scholarly journals Labor Induction And The Incidence of Intrapartum Maternal Fever In Epidural Labor Analgesia: A Retrospective Case-Control Study

Author(s):  
Min Wang ◽  
Yiting Li ◽  
Zhongya Gu ◽  
Duan Manlin

Abstract Background: To assess the influence of labor induction on the intrapartum maternal fever in epidural labor analgesia and to determine its association with intrapartum fever.Methods: A retrospective case-control study was performed during 2016–2018 in a first-class tertiary hospital. All patients who received epidural labor analgesia were allocated into either case (parturients who received labor induction and had intrapartum fever) or control (parturients who did not receive labor induction but had intrapartum fever) groups. Maternal demographic and intrapartum data, epidural infusions records, and neonatal short-term outcome were studied.Results: A total of 710 epidural labor analgesia occurred during the study period and 119 (16.76%) women had intrapartum fever. Intrapartum fever occurred in 66 (25.68%) women who received labor induction and in 53 (11.70%) who did not. After correction for confounding factors, labor induction (OR 2.818, 95% CI, 1.778–4.467, P<0.001), number of vaginal examinations (OR 1.242, 95% CI, 1.048–1.471, P=0.012), baseline maternal temperature (OR 6.702, 95% CI, 2.065–21.755, P=0.002), admission white blood cell count (OR 1.171, 95% CI, 1.052–1.303, P=0.004), and neonatal birth weight (OR 3.015, 95% CI, 1.739–5.227, P<0.001) were risk factors for intrapartum maternal fever during epidural labor analgesia.Conclusion: Labor induction was significantly associated with an increased risk of intrapartum maternal fever during epidural labor analgesia.

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Singh ◽  
S Gupta ◽  
T S Mishra ◽  
B D Banerjee ◽  
T Sharma ◽  
...  

Abstract Introduction Nephrolithiasis is pathological calcification in the excretory passages of the body and is prevalent among 7.6% of Indians. We aimed to study the various risk factors associated with renal stones from India. Method It was a hospital-based case-control study conducted over 18 months in a tertiary hospital in Delhi. Cases were defined as patients with renal stones diagnosed on the basis of history and radiological examination. Controls were similar to cases in all respects except for the diagnosis and selected from the hospital. A total of 18 risk factors, including age, gender, heavy metals, stress, metabolic factors, alcohol intake, dietary habits, co-morbidities, etc. were assessed. Logistic regression analysis was performed to calculate the strength of the risk associations. Results In the analysis of 60 cases and controls, we found 6 times, 5.5 times, and 2.4 times increased odds of renal stones in patients with increased arsenic, cadmium, and lead concentrations in blood, respectively. Similarly, there are 3 times increased odds of renal stones in patients suffering from stress. Conclusions Exposure to smoke, occupation dust, and contaminated water may lead to an increased ingestion/inhalation of heavy metals like cadmium, arsenic, and predisposing people to an increased risk of renal stones.


2019 ◽  
Vol 47 (10) ◽  
pp. 1532-1540 ◽  
Author(s):  
Junyu Liang ◽  
Danyi Xu ◽  
Chuanyin Sun ◽  
Weiqian Chen ◽  
Heng Cao ◽  
...  

Objective.To clarify the prevalence, risk factors, outcome, and outcome-related factors of hemophagocytic lymphohistiocytosis (HLH) in patients with dermatomyositis (DM), polymyositis (PM), or clinically amyopathic dermatomyositis (CADM).Methods.Data of patients with DM, PM, or CADM who were admitted to the First Affiliated Hospital of Zhejiang University from February 2011 to February 2019 were retrospectively collected. Patients diagnosed with HLH constituted the case group. A 1:4 case-control study was performed to identify risk factors for HLH in patients with DM, PM, or CADM through comparison, univariate, and multivariate logistic regression analysis. Intragroup comparison was made among patients with HLH to identify factors influencing unfavorable short-term outcome.Results.HLH was a rare (4.2%) but fatal (77.8%) complication in patients with DM, PM, or CADM. The retrospective case-control study revealed that higher on-admission disease activity (p = 0.008), acute exacerbation of interstitial lung disease (AE-ILD, p = 0.002), and infection (p = 0.002) were risk factors for complication of HLH in patients with DM, PM, or CADM. The following intragroup comparison showed that higher on-admission disease activity (p = 0.035) and diagnosis of CADM (p = 0.039) might influence the short-term outcome of patients with HLH. However, no risk factor was identified after false discovery rate correction.Conclusion.In this study, secondary HLH was a fatal complication, with higher on-admission disease activity, AE-ILD, and infection working as risk factors. The underlying role of infection and autoimmune abnormality in HLH in connective tissue disease was subsequently noted. Clinical factors influencing the short-term outcome of patients with secondary HLH require further study.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
N. Boutaybi ◽  
F. Razenberg ◽  
V. E. H. J. Smits-Wintjens ◽  
E. W. van Zwet ◽  
M. Rijken ◽  
...  

Our objective was to estimate the effect of therapeutic hypothermia on platelet count in neonates after perinatal asphyxia. We performed a retrospective case control study of all (near-) term neonates with perinatal asphyxia admitted between 2004 and 2012 to our neonatal intensive care unit. All neonates treated with therapeutic hypothermia were included in this study (hypothermia group) and compared with a historic control group of neonates with perinatal asphyxia treated before introduction of therapeutic hypothermia (2008). Primary outcome was thrombocytopenia during the first week after birth. Thrombocytopenia was found significantly more often in the hypothermia group than in the control group, 80% (43/54) versus 59% (27/46) (P=.02). The lowest mean platelet count in the hypothermia group and control group was97×109/Land125×109/L(P=.06), respectively, and was reached at a mean age of 4.1 days in the hypothermia group and 2.9 days in the control group (P<.001). The incidence of moderate/severe cerebral hemorrhage was 6% (3/47) in the hypothermia group versus 9% (3/35) in the control group (P=.64). In conclusion, neonates with perinatal asphyxia treated with therapeutic hypothermia are at increased risk of thrombocytopenia, without increased risk of cerebral hemorrhage.


2019 ◽  
Vol 16 (S2) ◽  
pp. 272-279 ◽  
Author(s):  
Lisa A. Mandl ◽  
Mayu Sasaki ◽  
Jingyan Yang ◽  
Sara Choi ◽  
Kelianne Cummings ◽  
...  

Abstract Background Post-operative ileus (POI) is common and can be associated with significant morbidity. Questions/Purposes We aimed to identify the incidence of and risk factors associated with severe post-operative ileus (SPOI) after elective orthopedic surgery. Methods We conducted a retrospective case–control study of patients undergoing elective orthopedic procedures at a single musculoskeletal specialty hospital. SPOI cases matched 1:2 to non-POI controls. International Classification of Diseases, Ninth Revision (ICD-9), codes were used to identify patients who were coded as having an episode of POI. After chart review, a subset was classified as clinical SPOI cases, based on set criteria. Regression models were constructed to identify variables associated with SPOI. Results Of 273 POI cases, 77 (28.2%) were classified as SPOI. Overall rates of SPOI were 2.74/1000 orthopedic discharges, with SPOI most common in spine surgeries (9.07/1000 spine procedure discharges). Hypothesis-generating multivariable conditional logistic regression suggested that, for hip and knee cases, not being on a full diet by post-operative day (POD) 2 posed an increased risk of SPOI. For spine cases, not being on a full diet on POD 2 and longer surgery times were associated with risk of SPOI. Conclusions In this retrospective case–control study, patients undergoing elective orthopedic procedures who had not progressed to full diet by POD 2 and spine patients with longer operative times were most at risk for SPOI. These data can be used clinically by peri-operative physicians to stratify patients according to risk.


2017 ◽  
Vol 6 (3) ◽  
pp. 382-390
Author(s):  
Christopher M Kollmann ◽  
Wolff Schmiegel ◽  
Thorsten Brechmann

Background and aims Apparent aspiration is a notable adverse event during gastrointestinal endoscopy under sedation (GIES), but data about inapparent aspiration are scarce. Generally, particularly older patients are at higher risk of suffering from adverse events. Objective The objective of this article is to determine the risk of pneumonia, lower respiratory tract infection (LRI) and systemic inflammatory activation after GIES, especially in patients of at least 65 years. Methods The retrospective case-control study included 250 patients undergoing GIES and assigned age-, gender- and time of performance-matched controls without invasive procedure or sedation (ratio 1:1). Results On day 3 patients of advanced age presented with both pneumonia and LRI more often (2.6 vs. 0.0%, p = 0.041 and 7.8 vs. 2.5%, p = 0.034, respectively). In general, several inflammatory parameters increased significantly after GIES (i.e. white blood cell count (increase of ≥ 25%) 18.6 vs. 6.9%, p < 0.001), leading to more frequent antibiotic treatment (6.8 vs. 1.6%, p = 0.004). The effects were less pronounced on day 7. Conclusions Patients of advanced age carry an increased risk of pneumonia and LRI after GIES. Patients are generally more likely to feature inflammation and to receive antibiotic treatment.


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