Demographic and Obstetric Risk Factors for Postnatal Psychiatric Morbidity

1996 ◽  
Vol 168 (5) ◽  
pp. 607-611 ◽  
Author(s):  
Rachel Warner ◽  
Louis Appleby ◽  
Anna Whitton ◽  
Brian Faragher
Keyword(s):  
Risk Factors ◽  
Postnatal Depression ◽  
Maternity Leave ◽  
Unplanned Pregnancy ◽  
Psychiatric Morbidity ◽  
Unwanted Pregnancy ◽  
Depression Scale ◽  
Factors Associated ◽  
Head Of Household ◽  
The Impact

BackgroundPostnatal depression follows 10% of live births but there is little consensus on the risk factors associated with its development. Previous smaller studies have been unable to quantify the impact of independent risk factors as relative and attributable risks.MethodThe Edinburgh Postnatal Depression Scale (EPDS) was used to screen a systematic sample of 2375 women, six to eight weeks after delivery. Information on socio-demographic and obstetric variables was collected at the screening interview. The risk factors associated with high EPDS scores (>12) were determined and entered stepwise into a regression model.ResultsFour independent variables were found to be associated with an EPDS score above this threshold. These were an unplanned pregnancy (OR 1.44); not breast-feeding (OR 1.52), and unemployment in either the mother, i.e. no job to return to following maternity leave (OR 1.56), or the head of household (OR 1.50). These four variables appeared to explain the risk associated with other risk factors.ConclusionsAlthough a direct aetiological role for these risk factors is not certain, they may indicate strategies for the prevention of affective morbidity in postnatal women. These may include reducing unwanted pregnancy and employment for women after childbirth.

Postnatal depression and elation among mothers and their partners: Prevalence and predictors

1997 ◽  
Vol 171 (6) ◽  
pp. 550-555 ◽  
Author(s):  
Abbie Lane ◽  
Rita Keville ◽  
Mary Morris ◽  
Anthony Kinsella ◽  
Michael Turner ◽  
...  
Keyword(s):  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Unplanned Pregnancy ◽  
Depression Scale ◽  
Bottle Feeding ◽  
Mood Disturbance ◽  
Antenatal Visit ◽  
Factors Associated ◽  
Public Status ◽  
Increased Risk

BackgroundCorrelates and predictors of mood disturbance at 3 days and 6 weeks postpartum were assessed in Irish mothers and their partners.MethodThe Edinburgh Postnatal Depression Scale (EPDS) and the Highs Scale were used to assess 370 mothers and their partners. Socio-demographic, clinical and obstetric data were collected at patients' first antenatal visit. Factors associated with EPDS scores of ≥ 13 and Highs scores of ≥ 8 were examined.ResultsOn the EPDS 11.4% of mothers scored ≥ 13 at 3 days postpartum and 11% at 6 weeks, while 18.3% of mothers scored ≥ 8 on the Highs Scale at 3 days and 9% at 6 weeks. Scores on the EPDS and Highs Scale were interrelated. Factors associated with EPDS scores of ≥ 13 at 6 weeks were single status, unemployment, unplanned pregnancy, public status and bottle-feeding. The best predictors of EPDS ≥ 13 at 6 weeks were mothers' scores on the EPDS and the Highs Scale at 3 days. Three per cent of partners scored ≥ 13 on the EPDS at 3 days postpartum and 1.2% at 6 weeks.ConclusionsFactors associated with mothers' mood disturbance were readily identifiable and collected routinely at antenatal intake. Mothers' mood within 3 days of delivery was the best predictor of later postnatal depression. Paternal mood disturbance was rare. Certain women may be at increased risk for postnatal mood disturbance and may be amenable to early identification and intervention.

Risk Factors for Delayed Onset of Lactogenesis II Among Primiparous Mothers from a Brazilian Baby-Friendly Hospital

2019 ◽  
Vol 36 (1) ◽  
pp. 146-156 ◽  
Author(s):  
Beatriz de Oliveira Rocha ◽  
Marcia Penido Machado ◽  
Livia Lima Bastos ◽  
Livia Barbosa Silva ◽  
Ana Paula Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Depression Scale ◽  
Factors Associated ◽  
Delayed Onset ◽  
Scale Scores ◽  
Observational Cohort ◽  
Breastfeeding Cessation ◽  
Prospective Longitudinal

Background: Low milk supply is frequently reported as a reason for exclusive breastfeeding cessation. Research aims: To determine the occurrence of, and the risk factors associated with, delayed onset of lactogenesis II among primiparas seen at a Baby-Friendly Hospital in Brazil. Method: We conducted a prospective longitudinal observational cohort study of 224 primiparas who had a singleton delivery. Data were first collected at the hospital. We assessed the onset of lactogenesis on day four postpartum, based on maternal reports of changes in breast fullness. Breastfeeding practices and Edinburgh Postnatal Depression Scale were evaluated on day seven postpartum. Using Poisson regression, we assessed significant factors associated with delayed onset of lactogenesis II. Results: Delayed lactogenesis II occurred in 18.8% ( n = 42) of participants and was significantly associated with alcohol drinking during pregnancy (IRR = 2.710, 95% CI [1.469, 4.996]); Edinburgh Postnatal Depression Scale scores ≥ 10 (IRR = 2.092, 95% CI [1.118, 3.916]), and the age of the mother (IRR: 1.081, 95% CI [1.039, 1.125]). Conclusion: Postpartum depression and alcohol ingestion during pregnancy may be associated with lactogenesis II delay, but more research is needed to elucidate the directionality of these relationships. Older mothers are at risk of delayed lactogenesis II onset. The frequency of delayed lactogenesis in this population is similar to the rates seen in previous Latin America studies and much lower than the ranges seen in North America, possibly because of the low proportion of obesity and severe gestational diabetes in this sample.

scholarly journals Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 105
Author(s):  
Jatapat Hemapanpairoa ◽  
Dhitiwat Changpradub ◽  
Sudaluck Thunyaharn ◽  
Wichai Santimaleeworagun
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Vancomycin Resistance ◽  
Cox Proportional Hazards Model ◽  
Factors Associated ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
The Impact

The prevalence of enterococcal infection, especially E. faecium, is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by E. faecium and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018. One hundred and forty-five patients with E. faecium infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-E. faecium vs. vancomycin susceptible (VS)-E. faecium were 57.7% vs. 38.7% and 69.2% vs. 47.1%, respectively. The median length of hospitalization was significantly longer in patients with VR-E. faecium infection. In logistic regression analysis, VR-E. faecium, Sequential Organ Failure Assessment (SOFA) scores, and bone and joint infections were significant risk factors associated with both 30-day and 90-day mortality. Moreover, Cox proportional hazards model showed that VR-E. faecium infection (HR 1.91; 95%CI 1.09–3.37), SOFA scores of 6–9 points (HR 2.69; 95%CI 1.15–6.29), SOFA scores ≥ 10 points (HR 3.71; 95%CI 1.70–8.13), and bone and joint infections (HR 0.08; 95%CI 0.01–0.62) were significant risk factors for mortality. In conclusion, the present study confirmed the impact of VR-E. faecium infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-E. faecium infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes.

Postpartum psychiatric illness in Arab culture: Prevalence and psychosocial correlates

1997 ◽  
Vol 171 (1) ◽  
pp. 65-68 ◽  
Author(s):  
R. Ghubash ◽  
M. T. Abou-Saleh
Keyword(s):  
Risk Factors ◽  
Postpartum Depression ◽  
United Arab Emirates ◽  
Western Europe ◽  
Arab World ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Self Report ◽  
Arab Culture ◽  
Industrialised Countries

BackgroundThere have been numerous studies of the prevalence of postpartum depression and its putative risk factors in Western Europe and North America, but very few studies in developing countries including the Arab world.MethodNinety-five women admitted to the New Dubai Hospital in Dubai, United Arab Emirates, for childbirth were studied. All subjects were assessed in the postpartum period using clinical and socio-cultural instruments: the Self Report Questionnaire (SRQ) at day 2, the Edinburgh Postnatal Depression Scale (EPDS) at day 7, and the Present State Examination (PSE) at week 8 ± 2 and week 30 ± 2 after delivery.ResultsThe prevalence rate of psychiatric morbidity was 24.5% by the SRQ, 17.8% by the EPDS, and 15.8% by the PSE. A number of psychosocial factors emerged as putative risk factors for postpartum depression.ConclusionsThe prevalence rates of postpartum psychiatric morbidity and its risk factors in this Arab culture are similar to the results obtained in numerous previous studies in industrialised countries. These findings have implications for the early detection and care of women at risk for postpartum depression.

Prevalence and risk factors for chalazion in an older veteran population

2021 ◽  
pp. bjophthalmol-2020-318420
Author(s):  
Sneh Patel ◽  
Natalia Tohme ◽  
Emmanuel Gorrin ◽  
Naresh Kumar ◽  
Brian Goldhagen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tear Film ◽  
International Classification Of Diseases ◽  
Retrospective Case ◽  
Eyelid Margin ◽  
Factors Associated ◽  
Classification Of Diseases ◽  
Health Database ◽  
Irritable Bowel ◽  
The Impact

BackgroundChalazia are common inflammatory eyelid lesions, but their epidemiology remains understudied. This retrospective case–control study examined the prevalence, risk factors and geographic distribution of chalazia in a large veteran population.MethodsData on all individuals seen at a Veterans Affairs (VA) clinic between October 2010 and October 2015 were extracted from the VA health database. Subjects were grouped based on International Classification of Diseases, Ninth Revision (ICD-9) code for chalazion. Univariable logistic regression modelling was used to identify clinical and demographic factors associated with chalazion presence, followed by multivariable modelling to examine which factors predicted risk concomitantly. All cases were mapped across the continental US using geographic information systems modelling to examine how prevalence rates varied geographically.ResultsOverall, 208 720 of 3 453 944 (6.04%) subjects were diagnosed with chalazion during the study period. Prevalence was highest in coastal regions. The mean age of the population was 69.32±13.9 years and most patients were male (93.47%), white (77.13%) and non-Hispanic (93.72%). Factors associated with chalazion risk included smoking (OR=1.12, p<0.0005), conditions of the tear film (blepharitis (OR=4.84, p<0.0005), conjunctivitis (OR=2.78, p<0.0005), dry eye (OR=3.0, p<0.0005)), conditions affecting periocular skin (eyelid dermatitis (OR=2.95, p<0.0005), rosacea (OR=2.50, p<0.0005)), allergic conditions (history of allergies (OR=1.56, p<0.0005)) and systemic disorders (gastritis (OR=1.54, p<0.0005), irritable bowel syndrome (OR=1.45, p<0.0005), depression (OR=1.35, p<0.0005), anxiety (OR=1.31, p<0.0005)). These factors remained associated with chalazion risk when examined concomitantly.ConclusionPeriocular skin, eyelid margin and tear film abnormalities were most strongly associated with risk for chalazion. The impact of environmental conditions on risk for chalazion represents an area in need of further study.

scholarly journals Nephrectomy Delay of More than 10 Weeks from Diagnosis Is Associated with Decreased Overall Survival in pT3 RCC

2021 ◽  
Vol 8 (2) ◽  
pp. 27-33
Author(s):  
Jiping Zeng ◽  
Ken Batai ◽  
Benjamin Lee
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Logistic Regression ◽  
Proportional Hazards ◽  
Surgical Margin ◽  
Cox Proportional Hazards ◽  
Cancer Center ◽  
Integrated Network ◽  
Factors Associated ◽  
The Impact

In this study, we aimed to evaluate the impact of surgical wait time (SWT) on outcomes of patients with renal cell carcinoma (RCC), and to investigate risk factors associated with prolonged SWT. Using the National Cancer Database, we retrospectively reviewed the records of patients with pT3 RCC treated with radical or partial nephrectomy between 2004 and 2014. The cohort was divided based on SWT. The primary out-come was 5-year overall survival (OS). Logistic regression analysis was used to investigate the risk factors associated with delayed surgery. Cox proportional hazards models were fitted to assess relations between SWT and 5-year OS after adjusting for confounding factors. A total of 22,653 patients were included in the analysis. Patients with SWT > 10 weeks had higher occurrence of upstaging. Using logistic regression, we found that female patients, African-American or Spanish origin patients, treatment in academic or integrated network cancer center, lack of insurance, median household income of <$38,000, and the Charlson–Deyo score of ≥1 were more likely to have prolonged SWT. SWT > 10 weeks was associated with decreased 5-year OS (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.15–1.33). This risk was not markedly attenuated after adjusting for confounding variables, including age, gender, race, insurance status, Charlson–Deyo score, tumor size, and surgical margin status (adjusted HR, 1.13; 95% CI, 1.04–1.24). In conclusion, the vast majority of patients underwent surgery within 10 weeks. There is a statistically significant trend of increasing SWT over the study period. SWT > 10 weeks is associated with decreased 5-year OS.

#31: Risk Factors Associated with Mortality due to Multidrug-Resistant Organisms in Pediatric Oncology Patients with Febrile Neutropenia

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S15-S16
Author(s):  
Miguel A Minero ◽  
Asia Castro ◽  
Martha Avilés-Robles
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Pediatric Patients ◽  
Bloodstream Infections ◽  
Oncology Patients ◽  
Factors Associated ◽  
Patients With Cancer ◽  
The Impact

Abstract Background Infectious processes are frequent complications presented in pediatric patients with cancer. Currently, the indiscriminate use of antibiotics induces resistance to available treatments, creating the emergence of multi-drug-resistant organisms (MDROs). Due to the impact in morbidity and mortality secondary to MDRO infection, we aimed to identify risk factors associated with mortality in infections due to MDROs in pediatric patients with cancer. Methods Case–control study nested in a prospective cohort of pediatric oncology patients with febrile neutropenia (FN) at Hospital Infantil de México Federico Gómez (HIMFG) in Mexico City from March 2015 to September 2017. MDRO was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories. Patients with FN episodes who died from an infection due to MDROs were defined as cases and patients with FN episodes of an infection due to MDROs who did not die were defined as controls. Mucositis, septic shock, PICU stay, and bacterial prophylaxis (Trimethoprim/Sulfamethoxazole) were compared between groups. Descriptive statistics was performed and Pearson χ 2 or Student’s t-test were used to compare risk factors between groups. Results A total of 929 FN episodes were documented, 44.4% episodes occurred in male patients, mean age was 7.9 years, with the population under 5 years being the most represented (68.2%). The most frequent diagnosis was acute lymphoblastic leukemia in 75% followed by rhabdomyosarcoma in 10.5% and acute myeloid leukemia in 9.6%. Prophylaxis (trimethoprim/sulfamethoxazole) was used in 86%, mucositis was present in 9.2% of episodes. 12.1% had septic shock and 4.7% were admitted to PICU. In 148 FN episodes (15.9%) a microorganism was identified, of these 50 (33.7%) were due to an MDROs. Urinary tract infection was the most frequent site (49%), followed by bloodstream infections (47%). K. pneumoniae was the most frequent MDRO in 22.8%, followed by E. coli in 19.2% and P. aeruginosa in 14%. Septic shock was presented in 26% of MDROs infections. Overall mortality was 1.94% and only 0.86% (8) were secondary to MDROs. Of patients with MDRO isolated mortality was 30% (15/50). Mortality associated with bloodstream infection due to MDROs was 25% compared with other source of MDROs infections (3%) (P = 0.01). Septic shock was present in 40% of patients with death due to MDROs infection (P = 0.001). Conclusions In our population of children with FN episodes who had an isolated microorganism, infection due to MDROs are high (33.7%) and MDROs infection-directed mortality was as high as 30%. Bloodstream infections and septic shock were risk factors associated with mortality due to MDROs.

LESSONS FROM THE FIRST COVID WAVE AND STRAIN - A STUDY OF PSYCHIATRIC DISORDERS IN THE PANDEMIC - FACTORS ASSOCIATED AND PREVENTIVE STRATEGIES

2021 ◽  
pp. 22-28
Author(s):  
Ojas Unavane ◽  
Karishma Rupani ◽  
Kajal Makwana ◽  
Shilpa Adarkar ◽  
Upali Anand
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Past History ◽  
Psychiatric Morbidity ◽  
Working Hours ◽  
Causative Factor ◽  
Lessons Learned ◽  
Daily Routine ◽  
Snowball Sampling ◽  
Factors Associated

Background: The COVID-19 pandemic has affected people worldwide. Desperate times (SARS COV-2 being a novel virus) called in for desperate measures in that right from its containment strategies to failed treatment trials have had various ramications affecting various spheres of our lives. It has already been established that the pandemic has taken a toll on mental health, cutting across all strata of society. However, apart from the pandemic in it itself as a causative factor, there are various other factors contributing to the increase in the mental health burden; some of which are modiable. An in-depth understanding of these modiable risk factors is the need of the hour, so that policies and guidelines can be framed accordingly to salvage what can be; of the mental health of the population at large. Understanding these modiable risk factors are lessons learned which will help us mitigate the mental health morbidity during the subsequent waves of the Pandemic. Aim: To study the prevalence and factors associated with the psychiatric morbidity in the general population during the COVID - 19 pandemic. Methods: The data was collected by snowball sampling using an online form to collect the demographic and clinical variables with the DASS - 21 scale appended. Conclusion: The prevalence of depression and anxiety was found to be 25.3 % and 26.2 % respectively. The signicant factors associated with psychiatric morbidity ranged across the psychological biological and social domains, some non-modiable whilst others modiable risk factors. The modiable factors identied were substance use, past history of psychiatric illness, chronic physical illness, increased screen time use, watching news (online) about the pandemic, working hours, disruption of a daily routine and a change in the lifestyle of people

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