scholarly journals Valproate prescription to women of childbearing age in English primary care: repeated cross-sectional analyses and retrospective cohort study

2020 ◽  
Author(s):  
Mariangela Gaudio ◽  
Emmanouela Konstantara ◽  
Mark Joy ◽  
Jeremy Van Vlymer ◽  
Simon de Lusignan
Keyword(s):  
Primary Care ◽  
Retrospective Cohort ◽  
Practice Variation ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Sentinel Network ◽  
Childbearing Potential ◽  
Prescription Patterns ◽  
Over Time

Abstract Background: Valproate is teratogenic drug that should be avoided during the preconception period and pregnancy. The aim was to explore GPs’ prescription patterns over time, describe trends, and explore inter-practice variation within primary care. Methods: We identified women of childbearing age (12-46 years old) in the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network. We performed repeated cross-sectional analyses from 2004 to 2018 to determine rates of prescription and a retrospective cohort estimated the prevalence of use of valproate during pregnancy. Results: In 2004, 0.31% (95% Confidence Interval (95%CI):0.18 to 0.44%) women were prescribed valproate, decreasing to 0.16% (95%CI:0.07 to 0.24%) by 2018. Among women with epilepsy, the rate fell from 15.2% (95%CI:14.4 to 16.0%) to 8.8 % (95% CI:8.2 to 9.7%) over the same period. In 2018, almost two thirds (62.2%) of women who were prescribed valproate had epilepsy only, whereas bipolar disorder and migraine accounted for 15.8% and 7.4% respectively. Contraceptive prescriptions did not increase over time, and only in 2018 was there greater odds of being prescribed contraception (OR 1.41, 95%CI:1.08 to 1.45). Just under a fifth (19.7%) of women were prescribed valproate during their pregnancy; two out of three of these pregnancies were preceded by folic acid prescription (5 mg). While some practices reduced their rate of valproate prescription, others did not.Conclusions: Regulatory guidelines have changed GPs' prescription patterns in women of childbearing potential for valproate but not for contraception. Further research is needed to identify the barriers of GPs and women of childbearing potential to undertaking contraception.

scholarly journals Pregnancy protection and pregnancies in women prescribed ACE inhibitors or ARBs: a cross-sectional study in primary care

2020 ◽  
Vol 70 (700) ◽  
pp. e778-e784
Author(s):  
Elizabeth Lovegrove ◽  
John Robson ◽  
Patricia McGettigan
Keyword(s):  
Primary Care ◽  
Ace Inhibitors ◽  
Ace Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Women Of Childbearing Age ◽  
Sectional Study ◽  
Childbearing Age ◽  
Cross Sectional

BackgroundThe teratogenic risks of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are well documented, but prescribing these in younger women in primary care is becoming increasingly frequent.AimTo record how frequently women of childbearing age, who are prescribed an ACE inhibitor or ARB, receive preconception advice and/or are prescribed contraception, and how many pregnancies, terminations, and miscarriages occur in this population. Additionally, to ascertain whether patterns in the above differ across age groups.Design and settingCross-sectional study conducted among patients from 141 general practices in East London.MethodWomen aged 15–45 years who were issued a prescription for an ACE inhibitor or ARB between 1 October 2018 and 1 January 2019 inclusive were included. An electronic search strategy was designed to extract pseudonymised data concerning preconception and contraception advice, contraception, and pregnancies from the electronic clinical system; this was applied to the selected cohort on 1 January 2019. Data were analysed in 5-year age groups.ResultsOf 302 939 women aged 15–45 years, 2651 (0.9%) were prescribed an ACE inhibitor or an ARB in a 3-month period. Of these, 2159 (81.4%) had no advice and no contraception prescription recorded, 35 (1.3%) had preconception advice recorded, and 230 (8.7%) had contraception advice recorded. A total of 100 pregnancies and 21 terminations/miscarriages were recorded in the 12 months preceding the index date (1 January 2019).ConclusionThis study found that the recording of pre-pregnancy advice and contraception in women of childbearing age who were prescribed an ACE inhibitor or an ARB was suboptimal; this may place women and their babies at risk of exposure to teratogens during pregnancy. The findings indicate that there is a need for improved safety strategies based in primary care.

scholarly journals Incidence of household transmission of acute gastroenteritis (AGE) in a primary care sentinel network (1992–2017): cross-sectional and retrospective cohort study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e022524 ◽  
Author(s):  
Simon de Lusignan ◽  
Emmanouela Konstantara ◽  
Mark Joy ◽  
Julian Sherlock ◽  
Uy Hoang ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Acute Gastroenteritis ◽  
Retrospective Cohort ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sentinel Network ◽  
Household Transmission

IntroductionAcute gastroenteritis (AGE) is a highly transmissible condition. Determining characteristics of household transmission will facilitate development of prevention strategies and reduce the burden of this disease.We are carrying out this study to describe household transmission of medically attended AGE, and explore whether there is an increased incidence in households with young children.Methods and analysisThis study used the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network, comprising data from 1 750 167 registered patients (August 2017 database). We conducted a novel analysis using a ’household key', to identify patients within the same household (n=811 027, mean 2.16 people). A 25-year repeated cross-sectional study will explore the incidence of medically attended AGE overall and then a 5-year retrospective cohort study will describe household transmission of AGE. The cross-sectional study will include clinical data for a 25-year period—1 January 1992 until the 31 December 2017. We will describe the incidence of AGE by age-band and gender, and trends in incidence. The 5-year study will use Poisson and quasi-Poisson regression to identify characteristics of individuals and households to predict medically attended AGE transmitted in the household. This will include whether the household contained a child under 5 years and the age category of the first index case (whether adult or child under 5 years). If there is overdispersion and zero-inflation we will compare results with negative binomial to handle these issues.Ethics and disseminationAll RCGP RSC data are pseudonymised at the point of data extraction. No personally identifiable data are required for this investigation. The protocol follows STrengthening the Reporting of OBservational studies in Epidemiology guidelines (STROBE). The study results will be published in a peer-review journal, the dataset will be available to other researchers.

scholarly journals Prevalence of High HDL Cholesterol and Its Associated Factors Among Tunisian Women of Childbearing Age: A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5461
Author(s):  
Fatma Ben Cherifa ◽  
Jalila El Ati ◽  
Radhouene Doggui ◽  
Myriam El Ati-Hellal ◽  
Pierre Traissac
Keyword(s):  
Associated Factors ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Protective Role ◽  
Lifestyle Factors ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Biological Variables

The protective role of high high-density lipoprotein cholesterol (HDL-C) against cardiovascular risk has been questioned recently. Due to the increasing trend of cardiovascular diseases (CVD) in Tunisia, this study aimed to determine the prevalence of high HDL-C and its associated factors in Tunisian women of childbearing age. A cross-sectional survey was conducted among a subsample of 1689 women, aged 20 to 49 years, in the Great Tunis region. Data on socio-demographic and lifestyle factors were collected by a questionnaire. Overall adiposity was assessed by body mass index (BMI). All biological variables were assayed in blood samples coated with anticoagulant ethylene diamine tetra acetic acid (EDTA) by enzymatic methods. Stata software (2015) was used for data management and statistical analysis. High HDL-C values were recorded in 26.6% of selected women. After adjustment for all socio-demographic and lifestyle factors, age, hypertension, and smoking were negatively associated with high HDL-C levels, while family history of cancer was positively associated with high HDL-C in women. An additional investigation on the relationship between high HDL-C and cancer risk should be performed due to controversial results.

scholarly journals HUBUNGAN USIA DAN PARITAS TERHADAP KEJADIAN PRE EKLAMPSIA DI RSD BALUNG JEMBER

2021 ◽  
Vol 2 (3) ◽  
pp. 85-91
Author(s):  
Yuningsih
Keyword(s):  
Medical Records ◽  
Random Sampling ◽  
P Value ◽  
Multiple Logistic Regression ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Chi Square ◽  
Cross Sectional ◽  
Independent Variables ◽  
Chi Square Test

One of the contributors to maternal and infant mortality is the incidence of preeclampsia that occurs during pregnancy. The cause of preeclampsia is still unknown, but it is suspected that age and parity are one of the triggers for this occurrence. Women of childbearing age who are nulliparous with extreme age under the age of less than 20 years and women with the age of more than 35 years are most commonly found to have preeclampsia. The design in this study is analytic with a cross sectional approach. The population of all mothers giving birth in the delivery room of RSD Balung Jember was 3594 in 2019. The number of samples taken using non-random sampling by purposive sampling was finally obtained by 97 respondents. In this study, the independent variables were maternal age and parity, while the dependent variable was the incidence of preeclampsia. The instrument used is medical records. The data is processed by editing, coding, processing and cleaning processes. Data were analyzed using multiple logistic regression. The results of the chi-square test for the age variable obtained that the Pearson chi-square value was 0.019 and the p value = 0.000 <0.05 from these results Ho was rejected, and the parity variable the Pearson chi- square value was 0.019 and the p value = 0.000 <0.05 from these results Ho is rejected. In conclusion, there is a relationship between age and preeclampsia, and there is a relationship between parity and preeclampsia.

scholarly journals Description Of Nutrition Status Of Bride And Groom Based On Level Knowledge Of The First 1000 Days Of Life In Cimanggis Depok

2017 ◽  
Vol 8 (2) ◽  
pp. 72-79
Author(s):  
Nadira Nurarifah ◽  
Titus Priyo Harjatmo
Keyword(s):  
Nutritional Status ◽  
Qualitative Method ◽  
Nutrition Status ◽  
Sensitive Period ◽  
Research Use ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Status Of Women

The First Thousand Days of Life, which is 270 days during pregnancy and 730 days in the first life of the baby, is a sensitive period because the problems that arise are permanent. The biggest problem that occurs in children is stunting (37.2%). In addition, one factor that supports the nutritional status of women of childbearing age who still experience Chronic Energy (20.8%). The best approach is to prepare the bridge and groom's nutritional status and increase knowledge about the First 1000 Days of Life. The purpose of this study is to determine the description of nutritional status of prospective brides based on knowledge about the First 1000 Days of Life. This research use qualitative method with cross sectional design with sampling accidental sampling within 1 week with result of 21 bride candidate. Result of nutritional status of bride candidate is normal (85,7%), while for knowledge about 1000 First Day of Life included in enough category (57,1%). Suggestion for the office of religious affairs is that on pre-marriage counseling is given material about the First 1000 Days of Life. Some extension materials about the motto of the card to healthy, calcium-containing foods and the suggestion to consume tablets added blood.

scholarly journals HUBUNGAN KADAR IODIUM GARAM KONSUMSI DAN TINGKAT KONSUMSI IODIUM DENGAN KADAR EKSKRESI IODIUM URIN WANITA USIA SUBUR

2017 ◽  
Vol 1 (01) ◽  
pp. 61
Author(s):  
Hepi Diah Apika ◽  
Endo Dardjito ◽  
Dyah Umiyarni Purnamasari
Keyword(s):  
Random Sampling ◽  
Sampling Technique ◽  
Iodine Content ◽  
Simple Random Sampling ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Consumption Level ◽  
Salt Consumption ◽  
Food Recall

Abstract The purpose of this study analyze the relationship between the iodine content of salt consumption and the level of consumption of iodine levels in women of childbearing age UIE. The study was observational with cross sectional design. The research location in the village of Kebumen, Baturraden subdistrict, Banyumas. Subjects were 38 selected by simple random sampling technique. The consumption level of iodine was measured by the method of Food Recall 2x24 hours. Salt iodine content was measured by iodometric titration method and UIE levels measured by acid digestion method in the laboratory BP2GAKI Magelang. Data analysis using spearman correlation. A total of 71.1% women of childbearing age using the iodine content of salt consumption of <30 ppm. The consumption level of iodine less subject category (86.8%). UIE levels by an average of 156.50 μg/L category of normal iodine intake. There was no relationship with the iodine content of salt UIE levels (p=0.671). No correlation with levels of iodine consumption levels UIE (p=0.586). Levels of UIE women of childbearing age are not affected by the iodine content of salt and iodine consumption levels.   Keywords: Iodized salt, consumption levels, UIE   Abstrak   Tujuan penelitian ini adalah menganalisis hubungan kadar yodium konsumsi garam dan tingkat konsumsi kadar yodium pada wanita usia subur UIE. Penelitian ini bersifat observasional dengan rancangan cross sectional. Lokasi penelitian di desa Kebumen, Kecamatan Baturraden, Banyumas. Subjek penelitian dipilih dengan teknik simple random sampling. Tingkat konsumsi yodium diukur dengan metode Food Recall 2x24 jam. Kandungan garam yodium diukur dengan metode titrasi iodometrik dan tingkat UIE yang diukur dengan metode pencernaan asam di laboratorium BP2GAKI Magelang. Analisis data menggunakan korelasi spearman. Sebanyak 71,1% wanita usia subur menggunakan kandungan yodium konsumsi garam <30 ppm. Tingkat konsumsi kategori subjek kurang yodium (86,8%). Tingkat UIE rata-rata 156,50 μg / L kategori asupan yodium normal. Tidak ada hubungan dengan kadar yodium kadar garam UIE (p = 0,671). Tidak ada korelasi dengan tingkat kadar konsumsi yodium UIE (p = 0,586). Tingkat wanita UIE pada usia subur tidak terpengaruh oleh kadar yodium tingkat konsumsi garam dan yodium.  Kata kunci: garam beryodium, tingkat konsumsi, UIE

scholarly journals Tingkat Pengetahuan Ibu Hamil tentang HIV/AIDS dengan Perilaku Pemeriksaan Test PITC (Provider Initiated Test and Counselling) di Puskesmas Sleman Yogyakarta

2016 ◽  
Vol 3 (1) ◽  
pp. 48
Author(s):  
Annisaa’ Nurmasari ◽  
Fatimah Fatimah ◽  
Febrina Suci Hati
Keyword(s):  
Pregnant Women ◽  
Sampling Technique ◽  
P Value ◽  
Knowledge Level ◽  
Test Results ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Hiv Aids

<p>HIV infection in pregnant women can threaten the life of the mother and the mother can transmit the virus to their babies. Sleman PHC registered 2 people including one pregnant woman and one women of childbearing age in the year of 2014. Incidence of pregnant women suffering from HIV-AIDS in 2014 is 1 patients and detected from PITC test results for 7 weeks in a row is 1 patient. And in January year of 2015 found 1 patient with 3 times test and the results was positive. The purpose of this study was to determine relationship between Knowledge Level of Pregnant women about HIV/AIDS and Behaviour of PITC (Provider Initiated Test and Counselling) test. This study was a quantitative analysis of correlation with cross-sectional design. The population of this study were all pregnant women checkups at the health center in Yogyakarta Sleman. The sampling technique was used accidental sampling study which consisted of 72 respondents. The analysis used univariate and bivariate. The results showed that most respondents aged 20-35 (72.2%), senior high school education (47.2%) and work as a housewife (IRT) (38.9%). Most respondents have good knowledge about HIV/AIDS were 50 respondents (69.4%). Most respondents perform checks PITC were 71 respondents (98.6%). There was no relationship between knowledge level of pregnant women about HIV/AIDS and Behaviour of PITC (p-value=0.243&gt;0.005). In Conclusion, There was no relationship between knowledge level of pregnant women about HIV/AIDS and Behaviour of PITC in Sleman, Yogyakarta.</p>

Knowledge, attitude and practices regarding implants among women of childbearing age

2021 ◽  
pp. 1-9
Author(s):  
Irshad Begum Shaikh ◽  
Syed Imtiaz Ahmed Jafry ◽  
Syed Muhammad Zulfiqar Hyder Naqvi ◽  
Syeda Nadia Firdous ◽  
Admin
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Contraceptive Method ◽  
Women Of Childbearing Age ◽  
Reproductive Health Services ◽  
Childbearing Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Child Bearing

Abstract A cross-sectional survey was conducted from February 2016 to September 2016 to assess knowledge, attitude and practices regarding implants among women of childbearing age visiting Reproductive Health Services Center, Civil Hospital,Karachi. A total of 396 adult non-pregnant married females of child bearing age, from 18 to 49 years old, were interviewed using a structured questionnaire.Only153 (38.6%) of therespondentshad knowledge about implants whereas out of them 122 (79.7%) acquired it from family planning clinics. Almost two third of them (n=267, 67.4%) were in favor of using implants as a contraceptive method. Moreover, 244 (61.6%) of them were of the opinion that if given the choice, they will use implanon though out of total 316 (79.8%) respondents who ever used contraceptives, only 3 (0.9%) used implants.Despiteafavorable attitude, limited knowledge and poor practices of the respondents highlighted the study findings. Keywords: Knowledge, Attitude, Contraception, Progestins, Continuous...

scholarly journals Ingresos en UCI por causas obstétricas

2018 ◽  
Vol 18 (1) ◽  
pp. 304-345 ◽  
Author(s):  
Luana Feitosa Mourão ◽  
Igor Cordeiro Mendes ◽  
Antonio Dean Barbosa Marques ◽  
Virna Ribeiro Feitosa Cestari ◽  
Roussana Maria Barreto de Brito Braga
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
First Trimester ◽  
Lung Edema ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional ◽  
First Trimester Of Pregnancy ◽  
Terapia Intensiva ◽  
Las Mujeres

Objetivou-se analisar as internações de mulheres em idade fértil em uma Unidade de Terapia Intensiva Obstétrica. Estudo transversal, documental e retrospectivo, realizado em uma Unidade de Terapia Intensiva Obstétrica, localizada em Fortaleza/Ceará, com a presença de mulheres em idade fértil admitidas na unidade no ano de 2016. Os dados foram coletados dos prontuários que atenderam aos critérios de inclusão, durante o mês de abril de 2017, mediante um formulário semiestruturado e analisados por meio de estatística descritiva, sendo incluídos 106 prontuários. A maioria das mulheres tinham faixa etária entre 20 a 29 anos, pardas, em união estável, com ensino médio completo, primíperas, com início do pré-natal no 1º trimestre gestacional, com 4 a 6 consultas. Dentre as causas obstétricas diretas (61,1%) as principais foram Eclâmpsia (34,4%), Síndrome de Hellp (15,1%) e Pré-eclâmpsia grave (11%) e para as causas obstétricas indiretas (38,9%) destacam-se Insuficiência renal (13,5%), Edema agudo de pulmão (11,5%) e Cardiopatia (9,6%). Os dados revelam uma linha ténue no que concerne a atenção a saúde da mulheres dentro do ciclo gravídico-puerperal. Su objetivo es analizar los ingresos de mujeres en edad fértil en una Unidad de Cuidados Intensivos Obstétrica. Estudio transversal, documental y retrospectivo, realizado en una Unidad de Cuidados Intensivos Obstétrica, ubicada en Fortaleza / Ceará, con la presencia de mujeres en edad fértil admitidas en la unidad en el año 2016. Los datos fueron recolectados de los registros que atendieron a los criterios de inclusión. Durante el mes de abril de 2017, mediante un formulario semiestructurado y analizado por medio de estadística descriptiva, siendo incluidos 106 registros. La mayoría de las mujeres tenía un grupo de edad entre 20 y 29 años, pardas, en unión estable, con enseñanza media completa, primíperas, con inicio del prenatal en el primer trimestre gestacional, con 4 a 6 consultas. Entre las causas obstétricas directas (61,1%) las principales fueron Eclampsia (34,4%), Síndrome de Hellp (15,1%) y Pre-eclampsia grave (11%) y para las causas obstétricas indirectas (38,9 (%), Se observan las siguientes: Insuficiencia renal (13,5%), Edema agudo de pulmón (11,5%) y Cardiopatía (9,6%). Los datos revelan una línea tenue en lo que concierne a la atención a la salud de las mujeres dentro del ciclo gravídico-puerperal. The objective was to analyze the admission of women of childbearing age to an Obstetric Intensive Care Unit. A cross-sectional, documentary and retrospective study was carried out in an Obstetric Intensive Care Unit, located in Fortaleza/Ceará, with women of childbearing age admitted to the unit in 2016. Data were collected from 106 medical records that met the inclusion criteria during the month of April 2017, using a semi-structured form, and analyzed by means of descriptive statistics. The majority of the women were between 20 and 29 years old, common-law married, with complete secondary education, primiparous, had initiated prenatal care in the first trimester of pregnancy, and attended 4 to 6 consultations. Among the direct obstetric causes (61.1%), the most frequent were Eclampsia (34.4%), HELLP syndrome (15.1%) and Severe preeclampsia (11%). The indirect obstetric causes (38.9%) included Renal insufficiency (13.5%), Acute lung edema (11.5%) and Heart disease (9.6%). Data revealed a fragile health care for women within the pregnant-puerperal cycle.

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