◽

Multivariable Analysis ◽

Urine Drug Screen ◽

Methamphetamine Use ◽

Significant Difference ◽

Emerging Risk ◽

History Of ◽

History Of Use

Abstract Background Methamphetamine use is an emerging risk factor for intracerebral hemorrhage (ICH). The aim of this study was to investigate the use of urine drug screen (UDS) for identifying methamphetamine-associated ICH. Methods This is a retrospective, single-center study of consecutive patients hospitalized with spontaneous ICH from January 2013 to December 2017. Patients were divided into groups based on presence of UDS. The characteristics of patients with and without UDS were compared. Factors associated with getting UDS were explored using multivariable analyses. Results Five hundred ninety-six patients with ICH were included. UDS was performed in 357 (60%), and positive for methamphetamine in 44 (12.3%). In contrast, only 19 of the 357 patients (5.3%) had a documented history of methamphetamine use. Multivariable analysis demonstrated that patients screened with UDS were more likely to be younger than 45 (OR, 2.24; 95% CI, 0.26–0.78; p = 0.004), male (OR, 1.65; 95% CI, 0.44–0.84; p = 0.003), smokers (OR, 1.74; 95% CI, 1.09–2.77; p < 0.001), with history of methamphetamine use (OR, 10.48; 95% CI, 2.48–44.34; p < 0.001), without diabetes (OR 1.47; 95% CI, 0.471–0.975; p = 0.036), not on anticoagulant (OR, 2.20; 95% CI, 0.26–0.78; p = 0.004), with National Institutes of Health Stroke Scale (NIHSS) > 4 (OR, 1.92; 95%CI, 1.34–2.75; p < 0.001), or require external ventricular drain (EVD) (OR, 1.63; 95%CI, 1.07–2.47; p = 0.021. There was no significant difference in race (p = 0.319). Reported history of methamphetamine use was the strongest predictor of obtaining a UDS (OR,10.48). Five percent of patients without UDS admitted history of use. Conclusion UDS identified 12.3% of ICH patients with methamphetamine use as compared to 5.3% per documented history of drug use. There was no racial bias in ordering UDS. However, it was more often ordered in younger, male, smokers, with history of methamphetamine use, without diabetes or anticoagulant use.

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Association of Baldness with Coronary Artery Disease and Its Severity

Galen Medical Journal ◽

10.31661/gmj.v9i0.1474 ◽

2020 ◽

Vol 9 ◽

pp. 1474

Author(s):

Reza Arefi ◽

Mehdi Pishgahi ◽

Adel Joharimoghaddam ◽

Mohammad Ali Momeni ◽

Mehran Khoshfetrat

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Family History ◽

Small Body ◽

Positive Family History ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Significant Difference ◽

History Of ◽

Artery Disease

Background: The pivotal role of baldness as a potential risk factor for cardiovascular disorders remains a debate, and the small body of literature has generated inconsistent findings. We aimed to assess the association between baldness and the risk for coronary artery disease (CAD) and its severity in a sample of Iranian men. Materials and Methods: This cross-sectional study was performed on 105 consecutive patients suspected to CAD and scheduled for elective coronary angiography. The severity of CAD was determined according to the number of involved coronary vessels. For assessing the severity of baldness, the Hamilton-Norwood scale for grading of androgenetic alopecia in males was used. Results: The overall frequency of CAD in the groups with and without baldness was 88.9% and 72.5%, respectively, indicating a significant difference (P=0.033). Similarly, patients with the family history of baldness suffered more from CAD as compared to those without history (93.3% vs.76.0%). However, no significant association was found between the baldness and non-baldness groups with regard to the severity of CAD (P=0.291). According to the multivariable logistic regression model, the presence of baldness could predict the increased likelihood of CAD (or=3.037, P=0.046). Conclusion: Along with traditional risk factors for CAD, the presence of baldness and positive family history of this phenotype could be considered as the primary determinant for the increasing likelihood of CAD. [GMJ.2020;9:e1474]

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Abstract TP207: Baseline Characteristics And Functional Outcomes Of Pontine And Non-pontine Infarcts: On Behalf Of The Secondary Prevention Of Small Subcortical Strokes (SPS3) Investigators

Stroke ◽

10.1161/str.44.suppl_1.atp207 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Thalia S Field ◽

Jeff Szychowski ◽

Carlos Kase ◽

David Anderson ◽

Jorge Tapia ◽

...

Keyword(s):

Secondary Prevention ◽

Functional Outcomes ◽

Small Vessel Disease ◽

Small Vessel ◽

Multivariable Logistic Regression Model ◽

Significant Difference ◽

All Cause Mortality ◽

History Of ◽

Baseline Characteristics ◽

Stroke Mechanism

BACKGROUND: Pontine stroke accounts for 7% of ischemic infarcts and 25% are due to cerebral small vessel disease (CVSD). Risk factors and functional outcomes distinguishing pontine from non-pontine small vessel infarcts are not well-defined. METHODS: Data are from the Secondary Prevention of Small Subcortical Strokes (SPS3) trial. Patients have MRI-proven small vessel infarcts. The analysis compared baseline characteristics, clinical features and functional outcomes of participants with pontine and non-pontine infarcts. RESULTS: Of 2871 participants, 634 (22%) had pontine infarcts. Pontine patients were more often male (69% vs 61%, p=0.0009), with history of hypertension (82% vs 73%, p<0.0001) and diabetes (45% vs 34%, p<0.0001). More Hispanics (38% vs 28%), Blacks (20% vs 15%), and fewer Whites (40% vs 54%, p<0.0001) had pontine infarcts. Pontine participants were more likely to have no white matter abnormalities (WMA) on MRI (13% vs 2%, p<0.0001). There was no difference in mean age (64 vs 63), presence of multiple infarcts (39% vs 40%), or rates of intra- (18% vs 16%) or extracranial (2% vs 3%) stenosis. Pontine infarcts had worse functional outcomes (mRS≤2 29% vs 23%, p<0.0001) and higher rates of MI on followup (1.1%/yr vs 0.5%, HR 2.2(1.3-3.7)). There was no significant difference for rates of stroke (2.5%/yr vs 2.6%) or all-cause mortality (2.2%/yr vs 1.6%) on followup. In a multivariable logistic regression model, significant differences persisted for gender (OR 1.4(1.1-1.8)), history of hypertension (1.6(1.2-2.1)) and diabetes (1.4(1.1-1.8)), white vs. black race (0.5(0.4-0.7)), and degree of WMA (moderate vs mild 0.6(0.5-0.9); severe vs mild 0.5(0.4-0.7)). CONCLUSIONS: Participants with pontine infarcts had distinct baseline characteristics from those with non-pontine infarcts. These differences suggest that a stroke mechanism distinct from conventional CVSD may be responsible for a majority of pontine infarcts and may help to target future therapeutic strategies.

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Seroprevalence of Human Hydatidosis in Ardabil Province, North-West of Iran

Iranian Journal of Parasitology ◽

10.18502/ijpa.v16i4.7872 ◽

2021 ◽

Author(s):

Zahra Heidari ◽

Behnam Mohammadi-Ghalehbin ◽

Zahra Alizadeh ◽

Soheila Molaei ◽

Hadi Peeri Dogaheh ◽

...

Keyword(s):

Rural Areas ◽

Cystic Echinococcosis ◽

High Titer ◽

Parasitic Infection ◽

Elisa Test ◽

Cluster Sampling ◽

Multivariable Logistic Regression Model ◽

North West ◽

Significant Difference ◽

History Of

Background: Cystic Echinococcosis is considered a cosmopolitan cyclozoonotic parasitic infection. This study aimed at evaluating the seroprevalence of human hydatidosis using ELISA test and find the role of mutable factors such as age, sex, occupation, residency in the broadcast of the parasites in rural Ardabil Province, North-West of Iran. Methods: The study population was 950 asymptomatic individuals selected randomly from urban and rural populations of Ardabil province, North-West of Iran by randomized cluster sampling in 2019-2020. Immunoglobulin G antibodies against Echinococcus granulosus spp. were analyzed by ELISA test. Data were analyzed using SPSS software and Multivariable logistic regression model. Results: Overall, 42 (4.4%) of the participants had anti E. granulosus antibodies in this region. High titer antibodies were most prevalent in people age group of >70 yr old, rural areas, females and people having history of contact with dog that showed significant difference. There was no significant association between the presence of Echinococcus antibodies and sex, occupation, having history of eating unwashed vegetable. Conclusion: This is the first description of the seroprevalence of E. granulosus infection in the population in Ardabil Province, North-West of Iran. Obtained rate of hydatidosis approves the importance of diagnosing human cystic echinococcosis in these regions and it is expected that the authorities be careful to screen the disease.

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Obesity is Not Associated with Perioperative Adverse Events in Patients Undergoing Complex Revision Surgery for the Thoracolumbar Spine

10.21203/rs.3.rs-789945/v1 ◽

2021 ◽

Author(s):

Takashi Hirase ◽

Jeremiah F. Ling ◽

Varan Haghshenas ◽

David Dong ◽

Darrell S. Hanson ◽

...

Keyword(s):

Adverse Events ◽

Spine Surgery ◽

Revision Surgery ◽

Multivariable Analysis ◽

Thoracolumbar Spine ◽

Psoas Muscle ◽

Perioperative Outcomes ◽

Multivariable Logistic Regression Model ◽

Level Of Evidence ◽

Significant Difference

Abstract Study Design: Retrospective cohort studyObjective: This study sought to determine the relationship between obesity and perioperative adverse events (AEs) with patients undergoing complex revision thoracolumbar spine surgery while controlling for psoas muscle index (PMI) as a confounding variable.Methods: Between May 2016 and February 2020, a retrospective analysis of individuals undergoing complex revision surgery of the thoracolumbar spine was performed at a single institution. Obesity was defined as BMI ≥ 30.0 kg/m2. PMI < 500 mm2/m2 for males and < 412 mm2/m2 for females were used to define sarcopenia. A Spine Surgical Invasiveness Index (SSII) > 10 was used to define complex revision surgery. A multivariable logistic regression model was used to ascertain the effects of sarcopenia, obesity, age, and gender on the likelihood of the occurrence of any AE.Results: The study included 114 patients. 54 patients were in the obese cohort and 60 patients in the non-obese cohort. There was not a significant difference in perioperative outcomes of both the obese and non-obese patients. Multivariable analysis demonstrated that sarcopenic individuals had a significantly higher likelihood for an AE than non-sarcopenic individuals (OR: 7.53, 95% CI: 3.05-18.60). Obesity did not have a significant effect in predicting AEs.Conclusions: Obesity is not associated with perioperative AEs, 30-day readmission rates, 30-day re-operation rates, rate of discharge to a facility, or post-operative length of stay (LOS) among patients undergoing complex revision thoracolumbar spine surgery.Level of Evidence: III

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Factor V Leiden Is Associated with Repeated and Recurrent Unexplained Fetal Losses

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656060 ◽

1997 ◽

Vol 77 (05) ◽

pp. 0822-0824 ◽

Cited By ~ 145

Author(s):

Elvira Grandone ◽

Maurizio Margaglione ◽

Donatella Colaizzo ◽

Marina d'Addedda ◽

Giuseppe Cappucci ◽

...

Keyword(s):

Protein C ◽

Strong Association ◽

Activated Protein C ◽

Fetal Loss ◽

Factor V Leiden ◽

Factor V ◽

Significant Difference ◽

History Of ◽

Fv Leiden ◽

Caucasian Women

SummaryActivated protein C resistance (APCR) is responsible for most cases of familial thrombosis. The factor V missense mutation Arg506>Gln (FV Leiden) has been recognized as the commonest cause of this condition. Recently, it has been suggested that APCR is associated with second trimester fetal loss. We investigated the distribution of FV Leiden in a sample (n = 43) of Caucasian women with a history of two or more unexplained fetal losses. A group (n = 118) of parous women with uneventful pregnancies from the same ethnical background served as control. We found the mutation in 7 cases (16.28%) and 5 controls (4.24%; p = 0.011). A statistically significant difference between women with only early fetal loss vs those with late events (p = 0.04) was observed. Our data demonstrate a strong association between FV Leiden and fetal loss. Furthermore, they indicate that late events are more common in these patients.

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PCR-RFLP Detection od PAI-2 Gene Variants: Prevelence in Ethnic Groups and Disease Relationship in patients Undergoing corony Angiography

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656084 ◽

1997 ◽

Vol 77 (05) ◽

pp. 0955-0958 ◽

Cited By ~ 8

Author(s):

Carole A Foy ◽

Peter J Grant

Keyword(s):

Gene Variants ◽

Genotype Distribution ◽

Pima Indians ◽

Significant Difference ◽

Pcr Rflp ◽

History Of ◽

Caucasian Patients ◽

Clinical Conditions ◽

Rflp Assay ◽

Coronary Atheroma

SummaryPAI-2 is a fibrinolytic inhibitor produced predominantly by monocytes. Most PAI-2 is intracellular making study in clinical conditions difficult. Abnormalities in production may be associated with inflammation and fibrinolysis at sites of tissue damage such as the atherosclerotic plaque.PAI-2 gene variants have been described: variant A consists of Asn120, Asn404 and Ser413 and variant B consists of Asp120, Lys404 and Cys413. We designed a PCR-RFLP assay using primers spanning the region containing Asn/Lys404 and Ser/Cys413. Variant B contains an Mwol restriction site. We analysed 302 Pima Indians and 286 healthy Caucasian volunteers. To investigate relationships between genotype and vascular disease we analysed 333 Caucasian patients undergoing coronary angiography.Gene variant B was more common in the Pimas than in Caucasians (p <0.0001). There was no significant difference in genotype distribution between the volunteers and patients. In the patients there was no association between genotype and either a history of MI or extent of coronary atheroma.

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Breastfeeding Training through Role-Play and Effects on Mother-infant Attachment Behaviours: A Randomised Controlled Trial

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/6232 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Farokh Saljughi ◽

Mitra Savabi-Esfahani ◽

Shahnaz Kohan ◽

Soheila Ehsanpour

Keyword(s):

Pregnant Women ◽

Maternal Employment ◽

Controlled Trial ◽

Role Play ◽

Intervention Group ◽

Control Group ◽

Maternal Behaviour ◽

Infant Attachment ◽

Significant Difference ◽

History Of

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.

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