scholarly journals Association of Mercury Exposure and Maternal Sociodemographics on Birth Outcomes of Indigenous and Tribal Women in Suriname

2021 ◽  
Vol 18 (12) ◽  
pp. 6370
Author(s):  
Gaitree K. Baldewsingh ◽  
Ashna D. Hindori-Mohangoo ◽  
Edward D. van Eer ◽  
Hannah H. Covert ◽  
Arti Shankar ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
System Analysis ◽  
Adverse Birth Outcomes ◽  
Logistic Regression Models ◽  
Tribal Women ◽  
Younger Age ◽  
The Caribbean ◽  
Risk Reduction Measures ◽  
Environmental And Occupational Health ◽  
Lower Household Income

Information regarding adverse birth outcomes (ABO) of Indigenous and Tribal women living in the remote tropical rainforest of Suriname, where mercury (Hg) use is abundant in artisanal gold mining, is not available. In the context of a health system analysis, we examined the association between Hg exposure, maternal sociodemographics on the ABO of Indigenous and Tribal women living in Suriname’s interior and its capital, Paramaribo. ABO were determined in pregnant women enrolled from December 2016 to July 2019 in the Caribbean Consortium for Environmental and Occupational Health prospective environmental epidemiologic cohort study. Associations were explored using Pearson’s χ2-test and the Mann–Whitney U-test. Among 351 singleton participants, 32% were Indigenous, residing mainly in the interior (86.8%), and 23.1% had ABO. Indigenous participants had higher rates of ABO (29.8% vs. 19.8%) and preterm birth (PTB) (21.2% vs. 12.4%), higher Hg levels, delivered at a younger age, were less educated, and had lower household income compared to Tribal participants. Multivariate logistic regression models revealed that Indigenous participants had higher odds of ABO (OR = 3.60; 95% CI 1.70–7.63) and PTB (OR = 3.43; 95% CI 1.48–7.96) compared with Tribal participants, independent of Hg exposure and age at delivery. These results highlight the importance of effective risk reduction measures in support of Indigenous mothers, families, and communities.

scholarly journals Opioid and benzodiazepine dispensing and co-dispensing patterns among commercially insured pregnant women in the United States, 2007–2015

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Danya M. Qato ◽  
Aakash Bipin Gandhi
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
The United States ◽  
Adverse Birth Outcomes ◽  
Chi Square ◽  
Logistic Regression Models ◽  
Drug Use Disorders ◽  
Comorbidity Burden ◽  
Sample Characteristics

Abstract Background Little is known about benzodiazepine and opioid-benzodiazepine co-dispensing patterns among pregnant women. Understanding these patterns is necessary to mitigate high-risk medication use during pregnancy. Our objective in this analysis was to evaluate opioid and benzodiazepine dispensing and co-dispensing patterns among commercially insured pregnant women in the United States. Methods This retrospective study used a 10% random sample of commercially insured enrollees from the IQVIA™ Adjudicated Health Plan Claims Data from 2007 to 2015. The study included women (12–55 years of age) with completed pregnancies who had continuous medical and prescription drug coverage from 3 months prior to the date of conception through 3 months post-delivery. We estimated the prevalence of opioid and benzodiazepine dispensing and co-dispensing before, during, and after pregnancy, and evaluated trends in dispensing patterns across the study period (2007–2015) using Cochrane-Armitage tests. Chi-square tests were used to examine differences in demographic and clinical characteristics by dispensing and co-dispensing patterns. Among women that received an opioid or benzodiazepine during pregnancy, logistic regression models were used to quantify the association between sample characteristics and dispensing patterns (co-dispensing vs single dispensing). Results Of 168,025 pregnant women that met our inclusion criteria, 10.1% received at least one opioid and 2.0% received at least one benzodiazepine during pregnancy, while 0.5% were co-dispensed these drugs. During the study period (2007 vs 2015), prevalence of opioid dispensing during pregnancy decreased from 11.2 to 8.6% (p <  0.01); while benzodiazepine dispensing increased from 1.3 to 2.9% (p <  0.01), and the prevalence of co-dispensing, while low and stable, increased slightly from 0.39 to 0.44% (p <  0.01). Older age, a higher comorbidity burden, pain diagnosis, anxiety diagnosis, and alcohol, tobacco, and drug use disorders, were all associated with an increased odds of co-dispensing during pregnancy. Conclusions This study provides evidence that while opioid dispensing during pregnancy has decreased in the past decade, benzodiazepine dispensing has increased. The prevalence of opioid-benzodiazepine co-dispensing was rare and remained fairly stable during our study period. Those co-dispensed both drugs had a higher prevalence of adverse birth outcomes. Further research to establish the potentially causal relationship between opioid and benzodiazepine co-dispensing and adverse birth outcomes should be undertaken.

scholarly journals Iodine monitoring models contribute to avoid adverse birth outcomes related more than adequate iodine intake

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinju Dong ◽  
Shouyan Liu ◽  
Lingyun Wang ◽  
Xingjian Zhou ◽  
Qinghong Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Regression Models ◽  
Iodine Intake ◽  
Milk Consumption ◽  
Adverse Birth Outcomes ◽  
Logistic Regression Models ◽  
Multivitamin Supplements

Abstract Background Iodine plays an important role in pregnancy. How to maintain adequate iodine intake amongst pregnant women in each trimester of pregnancy to prevent adverse birth outcomes in central China is a challenge for clinical practice. Methods 870 pregnant women and their infants were enrolled in the study. Urinary iodine concentration (UIC) was measured using an inductively coupled plasma mass spectrometry (ICP-MS). Maternal and newborn information were obtained during follow-up. Multinomial logistic regression models were established. Results Median UIC of pregnant women was 172 ± 135 μg/L which is currently considered to be sufficient. Multivitamin supplements containing iodine, iodized salt intake and frequent milk intake were significantly associated with higher UIC. Multivariate logistic regression analysis showed that multivitamin supplements containing iodine and milk consumption were risk factors for more than adequate iodine (UIC ≥ 250 μg/L). Iodine-rich diet was significantly related to heavier birthweight, larger head circumference and longer femur length of the newborns while more than adequate iodine intake (UIC ≥ 250 μg/L) was a risk factor for macrosomia. Logistic regression models based on potential risk factors involving iodine containing supplements and iodine-rich diet were established to predict and screen pregnant women with high risk of more than adequate iodine intake among local pregnant women in different trimesters and guide them to supplement iodine reasonably to prevent the risk. Conclusions Multivitamin supplements containing iodine and milk consumption were risk factors for maternal UIC ≥ 250 μg/L which was a risk factor for macrosomia. Iodine monitoring models were established to provide guidance for pregnant women to reduce the risk of more than adequate iodine intake, thereby contributing to reduce the risk of having a macrosomia.

1365: Admission for Nephrolithiasis in Pregnancy and Risk of Adverse Birth Outcomes

2007 ◽  
Vol 177 (4S) ◽  
pp. 450-450
Author(s):  
Mia A. Swartz ◽  
Mona T. Lydon-Rochelle ◽  
David Simon ◽  
Jonathan L. Wright ◽  
Michael P. Porter
Keyword(s):  
Birth Outcomes ◽  
Adverse Birth Outcomes ◽  
In Pregnancy

scholarly journals Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Dyer ◽  
Rachel Hardeman ◽  
Dovile Vilda ◽  
Katherine Theall ◽  
Maeve Wallace
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Black Women ◽  
Low Birth Weight ◽  
Racial Disparities ◽  
Population Health ◽  
Birth Outcomes ◽  
Mass Incarceration ◽  
Interquartile Range ◽  
Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

scholarly journals Patients and relatives as auditors of safe practices in oncology and hematology day hospitals

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabel Rodrigo Rincón ◽  
Isabel Irigoyen Aristorena ◽  
Belén Tirapu León ◽  
Nicolás Zaballos Barcala ◽  
Maite Sarobe Carricas ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Tertiary Hospital ◽  
Patient Identification ◽  
Healthcare Organizations ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Younger Age ◽  
Day Hospitals ◽  
Cross Sectional Design ◽  
Safe Practices

Abstract Background When there is a gap in professionals’ adherence to safe practices during cancer treatment, the consequences can be serious. Identifying these gaps in order to enable improvements in patient safety can be a challenge. This study aimed to assess if cancer patients and their relatives can be given the skills to audit reliably four safe practices, and to explore whether they are willing to play this new role. Methods We recruited 136 participants in 2018, from the oncology and haematology day hospital of a tertiary hospital in Spain. Patient identification, hand hygiene, blood or chemotherapy identification, and side effects related to transfusion and chemotherapy, were the safe practices selected for evaluation. The study comprised two parts: an interventional educational program and a cross-sectional design to collect data and assess to what degree participants are able and willing to be auditors depending on their characteristics using multivariate logistic regression models. A participant’s auditing skill were assessed pre and post the educational intervention. Results The model was seeking predictors of being a good auditor. 63 participants (46.3%) were classified as good auditors after the training. To have younger age, higher educational level and to have had an experience of an adverse event were associated with a higher probability of being a good auditor. Additionally, 106 (77.9%) participants said that they would like to audit anonymously the professionals’ compliance of at least three of four safe practices. The willingness to audit safe practices differed depending on the safe practice but these differences did not reach statistical significance. Conclusions The data gathered by patients and relatives acting as auditors can provide healthcare organizations with valuable information about safety and quality of care that is not accessible otherwise. This new role provides an innovative way to engage patients and their families’ in healthcare safety where other methods have not had success. The paper sets out the methods that healthcare organizations need to undertake to enrol and train patients and relatives in an auditor role.

scholarly journals Modest reduction in adverse birth outcomes following the COVID-19 lockdown

2020 ◽  
Author(s):  
Ellen C. CANIGLIA ◽  
Lerato E. MAGOSI ◽  
Rebecca ZASH ◽  
Modiegi DISEKO ◽  
Gloria MAYONDI ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Adverse Birth Outcomes ◽  
Modest Reduction
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