scholarly journals Maternal age as a risk factor for cerebral palsy

2021 ◽  
Vol 84 (2) ◽  
pp. 117-131
Author(s):  
Marta Sternal ◽  
Barbara Kwiatkowska ◽  
Krzysztof Borysławski ◽  
Agnieszka Tomaszewska

Abstract The relationship between maternal age and the occurrence of cerebral palsy is still highly controversial. The aim of the study was to examine the effect of maternal age on the risk of CP development, taking into account all significant risk factors and the division into single, twin, full-term, and pre-term pregnancies. The survey covered 278 children with CP attending selected educational institutions in Poland. The control group consisted of data collected from the medical records of 435 children born at Limanowa county hospital, Poland. The analyses included socio-economic factors, factors related to pregnancy and childbirth, and factors related to the presence of comorbidities and diseases in the child. Constructed logistic regression models were used for statistical analyses. For all age categories included in the estimated models (assessing the effect of demographic factors on the development of CP), only the category of ≤24 years of age (in the group of all children) was significant. It was estimated that in this mother’s age category, the risk of CP is lower (OR 0.6, 95% CI: 0.3–1.0) in comparison to mothers aged 25-29 (p = 0.03). However, estimation with the use of a complex logistic regression model did not show any significant effect of maternal age on the incidence of CP in groups from different pregnancies types. It became apparent that maternal age is a weak predictor of CP, insignificant in the final logistic regression model. It seems correct to assume that the studies conducted so far, showing a significant effect of maternal age in this respect, may be associated with bias in the estimators used to assess the risk of CP due to the fact that other important risk factors for CP development were not included in the research.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4447-4447
Author(s):  
Ruth Pettengell ◽  
Andre Bosly ◽  
Thomas D. Szucs ◽  
Christian Jackisch ◽  
Robert Leonard ◽  
...  

Abstract Febrile neutropenia (FN) following chemotherapy often results in hospitalisation and chemotherapy dose delays or reductions in subsequent cycles. Although current guidelines highlight non-Hodgkin lymphoma (NHL) patients receiving standard regimens as having a significant risk of FN, the contribution of additional factors to the overall risk of FN is not fully understood. We present a logistic regression model describing the relationship of various clinical factors with FN occurrence in NHL. Predictors were chosen based on their clinical and statistical significance (5% level) and to allow comparison with other models. Data were obtained from the INC-EU Prospective Observational European Neutropenia Study, which aimed to assess the incidence and predictors of neutropenia, FN and chemotherapy dose limitations in breast cancer and lymphoma. 240 NHL patients were recruited from 37 centres in Belgium, France, Germany, Spain, and the UK. Ann Arbor stages were distributed: I 18%; II 26%; III 17%; IV 40%. Chemotherapy regimens received were 3-weekly CHOP-like (74%), 2-weekly CHOP-like (17%), ACVBP-like (4%) and other regimens (5%). Overall colony stimulating factor (CSF) prophylaxis in patients who had not previously experienced FN was 50%. FN incidence in any cycle was 22%. The resulting logistic regression model of any FN occurrence is shown in the table. Replacing GFR and height with the closely related parameters of age and weight slightly affected predictive ability but did not affect model stability. The area under the receiver operating characteristic curve was 0.84. Using the optimal probability cut-off, model test characteristics were 75% sensitivity and 76% specificity; corresponding to positive and negative predictive values of 48% and 91%, respectively. Low absolute neutrophil or white blood cell count (ANC, WBC), high baseline alkaline phosphatase, low GFR (or high age), low height (or low weight), cardiac comorbidity, recent infection, and high planned chemotherapy dose appeared to increase the risk of FN occurrence. Although chemotherapy dose reduction or delay protected against FN, these are associated with reduced survival in patients receiving CHOP-like regimens. CSF use was a protective factor. These results complement risk factors highlighted in current guidelines.


2020 ◽  
Vol 83 (1) ◽  
pp. 31-41
Author(s):  
Marta Sternal ◽  
Barbara Kwiatkowska ◽  
Krzysztof Borysławski ◽  
Agnieszka Tomaszewska

AbstractIn the literature there are no unequivocal assessments of the effect of paternal age on the risk of cerebral palsy (CP). The objective of the studies was the analysis of the influence of paternal age on this risk, considering all the important risk factors and division into singleton and twin, as well as term- and preterm-born infants. The inquiry included a group of 278 children with cerebral palsy from selected education-therapeutic institutions in Poland. The control group consisted of the data from medical records of 435 neonates born in God’s Mercy Hospital in Limanowa, Poland. The data were based on a questionnaire designed to obtain information which would make it possible to ascertain the probable etiological factors. Constructed models of logistic regression were used in statistical analysis. The results were presented as the odds ratio (OR) with 95% confidence interval (CI). Though the estimation with a complex model of logistic regression showed no significant effect of paternal age on the occurrence of cerebral palsy, it confirmed it as a stronger predictor compared to maternal age. Disregarding paternal of age while considering maternal age and other risk factors may lead to a bias in the estimations of the risk cerebral palsy.


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T Heseltine ◽  
SW Murray ◽  
RL Jones ◽  
M Fisher ◽  
B Ruzsics

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf Liverpool Multiparametric Imaging Collaboration Background Coronary artery calcium (CAC) score is a well-established technique for stratifying an individual’s cardiovascular disease (CVD) risk. Several well-established registries have incorporated CAC scoring into CVD risk prediction models to enhance accuracy. Hepatosteatosis (HS) has been shown to be an independent predictor of CVD events and can be measured on non-contrast computed tomography (CT). We sought to undertake a contemporary, comprehensive assessment of the influence of HS on CAC score alongside traditional CVD risk factors. In patients with HS it may be beneficial to offer routine CAC screening to evaluate CVD risk to enhance opportunities for earlier primary prevention strategies. Methods We performed a retrospective, observational analysis at a high-volume cardiac CT centre analysing consecutive CT coronary angiography (CTCA) studies. All patients referred for investigation of chest pain over a 28-month period (June 2014 to November 2016) were included. Patients with established CVD were excluded. The cardiac findings were reported by a cardiologist and retrospectively analysed by two independent radiologists for the presence of HS. Those with CAC of zero and those with CAC greater than zero were compared for demographic and cardiac risks. A multivariate analysis comparing the risk factors was performed to adjust for the presence of established risk factors. A binomial logistic regression model was developed to assess the association between the presence of HS and increasing strata of CAC. Results In total there were 1499 patients referred for CTCA without prior evidence of CVD. The assessment of HS was completed in 1195 (79.7%) and CAC score was performed in 1103 (92.3%). There were 466 with CVD and 637 without CVD. The prevalence of HS was significantly higher in those with CVD versus those without CVD on CTCA (51.3% versus 39.9%, p = 0.007). Male sex (50.7% versus 36.1% p= <0.001), age (59.4 ± 13.7 versus 48.1 ± 13.6, p= <0.001) and diabetes (12.4% versus 6.9%, p = 0.04) were also significantly higher in the CAC group compared to the CAC score of zero. HS was associated with increasing strata of CAC score compared with CAC of zero (CAC score 1-100 OR1.47, p = 0.01, CAC score 101-400 OR:1.68, p = 0.02, CAC score >400 OR 1.42, p = 0.14). This association became non-significant in the highest strata of CAC score. Conclusion We found a significant association between the increasing age, male sex, diabetes and HS with the presence of CAC. HS was also associated with a more severe phenotype of CVD based on the multinomial logistic regression model. Although the association reduced for the highest strata of CAC (CAC score >400) this likely reflects the overall low numbers of patients within this group and is likely a type II error. Based on these findings it may be appropriate to offer routine CVD risk stratification techniques in all those diagnosed with HS.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anping Guo ◽  
Jin Lu ◽  
Haizhu Tan ◽  
Zejian Kuang ◽  
Ying Luo ◽  
...  

AbstractTreating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.


2016 ◽  
Vol 32 (1) ◽  
pp. 34-38
Author(s):  
Biplob Kumar Das ◽  
Kanak Jyoti Mondal

Stroke is one of the foremost causes of morbidity, mortality and is a socioeconomic challenge. This is particularly true for developing countries like Bangladesh, where health support system including the rehabilitation system is not within the reach of common people. Hypertriglycerademia has an effective influence in the pathogenesis of Ischaemic Stroke (IS). So, the focus of this study was to evaluate and assess the association of serum triglyceride level in patients of IS. This case control study was carried out in the Department of Neurology in collaboration with Department of Biochemistry, BSMMU, Dhaka from July 2011 to June 2013. In this study, 60 diagnosed cases of ischaemic stroke patients and 60 age and sex matched healthy controls were enrolled. Risk factors of Ischemic Stroke (IS) patients were assessed ( adjusted Odds Ratio) in comparison with healthy adults. In this study, being married [OR. 1.95, 95% CI (0.40-9.42), p=0.409] , smoker [OR.1.65, 95% CI (0.57 - 4.82),p= 0.357], DM [OR. 1.48, 95% CI (0.36-6.06), p=0.582 ], IHD [OR. 1.51, 95% CI (0.29 – 7.89), p=0.624] , HTN [OR. 3.66, 95% CI (1.11–12.12), p=0.033] , overweight [OR.2.31, 95% CI (0.77 – 6.91), 0.135] and obesity [OR. 16.19, 95% CI (1.31–200.6), p=0.030] , increased level of serum TC [OR.8.24, 95% CI (2.07 – 32.83), p=0.003], TG [OR. 9.40, 95% CI (1.17 -75.86), p=0.035], LDL [OR. 0.45, 95% CI (0.10–2.05), p=0.308],and decreased level of HDL [OR. 3.37, 95% CI (1.03 - 12.25), p=0.045] were found as risk factors in developing IS. Independent t-test was done to find out the statistically significant differences of continuous variables like serum lipid profile between case and control group. The mean (SD) value of TG which is focus of this study, was found 237.67 (61.74) in case group, and 169.97 (26.95) in control group which was highly statistically significant (p < 0.0001). All of the significant variables were entered into stepwise logistic regression analysis model. From the logistic regression model, it can be finally concluded that hypertension, obesity, increased level of TC, increased level of TG and decreased level of HDL were statistically significant risk factors for development of IS. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 34-38


2021 ◽  
Author(s):  
Li Lu Wei ◽  
Yu jian

Abstract Background Hypertension is a common chronic disease in the world, and it is also a common basic disease of cardiovascular and brain complications. Overweight and obesity are the high risk factors of hypertension. In this study, three statistical methods, classification tree model, logistic regression model and BP neural network, were used to screen the risk factors of hypertension in overweight and obese population, and the interaction of risk factors was conducted Analysis, for the early detection of hypertension, early diagnosis and treatment, reduce the risk of hypertension complications, have a certain clinical significance.Methods The classification tree model, logistic regression model and BP neural network model were used to screen the risk factors of hypertension in overweight and obese people.The specificity, sensitivity and accuracy of the three models were evaluated by receiver operating characteristic curve (ROC). Finally, the classification tree CRT model was used to screen the related risk factors of overweight and obesity hypertension, and the non conditional logistic regression multiplication model was used to quantitatively analyze the interaction.Results The Youden index of ROC curve of classification tree model, logistic regression model and BP neural network model were 39.20%,37.02% ,34.85%, the sensitivity was 61.63%, 76.59%, 82.85%, the specificity was 77.58%, 60.44%, 52.00%, and the area under curve (AUC) was 0.721, 0.734,0.733, respectively. There was no significant difference in AUC between the three models (P>0.05). Classification tree CRT model and logistic regression multiplication model suggested that the interaction between NAFLD and FPG was closely related to the prevalence of overweight and obese hypertension.Conclusion NAFLD,FPG,age,TG,UA, LDL-C were the risk factors of hypertension in overweight and obese people. The interaction between NAFLD and FPG increased the risk of hypertension.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S448-S448
Author(s):  
Alison L Blackman ◽  
Sabeen Ali ◽  
Xin Gao ◽  
Rosina Mesumbe ◽  
Carly Cheng ◽  
...  

Abstract Background The use of intraoperative topical vancomycin (VAN) is a strategy aimed to prevent surgical site infections (SSI). Although there is evidence to support its efficacy in SSI prevention following orthopedic spine surgeries, data describing its safety, specifically acute kidney injury (AKI) risk, is limited. The purpose of this study was to determine the AKI incidence associated with intraoperative topical VAN. Methods This is a retrospective cohort study reviewing patient encounters where intraoperative topical VAN was administered from February 2018 to July 2018. All adult patients ( ≥18 years) that received topical VAN in the form of powder, beads, rods, paste, cement spacers, or unspecified topical routes were included. Patient encounters were excluded for AKI or renal replacement therapy (RRT) at baseline, ≤ 2 serum creatinine values drawn after surgery, and/or if irrigation was the only topical formulation given. The primary outcome was the percentage of patients who developed AKI after intraoperative topical VAN administration. AKI was defined as an increase in serum creatinine (SCr) ≥50% from baseline, an increase in SCr >0.5 from baseline, or0 if RRT was initiated after topical VAN was given. Secondary outcomes included analysis of AKI risk factors and SSI incidence. AKI risk factors were analyzed using a multivariable logistic regression model. Results A total of 589 patient encounters met study criteria. VAN powder was the most common formulation (40.9%), followed by unspecified topical routes (30.7%) and beads (9.9%%). Nonspinal orthopedic surgeries were the most common procedure performed 46.7%. The incidence of AKI was 8.7%. In a multivariable logistic regression model, AKI was associated with concomitant systemic VAN (OR 3.39, [3.39–6.22]) and total topical VAN dose. Each doubling of the topical dose was associated with increased odds of developing AKI (OR = 1.42, [1.08–1.86]). The incidence of SSI was 5.3%. Conclusion AKI rates associated with intraoperative topical VAN are comparable to that of systemic VAN. Total topical vancomycin dose and concomitant systemic VAN was associated with an increased AKI risk. Additional analysis is warranted to compare these patients to a similar population that did not receive topical VAN. Disclosures All authors: No reported disclosures.


2015 ◽  
Vol 32 (1) ◽  
pp. 288 ◽  
Author(s):  
Daniel Lapresa ◽  
Javier Arana ◽  
M.Teresa Anguera ◽  
J.Ignacio Pérez-Castellanos ◽  
Mario Amatria

This study shows how simple and multiple logistic regression can be used in observational methodology and more specifically, in the fields of physical activity and sport. We demonstrate this in a study designed to determine whether three-a-side futsal or five-a-side futsal is more suited to the needs and potential of children aged 6-to-8 years. We constructed a multiple logistic regression model to analyze use of space (depth of play) and three simple logistic regression models to determine which game format is more likely to potentiate effective technical and tactical performance.


2018 ◽  
Vol 29 (03) ◽  
pp. 260-265 ◽  
Author(s):  
Adiam Woldemicael ◽  
Sarah Bradley ◽  
Caroline Pardy ◽  
Justin Richards ◽  
Paolo Trerotoli ◽  
...  

Introduction Surgical site infection (SSI) is a key performance indicator to assess the quality of surgical care. Incidence and risk factors for SSI in neonatal surgery are lacking in the literature. Aim To define the incidence of SSI and possible risk factors in a tertiary neonatal surgery centre. Materials and Methods This is a prospective cohort study of all the neonates who underwent abdominal and thoracic surgery between March 2012 and October 2016. The variables analyzed were gender, gestational age, birth weight, age at surgery, preoperative stay in neonatal intensive care unit, type of surgery, length of stay, and microorganisms isolated from the wounds. Statistical analysis was done with chi-square, Student's t- or Mann–Whitney U-tests. A logistic regression model was used to evaluate determinants of risk for SSI; variables were analyzed both with univariate and multivariate models. For the length of hospital stay, a logistic regression model was performed with independent variables. Results A total of 244 neonates underwent 319 surgical procedures. The overall incidence of SSIs was 43/319 (13.5%). The only statistical differences between neonates with and without SSI were preoperative stay (<4 days vs. ≥4 days, p < 0.01) and length of hospital stay (<30 days vs. ≥30 days, p < 0.01). A pre-operative stay longer than 4 days was associated with almost three times increased risk of SSI (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.05–8.34, p = 0.0407). Gastrointestinal procedures were associated with more than ten times the risk of SSI compared with other procedures (OR 10.17, 95% CI 3.82–27.10, p < 0.0001). Gastroschisis closure and necrotizing enterocolitis (NEC) laparotomies had the highest incidence SSI (54% and 62%, respectively). The risk of longer length of hospital stay after SSI was more than three times higher (OR = 3.36, 95%CI 1.63–6.94, p = 0.001). Conclusion This is the first article benchmarking the incidence of SSI in neonatal surgery in the United Kingdom. A preoperative stay ≥4 days and gastrointestinal procedures were independent risk factors for SSI. More research is needed to develop strategies to reduce SSI in selected neonatal procedures.


Sign in / Sign up

Export Citation Format

Share Document