scholarly journals Sociodemographic and obstetric factors associated with the interruption of breastfeeding within 45 days postpartum - Maternar Cohort Study

2021 ◽  
Vol 21 (2) ◽  
pp. 575-586
Author(s):  
Vanessa Luciani Santos ◽  
Bruna Luiza Holand ◽  
Michele Drehmer ◽  
Vera Lúcia Bosa
Keyword(s):  
Maternal Age ◽  
Protective Factor ◽  
Maternity Hospital ◽  
Maternal Grandmother ◽  
Factors Associated ◽  
Robust Variance ◽  
Puerperal Woman ◽  
Obstetric Factors ◽  
Two Phases ◽  
Crude Analysis

Abstract Objectives: to evaluate and identify the prevalence of interruption of breastfeeding (BF) in the period of up to 45 days postpartum and the associated sociodemographic and obstetric factors. Methods: cohort of 622 puerperal women, selected between 2018 and 2019 in a reference maternity hospital in the South Brazil. Data collection was carried out in two phases, the first in the maternity hospital during hospitalization of the puerperal woman and the newborn and the second through a telephone call, which occurred 60 days after birth. Poisson regressions with robust variance were performed to identify the factors associated with interruption of BF in the first 45 days of life. The variables that presented p<0.20 in the crude analysis were included in the adjusted analysis. Results: the interruption of BF at 45 days was identified in 14% of the sample. Higher maternal age (PR= 0.46; CI95%= 0.22-0.93), eight years or less of education (PR= 2.11; CI95%= 1.05-4.25), support from the maternal grandmother (PR= 1.91; CI95%= 1.20-3.06) and receiving complement at the maternity hospital (PR= 1.53; CI95%= 1.04-2.25) were factors related to the interruption of BF in the 45-day postpartum period. Conclusion: maternal age ≥35 was a protective factor, and less education, the support of the maternal grandmother and receiving complement at the maternity hospital were predictors of early breastfeeding abandonment.

scholarly journals Tooth Loss Condition and Social Discrimination in Brazilian Healthcare Services

2021 ◽  
Vol 66 ◽  
Author(s):  
Alexandre F. Bulgarelli ◽  
Camila M. dos Santos ◽  
Rafaela S. Rech ◽  
Alexandre Baumgarten ◽  
Bárbara N. Goulart
Keyword(s):  
Health Services ◽  
Skin Color ◽  
Health Care Services ◽  
Tooth Loss ◽  
Protective Factor ◽  
Healthcare Services ◽  
Social Discrimination ◽  
Factors Associated ◽  
Robust Variance ◽  
Care Services

Objective: To explore factors associated with social discrimination against users of health services regarding dental aesthetic conditions.Methods: Based on a Brazilian National Survey, multivariate Poisson regressions with robust variance were used to explore the association of outcome discrimination related to different motivations in health services and exposure to sociodemographic and dental variables. Effect modification by complete prosthesis wearing was assessed.Results: Among the 60,200 people interviewed, 11.5% reported being discriminated against in health services. For women, a higher prevalence of discrimination was found among those in the age group of 30–44 years. For both sexes, discrimination was associated with black and brown skin color. Regarding dental characteristics, the higher the tooth loss was, the higher the prevalence of discrimination; however, complete prosthesis wearing presented as a protective factor. Social discrimination was the major motivation for reported discrimination and presented higher prevalence in edentulous individuals who did not wear prosthesis.Conclusion: Dental loss may lead to self-reported discrimination in health care services. The prevalence of discrimination increases when tooth loss increases, and the major reason associated is social discrimination.

scholarly journals APGAR SCORE RELATED TO MATERNAL/OBSTETRICAL AND NEONATAL FACTORS

2019 ◽  
Vol 5 ◽  
Author(s):  
Taissa Braga da Silva ◽  
Antônio José de Miranda Dantas Terceiro ◽  
Amanda Cavalcante Moreira ◽  
Victória De Maria Pereira Rocha Santos ◽  
Jéssica Oliveira de Sousa ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnant Woman ◽  
Maternal Age ◽  
Evaluation Method ◽  
Maternity Hospital ◽  
Live Births ◽  
Good Evaluation ◽  
Index Evaluation ◽  
Obstetric Factors ◽  
Type Of Delivery

Objective: To analyze the influence of maternal/obstetric and neonatal factors on the results of the Apgar Index evaluation. Method: Documentary, retrospective study with Declarations of Live Births of a hospital and maternity hospital in Sobral/CE in 2015. The variables analyzed were: maternal age, number of prenatal consultations performed by the pregnant woman, type of delivery, gestational age and weight at born. Result: The best indices were related to the maternal age of 21 to 30 (38.42%) years. Cesarean delivery concentrated the highest percentages (46.43%) in the score of 8-10. Observing the prenatal consultations performed, the best index was represented by the pregnant women who performed 7 more consultations (58.03%). The gestations of 37 to 41 weeks' gestation were concentrated at the best indices (68.99%). Children weighing 2,500 g or more presented the best indices (8-10) with 69.8%. Conclusion: The maternal/obstetric factors analyzed are important for a good evaluation of the Apgar Index.

scholarly journals Social and obstetric factors associated with the way of delivery: reality of a maternity school in the interior of the northeast

2021 ◽  
Vol 10 (10) ◽  
pp. e39101018514
Author(s):  
Danielle Alves de Andrade Rebouças ◽  
Thaisa Soares Caldas Batista ◽  
Lucas Aragão da Hora Almeida ◽  
Patrícia Silva Tofani ◽  
Grazielle Batista dos Santos ◽  
...  
Keyword(s):  
Elementary Education ◽  
Marital Status ◽  
Descriptive Analysis ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Maternity Hospital ◽  
Postpartum Women ◽  
Cross Sectional ◽  
Factors Associated ◽  
Obstetric Factors

The study aims to identify the social and obstetric factors associated with the mode of delivery of postpartum women attending a public maternity hospital located in the interior of the state of Sergipe, in the northeast region. This is a cross-sectional study that included 1,149 postpartum women in the immediate period, carried out between November 2016 and December 2019, who underwent functional kinesiological assessment for physical therapy care. Descriptive analysis and binary logistic regression were performed using the mode of delivery as the dependent variable. The results showed that the prevalence of cesarean deliveries was of 49.24% (n=565). Most puerperal women were young, married, primiparous and with elementary education. Vaginal delivery was associated with postpartum women with married marital status (OR, 10.463; 95%CI, 2.367-46.254), multipregnancy (OR, 9.54; 95% CI, 7.19-12.65), multiparous (OR, 8.79; 95%CI, 6.66-11.62), with no pain (OR, 2.08; 95%CI, 1.63-2.65), no comorbidities (OR,1.69, 95%CI, 1.23-2.28), number of prenatal consultations from one to seven (OR, 1.534; 95%CI, 1.18-1.98), and without difficulty to breastfeed (OR, 1.373, 95%CI, 1.04-1.80). The cesarean delivery route was associated with abortion in primiparae (OR, 1.69; 95%CI, 1.192-2.415) and education at the elementary level. (OR, 2.99; 95%CI, 1.403-6.411). It is concluded that social factors (education level and marital status), obstetric factors (parity, number of pregnancies, comorbidities, obstetric care) and immediate puerperal complaints (pain and difficulty in breastfeeding) were associated with the modes of delivery.

Neonatal Outcome of Macrosomia

2020 ◽  
Vol 40 (2) ◽  
pp. 114-119
Author(s):  
Subhash Chandra Shah ◽  
Anusmriti Guragain ◽  
Shreejana Pandey ◽  
Ajaya Kumar Dhakal
Keyword(s):  
Maternal Age ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Pregnancy Induced Hypertension ◽  
Factors Associated ◽  
Adverse Neonatal Outcome ◽  
Induced Hypertension ◽  
Appropriate For Gestational Age ◽  
Prolonged Hospital

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

scholarly journals Application of a second opinion ultrasound in Breast Imaging Reporting and Data System 4A cases: can immediate biopsy be avoided?

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110244
Author(s):  
Yantao Cai ◽  
Chenfang Zhu ◽  
Qianqian Chen ◽  
Feng Zhao ◽  
Shanyu Guo
Keyword(s):  
Minimally Invasive ◽  
Predictive Factors ◽  
Breast Imaging ◽  
Protective Factor ◽  
Multivariate Analyses ◽  
Data System ◽  
Second Opinion ◽  
Factors Associated ◽  
Peripheral Location ◽  
Biopsy Rate

Objective The probability of malignancy in women who are diagnosed with a Breast Imaging Reporting and Data System (BI-RADS) 4A score is low. Application of a second opinion ultrasound (SOUS), which is low in cost and minimally invasive, may lower the biopsy rate for patients who fall into this category. This study aimed to apply SOUS to patients with a BI-RADS score of 4A and predict the pathological results of a biopsy. Methods One hundred seventy-eight patients were analyzed. Univariate and multivariate analyses were performed to screen for predictive factors that are associated with malignancy. Categorical alteration of downgraded, unchanged, or upgraded was made after SOUS results. Changes in category were compared with biopsies to determine their predictive value of benignancy or malignancy. Results Independent factors associated with malignancy were age (>50 years), tumor size (≥20 mm), margin (not circumscribed), orientation (not parallel), and peripheral location, and an upgraded categorical alteration from SOUS. Downgraded categorical alterations were associated with benignancy. Conclusions In BI-RADS 4A cases, a biopsy is recommended when independent factors are associated with malignancy. A downgraded result from an SOUS examination is a protective factor, supporting the likelihood of benignancy in these patients.

Social and individual factors associated with condom use among single youths: an analysis of the 2018 Cameroon Demographic and Health Survey

2021 ◽  
pp. 1-27
Author(s):  
Jean-Robert Mburano Rwenge ◽  
Franklin Bouba Djourdebbe ◽  
Emmanuel Ekambi Ekambi
Keyword(s):  
Risk Factor ◽  
Condom Use ◽  
Sexual Intercourse ◽  
Health Survey ◽  
Protective Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Demographic And Health Survey ◽  
Main Risk Factor ◽  
Factors Associated ◽  
Service Sectors

Abstract In Cameroon, two-fifths of the population is between the age of 15 and 24. Adolescents and youths are an important social group for the development of the country and the realization of the demographic dividend. The promotion of sexual and reproductive health will enable youth to transform their potential into development. This study aimed to identify the determinants of condom use at last sexual intercourse among single youths, highlight gender differences in the factors associated with condom use and identify the characteristics of youths who were less likely to use condoms. Data were taken from the 2018 Cameroon Demographic and Health Survey. The study sample comprised 1464 single females and 989 single males age 15–24. Multivariate logistic regression analysis was used to test the study hypotheses. Overall, 51% of the female and 66% of the male youths reported using condoms at last sexual intercourse. For both sexes, the protective factor was not having children. Among the females, belonging to the Bamileke or Mbo ethnic groups and delaying first sexual intercourse were also protective, while working in the modern or service sectors was the main risk factor. Among male youths, residing in households whose heads had a higher educational level was protective and household poverty was the main risk factor. These findings support Cameroon’s multi-sectoral approach to HIV/AIDS prevention among youths, and emphasize the importance of involving parents, teachers and youths in prevention strategies.

scholarly journals Factors associated with dating violence in young university students of Veracruz - Boca del Río

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S I Valencia Almeida ◽  
J E Villegas Domínguez ◽  
E A Villegas Vázquez ◽  
J C Leyva Chipol ◽  
F G Márquez Celedonio
Keyword(s):  
Public Schools ◽  
University Students ◽  
Dating Violence ◽  
Private School ◽  
Protective Factor ◽  
Research Question ◽  
Social Situation ◽  
Cross Sectional ◽  
Factors Associated ◽  
Del Rio

Abstract Introduction In the Mexican - American population, violence occurs between 10 and 40% of initial affective relationships. Veracruz is one of the main Mexican states that suffers violence and is the one with the largest number of femicides (3.44 per 100,000 women). Research question: what are the associated factors in the victimization in the courtship of young university students from the Veracruz - Boca del Río conurbation zone? Methods A cross-sectional, prospective, observational and analytical study was conducted from August to November 2019. University students enrolled in a higher education educational program in public and private universities of Veracruz-Boca del Río, who have had the minus a dating relationship and those who did not agree to participate were excluded. Violence in dating was quantified with the “Questionnaire on Violence in Dating (CUVINO)” (Alfa Cronbach 0.91). The spss v22 software was used to analyze the data. Results 680 participants were included, distributed in private schools (56.47%) and public schools (43.52%), with 444 (65.2%) women and 236 (34.7%) men. The prevalence of dating violence was 74.9%, however, only 21.6% of the participants considered having had such a relationship. The factors associated with dating violence were studying in a private school (OR = 0.62 IC95% 0.4-0.9), witnessing some act of violence in your family (OR = 1.47 IC95% 1.02-2.12), meeting a friend with a relationship violent (OR = 2.0 95% CI 1.4-2.9), believe that abuse exists in courtship (OR = 4.7 95% CI 2.9-7.4) and suspect that you may be in a violent relationship (OR = 4.67 95% CI 2.22- 9.83), while not witnessing any act of violence in your family (OR = 0.61 95% CI 0.4-0.8) is a protective factor to avoid violence in dating, all these values with p &lt; 0.05. It was not associated with violence. Conclusions Violence in dating is associated with behaviors of family members and friends of the violent. Key messages The social situation close to a person influences the violence allowed in their courtship. Young people normalize violence in a relationship, since many of them do not identify it when living it.

scholarly journals COVID-19 pandemic related long-term chronic stress on the prevalence of depression and anxiety in the general population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tian Qi ◽  
Ting Hu ◽  
Qi-Qi Ge ◽  
Xiao-Na Zhou ◽  
Jia-Mei Li ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Chronic Stress ◽  
Protective Factor ◽  
Mental Health Problems ◽  
Anxiety Symptoms ◽  
Binary Logistic Regression Analysis ◽  
Depression And Anxiety ◽  
Factors Associated

Abstract Background The COVID-19 pandemic has lasted for more than 1 year, causing far-reaching and unprecedented changes in almost all aspects of society. This study aimed to evaluate the long-term consequences of the COVID-19 pandemic on depression and anxiety, and explore the factors associated with it. Methods A cross-sectional study using an online survey was conducted to assess mental health problems from February 2 to February 9, 2021 by using patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7). The insomnia severity index (ISI), demographic data and COVID-19 related variables were measured by a self-designed questionnaire. The factors associated with depressive and anxiety symptoms were identified by Pearson chi-square test and binary logistic regression analysis. Results In the study that 1171 participants enrolled, the overall prevalence of depressive and anxiety symptoms among general people was 22.6 and 21.4% respectively in the present study. Living alone was a potential risk factor for depressive symptoms, while regular exercises was a potential protective factor. The prevalence of depressive and anxiety symptoms was significantly associated with the severity of insomnia symptoms and the negative feelings about pandemic. Conclusion COVID-19 pandemic- related chronic stress has brought about profound impacts on long-term mental health in the general population. The level of insomnia and a negative attitude towards the pandemic are significantly correlated with unfavorable mental health. However, we failed to found a significant association of age and gender with the mental health symptoms, although they were recognized as well-established risk factors during the outbreak by some other studies. This discrepancy may be because the acute and chronic effects of the pandemic are influenced by different factors, which reminds that more attention should be paid to the intrinsic psychological factors and physical reactions towards COVID-19.

O-203 Application of machine learning to predict aneuploidy and mosaicism in embryos from in vitro fertilization (IVF) cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J A Ortiz ◽  
R Morales ◽  
B Lledo ◽  
E Garcia-Hernandez ◽  
A Cascales ◽  
...  
Keyword(s):  
Machine Learning ◽  
Predictive Model ◽  
Predictive Models ◽  
Maternal Age ◽  
The Other ◽  
Predictor Variables ◽  
Learning Models ◽  
Male Factor ◽  
Factors Associated ◽  
Machine Learning Models

Abstract Study question Is it possible to predict the likelihood of an IVF embryo being aneuploid and/or mosaic using a machine learning algorithm? Summary answer There are paternal, maternal, embryonic and IVF-cycle factors that are associated with embryonic chromosomal status that can be used as predictors in machine learning models. What is known already The factors associated with embryonic aneuploidy have been extensively studied. Mostly maternal age and to a lesser extent male factor and ovarian stimulation have been related to the occurrence of chromosomal alterations in the embryo. On the other hand, the main factors that may increase the incidence of embryo mosaicism have not yet been established. The models obtained using classical statistical methods to predict embryonic aneuploidy and mosaicism are not of high reliability. As an alternative to traditional methods, different machine and deep learning algorithms are being used to generate predictive models in different areas of medicine, including human reproduction. Study design, size, duration The study design is observational and retrospective. A total of 4654 embryos from 1558 PGT-A cycles were included (January-2017 to December-2020). The trophoectoderm biopsies on D5, D6 or D7 blastocysts were analysed by NGS. Embryos with ≤25% aneuploid cells were considered euploid, between 25-50% were classified as mosaic and aneuploid with &gt;50%. The variables of the PGT-A were recorded in a database from which predictive models of embryonic aneuploidy and mosaicism were developed. Participants/materials, setting, methods The main indications for PGT-A were advanced maternal age, abnormal sperm FISH and recurrent miscarriage or implantation failure. Embryo analysis were performed using Veriseq-NGS (Illumina). The software used to carry out all the analysis was R (RStudio). The library used to implement the different algorithms was caret. In the machine learning models, 22 predictor variables were introduced, which can be classified into 4 categories: maternal, paternal, embryonic and those specific to the IVF cycle. Main results and the role of chance The different couple, embryo and stimulation cycle variables were recorded in a database (22 predictor variables). Two different predictive models were performed, one for aneuploidy and the other for mosaicism. The predictor variable was of multi-class type since it included the segmental and whole chromosome alteration categories. The dataframe were first preprocessed and the different classes to be predicted were balanced. A 80% of the data were used for training the model and 20% were reserved for further testing. The classification algorithms applied include multinomial regression, neural networks, support vector machines, neighborhood-based methods, classification trees, gradient boosting, ensemble methods, Bayesian and discriminant analysis-based methods. The algorithms were optimized by minimizing the Log_Loss that measures accuracy but penalizing misclassifications. The best predictive models were achieved with the XG-Boost and random forest algorithms. The AUC of the predictive model for aneuploidy was 80.8% (Log_Loss 1.028) and for mosaicism 84.1% (Log_Loss: 0.929). The best predictor variables of the models were maternal age, embryo quality, day of biopsy and whether or not the couple had a history of pregnancies with chromosomopathies. The male factor only played a relevant role in the mosaicism model but not in the aneuploidy model. Limitations, reasons for caution Although the predictive models obtained can be very useful to know the probabilities of achieving euploid embryos in an IVF cycle, increasing the sample size and including additional variables could improve the models and thus increase their predictive capacity. Wider implications of the findings Machine learning can be a very useful tool in reproductive medicine since it can allow the determination of factors associated with embryonic aneuploidies and mosaicism in order to establish a predictive model for both. To identify couples at risk of embryo aneuploidy/mosaicism could benefit them of the use of PGT-A. Trial registration number Not Applicable

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