scholarly journals Pregnancy complications, substance abuse, and prenatal care predict birthweight in adolescent mothers

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Miriam Hacker ◽  
Christine Firk ◽  
Kerstin Konrad ◽  
Kerstin Paschke ◽  
Joseph Neulen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
High Risk ◽  
Prenatal Care ◽  
Health Outcomes ◽  
Adolescent Mothers ◽  
Pregnancy Complications ◽  
Roc Analysis ◽  
Low Birthweight ◽  
Abuse During Pregnancy

Abstract Background Reduced birthweight is associated with adverse physical and mental health outcomes later in life. Children of adolescent mothers are at higher risk for reduced birthweight. The current study aimed to identify the key risk factors affecting birthweight in a well-characterized sample of adolescent mothers to inform preventive public health efforts. Methods Sixty-four adolescent mothers (≤ 21 years of age) provided detailed data on pregnancy, birth and psychosocial risk. Separate regression analyses with (1) birthweight and (2) low birthweight (LBW) as outcomes, and pregnancy complications, prenatal care, maternal age, substance abuse during pregnancy, socioeconomic risk, stressful life events and the child’s sex as independent variables were conducted. Exploratively, a receiver operating characteristic (ROC) analysis was performed to investigate the quality of the discriminatory power of the risk factors. Results The following variables explained variance in birthweight significantly: prenatal care attendance (p = .006), pregnancy complications (p = .006), and maternal substance abuse during pregnancy (p = .044). Prenatal care attendance (p = .023) and complications during pregnancy (p = .027) were identified as significant contributors to LBW. Substance abuse (p = .013), pregnancy complications (p = .022), and prenatal care attendance (p = .044) showed reasonable accuracy in predicting low birthweight in the ROC analysis. Conclusions Among high-risk adolescent mothers, both biological factors, such as pregnancy complications, and behavioural factors amenable to intervention, such as substance abuse and insufficient prenatal care, seem to contribute to reduced birthweight in their children, a predisposing factor for poorer health outcomes later in life. More tailored intervention programmes targeting the specific needs of this high-risk group are needed.

Estimation of risk factors associated with difficult birth in ewes

2018 ◽  
Vol 58 (6) ◽  
pp. 1125 ◽  
Author(s):  
B. J. Horton ◽  
R. Corkrey ◽  
G. N. Hinch
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Litter Size ◽  
Low Birthweight ◽  
Condition Score ◽  
Cause Of Deaths ◽  
Ease Score ◽  
Very High ◽  
Australian Merino

In eight closely recorded Australian Merino and crossbred sheep flocks, all lamb deaths were examined and the cause of deaths identified if possible. Dystocia was identified as one of the major causes of lamb death and this study examined factors that could be used to identify ewes at high risk of dystocia, either to avoid dystocia or to assist with early intervention where possible. Dystocia was least common in lambs of ~4.8 kg, but there was a higher risk at both lower and higher birthweights. Dystocia with both low and high birthweight was more common in older ewes, ranging from negligible low birthweight dystocia in ewes less than 3 years old at lambing, to 5% in older ewes. Low birthweight dystocia increased with increasing litter size, with 40% dystocia in ewes at least 4 years of age with triplets. In contrast, high birthweight dystocia was not affected by litter size. A previous record of low birthweight dystocia was a risk factor for future low birthweight dystocia, but the same relationship was not observed for high birthweight dystocia. A high lambing ease score (difficult birth) with high birthweight was a risk factor for future high birthweight dystocia, but this was not the case for low birthweight dystocia. These differences between the risk factors for low and high birthweight dystocia suggest that they have different causes. High ewe liveweight and condition score during pregnancy may be additional indicators of the risk of dystocia, particularly for ewes with high liveweight in the first 60 days of pregnancy. For most ewes dystocia was difficult to predict, but there was a small proportion of ewes with a very high risk of dystocia and if these could be identified in advance they could be monitored much more closely than the rest of the flock.

Long-term health consequences of early-life exposure to substance abuse: an epigenetic perspective

2013 ◽  
Vol 4 (4) ◽  
pp. 269-279 ◽  
Author(s):  
A. M. Vaiserman
Keyword(s):  
Substance Abuse ◽  
Health Outcomes ◽  
Adult Life ◽  
Developmental Programming ◽  
Human Beings ◽  
Maternal Substance Abuse ◽  
Organ Systems ◽  
Abuse During Pregnancy ◽  
The Impact

A growing body of evidence highlights the importance of the nutritional or other environmental stimuli during critical periods of development in the long-term programming of organ systems and homeostatic pathways of the organism. The adverse influences early in development and particularly during intrauterine life have been shown to programme the risks for adverse health outcomes in adult life. The mechanisms underlying developmental programming remain still unclear. However, increasing evidence has been accumulated indicating the important role of epigenetic regulation including DNA methylation, histone modifications and non-coding RNAs in the developmental programming of late-onset pathologies, including cancer, neurodegenerative diseases, and type 2 diabetes. The maternal substance abuse during pregnancy, including smoking, drinking and psychoactive drug intake, is one of the important factors determining the process of developmental programming in modern human beings. The impact of prenatal drug/substance exposure on infant and early childhood development is currently in the main focus. The long-term programming effects of such exposures on aging and associated pathologies, however, have been reported only rarely. The purpose of this review is to provide a summary of recent research findings which indicate that maternal substance abuse during pregnancy and/or neonatal period can programme not only a child's health status, but also can cause long-term or even life-long health outcomes via mechanisms of epigenetic memory.

Predictors of Greater Than 80% Two-Year Mortality in Primary Myelofibrosis: A Mayo Clinic Study of 884 Karyotypically-Annotated Cases

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2806-2806
Author(s):  
Ayalew Tefferi ◽  
Naseema Gangat ◽  
Rakhee Vaidya ◽  
Kebede Begna ◽  
Curtis A. Hanson ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Blood Cell ◽  
Mayo Clinic ◽  
Roc Analysis ◽  
Primary Myelofibrosis ◽  
Mortality Rates ◽  
Allogenic Stem Cell Transplantation ◽  
High Risk Disease ◽  
Blast Count

Abstract Abstract 2806 Background: A high degree of prognostic certainty is required to recommend or discourage high risk treatment procedures in primary myelofibrosis (PMF). The Dynamic International Prognostic Scoring System (DIPSS-plus) uses eight risk factors to predict overall survival (OS) in PMF: unfavorable karyotype, peripheral blood (PB) blast count ≥1%, platelet count <100 × 109/L, white blood cell count (WBC) >25 × 109/L, hemoglobin level <10 g/dL, red blood cell transfusion need, constitutional symptoms, and age >65 years (Gangat et al. JCO 2011;29 :392). The presence of four or more of these risk factors defines high-risk disease. purpose: The purpose of the current study was to enhance the prognostic weight of some of the DIPSS-plus risk factors with the intent to identify one or two parameters that can reliably predict death in the first two years of disease. Methods: An updated Mayo Clinic database of 884 karyotypically-annotated patients with PMF was used. Calculations of 2-year mortality rates and variables considered for prognostic value were from time of referral to the Mayo Clinic. Cytogenetic risk categorization per DIPSS-plus was further refined to capture additional prognostic information from monosomal karyotype (MK) (Vaidya et al. Blood 2011;117 :5612) and inv(3)/i(17q) abnormalities (Caramazza et al. Leukemia 2011;25 :82). Receiver operating characteristic (ROC) analysis was employed to define best discriminant levels. Results: To date, 564 (64%) deaths have been documented. Each one of the aforementioned DIPSS-plus risk factors was associated with a 2-year mortality rate that ranged from 42% (PB blast count ≥1%) to 60% (unfavorable karyotype). High-risk disease per DIPSS-plus was associated with 57% two-year mortality. The only risk factors that were associated with >80% two-year mortality were MK (n =19) and inv(3)/i(17q) abnormalities (n =8) and both were associated with significantly worse survival, compared to other unfavorable karyotype (n =102): HR (95% CI) of 5.1 (3.1−8.4) and 3.9 (1.7−8.8), respectively. ROC analysis identified PB blast counts of 2% and 9% (AUC 0.62) and WBC of 43 × 109/L (AUC 0.66) as best discriminant levels for predicting 2-year mortality; OS was significantly worse in the presence of PB blast >9% (HR 4.1, 95% CI 2.8–6.1) vs. 2% to 9% (HR 1.8, 95% CI 1.5–2.2) vs. <2%; the corresponding 2-year mortality rates were 73%, 46% and 25%. OS was also significantly worse in the presence of WBC ≥40 × 109/L (HR 2.8, 95% CI 2.2–3.6) vs. 26–39 × 109/L (HR 1.6, 95% CI, 1.2–2.1) vs. <26 × 109/L; the corresponding 2-year mortality rates were 63%, 42% and 28%. Two-year mortality rates exceeded 80% in the presence of any two of the following: PB blast count >9%, WBC ≥40 × 109/L or unfavorable karyotype other than MK or inv(3)/i(17q). Conclusions: A greater than 80% 2-year mortality in PMF is predicted by the presence of MK, inv(3)/i(17q) abnormalities, or any two of the following: PB blast >9%, WBC ≥40 × 109/L, other unfavorable karyotype. Such patients and those with high DIPSS-plus risk should be referred to allogenic stem cell transplantation earlier than later. Disclosures: No relevant conflicts of interest to declare.

scholarly journals HIGH RISK OF POSTPARTUM HAEMORRHAGE AT BOUAKÉ UNIVERSITY HOSPITAL (NORTH-CENTRAL CÔTE D’IVOIRE)

2021 ◽  
Vol 1 (11) ◽  
pp. 78-91
Author(s):  
Zahouo Pascale Ghislaine KOUAMÉ ◽  
Adou Serge Judicaël ANOUA ◽  
N’Doumy Noël ABE
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Adolescent Mothers ◽  
Cote D'ivoire ◽  
Postpartum Haemorrhage ◽  
Côte D’Ivoire ◽  
Community Intervention ◽  
University Hospital ◽  
Cote D’Ivoire ◽  
Côte D'ivoire

Objectives. Postpartum haemorrhage is one of several direct causes of maternal death in Côte d’Ivoire. It is recurrent in the department of gynaecology and obstetrics at Bouaké University Hospital (CHU de Bouaké), but little is known to date about the underlying risk factors. The present study aims to describe the levels and trends displayed by the risk factors of postpartum haemorrhage before determining the contributing social factors in the aforesaid department. Material and methods. This study is retrospective in nature, concerning the period from 2014 to 2016. Data was obtained from delivery records and through individual interviews. The overall approach adopted is an anthropological one. Results. Postpartum haemorrhage is significant in light of its very high and increasing incidence (22.31%) among multiparous mothers. Within the latter category, fatal complications are a critical problem, with an annual average estimated at 35.98% and on the rise. The overall situation is alarming in view of this progressive deterioration. The persistence of the reproductive morbidity is attributable to various economic, social, cultural, and infrastructural factors. Conclusions. Communicational strategies are proposed as a type of community intervention conducive to social and behavioural change, with multiparous mothers as a priority target group, followed by older mothers in the medium term and by adolescent mothers in the long term. This should raise awareness about high-risk reproductive behaviours and practices as well as the environmental, economic, social, cultural, and infrastructural factors correlated to postpartum haemorrhage, with the ultimate goal of improving the quality and safety of reproductive practices. Keywords: postpartum haemorrhage, reproductive behaviour, high risk, obstetric emergency, maternal morbidity, Côte d’Ivoire.

Developing a Cerebral Palsy Risk Score for Newborns

2021 ◽  
Vol 104 (2) ◽  
pp. 240-246
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cerebral Palsy ◽  
High Risk ◽  
Risk Score ◽  
Low Birthweight ◽  
Prediction Score ◽  
University Hospital ◽  
P Value ◽  
Close Monitoring

Background: Cerebral palsy (CP) causes developmental delays, affecting quality of life. Many risk factors are theorized however, no total risks summary exists, nor a CP prediction score for newborns. The result is under surveillance, treatment delays, and non-rectifiable complications. Objective: To establish total risk factors and create a prediction score for assessing CP neonatal risk before discharge. A prediction score has great utility for medical professionals and parents in screening high-risk patients and developing adequate monitoring systems. Materials and Methods: Using a case-controlled retrospect of children aged 0 to 2 years, born at Thammasat University Hospital, Thailand between 2005 and 2014, prenatal, perinatal, and postnatal risks were compared between children without CP as control, and those diagnosed with CP as case, by multivariable logistic regression. Predictors were assessed with area under the receiver operating characteristic (AuROC), odds ratio (OR), 95% confidence interval (CI), p-value, and clinical predisposition. Logistic regression was applied, including calibration, validation, and categorization of risk. Results: Cerebral and non-cerebral malformations, multi-fetal gestation, low birthweight, and neonatal sepsis were found as potential predictors, scoring 3, 1.5, 1, 2, 2.5, respectively, AuROC being 0.86 (95% CI 0.79 to 0.92). Low, moderate, and high-risk groups were set with scores of less than 1, 1.5 to 3, and more than 3.5, respectively. Conclusion: The present predictive CP risks and scoring system shows excellent discrimination power. If newborns were categorized in the highrisk group, close monitoring and surveillance are needed. Keywords: Cerebral palsy, Risk score, Prenatal, Perinatal, Postnatal

scholarly journals Is adolescent pregnancy a risk factor for low birth weight?

2013 ◽  
Vol 47 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Alzira Maria D'avila Nery Guimarães ◽  
Heloísa Bettiol ◽  
Luiz De Souza ◽  
Ricardo Q Gurgel ◽  
Maria Luiza Dória Almeida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Birth Weight ◽  
Prenatal Care ◽  
Low Birth Weight ◽  
Adolescent Pregnancy ◽  
Adolescent Mothers ◽  
Northeastern Brazil ◽  
Smoking During Pregnancy ◽  
The Impact

OBJECTIVE: The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW) babies. METHODS: This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS: We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (< 20 years of age). Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS: Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.

Reducing AIDS and Substance Abuse Risk Factors Among Homeless, HIV-Infected, Drug-Using Persons

2000 ◽  
Vol 10 (1) ◽  
pp. 15-33 ◽  
Author(s):  
J. Richard Lewis ◽  
David P. Boyle ◽  
Linda S. Lewis ◽  
Maestro Evans
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Substance Use ◽  
High Risk ◽  
Treatment Program ◽  
Chart Review ◽  
Day Treatment ◽  
Retrospective Chart Review ◽  
Day Treatment Program ◽  
Abuse Risk

Objective: The impact of a comprehensive HIV education, housing support, and 12-step recovery program in a day treatment program for homeless persons infected with HIV was studied. Method: Participants' knowledge of HIV and substance abuse risk factors was assessed for a group of new clients and for a group of clients enrolled for 3 months using an author-developed questionnaire. Continuation of high-risk sexual and substance use behaviors was assessed using the approach. Success in maintaining housing and 12-step recovery was assessed using a retrospective chart review on a separate group of past participants. Results: Statistically significant positive changes in participants' knowledge of HIV and substance use and a decrease in self-reported high-risk behaviors were found. The retrospective chart review also indicated positive changes in housing stability and substance abuse recovery. Conclusions: Preliminary results support the conclusion that the day treatment program had positive effects on the three variables of concern.

scholarly journals Who Is at Risk for Preeclampsia? Risk Factors for Developing Initial Preeclampsia in a Subsequent Pregnancy

2020 ◽  
Vol 9 (4) ◽  
pp. 1103 ◽  
Author(s):  
Tamar Wainstock ◽  
Ruslan Sergienko ◽  
Eyal Sheiner
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Gestational Diabetes ◽  
Perinatal Mortality ◽  
Preterm Delivery ◽  
Pregnancy Complications ◽  
Low Birthweight ◽  
Subsequent Pregnancy ◽  
Increased Risk ◽  
Inter Pregnancy Interval

Background: The incidence of preeclampsia, which may cause significant maternal and perinatal morbidity, has risen in recent years, therefore it is critical to identify women at risk for preeclampsia. We aimed to identify risk factors in the first pregnancy (not complicated by preeclampsia) for preeclampsia in the subsequent pregnancy. Methods: A retrospective population-based nested case-control study was conducted, including all women with first (P1) and second (P2) singleton consecutive deliveries. Women who had experienced preeclampsia in their first pregnancy were excluded. Cases were defined as women with preeclampsia in their second pregnancy, and were compared to the controls, defined as women without this diagnosis in second pregnancy. Characteristics and complications of the first pregnancy were compared between cases and controls, and multivariable regression models were used to study the association between pregnancy complications (in the first pregnancy) and preeclampsia (in the subsequent pregnancy), while adjusting for confounders. Results: A total of 40,673 women were included in the study, 1.5% of second pregnancies were diagnosed with preeclampsia (n = 627, i.e., Cases). Cases, as compared to controls were older in their 1st pregnancy, with longer inter-pregnancy interval, and were more likely to have the following complications in their first pregnancy: preterm delivery (15.0% vs. 7.7%), low birthweight (17.9% vs. 10.3%), perinatal mortality (3.2% vs. 1.1%), and gestational diabetes (7.0% vs. 2.7%). In the multivariable model, adjusted for maternal age, obesity and inter-pregnancy interval, either one of these first pregnancy complications were independently associated with an increased risk for preeclampsia (adjusted OR for either of first pregnancy complication =1.73; 95% CI 1.37–2.14, <0.001), and the risk was greater for each additional complication (adjusted OR for ≥2 risk factors =3.54; 95% CI 2.28–5.52, p < 0.001). Conclusions: Complications in first pregnancy, including preterm delivery, perinatal mortality and gestational diabetes, are risk factors for primary preeclampsia in second pregnancy. First pregnancy may serve as a window of opportunity to identify women at risk for future preeclampsia and other morbidities later in life.

Sign in / Sign up

Export Citation Format

Share Document