Identifying high-risk subgroups for alcohol consumption among younger and older pregnant women

2015 ◽  
Vol 43 (1) ◽  
Author(s):  
Panagiota Kitsantas ◽  
Kathleen F. Gaffney ◽  
Huichuan Wu
Keyword(s):  
High Risk ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Maternal Age ◽  
Age Groups ◽  
Risk Groups ◽  
Obese Women ◽  
Drinking Alcohol ◽  
Pregnancy Risk ◽  
Cart Analysis

AbstractRecent studies indicate that older women are more likely to consume alcohol during pregnancy, but subgroups at highest risk within the context of maternal age have not been identified. This study identifies subgroups at risk for alcohol use during pregnancy among three age categories using classification and regression trees (CART) analysis.Using the 2002–2009 Pregnancy Risk Assessment Monitoring System (PRAMS) dataset (311,428 records of U.S. women), logistic regression and classification trees were constructed separately for age groups, ≤24, 25–29, and ≥30 years.Overall, 6.5% of women reported drinking alcohol during the last trimester of pregnancy. Alcohol consumption by age group was: 3.7% for ≤24, 5.7% for 25–29, and 10.1% for ≥30 years of age. Women ≤24 years were at greater risk of consuming alcohol if they also smoked (5.8%). Among nonsmokers, higher levels of education and being Hispanic were associated with a 35% increase in alcohol use. Distinct high-risk subgroups emerged for the 25–29-year-old group. Specifically, 12.8% of non-obese women who reported having experienced abuse during pregnancy also reported drinking alcohol in the last trimester. About 16% of women ≥30 years with at least 16 years of education, White or Hispanic with normal or underweight BMI, drank alcohol during their last trimester.Given limited health care resources for prevention and treatment, the early identification of high-risk groups for prenatal alcohol use is critical. This study provides evidence that risk factors contributing to alcohol consumption during pregnancy may differ by maternal age.

scholarly journals Prepregnancy Depression and Breastfeeding Duration: A Look at Maternal Age

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jordyn T. Wallenborn ◽  
Anny-Claude Joseph ◽  
Whitney C. Graves ◽  
Saba W. Masho
Keyword(s):  
Mental Health ◽  
Maternal Age ◽  
Multinomial Logistic Regression ◽  
Age Groups ◽  
The United States ◽  
Poor Mental Health ◽  
Breastfeeding Duration ◽  
Pregnancy Risk ◽  
Care Models ◽  
History Of

Background. In the United States, major depressive disorder affects one in five women aged 20-40 years. During these childbearing years, depression can negatively impact maternal behaviors that are crucial for infant growth and development. This study examined the relationship between prepregnancy depression and breastfeeding duration by maternal age. Methods. Data from Phase 7 (2012-2013) of the Pregnancy Risk Assessment Monitoring System (N=62,483) were analyzed. Prepregnancy depression was dichotomized while breastfeeding duration was categorized as never breastfed, breastfed 8 weeks or less, and breastfed more than 8 weeks. Maternal age was a significant effect modifier; therefore, results were stratified by maternal age. Multinomial logistic regression was used to obtain odds ratios and 95% confidence intervals (CI). Results. For women aged 20-24, 25-29, and 30-34 years with prepregnancy depression, the odds of never breastfeeding and breastfeeding 8 weeks or less were significantly higher than in women with no history of prepregnancy depression. Notably, among women aged 25-29 with prepregnancy depression, the odds of never breastfeeding and breastfeeding 8 weeks or less were 93% (adjusted odds ratio (AOR) = 1.93, 95% CI =1.57-2.37) and 65% (AOR = 1.65, 95% CI = 1.37-1.99) higher compared to women with no history of prepregnancy depression, respectively. Conclusions. Having a history of poor mental health before pregnancy may increase the likelihood of premature breastfeeding cessation. A woman’s mental health status before pregnancy should be considered in reproductive and prenatal care models. Efforts should be made to understand challenges women of specific age groups face when trying to breastfeed.

scholarly journals Patterns of antenatal care in low-versus high-risk pregnancies in Lebanon

2004 ◽  
Vol 10 (3) ◽  
pp. 268-276
Author(s):  
F. El Kak ◽  
M. Chaaya ◽  
O. Campbell ◽  
A. Kaddour
Keyword(s):  
High Risk ◽  
Antenatal Care ◽  
Laboratory Tests ◽  
Risk Groups ◽  
First Trimester ◽  
Pregnancy Risk ◽  
High Risk Women ◽  
Special Diets ◽  
Number Of Visits ◽  
Antenatal Visits

Westudied patterns of antenatal care in low- versus high-risk pregnancies in Lebanon comparing 538 women after delivery in urban Beirut with rural Baka’a. Most women had 9 antenatal care visits with an obstetrician, starting in the first trimester. Care for high-risk and low-risk pregnancies was similar in terms of type of provider, number of visits and timing of first visit. More high-risk women had advice about special diets, supplements and laboratory tests. Maternal and fetal outcomes showed that, controlling for area and pregnancy risk, more antenatal visits were associated with fewer preterm deliveries, more caesarean sections and fewer cases of postpartum depression. Overall, differences between risk groups were small

scholarly journals High-Risk Alcohol Consumption and Late-Life Alcohol Use Problems

2004 ◽  
Vol 94 (11) ◽  
pp. 1985-1991 ◽  
Author(s):  
Rudolf H. Moos ◽  
Penny L. Brennan ◽  
Kathleen K. Schutte ◽  
Bernice S. Moos
Keyword(s):  
High Risk ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Late Life

scholarly journals Investigation of aggravating psychosocial factors on health and predictability of smoking and alcohol use in post adolescent students

2013 ◽  
Vol 1 (2) ◽  
pp. 15 ◽  
Author(s):  
Effrosyni Barmpagianni ◽  
Antonios Travlos ◽  
Athina Kalokairinou ◽  
Athanasios Sachlas ◽  
Sofia Zyga
Keyword(s):  
High Risk ◽  
Alcohol Use ◽  
Behavioral Control ◽  
Risk Groups ◽  
Perceived Behavioral Control ◽  
Adolescent Students ◽  
Subjective Perceptions ◽  
Technological Educational ◽  
Technological Educational Institute ◽  
Attitudes Toward Smoking

Purpose of this study is to explore those factors which affect the health of students in postadolescent age, focusing on smoking and alcohol use, especially in regard to ways of predicting adoption of this behavior and its frequency to detect future users of tobacco and alcohol use but also high-risk groups, <em>i.e</em>. those people who are led to abuses. On the basis of the research part is the Theory of Planned Behaviour, the axes of which are to be investigated. Specifically, the factors evaluated, except for population parameters, behavioral attitudes, <em>i.e.</em> attitudes towards the behavior of tobacco use and alcohol regulations subjective perceptions and perceptions of control, perceived behavioral control and self-efficacy. Intention is explored to continue or start using tobacco and alcohol in the future and evaluate the behavior. The sample consisted of 138 students of postadolescent age, 18-25 years of both sexes, all of the University of Peloponnese and the Technological Educational Institute of Kalamata, Department of Sparta, Greece. The results of a series of statistical analysis, via SPSS 21.0 statistical program revealed the predictive power of perceived behavioral control and subjective norms to the intention of interpreting 64% of the variance of the latter, of the attitudes toward alcohol in relation to intention that interpret 69% of the variance, of the normative beliefs toward smoking with 69% range of interpretation to the dependent variable, of the perceived behavioral control of smoking with 72% and of the attitudes toward smoking with 77% of interpretation. The results demonstrate the significance and application in universities and technological educational institutes appropriate primary preventive interventions for students nonusers of tobacco and alcohol and appropriate programs of secondary and tertiary prevention in heavy users of tobacco and alcohol use and high-risk individual.

scholarly journals Alcohol consumption, obesity and hypertension: Relationship patterns along different age groups in Uganda

2019 ◽  
Author(s):  
Nazarius Mbona Tumwesigye ◽  
Gerald Mutungi ◽  
Silver Bahendeka ◽  
Ronald Wesonga ◽  
Monica H. Swahn ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Age Groups ◽  
Communicable Diseases ◽  
Age Group ◽  
Relationship Patterns ◽  
Non Communicable Diseases ◽  
Prevalence Ratios

AbstractIntroductionUganda is experiencing a significant increase in the prevalence of non-communicable diseases including hypertension and obesity. Frequent alcohol use is also highly prevalent in Uganda and is a key risk factor for both hypertension and obesity. This study determines the trends of frequent alcohol consumption, hypertension and obesity across different age groups, and the extent to which alcohol consumption affects the two.MethodsThe data were extracted from the 2014 National Non-communicable Diseases Risk Factor Survey (N=3,987) conducted among adults aged 18 to 69 years. Hypertension was defined as systolic blood pressure ≥140mmHG or diastolic blood pressure ≥90. Obesity was defined as body mass index >30 kg/m2. Frequent alcohol consumption was defined as alcohol use 3 or more times a week. Multivariable log binomial regression analysis was carried out for each of the two outcome variables against age group and controlled for frequency of alcohol consumption and few other independent factors. Non-parametric tests were used to compare trends of prevalence ratios across age groups. Modified Poisson regression was use in few instances when the model failed to converge.ResultsThe results showed increasing trend in the prevalence of hypertension and frequent alcohol consumption but a declining trend for obesity along different age groups (p<0.01). Frequency of alcohol consumption did not significantly modify the age group-hypertension and age group-obesity relationships although the effect was significant with ungrouped age. There was significance in difference of fitted lines for hypertension prevalence ratios between frequent drinkers and mild drinkers and between abstainers and frequent drinkers. Alcohol consumption did not have any significant effect on obesity-age group relationship.ConclusionThe results call for more research to understand the effect of alcohol on the hypertension-age relationship, and the obesity-age relationship. Why prevalence ratios for hypertension decline among those who take alcohol most frequently is another issue that needs further research.

scholarly journals Younger ages at risk of Covid-19 mortality in communities of color

2020 ◽  
Vol 4 ◽  
pp. 69 ◽  
Author(s):  
Keith P. Klugman ◽  
Solomon Zewdu ◽  
Barbara E. Mahon ◽  
Scott F. Dowell ◽  
Padmini Srikantiah ◽  
...  
Keyword(s):  
South Africa ◽  
High Risk ◽  
Age Groups ◽  
Risk Groups ◽  
Minority Communities ◽  
Communities Of Color ◽  
Younger Age ◽  
Disaggregated Data ◽  
The Uk ◽  
Selection Of

More than 85% of Covid-19 mortality in high income countries is among people 65 years of age or older. Recent disaggregated data from the UK and US show that minority communities have increased mortality among younger age groups and in South Africa initial data suggest that the majority of deaths from Covid-19 are under 65 years of age. These observations suggest significant potential for increased Covid-19 mortality among younger populations in Africa and South Asia and may impact age-based selection of high-risk groups eligible for a future vaccine.

Multicentre study of physical abuse and limb fractures in young children in the East Anglia Region, UK

2019 ◽  
Vol 104 (10) ◽  
pp. 956-961 ◽  
Author(s):  
Piers D Mitchell ◽  
Richard Brown ◽  
Tengyao Wang ◽  
Rajen D Shah ◽  
Richard J Samworth ◽  
...  
Keyword(s):  
High Risk ◽  
Young Children ◽  
Physical Abuse ◽  
Child Protection ◽  
Significant Variation ◽  
Age Groups ◽  
High Standard ◽  
Risk Groups ◽  
Case Conference ◽  
East Anglia

ObjectiveTo determine if the detection of physical abuse in young children with fractures is of uniform high standard in the East Anglia Region of the UK, and whether we can identify areas for improvement in our detection of high-risk groups.DesignMulticentre retrospective 4-year study.Setting7 hospitals across the East Anglia Region of Britain (East Anglia Paediatric Physical Abuse and Fractures study).ParticipantsAge groups and fractures indicated as being at higher risk for physical abuse (all children under 12 months of age, and fractures of humerus and femur in children under 36 months of age).Outcome measuresOur criterion for physical abuse was the decision of a multiagency child protection case conference (CPCC).ResultsProbability of CPCC decision of physical abuse was highest in infants, ranging from 50% of fractures sustained in the first month of life (excluding obstetric injuries) to 10% at 12 months of age. Only 46%–86% of infants (under 12 months) with a fracture were assessed by a paediatrician for physical abuse after their fracture. Significant variation in the use of skeletal surveys and in CPCC decision of physical abuse was noted in children attending different hospitals.ConclusionsIt is a concern that significant variation between hospitals was found in the investigation and detection of physical abuse as confirmed by CPCC decisions. To minimise failure to detect true cases of physical abuse, we recommend that all high-risk children should be assessed by a paediatrician prior to discharge from the emergency department. Our proposed criteria for assessment (where we found probability of CPCC decision of physical abuse was at least 10%) are any child under the age of 12 months with any fracture, under 18 months of age with femur fracture and under 24 months with humeral shaft fracture (not supracondylar).

scholarly journals Estimating Long-Term Drinking Patterns for People with Lifetime Alcohol Use Disorder

2019 ◽  
Vol 39 (7) ◽  
pp. 765-780
Author(s):  
Carolina Barbosa ◽  
William N. Dowd ◽  
Arnie P. Aldridge ◽  
Christine Timko ◽  
Gary A. Zarkin
Keyword(s):  
High Risk ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Transition Probabilities ◽  
World Health ◽  
Drinking Patterns ◽  
Short Term ◽  
Demographic Groups ◽  
Very High

Background. There is a lack of data on alcohol consumption over time. This study characterizes the long-term drinking patterns of people with lifetime alcohol use disorders who have engaged in treatment or informal care. Methods. We developed multinomial logit models using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to estimate short-term transition probabilities (TPs) among the 4 World Health Organization drinking risk levels (low, medium, high, and very high risk) and abstinence by age, sex, and race/ethnicity. We applied an optimization algorithm to convert 3-year TPs from NESARC to 1-year TPs, then used simulated annealing to calibrate TPs to a propensity-scored matched set of participants derived from a separate 16-year study of alcohol consumption. We validated the resulting long-term TPs using NESARC-III, a cross-sectional study conducted on a different cohort. Results. Across 24 demographic groups, the 1-year probability of remaining in the same state averaged 0.93, 0.81, 0.49, 0.51, and 0.63 for abstinent, low, medium, high, and very high-risk states, respectively. After calibration to the 16-year study data ( N = 420), resulting TPs produced state distributions that hit the calibration target. We find that the abstinent or low-risk states are very stable, and the annual probability of leaving the very high-risk state increases by about 20 percentage points beyond 8 years. Limitations. TPs for some demographic groups had small cell sizes. The data used to calibrate long-term TPs are based on a geographically narrow study. Conclusions. This study is the first to characterize long-term drinking patterns by combining short-term representative data with long-term data on drinking behaviors. Current research is using these patterns to estimate the long-term cost effectiveness of alcohol treatment.

Myelodysplastic Syndromes in Patients Younger Than Age 50

2006 ◽  
Vol 24 (34) ◽  
pp. 5358-5365 ◽  
Author(s):  
Andrea Kuendgen ◽  
Corinna Strupp ◽  
Manuel Aivado ◽  
Barbara Hildebrandt ◽  
Rainer Haas ◽  
...  
Keyword(s):  
High Risk ◽  
Median Survival ◽  
Myelodysplastic Syndromes ◽  
Age Groups ◽  
Young Patients ◽  
Risk Groups ◽  
Classification Systems ◽  
Risk Scores ◽  
International Prognostic Scoring System ◽  
Risk Categories

Purpose Myelodysplastic syndromes (MDS) mainly occur in the elderly but can affect younger individuals too. The latter require special consideration to identify suitable candidates for allogeneic stem-cell transplantation, a potentially curative approach carrying a high risk of treatment-related complications. Patients and Methods We report the largest series of young MDS patients as yet, including 232 patients younger than 50 years. Their clinical characteristics and prognosis are compared with 2,496 patients older than 50 years. Results Survival was significantly longer in the younger versus older age group (40 v 23 months, respectively; P < .00005). The difference arose from patients belonging to the low- and intermediate-I–risk categories of the International Prognostic Scoring System (median survival not reached v 45 months, respectively; P < .00005). In contrast, survival was identical for both age groups (8 months for both younger and older patients; P = .81) in the intermediate-II–and high-risk categories. Established classification systems and risk scores were applicable to young patients with primary MDS. Interestingly, a particularly large difference in median survival time was seen between the intermediate-I–and intermediate-II–risk groups (176 v 8 months, respectively). For low-risk patients, the overall survival rate was more than 86% at 20 years. Conclusion According to these results, aggressive treatment approaches should rarely be recommended to younger MDS patients belonging to the low and intermediate-I risk groups.

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