scholarly journals Anemia during different trimesters of pregnancy and hypertensive disorders are associated with adverse maternal and perinatal outcomes in Bekwai Municipality, Ghana: protocol for a prospective cohort study.

2019 ◽  
Author(s):  
Kwabena Acheampong ◽  
Xiongfeng Pan ◽  
Aizhong Liu
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Birth Outcomes ◽  
Prospective Cohort Study ◽  
Logistic Regression Analysis ◽  
Prospective Cohort ◽  
Perinatal Outcomes ◽  
Baseline Characteristics

Abstract Background: Data examining whether anemia during different trimesters of pregnancy affects maternal and birth outcomes is lacking. Studies typically look at associations between risk factors and anemia or anemia and birth outcomes but have limited information as to whether birth outcomes differ with different trimesters of anemia. The main objective of this study is to determine whether anemia during different trimesters of pregnancy and hypertension disorders is associated with adverse maternal and perinatal outcomes in Ghana.Methods: This will be a primary analysis of data from a hospital-based prospective cohort study in four selected hospitals in the Bekwai Municipality, Ghana from February 2020 to August 2020. All singleton pregnancy at less than 20 weeks to women with at least one hemoglobin measure during pregnancy will be included. The risk of maternal and perinatal outcomes will be measured. Descriptive statistics will be used to describe the baseline characteristics of our cohort. Baseline characteristics of the two groups will be compared using Pearson Chi-square (χ2) test for categorical variables; the independent t-test and Mann–Whitney U test for parametric and nonparametric continuous variables, respectively. The risk associated with anemia and maternal and perinatal outcomes, using the history of anemia (Hb<11g/dL) in different trimesters will be calculated by logistic regression analysis, conditional on the baseline covariates. Possible confounding variables will be identified from background data, obstetric risk factors, and health behaviors. Multivariate analysis of significant effects (p<0.05) will be based on multiple logistic regression analysis. Confidence intervals will be evaluated at 95%. Data will be coded and examined using the SPSS program IBM version 20.Discussion: The better understanding of whether anemia during different trimesters of pregnancy and hypertension disorders is associated with adverse maternal and perinatal outcomes in Bekwai Municipality of Ghana. This study will establish targets for early intervention and identify risk factors to save and improve the lives of pregnant women and inborn by developing solutions that promote the quality and accountability of health services for the most vulnerable. These findings will be served as a policy document to governments in designing effective programs to curb the increasing prevalence of anemia and its associated health consequences.

scholarly journals DL-3-n-butylphthalide Delays Cognitive Decline in Patients With Mild to Moderate Alzheimer's Disease Already Receiving Donepezil: A Multicenter, Prospective Cohort Study

2020 ◽  
Author(s):  
Jin Wang ◽  
Xiaojuan Guo ◽  
Wenhui Lu ◽  
Jie Liu ◽  
Hong Zhang ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Daily Living

Abstract Background：Vascular factors and mitochondria dysfunction contributeto thepathogenesis of Alzheimer’s Disease (AD).DL-3-n-butylphthalide (NBP)has an effect in protecting mitochondria and improving microcirculation. We investigated the effect of NBP in patients with mild-moderate AD already receiving donepezil.Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n=43) or the donepezil combined NBP group (n=49) for 48 weeks. The primary outcome was change of Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog) from baseline after treatment 48 weeks. All patients were also evaluated with clinician’s interview-based impression of change plus caregiver input (CIBIC-plus), Alzheimer's disease cooperative study-activities of daily living (ADCS-ADL) and neuropsychiatric inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using logistic regression analysis.Results:The univariate analysis showed that age wasolder in donepezil alone group(P=0.005), prevalence of hypertension was higher in donepezil alone group(P=0.026).The ADAS-cog score change from baseline in thedonepezil alone group was significant than that in the donepezil combined NBP group at 48 weeks(1.82±5.20 vs -0.38±4.46, P=0.048). The multivariate logistic regression analysis showed that between the 2 groups, there were significant differencesin changes on the ADAS-cog(OR=0.879,95% CI:[0.785,0.984],P=0.026),MMSE(OR=1.270,95% CI:[1.036,1.557],P=0.021), and ADCS-ADL(OR=1.067,95% CI:[1.002,1.136],P=0.042) but no significant differences for changes on the NPI(OR=0.955,95% CI:[0.901，1.013],P=0.125)and CIBIC-plus (OR=0.356,95% CI:[0.093,1.364],P=0.132). The occurrence of AEs was similar in the 2 groups.Conclusions:Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.Trial registration:Clinical trial registration URL:https://clinicaltrials.gov/ct2/show/NCT02711683?term=NCT02711683&draw=2&rank=1ClinicalTrials.gov Identifier: NCT02711683. Date of registration: March 14,2016.

scholarly journals A Prospective Cohort Study of Modifiable Risk Factors for Gestational Diabetes among Hispanic Women: Design and Baseline Characteristics

2010 ◽  
Vol 19 (1) ◽  
pp. 117-124 ◽  
Author(s):  
Lisa Chasan-Taber ◽  
Renée Turzanski Fortner ◽  
Audra Gollenberg ◽  
John Buonnaccorsi ◽  
Nancy Dole ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hispanic Women ◽  
Modifiable Risk Factors ◽  
Baseline Characteristics

scholarly journals Risk factors associated with surgical site infections after thoracic or lumbar surgery: a 6-year single centre prospective cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Vera Spatenkova ◽  
Ondrej Bradac ◽  
Zdenek Jindrisek ◽  
Jan Hradil ◽  
Daniela Fackova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Wound Complications ◽  
Multivariate Logistic Regression ◽  
Single Centre

Abstract Background Surgical site infection (SSI) is a risk in every operation. Infections negatively impact patient morbidity and mortality and increase financial demands. The aim of this study was to analyse SSI and its risk factors in patients after thoracic or lumbar spine surgery. Methods A six-year single-centre prospective observational cohort study monitored the incidence of SSI in 274 patients who received planned thoracic or lumbar spinal surgery for degenerative disease, trauma, or tumour. They were monitored for up to 30 days postoperatively and again after 1 year. All patients received short antibiotic prophylaxis and stayed in the eight-bed neurointensive care unit (NICU) during the immediate postoperative period. Risk factors for SSI were sought using multivariate logistic regression analysis. Results We recorded 22 incidences of SSI (8.03%; superficial 5.84%, deep 1.82%, and organ 0.36%). Comparing patients with and without SSI, there were no differences in age (p=0.374), gender (p=0.545), body mass index (p=0.878), spine diagnosis (p=0.745), number of vertebrae (p=0.786), spine localization (p=0.808), implant use (p=0.428), American Society of Anesthesiologists (ASA) Score (p=0.752), urine catheterization (p=0.423), drainage (p=0.498), corticosteroid use (p=0.409), transfusion (p=0.262), ulcer prophylaxis (p=0.409) and diabetes mellitus (p=0.811). The SSI group had longer NICU stays (p=0.043) and more non-infectious hospital wound complications (p<0.001). SSI risk factors according to our multivariate logistic regression analysis were hospital wound complications (OR 20.40, 95% CI 7.32–56.85, p<0.001) and warm season (OR 2.92, 95% CI 1.03–8.27, p=0.044). Conclusions Contrary to the prevailing literature, our study did not identify corticosteroids, diabetes mellitus, or transfusions as risk factors for the development of SSI. Only wound complications and warm seasons were significantly associated with SSI development according to our multivariate regression analysis.

scholarly journals 447 - Risk factors associated with sleep disturbance in a general elderly Japanese population: The Arao Cohort Study

2020 ◽  
Vol 32 (S1) ◽  
pp. 167-167
Author(s):  
Kazuki Honda ◽  
Tomohisa Ishikawa ◽  
Ryuji Fukuhara ◽  
Seiji Yuki ◽  
Yusuke Miyagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Sleep Disturbance ◽  
Logistic Regression Analysis ◽  
Barthel Index ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Factors Associated

[Background]Sleep disturbance is a common symptom in elderly people. However, the associated risk factors have not been completely clarified. We examined possible risk factors associated with sleep disturbance in a community-based Japanese cohort study.[Methods]1521 community-dwelling individuals aged 65 years or older were selected from a consecutive series at a cohort study from 2016 to 2018 in Arao city, where located at south part of Japan. In this survey, the clinical valuables were collected as follows: age, sex, occupational status, education, lifestyle information, medical history, EuroQoL(EQ)-5D (a score of health-related quality of life [QOL]), Barthel index (a score of performance in activities of daily living), a score of Geriatric Depression Scale (GDS) and a score of Mini-Mental State Examination (MMSE). Sleep disturbance was assessed by the Pittsburgh Sleep Quality Index (when the global score was 6 or over, sleep disturbance was determined to be present). Multiple logistic regression analysis was used to examine the association between clinical valuables and sleep disturbance. This research was supported by AMED (Japan Agency for Medical Research and Development) under Grant Number JP18dk0207025h0003 and has been approved by the research ethics committee of Kumamoto University. Informed consent was obtained from all participants and their family members.[Results]Multiple logistic regression analysis revealed that Parkinson disease (Odds ratio[OR]=5.59), living alone (OR=1.93), liver disease (OR=1.89), hyperlipidemia (OR=1.36), higher score of GDS (OR=1.14), lower scores of both EQ-5D index (OR=1.11) and Barthel index (OR=1.03) were significantly associated as risk factors with sleep disturbance. Unexpectedly, lower score of MMSE was not a significant risk factor.[Conclusion]These results suggest that several physical illnesses, solitude, depressive symptoms and lower QOL, but not cognitive impairment, might be crucial risk factors associated with sleep disturbance in elderly population.

scholarly journals Nomogram-Based Prediction of the Risk of Macrosomia: A Prospective Cohort Study in a Chinese Population

2021 ◽  
Author(s):  
Jing Du ◽  
Sanbao Chai ◽  
Xin Zhao ◽  
Jianbin Sun ◽  
Ning Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Operating Characteristic ◽  
Multivariate Logistic Regression Analysis ◽  
Maternal Factors ◽  
Multivariate Logistic Regression ◽  
History Of

Abstract Objective: This study aimed to establish a nomogram for predicting the risk of macrosomia in early pregnancy.Methods: We performed a prospective cohort study involving 1,549 pregnant women. According to the birth weight of newborn, the subjects were divided into two groups: macrosomia group and non-macrosomia group. Multivariate logistic regression was used to analyze the risk factors for macrosomia.Results: The prevalence of macrosomia was 6.13% (95/1549) in our hospital. Multivariate logistic regression analysis showed the risk factors of macrosomia were prepregnancy overweight (OR: 2.126, 95% CI: 1.181-3.826)/obesity (OR: 3.536, 95% CI: 1.555-8.036), multiparity (OR:1.877, 95% CI: 1.160-3.039), the history of macrosomia (OR: 36.971, 95% CI: 19.903-68.674), the history of GDM/DM (OR: 2.285, 95% CI: 1.314-3.976), the higher levels of HbA1c (OR: 1.763, 95% CI: 1.004-3.097) and TC (OR: 1.360, 95% CI: 1.004-1.842). A nomogram was developed for predicting macrosomia based on maternal factors related to the risk of macrosomia in early pregnancy. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.807 (95% CI: 0.755–0.859), the sensitivity and specificity of the model were 0.716 and 0.777, respectively.Conclusion: The nomogram model provides an accurate mothed for clinicians to early predict macrosomia.

scholarly journals Taking the plunge: Water immersion for labour and birth amongst women with moderate obstetric risk factors: A prospective cohort study

2021 ◽  
Author(s):  
Emma Seed ◽  
Lauren Kearney ◽  
Edward Weaver ◽  
Rachael Nugent
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Water Immersion ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Significant Difference ◽  
Mode Of Birth

Objective: This study investigated maternal and fetal outcomes following warm water immersion (WWI) and/or waterbirth compared with land birth for women with moderate obstetric risk factors. Design: Prospective cohort study. Setting: Maternity hospital, Australia, 2019-2020 Population: 1665 participants, some with ‘risk factors’ for adverse perinatal outcomes requiring continuous electronic fetal monitoring (CEFM) during labour. Method: Multivariate logistical regressions were used to determine the odds of neonatal and maternal outcome measures between three groups: waterbirth, WWI and land birth Main outcome measures: Neonatal morbidity and mortality, including neonatal unit admission (NNU). Maternal clinical outcome measures, including mode of birth, perineal injury, postpartum haemorrhage, length of labour and morbidity. Results: NNU admissions for a suspected infectious condition were significantly higher in the land birth group (p=0.035). After accounting for labour duration, epidural use, previous birth mode, and labour onset, no significant difference was detected between land births and WWI/water births in the odds of NNU admission (p=0.200). No babies were admitted to NNU with signs of water inhalation or drowning. Women birthing on land had a higher mean blood loss (p=0.036) and were more likely to be febrile (2% v 0%; p=0.007); Obstetric anal sphincter injury was similar between groups. Pharmacological analgesia use was lower in the WB/WWI group (p<0.001). There was 1 cord avulsion in the waterbirth group (0.41%). Mode of birth was similar between groups (p=0.697). Conclusion: Despite moderate obstetric risk factors such as oxytocin administration and induction of labour; maternal and neonatal outcomes were similar between groups.

scholarly journals Incidence and risk factors of Postdural Puncture Headache: Prospective cohort study design

2020 ◽  
Author(s):  
Bedilu Girma Weji ◽  
Mohammed Suleiman Obsa ◽  
Kidest Getu Melese ◽  
Gedion Asnake Azeze
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Lumbar Puncture ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Spinal Needle ◽  
Postdural Puncture Headache ◽  
Needle Size ◽  
Cohort Study Design

Abstract Background:Postdural puncture headache is one of the complications following spinal anaesthesia and accidental dural puncture. Several modifiable risk factors contribute to the development of headache after lumbar puncture, which includes needle size, needle design, direction of the bevel and number of lumbar puncture attempts. This study aimed to assess the incidence and risk of postdural puncture headache.Methods:This prospective cohort study design was conducted using a consecutive sampling method. Regular supervision and follow-up were performed. Data were entered into Epi info version 7 software and transported to SPSS version 20 for analysis. The odds ratio and 95% confidence interval were computed. The findings of the study were reported using tables, figures and narrations. Variables that were found to be candidates (p value < 0.25) on binary logistic regression entered into a multiple logistic regression analysis to identify independent predictors of postdural puncture headache.Results:One hundred fifty eligible study participants were included in our study, of which 28.7% had developed postdural puncture headache. This study found that needle size, number of cerebro spinal fluid drops and multiple attempts were significant independent predictors of postdural puncture headache (p < 0.05). In addition, twenty-five needles were identified as the strongest preoperative independent predictor of postdural puncture headache (AOR = 4.150, CI = 1.433- 12.021)Conclusions:A recent study revealed that a small spinal needle was much better than a large cutting spinal needle regarding the frequency of postdural puncture headache. In addition, frequent attempts during lumbar puncture and increased cerebro spinal fluid leakage were associated with the events. In view of this, we recommend the use of a small spinal needle to avoid more leakage of cerebrospinal fluid and multiple attempts at spinal anesthesia and lumbar puncture.

scholarly journals Risk Factors for Mortality in Melioidosis: A Single-Centre, 10-Year Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Raviraj Menon ◽  
Poornima Baby ◽  
Anil Kumar V. ◽  
Sandeep Surendran ◽  
Manu Pradeep ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Logistic Regression Analysis ◽  
Mortality Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Therapeutic Benefits ◽  
Chi Square Analysis

Melioidosis is a tropical infectious disease with diverse clinical presentations. We aimed to investigate the characteristics and mortality risk factors of patients diagnosed with melioidosis in the past 10 years. This was a retrospective cohort study conducted at a quaternary care centre in South India. Clinical, demographic, and biochemical data in patients diagnosed with melioidosis with cultures were collected between January 2011 and December 2020 from medical records. Logistic regression analysis was performed to screen mortality risk factors of melioidosis in addition to descriptive statistics and chi-square analysis. Seventy-three melioidosis patients’ records were analysed, and the most common comorbidity was type 2 diabetes mellitus (n = 53, 72.6%). The patients showed diverse presentations: pulmonary involvement, 30 (41.1%); splenomegaly, 29 (39.7%); abscesses and cutaneous involvement, 18 (24.7%); lymph node, 10 (13.7%); arthritis and osteomyelitis, 9 (12.3%); and genitourinary infection, 4 (5.4%). The mortality was noted to be 15 (20.5%). Logistic regression analysis indicated that chronic kidney disease (OR = 14.0), CRP >100 IU/L (OR = 6.964), and S. albumin <3 gm/dl (OR = 8.0) were risk factors associated with mortality and can guide in risk stratification. Hypoalbuminemia is a novel mortality risk factor, detected in this study, and requires further investigation to validate its utility as a prognostic marker and reveal possible therapeutic benefits in clinical correction.

scholarly journals Evolution of second trimester low implanted placenta to previa at term: a prospective cohort study

2018 ◽  
Vol 7 (11) ◽  
pp. 4330
Author(s):  
Omar M. Shaaban ◽  
Hamdy A. Ahmed ◽  
Mohammed K. Ali ◽  
Ahmed M. Abbas ◽  
Ahmed Nasr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Pregnant Women ◽  
Prospective Cohort ◽  
Placenta Previa ◽  
Lower Edge ◽  
Second Trimester ◽  
History Of

Background: The objective of this study is to identify the percentage of low implanted placenta (LIP) at second trimester of pregnancy and identify the risk factors of its persistence to placenta previa (PP) at term.Methods: Through a registered prospective cohort study conducted at tertiary hospital in Upper Egypt, authors screened all pregnant ladies comes to present facility for antenatal second trimester USG between 18-24 weeks gestation. All participants interviewed for detailed risk factors of placenta previa. Those diagnosed to have a LIP (≤1.5 cm from the internal os) had had TVS to confirm the exact distance between the lower edge of the placenta and the internal os. Serial USG had been done every 4 weeks up to delivery to measure the same distance. The primary outcome was the percentage of LIP at 18-24 weeks. Logistic regression analysis was performed to predict the risk factors for PP at term.Results: Through screening of 1000 pregnant lady, LIP had been identified in (52 cases) 5.2% of pregnant women between 18-24 weeks. This percentage dropped gradually to reach 1.3% at 36 weeks of gestation and at time of delivery. The logistic regression analysis demonstrated that the distance between the internal os and the lower edge of the placenta between 18-24 weeks was the single significant variable associated with PP at term (p<0.001, odds ratio 0.319, 95% CI 0.20-0.50). However, excluding the distance from the regression model demonstrated other risk factors as previous miscarriage, previous cesarean section (CS), and history of multiple pregnancies and history of previous PP.Conclusions: About 5.0% of pregnant women have LIP at the second trimester of pregnancy (18-24 weeks) and only 25.0 % of them remain placenta previa at term. A cut-off value of 10 mm between the internal os and the lower edge of the placenta is the most important predictor of development of PP.

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