Patterns of contraceptive use among Australian women of reproductive age with chronic disease: a prospective cohort study

Objective: Examine patterns of contraceptive use among reproductive age women, with and without chronic disease, and investigate factors which influence contraceptive use over time. Design: Population-based cohort study Setting and population: Data from 8,030 women from the Australian Longitudinal Study on Women’s Health. Main outcome measures: Contraceptive patterns identified using latent transition analysis. Methods: Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. Results: Women with chronic disease used contraception at similar rates to women without chronic disease however contraceptive non-use increased over the observation period (13.6% vs 12.7% in 2018 when aged 40-45 years). When specific contraceptive use patterns were examined over time, differences were found for women with autoinflammatory diseases only. Compared to women without chronic disease using the pill and condoms, women with autoinflammatory disease had increased odds of using condom and natural methods (OR=1.20, 95% CI=1.00, 1.44), and sterilisation and other methods (OR=1.61, 95% CI=1.08, 2.39) or no contraception (OR=1.32, 95% CI=1.04, 1.66), compared to women without chronic disease using short-acting methods and condoms. Conclusion: Potential gaps in the provision of appropriate contraceptive access and care exist for women with chronic disease, particularly those diagnosed with autoinflammatory conditions. Development of national guidelines as well as a clear coordinated contraceptive strategy from adolescence through to the mid reproductive years and perimenopause encouraging regular contraceptive review during care management to increase support for, and agency among, women with chronic disease is required.

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Death and Chronic Disease Risk Associated With Poor Life Satisfaction: A Population-Based Cohort Study

American Journal of Epidemiology ◽

10.1093/aje/kwy245 ◽

2018 ◽

Vol 188 (2) ◽

pp. 323-331 ◽

Cited By ~ 6

Author(s):

Laura C Rosella ◽

Longdi Fu ◽

Emmalin Buajitti ◽

Vivek Goel

Keyword(s):

Life Satisfaction ◽

Cohort Study ◽

Chronic Disease ◽

Disease Risk ◽

Population Based ◽

Chronic Disease Risk

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Changes in serum TG levels during pregnancy and their association with postpartum hypertriglyceridemia: a population-based prospective cohort study

Lipids in Health and Disease ◽

10.1186/s12944-021-01549-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Yandi Zhu ◽

Haiyan Zhu ◽

Qinyu Dang ◽

Qian Yang ◽

Dongxu Huang ◽

...

Keyword(s):

Logistic Regression ◽

Pregnant Women ◽

Blood Lipid ◽

Roc Curves ◽

Population Based ◽

Linear Mixed Effect Model ◽

Mixed Effect ◽

Adverse Pregnancy ◽

Stratified Analysis ◽

Over Time

Abstract Background Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. However, some adverse pregnancy outcomes are thought to be related to gestational lipid levels. Therefore, it is necessary to have a reference range for lipid changes during gestation. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters. Methods A total of 908 pregnant women were followed from recruitment to 42 days postpartum, and their serum lipids were collected at gestational weeks 6–8, 16, 24, and 36 and 42 days postpartum. The major outcome was postpartum hypertriglyceridemia. The association between gestational and postpartum TG levels was analysed by stepwise multiple linear regression. A two-stage approach including a linear mixed-effect model and linear or logistic regression was conducted to explore the contribution of the changes in TG over time in pregnancy to postpartum hypertriglyceridemia. Logistic regression was constructed to examine the association between gestational TG levels and postpartum hypertriglyceridemia. Cut-off points were calculated by receiver operating characteristic (ROC) curves. Results There was a tendency for serum TG to increase with gestational age and decrease at 42 days postpartum. Prepregnancy overweight, obesity, and GDM intensified this elevation. Higher TG levels at gestational weeks 6–8, 16, 24, and 36 were positively associated with a higher risk of postpartum hypertriglyceridemia [OR 4.962, 95 % CI (3.007–8.189); OR 2.076, 95 % CI (1.303–3.309); OR 1.563, 95 % CI (1.092–2.236); and OR 1.534, 95 % CI (1.208–1.946), respectively]. The trend of the change in TG over time was positively associated with the TG level and risk of postpartum hypertriglyceridemia [OR 11.660, 95 % CI (6.018–22.591)]. Based on ROC curves, the cut-off points of serum TG levels were 1.93, 2.35, and 3.08 mmol/L at gestational weeks 16, 24, and 36, respectively. Stratified analysis of prepregnancy body mass index (pre-BMI) and GDM showed that higher gestational TG was a risk factor for postpartum hypertriglyceridemia in women with normal pre-BMI and without GDM. Conclusions Gestational TG and its elevation were risk and predictive factors of postpartum hypertriglyceridemia, especially in pregnant women with normal pre-BMI or without GDM.

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Have associations between mental health and health related behaviours changed between 2005 and 2015? A population based cross-cohort study

10.1101/2020.03.06.20032235 ◽

2020 ◽

Author(s):

Suzanne H. Gage ◽

Praveetha Patalay

Keyword(s):

Mental Health ◽

Substance Use ◽

Cohort Study ◽

Mental Health Problems ◽

Weight Perception ◽

Population Based ◽

Parents And Children ◽

Health Related ◽

Avon Longitudinal Study ◽

Over Time

AbstractBackgroundPoor adolescent mental health is a growing concern over recent decades with evidence of increasing internalising mental health problems corresponding with decrease in anti-social, smoking and alcohol behaviours. However, understanding whether and how the associations between mental health and health-related behaviours such as substance use, anti-social behaviour and obesity have changed over time is less well-understood.ObjectivesWe investigate whether the associations between different health-related outcomes in adolescence are stable or changing over time in two recent cohorts of adolescents born ten years apart.MethodData from two UK birth cohort studies, the Avon Longitudinal Study of Parents and Children (ALSPAC, born 1991-92, N=5627, 50.7% female) and Millennium Cohort Study (MCS, born 2000-1, N=11318, 50.6% female) at age 14 sweeps are used. The health outcomes of focus are depressive symptom score, substance use (alcohol, smoking, cannabis and other drugs), antisocial behaviours (assault, graffiti, vandalism, shoplifting and rowdy behaviour), weight (BMI), weight perception (perceive self as overweight) and sexual activity (had sexual intercourse).ResultsOur results suggest although directions of associations between mental-health and health-related behaviours (eg smoking) are similar over time, their strength across the distribution has changed. While smoking and alcohol use behaviours are decreasing in adolescents, those that endorse these behaviours in 2015 are more likely to have co-occurring mental-health and other problems than those born in 2005. Similarly, higher body mass index is more strongly associated with depressive symptoms in 2015.ConclusionsOur findings suggest that associations between these factors has changed over time, which has implications for public health and our understanding of the mechanisms underlying their observed associations in the population.

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Association between Anemia and Stroke in Females: A Nationwide, Population-Based Cohort Study in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207440 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7440

Author(s):

Yuan Sui ◽

Chien-Tai Hong ◽

Li-Nien Chien ◽

Hung-Yi Liu ◽

Hung-Yi Chiou ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Ischemic Stroke ◽

Stroke Risk ◽

Medical Condition ◽

Positive Association ◽

Population Based ◽

Reproductive Age ◽

Research Database ◽

Female Patients

Optimal stroke prevention strategies for women should take into account specific sex-related stroke risk factors. Anemia is a common medical condition in females, particularly in women of reproductive age. This study investigated whether anemia is an independent risk factor for stroke in females in a population-based cohort study. We investigated newly diagnosed anemic female patients with no history of central nervous system disease, psychiatric disorders, traumatic brain injury, major operations or hemorrhagic diseases identified from the Taiwan National Health Insurance Research Database. Non-anemic matched controls (1:1) were selected based on a propensity score estimated using a logistic regression model that included demographic characteristics and comorbidities. A competing risk analysis was applied to estimate the stroke risk in anemic patients compared to that of their matched controls. In our study, the adjusted sub-distribution hazard ratios (aSHRs) of overall, hemorrhagic and ischemic stroke in anemic female patients aged <50 years were 1.35 (95% confidence interval (CI): 1.19–1.52, p < 0.001), 1.31 (95% CI, 1.09-1.56, p < 0.003), and 1.35 (95% CI, 1.15–1.58, p < 0.001), respectively, compared to non-anemic female controls. However, a positive association between anemia and stroke was not found for those aged ≥50 years. Similar results were observed when the follow-up age was limited to 50 years to reduce the potential effects of menopause on stroke. In conclusion, the present population-based cohort study found that anemia is a potential risk factor for overall, hemorrhagic and ischemic stroke in females of reproductive age.

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Temporal Trends in Surgical Resection Rates and Biologic Prescribing in Crohn’s Disease: A Population-based Cohort Study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa044 ◽

2020 ◽

Vol 14 (9) ◽

pp. 1241-1247

Author(s):

P W Jenkinson ◽

N Plevris ◽

S Siakavellas ◽

M Lyons ◽

I D Arnott ◽

...

Keyword(s):

Cohort Study ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Biologic Therapy ◽

Temporal Trends ◽

Cumulative Risk ◽

Population Based ◽

Cumulative Probability ◽

Cox Regression Analysis ◽

Over Time

Abstract Background The use of biologic therapy for Crohn’s disease [CD] continues to evolve, however, the effect of this on the requirement for surgery remains unclear. We assessed changes in biologic prescription and surgery over time in a population-based cohort. Methods We performed a retrospective cohort study of all 1753 patients diagnosed with CD in Lothian, Scotland, between January 1, 2000 and December 31, 2017, reviewing the electronic health record of each patient to identify all CD-related surgery and biologic prescription. Cumulative probability and hazard ratios for surgery and biologic prescription from diagnosis were calculated and compared using the log-rank test and Cox regression analysis stratified by year of diagnosis into cohorts. Results The 5-year cumulative risk of surgery was 20.4% in cohort 1 [2000–2004],18.3% in cohort 2 [2005–2008], 14.7% in cohort 3 [2009–2013], and 13.0% in cohort 4 [2014–2017] p <0.001. The 5-year cumulative risk of biologic prescription was 5.7% in cohort 1, 12.2% in cohort 2, 22.0% in cohort 3, and 44.9% in cohort 4 p <0.001. Conclusions The increased and earlier use of biologic therapy in CD patients corresponded with a decreasing requirement for surgery over time within our cohort. This could mean that adopting a top-down or accelerated step-up treatment strategy may be effective at reducing the requirement for surgery in newly diagnosed CD.

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Implications of parental lifestyle changes and education level on adolescent offspring weight: a population based cohort study - The HUNT Study, Norway

BMJ Open ◽

10.1136/bmjopen-2018-023406 ◽

2018 ◽

Vol 8 (8) ◽

pp. e023406 ◽

Cited By ~ 4

Author(s):

Marit Naess ◽

Erik R Sund ◽

Turid Lingaas Holmen ◽

Kirsti Kvaløy

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Parental Education ◽

Population Based ◽

Education Level ◽

Lifestyle Changes ◽

Education Levels ◽

Reduced Physical Activity ◽

Z Scores ◽

Over Time

ObjectiveObesity tends to cluster in families reflecting both common genetics and shared lifestyle patterns within the family environment. The aim of this study was to examine whether parental lifestyle changes over time, exemplified by changes in weight and physical activity, could affect offspring weight in adolescents and if parental education level influenced the relationship.Design, setting and participantsThe population-based cohort study included 4424 parent-offspring participants from the Nord-Trøndelag Health Study, Norway. Exposition was parental change in weight and physical activity over 11 years, and outcome was offspring weight measured in z-scores of body mass index (BMI) in mixed linear models.ResultsMaternal weight reduction by 2–6 kg was significantly associated with lower offspring BMI z-scores: −0.132 (95% CI −0.259 to −0.004) in the model adjusted for education. Parental weight change displayed similar effect patterns on offspring weight regardless of parents’ education level. Further, BMI was consistently lower in families of high education compared with low education in the fully adjusted models. In mothers, reduced physical activity level over time was associated with higher BMI z-scores in offspring: 0.159 (95% CI 0.030 to 0.288). Associations between physical activity change and adolescent BMI was not moderated by parental education levels.ConclusionLifestyle changes in mothers were associated with offspring BMI; reduced weight with lower—and reduced physical activity with higher BMI. Father’s lifestyle changes, however, did not significantly affect adolescent offspring’s weight. Overall, patterns of association between parental changes and offspring’s BMI were independent of parental education levels, though adolescents with parents with high education had lower weight in general.

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Trends in chlamydia and gonorrhoea testing and positivity in Western Australian Aboriginal and non-Aboriginal women 2001–2013: a population-based cohort study

Sexual Health ◽

10.1071/sh16207 ◽

2017 ◽

Vol 14 (6) ◽

pp. 574 ◽

Cited By ~ 4

Author(s):

Joanne Reekie ◽

Basil Donovan ◽

Rebecca Guy ◽

Jane S. Hocking ◽

John M. Kaldor ◽

...

Keyword(s):

Age Groups ◽

Population Based ◽

Reproductive Age ◽

Nucleic Acid Amplification ◽

Effective Prevention ◽

Aboriginal Women ◽

Adjusted Incidence Rate ◽

Rate Ratios ◽

Adjusted Incidence ◽

Over Time

Background: This study aimed to examine trends in chlamydia and gonorrhoea testing and positivity in Aboriginal and non-Aboriginal women of reproductive age. Methods: A cohort of 318002 women, born between 1974 and 1995, residing in Western Australia (WA) was determined from birth registrations and the 2014 electoral roll. This cohort was then probabilistically linked to all records of chlamydia and gonorrhoea nucleic acid amplification tests conducted by two large WA pathology laboratories between 1 January 2001 and 31 December 2013. Trends in chlamydia and gonorrhoea testing and positivity were investigated over time and stratified by Aboriginality and age group. Results: The proportion of women tested annually for chlamydia increased significantly between 2001 and 2013 from 24.5% to 36.6% in Aboriginal and 4.0% to 8.5% in non-Aboriginal women (both P-values <0.001). Concurrent testing was high (>80%) and so patterns of gonorrhoea testing were similar. Chlamydia and gonorrhoea positivity were substantially higher in Aboriginal compared with non-Aboriginal women; age-, region- and year-adjusted incidence rate ratios were 1.52 (95% confidence interval (CI) 1.50–1.69, P < 0.001) and 11.80 (95% CI 10.77–12.91, P < 0.001) respectively. Chlamydia positivity increased significantly in non-Aboriginal women aged 15–19 peaking in 2011 at 13.3% (95% CI 12.5–14.2%); trends were less consistent among 15–19-year-old Aboriginal women but positivity also peaked in 2011 at 18.5% (95% CI 16.9–20.2%). Gonorrhoea positivity was 9.7% (95% CI 9.3–10.1%), 6.7% (95% CI 6.4–7.0%), 4.7% (4.4–5.0%), and 3.1% (2.8–3.4%) among Aboriginal women aged respectively 15–19, 20–24, 25–29 and ≥30 years, compared with <1% in all age groups in non-Aboriginal women. Over time, gonorrhoea positivity declined in all age groups among Aboriginal and non-Aboriginal women. Conclusion: Between 2001 and 2013 in WA chlamydia and gonorrhoea positivity remained highest in young Aboriginal women despite chlamydia positivity increasing among young non-Aboriginal women. More effective prevention strategies, particularly for young Aboriginal women, are needed to address these disparities.

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Long-term outcomes of adult out-of-hospital cardiac arrest in Queensland, Australia (2002–2014): incidence and temporal trends

Heart ◽

10.1136/heartjnl-2020-317333 ◽

2020 ◽

pp. heartjnl-2020-317333

Author(s):

Katherine Pemberton ◽

Richard C Franklin ◽

Emma Bosley ◽

Kerrianne Watt

Keyword(s):

Cardiac Arrest ◽

Temporal Trends ◽

Population Data ◽

Population Based ◽

Incidence Rates ◽

Long Term Outcomes ◽

Australian Bureau Of Statistics ◽

Hospital Cardiac Arrest ◽

Over Time

ObjectiveTo describe annual incidence and temporal trends (2002–2014) in incidence of long-term outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics, by age, gender, geographical remoteness and socioeconomic status (SES).MethodsThis is a retrospective cohort study. Cases were identified using the QAS OHCA Registry and were linked with entries in the Queensland Hospital Admitted Patient Data Collection and the Queensland Registrar General Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence. Inclusion criteria were adult (18+ years) residents of Queensland who suffered OHCA of presumed cardiac aetiology and survived to hospital admission. Analyses were undertaken by three mutually exclusive outcomes: (1) survival to less than 30 days (Surv<30 days); (2) survival from 30 to 364 days (Surv30–364 days); and (3) survival to 365 days or more (Surv365+ days). Incidence rates were calculated for each year by gender, age, remoteness and SES. Temporal trends were analysed.ResultsOver the 13 years there were 4393 cases for analyses. The incidence of total admitted events (9.72–10.13; p<0.01), Surv30–364 days (0.18–0.42; p<0.05) and Surv365+ days (1.94–4.02; p<0.001) increased significantly over time; no trends were observed for Surv<30 days. An increase in Surv365+ days over time was observed in all remoteness categories and most SES categories.ConclusionEvidence suggests that implemented strategies to improve outcomes from OHCA have been successful and penetrated groups living in more remote locations and the lower socioeconomic groups. These populations still require focus. Ongoing reporting of long-term outcomes from OHCA should be undertaken using population-based incidence.

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