scholarly journals Well-managed gestational diabetes mellitus is no longer a risk factor for neonatal RDS — a case-control study

2020 ◽  
Author(s):  
Guannan Xi ◽  
Qian Ying ◽  
Xuefeng Wang ◽  
Fei Luo ◽  
Chengqiu Lu ◽  
...  

Abstract Abstract BACKGROUND Diabetes in pregnancy used to be considered associated with a higher risk of respiratory distress syndrome(RDS) in neonates. However, as antenatal examinations have improved, whether well-managed gestational diabetes remains an independent risk factor is unclear. This study was to determine the associations of well-managed gestational diabetes with morbidity and complications of RDS. Method This was a case-control study conducted at the Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China. We collected data from 101 RDS infants and 101 RDS infants from among 1749 infants, through a standardized protocol with predefined inclusion and exclusion criteria. Assessment of diabetes management was based on HbA1c and random blood glucose measurements. Univariable and multivariable logistic regression was performed to calculate the odds ratio (OR). An intergroup analysis was conducted between RDS infants and those without RDS, and a subgroup analysis was conducted between RDS neonates born to women with gestational diabetes and those born to women without gestational diabetes. RESULTS The mean (±SD) gestational age of the RDS infants was 35.9 (1.9) weeks, which was similar to that of the non-RDS infants (35.7 (±1.3) weeks). The HbA1c levels at diabetes diagnosed, the HbA1c levels right before delivery and the RBG levels before delivery had no significant differences, and all of them were below a well-controlled level. In the intergroup analysis, the morbidity of gestational diabetes between the two groups showed no significant differences in the adjusted analyses (adjusted OR 1.40, 95% CI 0.59-3.36). However, the case group had significantly more placental abnormalities (adjusted OR 3.61, 95% CI 1.63-8.00), fetal distress (adjusted OR 4.20, 95% CI 1.87-9.46), and asphyxia (adjusted OR 3.74, 95% CI 1.59-8.81) than the control group. In the subgroup analysis, the total dose of the PS applications, incidence of complications, and need for respiratory support (total and separate) were not significantly different between the two groups. CONCLUSIONS Well managed gestational diabetes is no longer a significant risk factor for RDS, while acute or chronic ischemia factors are. With regards to most GDM, diet and exercise are sufficient for maintaining an HbA1c below 6.5%

2020 ◽  
Author(s):  
Guannan Xi ◽  
Qian Ying ◽  
Xuefeng Wang ◽  
Fei Luo ◽  
Chengqiu Lu ◽  
...  

Abstract BACKGROUND Diabetes in pregnancy used to be considered associated with a higher risk of respiratory distress syndrome(RDS) in neonates. However, whether well-managed gestational diabetes remains an independent risk factor is unclear. This study was to determine the associations of them.METHOD This was a case-control study conducted at the Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China. We collected data from 101 RDS infants and 101 RDS infants from among 1749 infants, through a standardized protocol with predefined inclusion and exclusion criteria. Two investigators enrolled in recording same datas twice to minimize bias. Assessment of diabetes management was based on HbA1c and random blood glucose measurements. Univariable and multivariable logistic regression was performed to calculate the odds ratio (OR). An intergroup analysis was conducted between RDS infants and those without RDS, and a subgroup analysis was conducted between RDS neonates born to women with gestational diabetes and those born to women without gestational diabetes.RESULTS The mean (±SD) gestational age of the RDS infants was 35.9 (±1.9) weeks, which was similar to that of the non-RDS infants (35.7±1.3)weeks). The HbA1c levels at diabetes diagnosed, the HbA1c levels right before delivery and the RBG levels before delivery had no significant differences, and all of them were below a well-controlled level. In the intergroup analysis, the morbidity of gestational diabetes between the two groups showed no significant differences in the adjusted analyses (adjusted OR 1.40, 95% CI 0.59-3.36). However, the case group had significantly more placental abnormalities (adjusted OR 3.61, 95% CI 1.63-8.00), fetal distress (adjusted OR 4.20, 95% CI 1.87-9.46), and asphyxia (adjusted OR 3.74, 95% CI 1.59-8.81) than the control group. In the subgroup analysis, the total dose of the PS applications, incidence of complications, and need for respiratory support (total and separate) were not significantly different between the two groups.CONCLUSIONS Well managed gestational diabetes is no longer a significant risk factor for RDS, while acute or chronic ischemia factors are. Diet and exercise are sufficient for the GDM management target of HbA1c below 6.5%.


2020 ◽  
Author(s):  
Guannan Xi ◽  
Qian Ying ◽  
Xuefeng Wang ◽  
Fei Luo ◽  
Chengqiu Lu ◽  
...  

Abstract BACKGROUND Diabetes in pregnancy used to be considered associated with a higher risk of respiratory distress syndrome(RDS) in neonates. However, as antenatal examinations have improved, whether well-managed gestational diabetes remains an independent risk factor is unclear. This study was to determine the associations of well-managed gestational diabetes with morbidity and complications of RDS. Method This was a case-control study conducted at the Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China. We collected data from 101 RDS infants and 101 RDS infants from among 1749 infants, through a standardized protocol with predefined inclusion and exclusion criteria. Assessment of diabetes management was based on HbA1c and random blood glucose measurements. Univariable and multivariable logistic regression was performed to calculate the odds ratio (OR). An intergroup analysis was conducted between RDS infants and those without RDS, and a subgroup analysis was conducted between RDS neonates born to women with gestational diabetes and those born to women without gestational diabetes. RESULTS The mean (±SD) gestational age of the RDS infants was 35.9 (1.9) weeks, which was similar to that of the non-RDS infants (35.7 (±1.3) weeks). The HbA1c levels at diabetes diagnosed, the HbA1c levels right before delivery and the RBG levels before delivery had no significant differences, and all of them were below a well-controlled level. In the intergroup analysis, the morbidity of gestational diabetes between the two groups showed no significant differences in the adjusted analyses (adjusted OR 1.40, 95% CI 0.59-3.36). However, the case group had significantly more placental abnormalities (adjusted OR 3.61, 95% CI 1.63-8.00), fetal distress (adjusted OR 4.20, 95% CI 1.87-9.46), and asphyxia (adjusted OR 3.74, 95% CI 1.59-8.81) than the control group. In the subgroup analysis, the total dose of the PS applications, incidence of complications, and need for respiratory support (total and separate) were not significantly different between the two groups. CONCLUSIONS Well managed gestational diabetes is no longer a significant risk factor for RDS, while acute or chronic ischemia factors are. With regards to most GDM, diet and exercise are sufficient for maintaining an HbA1c below 6.5%


2015 ◽  
Vol 04 (03) ◽  
pp. 111-114 ◽  
Author(s):  
Tayeb Ghadimi ◽  
Bahman Gheitasi ◽  
Sayran Nili ◽  
Mohammad Karimi ◽  
Ebrahim Ghaderi

Abstract Purpose: The aim of this study was to investigate occupational risk factors associated with bladder cancer. Materials and Methods: In this case–control study, control group included patients who referred to a specialized clinic in the same city and hospitals where patients had been registered. Data were entered into SPSS software. Odds ratios (OR) were calculated for occupational variables and other characteristics. Then, using logistic regression, the association between cancer and drugs was studied while smoking was controlled. Results: Cigarette smoking, even after quitting, was also associated with bladder cancer (OR = 2.549). Considering the classification of occupations, the OR of working in metal industry in patients was 10.629. Multivariate analysis showed that use of the drug by itself can be a risk factor for bladder cancer. Drug abuse together with the control of smoking increased the risk of bladder cancer by 4.959. Conclusion: According to the findings of this study, contact with metal industries such as welding, and working with tin was found as a risk factor for bladder cancer. In addition, cigarette smoking and opium abuse individually were associated with bladder cancer.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yu Sato ◽  
Kengo Murata ◽  
Miake Yamamoto ◽  
Tsukasa Ishiwata ◽  
Miyako Kitazono-Saitoh ◽  
...  

AbstractThe bronchoscopy, though usually safe, is occasionally associated with complications, such as pneumonia. However, the use of prophylactic antibiotics is not recommended by the guidelines of the British Thoracic Society. Thus far there are few reports of the risk factors for post-bronchoscopy pneumonia; the purpose of this study was to evaluate these risk factors. We retrospectively collected data on patients in whom post-bronchoscopy pneumonia developed from the medical records of 2,265 patients who received 2666 diagnostic bronchoscopies at our institution between April 2006 and November 2011. Twice as many patients were enrolled in the control group as in the pneumonia group. The patients were matched for age and sex. In total, 37 patients (1.4%) had post-bronchoscopy pneumonia. Univariate analysis showed that a significantly larger proportion of patients in the pneumonia group had tracheobronchial stenosis (75.7% vs 18.9%, p < 0.01) and a final diagnosis of primary lung cancer (75.7% vs 43.2%, p < 0.01) than in the control group. The pneumonia group tended to have more patients with a history of smoking (83.8% vs 67.1%, p = 0.06) or bronchoalveolar lavage (BAL) (4.3% vs 14.9%, p = 0.14) than the control group. In multivariate analysis, we found that tracheobronchial stenosis remained an independent risk factor for post-bronchoscopy pneumonia (odds ratio: 7.8, 95%CI: 2.5–24.2). In conclusion, tracheobronchial stenosis was identified as an independent risk factor for post-bronchoscopy pneumonia by multivariate analysis in this age- and sex- matched case control study.


Rheumatology ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 1281-1287 ◽  
Author(s):  
David Armstrong ◽  
Alex Dregan ◽  
Mark Ashworth ◽  
Patrick White ◽  
Chris McGee ◽  
...  

Abstract Objectives To test the hypothesis that prior antibiotics influences the risk of developing RA. Methods A case–control study was conducted over 15 years using the UK’s Royal College of General Practitioners Research and Surveillance Centre database. The frequency and type of antibiotic prescription for patients who subsequently developed RA were compared with antibiotic prescriptions in a control group of patients who remained free of RA. Cases, defined as patients with a new diagnosis of RA made between 2006 and 2018, were matched with up to four RA-free controls on practice, age, gender and date of diagnosis. Exposure was measured by the number and type of prescriptions for antibiotics prior to the RA diagnosis or to the index date in controls. Results A total of 8482 patients with a new diagnosis of RA between 2006 and 2018 were compared with 22 661 controls. There was a higher likelihood of an RA diagnosis after antibiotic prescriptions within 1 year, 5 years and ever with a strong dose–response. Patients receiving &gt;10 antibiotics in a 5 year period were more than twice as likely to receive an RA diagnosis as controls [adjusted odds ratio 2.65 (CI 2.40, 2.93)]. Conclusion Exposure to antibiotics prior to the diagnosis was a significant risk factor for RA. This could reflect an immunological response to a compromised microbiome. Alternatively, patients with pre-symptomatic or early undiagnosed RA may have been more likely to present to their general practitioner with infections due to an unrecognized effect of RA.


2021 ◽  
Author(s):  
Nooria Atta ◽  
Fahima Aram ◽  
Nafisa Naseri ◽  
Mahbooba Sahak

Abstract Background: Ectopic pregnancy (EP) is defined as a pregnancy in which fertilized oocyte implants outside the endometrial cavity. Although there is no known etiology for ectopic pregnancy, some risk factors of EP have been determined. It has been evident that ectopic pregnancy can be of multifactorial origin. This multicenter research aims to study risk factors associated with increased risk of ectopic pregnancy in women living in Kabul. Methods: A multicenter case control study was conducted in five tertiary maternity hospitals located in Kabul, Afghanistan. A total of 457 pregnant women were included in this study. In the case group, women with diagnosed ectopic pregnancy, while in control group women with intrauterine pregnancy were included. For each case in this study, two controls were enrolled. Results: The mean (SD) age of women in case group was 27.9 (6) years while in control group it was 26.4 (5.5) years. This difference was not statistically significant. We found a significant association between history of abortion and EP (Adj. OR=1.57; 95%CI: 1.02, 2.42). Having history of abdominal/pelvic surgery was a risk factor for EP with adjusted OR 1.94 (95%CI: 1.15, 3.30). In this study we found an increasing risk of EP in women of 35 years or older compared to younger women (Crude OR=2.26; p= 0.024). In women reporting prior EP, the chance of its recurrence was increased (Crude OR= 9.64; 95%CI: 1.1, 83.2). No association of gravidity and parity was found with EP incidence. Conclusions: In this study we found a statistically significant association between history of abdominal/pelvic surgery and EP. In addition, history of abortion was suggested as a risk factor for ectopic pregnancy. In case of having a previous EP probability of its recurrence will be increased. Women with advanced age having other potential risk factors will be facing higher risk of EP.


Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kyle B Walsh ◽  
Opeolu Adeoye ◽  
Padmini Sekar ◽  
Jennifer Osborne ◽  
Charles J Moomaw ◽  
...  

Introduction: Hypertension (HTN), particularly untreated HTN, has been found to be a significant risk factor for ICH in predominately white ICH populations. We evaluated the risk of treated and untreated HTN on ICH in a multi-ethnic case-control study. Hypothesis: Treated and untreated HTN confer variable risk for ICH by race/ethnicity. Methods: The Ethnic/Racial Variations of ICH (ERICH) study is a prospective, multicenter, case-control study of ICH among whites, blacks, and Hispanics. Cases were enrolled from 42 recruitment centers using hot-pursuit. Controls matched to cases 1:1 by age (±5 years), sex, race/ethnicity, and metropolitan area were recruited by random-digit dialing. Subjects were interviewed to determine whether they had a history of HTN and if they took medications to reduce blood pressure. Results: Between 9/2010 and 6/2015, 891 white, 833 black, and 599 Hispanic case/control pairs were enrolled. Higher proportions of black and Hispanic ICH with HTN were untreated, compared with whites (43.3% and 48.3% vs. 33.2%; p=.0002 and p<.0001, respectively). When adjusted for medical insurance status, a significant difference persisted for whites vs. Hispanics (p=.002), but not whites vs. blacks (p=.197). In multivariate analyses adjusted for alcohol use, anticoagulation, hypercholesterolemia, education, and insurance status, treated HTN was a significant risk factor for ICH in whites (OR=1.72, 95% CI 1.33-2.22, p<.0001), blacks (3.04, 2.13-4.34, <.0001), and Hispanics (2.57, 1.64-4.00, <.0001). Untreated HTN was a substantially greater risk factor for ICH for all three racial/ethnic groups: whites (9.53, 5.88-15.45, <.0001), blacks (11.10, 7.06-17.47, <.0001), Hispanics (9.65, 5.49-16.95, <.0001). In the subtype analyses of deep, lobar, and infratentorial ICH, untreated HTN resulted in ORs of 3.50 to 24.81, with statistical significance for all subtypes and ethnic groups. Conclusion: Treatment of HTN reduces the risk of ICH conferred by HTN markedly, but not completely. Untreated hypertension, which is significantly more prevalent among black and Hispanic ICH cases than among white cases, confers at least a 9-fold risk of ICH regardless of race. Treatment of hypertension is expected to have substantial impact on risk of ICH.


2016 ◽  
Vol 17 (11) ◽  
pp. 930-933
Author(s):  
Javed Khan ◽  
B Vikas Prasad ◽  
Gauri S Kakatkar ◽  
Meetu Jain ◽  
Maulik Patel ◽  
...  

ABSTRACT Introduction Oral cancer is one of the most common cancers in the world. Although multifactorial, the exact pathogenesis of oral cancer is still unclear. Apart from tobacco chewing and smoking, chronic long-term irritation by ill-fitting denture is also said to be an important risk factor for the development of oral cancer. Literature quotes some amount of evidence that correlates long-term denture irritation as a risk factor for the development of oral cancer. Hence, we analyzed the correlation of denturerelated sores as a risk factor for the development of oral cancer. Materials and methods The present case–control study included 140 newly diagnosed oral cancer cases and 140 patients as the control healthy group. One-hour questionnaire was framed and was conducted to the control group and the study group by 10 experienced interviewers who were trained for such type of analysis. Assessment of the patients’ socioeconomic status, cigarette smoking habit, alcohol drinking habit, and oral health status was done and compared on the two study groups. Logistic regression models along with multivariate models were used for the assessment of the results. Results In the control group and the cancer patient group, total of 140 new cancer cases and 140 subjects were included. Out of 140 patients in the cancer group, 16 were nonsmokers, while 110 smoked cigarette in the cancer patient group. As far as alcohol consumption is concerned, 42 patients in the control group and 102 patients in the oral cancer group were chronic heavy drinkers. Fried food intake was high in both the groups. Significant correlation was obtained while comparing the heavy smokers, heavy alcohol consumers, and oral health status in both the study groups. Conclusion Our results favor the hypothesis that positive correlation exists between oral cancer risk and recurrent denture sores. Clinical significance People wearing denture prosthesis should be periodically visualized for identification of any mucosal alteration or changes at the earliest. How to cite this article Jain P, Jain M, Prasad BV, Kakatkar GS, Patel M, Khan J. A Case–control Study for the Assessment of Correlation of Denture-related Sores and Oral Cancer Risk. J Contemp Dent Pract 2016;17(11):930-933.


2003 ◽  
Vol 130 (3) ◽  
pp. 353-366 ◽  
Author(s):  
J. NEIMANN ◽  
J. ENGBERG ◽  
K. MØLBAK ◽  
H. C. WEGENER

A case control study comprising 282 cases and 319 matched controls was conducted in Denmark during 1996–7. Two estimates of the odds ratio (OR) were determined for each risk factor with and without ‘protective factors’ fitted into the final model. Consumption of undercooked poultry (OR 4·5; 8·2), consumption of red meat at a barbecue (OR 2·3; 4·1), consumption of grapes (OR 1·6; 2·8) and drinking unpasteurized milk (OR 2·3; 11·8) were identified as risk factors in both models. Frequent consumption of pork chops (OR 4·4) and daily contact with domestic animals and pets were identified as risk factors in one of the two models only. Finally, foreign travel was found to be a significant risk factor (OR 2·5). Seasonal and regional interaction was observed for several risk factors and the time elapsed from interviewing of cases to interviewing of controls seemed to influence the effect of certain seasonal dependent risk factors.


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