scholarly journals Childbirth Care among SARS-CoV-2 Positive Women in Italy

2021 ◽  
Vol 18 (8) ◽  
pp. 4244
Author(s):  
Serena Donati ◽  
Edoardo Corsi ◽  
Michele Antonio Salvatore ◽  
Alice Maraschini ◽  
Silvia Bonassisa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Caesarean Section Rate ◽  
Perinatal Outcomes ◽  
Population Based ◽  
Web Based ◽  
Support Person ◽  
Skin Contact ◽  
Skin To Skin ◽  
Over Time ◽  
Childbirth Care

The new coronavirus emergency spread to Italy when little was known about the infection’s impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother–child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother–newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room; the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother’s milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to “better safe than sorry” care choices. An improvement of the peripartum care indicators was observed over time.

scholarly journals Comparison of adverse perinatal outcomes between Asians and Caucasians: a population-based retrospective cohort study in Ontario

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Gestational Age ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Population Based ◽  
Adverse Perinatal Outcomes

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.

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

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.

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

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 &lt;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 &lt;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.

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

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e023406 ◽  
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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