scholarly journals Factors associated with cesarean delivery in adult nulliparous women

2021 ◽  
Vol 43 ◽  
pp. e53083
Author(s):  
Maria Cristina Antunes Willemann ◽  
Célia Adriana Nicolotti ◽  
Tatiane Baratieri ◽  
Emil Kupek
Keyword(s):  
Cesarean Section ◽  
Sociodemographic Factors ◽  
P Value ◽  
Adult Women ◽  
Normal Delivery ◽  
Factors Associated ◽  
Nulliparous Women ◽  
Favorable Conditions ◽  
Prenatal Visits ◽  
Years Of Schooling

The aim of this study was to analyze the sociodemographic factors associated with cesarean section in adult women with conditions favorable for normal delivery and to identify the groups most likely to undergo this surgery in the state of Santa Catarina (SC). A case control study with microdata from the Sistema de Informação de Nascidos Vivos on 7,065 women for 2016 in SC. A relationship between cesarean section and sociodemographic variables was analyzed by logistic regression where we calculated the Adjusted Odds Ratio (AOR), confidence interval and p-value. The probability of cesarean section for each group of women (called "interaction") was also calculated. Among women with more favorable conditions for normal childbirth, the prevalence of cesarean section was 41.1%. Lower chance of cesarean section was found for women without partners (AOR: 0.79 [0.71-0.87]), up to 8 years of schooling (AOR: 0.56 [0.47-0.66]), with up to 2 prenatal visits (AOR: 0.46 [0.23-0.90]). The most likely group of women (51.4% [49.3-53.4]) to undergo cesarean section are women who perform 7 to 15 prenatal visits and have 12 or more years of schooling. A cesarean section occurs with women who have greater access to education and prenatal care and those who have partners, even though the aspects favor normal childbirth, suggesting that this does not seem to be a decision only by women.

scholarly journals NCDB Analysis of Melanoma 2004–2015: Epidemiology and Outcomes by Subtype, Sociodemographic Factors Impacting Clinical Presentation, and Real-World Survival Benefit of Immunotherapy Approval

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1455
Author(s):  
Sunny R. K. Singh ◽  
Sindhu J. Malapati ◽  
Rohit Kumar ◽  
Christopher Willner ◽  
Ding Wang
Keyword(s):  
Metastatic Melanoma ◽  
Metastatic Disease ◽  
Real World ◽  
Care Delivery ◽  
Sociodemographic Factors ◽  
P Value ◽  
Real World Data ◽  
Factors Associated ◽  
Improvement In Survival ◽  
The Impact

Background: The incidence of invasive melanoma is rising, and approval for the first immune checkpoint inhibitor (ICI) to treat metastatic melanoma occurred in 2011. We aim to describe the epidemiology and outcomes in recent years, sociodemographic factors associated with the presence of metastasis at diagnosis, and the real‐world impact of ICI approval on survival based on melanoma subtype and race. Methods: This is a retrospective analysis of the National Cancer Database (NCDB) from the years 2004–2015. The primary outcome was the overall survival of metastatic melanoma by subtype. Secondary outcomes included sociodemographic factors associated with the presence of metastasis at diagnosis and the impact of treatment facility type and ICI approval on the survival of metastatic melanoma. Results: Of the 419,773 invasive melanoma cases, 93.80% were cutaneous, and 4.92% were metastatic at presentation. The odds of presenting with metastatic disease were higher in African Americans (AA) compared to Caucasians (OR 2.37; 95% CI 2.11–2.66, p < 0.001). Treatment of metastatic melanoma at an academic/research facility was associated with lower mortality versus community cancer programs (OR 0.75, 95 % CI 0.69–0.81, p-value<0.001). Improvement in survival of metastatic melanoma was noted for Caucasians after the introduction of ICI (adjusted HR 0.80, 95% CI 0.78–0.83, p < 0.001); however, this was not statistically significant for AA (adjusted HR 0.80, 95% CI 0.62–1.02, p‐value = 0.073) or ocular cases (HR 1.03, 95% CI 0.81–1.31, p‐value 0.797). Conclusion: Real‐world data suggest a 20% improvement in survival of metastatic melanoma since the introduction of ICI. The disproportionately high odds of metastatic disease at presentation in AA patients with melanoma suggest the need for a better understanding of the disease and improvement in care delivery.

scholarly journals Prelabor cesarean section: the role of advanced maternal age and associated factors

2021 ◽  
Vol 55 ◽  
pp. 9
Author(s):  
Katrini Guidolini Martinelli ◽  
Silvana Granado Nogueira da Gama ◽  
André Henrique do Vale de Almeida ◽  
Marcos Nakamura-Pereira ◽  
Edson Theodoro dos Santos Neto
Keyword(s):  
Cesarean Section ◽  
Public Service ◽  
Maternal Age ◽  
Age Groups ◽  
Advanced Maternal Age ◽  
Public And Private ◽  
Clinical Criteria ◽  
The Public ◽  
Factors Associated ◽  
Nulliparous Women

OBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean section and to identify the factors associated with prelabor cesarean section in AMA women, according to the mode of type of labor financing (private or public). METHODS Based on the Birth in Brazil survey, the research was conducted on representative sample of mothers for the country (Brazil), regions, type of hospital and location (capital or not), in 2011/2012. This study included 15,071 women from two age groups: 20–29 years and ≥ 35 years. The information was collected from interviews with puerperal woman, prenatal cards, and medical records of mothers and newborns. Multiple logistic regression modelling was used to verify the association between prelabor cesarean section and maternal, prenatal and childbirth characteristics, according to the mode of financing. RESULTS Our results showed a higher use of prelabor cesarean section for AMA (≥ 35 years) women in the public service (OR = 1.63; 95%CI 1.38–1.94) and in the private service (OR = 1.44; 95%CI 1.13–1.83), compared with women aged 20–29 years. In the adjusted model, we recorded three factors associated with the prelabor cesarean section in AMA women in both, public and private sectors: the same professional in prenatal care and childbirth (OR = 4.97 and OR = 4.66); nulliparity (OR = 6.17 and OR = 10.08), and multiparity with previous cesarean section (from OR = 5.73 to OR = 32.29). The presence of obstetric risk (OR = 1.94; 95%CI .44–2.62) also contributed to the occurrence of prelabor cesarean section in women who gave birth in the public service. CONCLUSIONS AMA was an independent risk factor for prelabor cesarean in public and private services. In the public, prelabor cesarean in AMA was more influenced by clinical criteria. Higher chance of prelabor cesarean section in nulliparous women increases the chance of cesarean section in multiparous women, as we showed in this study, which increases the risk of anomalous placental implantation.

scholarly journals Factors Associated With Postoperative Opioid Prescribing After Primary Elective Cesarean Section

2021 ◽  
Author(s):  
Michael S Patzkowski ◽  
Kevin L Hammond ◽  
Germaine Herrera ◽  
Krista B Highland
Keyword(s):  
Pain Management ◽  
Cesarean Section ◽  
Medical Center ◽  
Elective Cesarean Section ◽  
Adult Women ◽  
Electronic Health Record Data ◽  
Present Sample ◽  
Factors Associated ◽  
Opioid Prescribing ◽  
Medical Factors

ABSTRACT Introduction Guidelines indicate the need to balance the risks of opioid prescribing with the need to adequately manage pain after cesarean section (CS). Although guidelines suggest the need for tailored opioid prescribing, it is unclear whether providers currently tailor opioid prescribing practices given patient-related factors. Thus, research is needed to first understand post-CS pain management and opioid prescribing. The objective of the present study was to identify factors related to CS discharge opioid prescriptions. Material and Methods This retrospective cohort study was approved by the Brooke Army Medical Center Institutional Review Board (San Antonio, Texas; #C.2020.094e) on June 23, 2020. Electronic health record data of healthy adult women undergoing primary elective CS, performed under regional neuraxial anesthesia at a single, academic, tertiary medical center from 2018 to 2019, were included. Multivariable regression examined patient and medical factors associated with post-CS opioid prescriptions. Results In the present sample (N = 169), 23% (n = 39) of patients did not use opioids postoperatively, while inpatient and almost all of those patients (n = 36) received a discharge prescription for opioids with a median amount of 225 morphine milligram equivalent doses. There was a lack of evidence indicating that patient and medical factors were associated with discharge opioid dose. Conclusion Patient and medical factors were not associated with post-CS opioid prescribing. Larger studies are needed to better elucidate optimal post-CS pain management in the days and months that follow CS. Such findings are needed to better tailor opioid prescribing, consistent with clinical practice guidelines.

scholarly journals Factors Associated with Inadequate Birth Intervals in the BRISA Birth Cohort, Brazil

2020 ◽  
Vol 42 (02) ◽  
pp. 067-073
Author(s):  
Raphael Barbosa ◽  
Maria Teresa Seabra Soares Britto Alves ◽  
Ian Nathasje ◽  
Deysianne Chagas ◽  
Vanda Ferreira Simões ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Birth Interval ◽  
Multinomial Logistic Regression ◽  
Short Interval ◽  
Univariate Analysis ◽  
P Value ◽  
Birth Intervals ◽  
Short Intervals ◽  
Factors Associated ◽  
Prenatal Visits

Abstract Objective To determine the prevalence of inadequate birth interval and its associated factors in the BRISA study. Methods Cross-sectional study using data from the BRISA cohort. Birth interval was categorized into “adequate” (≥ 2 years or < 5 years between births), “short interval” (< 2 years) and “long interval” (≥ 5 years). The analysis of the factors associated with short and long birth intervals used multinomial logistic regression. Results The prevalence of adequate birth intervals was 48.3%, of long intervals, 34.6%, and of short intervals, 17.1%. Skin color, age, education level, economic status, type of delivery, number of prenatal visits, parity, blood pressure, diabetes, and anemia (p-value was < 0.2 in the univariate analysis) proceeded to the final model. The variable ≥ 3 births (odds ratio [OR] = 1.29; confidence interval [CI]: 1.01–1.65) was associated with short intervals. Age < 20 years old (OR = 0.48; CI: 0.02–0.12) or ≥ 35 years old (OR = 2.43; CI: 1.82–3.25), ≥ 6 prenatal visits (OR = 0.58; CI: 0.47–0.72), ≥ 3 births (OR = 0.59; CI: 0.49–0.73), and gestational diabetes (OR = 0.38; CI: 0.20–0.75) were associated with long intervals. Conclusion Older mothers were more likely to have long birth intervals, and higher parity increases the chances of short birth intervals. Furthermore, gestational diabetes and adequate prenatal care presented higher chances of having adequate birth intervals, indicating that health assistance during pregnancy is important to encourage an adequate interval between gestations.

scholarly journals Cesarean Section and Its Correlates Among Early Child Bearing Women in Nepal

2021 ◽  
Vol 10 (4) ◽  
pp. 77-83
Author(s):  
Aliza KC Bhandari ◽  
Ashmita Adhikari ◽  
Mijjal Shrestha ◽  
Mahbubur Rahman
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
Cesarean Section ◽  
Early Pregnancy ◽  
Logistic Regression Model ◽  
P Value ◽  
Age Group ◽  
Early Child ◽  
Factors Associated ◽  
Child Bearing

Background: Cesarean section (CS) is an important indicator of accessibility to emergency obstetric care. In Nepal there is a high rate of early marriage leading to increase in teen age pregnancy however, the factors associated with CS among early child bearing women remains unreported. Hence, the objective of this study is to examine the factors associated with CS among early child bearing women. Methods: We used the 2016 National Demographic and Health Survey (NDHS) data obtained from DHS department of USAID for this study. Bivariable analysis was done using chi square test. We used logistic regression model to identify the factors associated with CS among early child bearing women. Results: Out of 4006 women of reproductive age group from 1996 to 2016, more than 50% had early pregnancy. The population-based cesarean section (CS) rate was about 10% [95% confidence interval: (8.9-11.6)]. Our logistic regression model showed that women with early child bearing had 32% (p-value <0.05, 95% confidence interval: 0.50- 0.94) less chance of having CS than women of age group 19-29 years. It was also evident that poorest women of same age group had 66% less likelihood of having CS than the richest (p-value: <0.05, 95% confidence interval: 0.29-0.99). Similarly, women from province-1, province-3 and province-4, having complete four antenatal check-ups and delivering in a private institution were associated with CS among early child bearers. Conclusion: The odds of having CS decreased by 66% among women with early pregnancy than their counterparts after adjusting for all other covariates. This suggests that the early pregnancy might not be the risk factor for having a CS. However, we also found that this relationship might have been confounded by the interaction between wealth index and age groups as there was a huge disparity in CS rate among poorest and wealthiest women who had early child bearing. Thus, Nepal government should focus more on providing adequate accessibility to CS services throughout the population so that every woman could utilize the services in need.

scholarly journals Adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia: A prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257485
Author(s):  
Getachew Mullu Kassa ◽  
Ayodele O. Arowojolu ◽  
Akin Tunde A. Odukogbe ◽  
Alemayehu Worku Yalew
Keyword(s):  
Cohort Study ◽  
Postpartum Depression ◽  
Cesarean Section ◽  
Antenatal Care ◽  
Adolescent Pregnancy ◽  
Postnatal Depression ◽  
Northwest Ethiopia ◽  
P Value ◽  
Maternal Outcomes ◽  
Adult Women

Background Adolescent pregnancy is considered a major contributor to maternal and child morbidity and mortality, the greatest concern of developing countries and an important public health issue globally. Adolescents are responsible for eleven percent of births worldwide and they face several pregnancy and childbirth related complications. However, in low-income countries like Ethiopia, there are limited researches conducted to investigate outcomes of adolescent pregnancy. Therefore, this study was conducted to assess the adverse maternal outcomes of adolescent pregnancy in Northwest Ethiopia. Methods A prospective cohort study was conducted in 12 health facilities from seven districts in East Gojjam zone, Northwest Ethiopia. A total of 418 adolescents (15–19 years old) and 836 adult women (20–34 years old) who attended randomly selected health facilities in East Gojjam zone were included. Data were collected starting from admission to the maternity ward for labor and delivery, and postnatal depression was measured at six weeks’ postpartum period using the Edinburgh Postnatal Depression Scale. Generalized estimating equations (GEE) was used to account for the within subject correlation and assess the effect of different known factors that could influence the outcome of this study. Results A lower percentage of adolescent (58.4%) than adult (71.2%) women had their first antenatal care booking before 16 weeks of gestation. After adjusting for different confounding factors, the adverse outcome that was significantly associated with adolescent pregnancy was postpartum depression (AOR: 2.29; 95% CI, 1.42, 3.7, p-value = 0.001). Assisted vaginal delivery (AOR: 0.44; 95% CI, 0.23, 0.86, p-value 0.016) and cesarean section (AOR: 0.43; 95% CI, 0.19, 0.97, p-value = 0.042) were significantly lower among adolescent women. Conclusions Adolescent pregnancy is associated with higher odds of postpartum depression, and lower odds to undergo cesarean section and assisted vaginal delivery than adult women. Perinatal care services should be more adolescent-friendly to ensure early diagnosis and treatment of postpartum depression. School and community-based awareness programs regarding use of contraception to prevent unwanted adolescent pregnancy, early antenatal care booking and adverse pregnancy outcomes of adolescent pregnancy and provision of psychosocial support are recommended.

scholarly journals Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age: A hospital-based study in Woldia, Ethiopia

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Yalew Mihret ◽  
Fentanesh Endalew ◽  
Hunegnaw Almaw ◽  
Melese Linger
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Sociodemographic Factors ◽  
Bottle Feeding ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Feeding Practice ◽  
Factors Associated ◽  
Multivariable Logistic Regression

Introduction: Bottle feeding should be avoided when possible in infants under the age of two to improve health outcomes. The magnitude of bottle feeding practice is currently increasing in Ethiopia, however factors associated with bottle feeding usage are rarely addressed in research. We aimed to fill this gap and assess the magnitude of bottle feeding and its association with sociodemographic factors among infants in Woldia, Ethiopia in 2019.Methods: A hospital-based cross-sectional study was conducted in Woldia General Hospital at the Immunization Clinic. A total of 255 mothers who had infants were selected by systematic random sampling method. Data was collected through face-to-face interview using a structured standardized questionnaire. The data was entered to EpiData version 3.1 and analyzed using SPSS version 20. Binary logistic regression analysis models were used to assess the association between dependent and independent variables. Variables with p-value < 0.2 in bivariable logistic regression analysis were entered to multivariable logistic regression analysis. Finally, variables with p-value < 0.05 with 95% CI in multivariable logistic regression were taken as independent predictors. COR and AOR were used to show the strength of association between the dependent and independent variables.Results: The rate of bottle feeding practice in this study was 42.7% (95%CI: 35.8,48.2). Being an infant age 0-5 months old [AOR=0.16; 95%CI: 0.06,0.4], being a mother age 35-50 years old [AOR=0.43; 95%CI: 0.22, 0.85], having 2-5 children [AOR=6.37; 95%CI: 1.33, 30.44], and being a farmer as reported mother’s occupation [AOR=2.72; 95%CI: 1.30, 5.67] showed significant association with bottle feeding practice.Conclusion: The magnitude of bottle feeding practice was significantly higher in the current study as compared to national prevalence. Several sociodemographic factors showed significant association with bottle feeding practice which need to be explored further in the future research.

scholarly journals Exposure to simultaneous sedentary behavior domains and sociodemographic factors associated in public servants

2017 ◽  
Vol 19 (4) ◽  
pp. 469
Author(s):  
Fernanda Cerveira Fronza ◽  
Juliane Berria ◽  
Giseli Minatto ◽  
Edio Luiz Petroski
Keyword(s):  
Sedentary Behavior ◽  
Educational Level ◽  
Sociodemographic Factors ◽  
Sitting Time ◽  
Sociodemographic Characteristics ◽  
Public Servants ◽  
Cross Sectional ◽  
Factors Associated ◽  
Daily Time ◽  
Years Of Schooling

DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n4p469 Exposure to sedentary behavior may contribute to health problems. This study aimed to estimate the prevalence of exposure to simultaneous sedentary behavior domains and verify associated sociodemographic characteristics among technical and administrative servers of a Brazilian university. This is a cross-sectional epidemiological study carried out with 623 technical and administrative servers. Sedentary behavior was identified through a questionnaire in the following domains: commuting (active / passive), sitting time at work, daily time spent watching television and computer use (≥3 hours / day). Sociodemographic variables were age, sex and educational level. The prevalence of servers that had one, two, three and four simultaneous sedentary behavior was 28.4%, 43.2%, 22.5% and 4.3%, respectively. Women were more likely to have three sedentary behavior simultaneously (OR = 1.61, CI 95% = 1.02, 2.56). Servers with 9-11 years of schooling were less exposed to two (OR = 0.27, CI 95% = 0.17, 0.44), three (OR = 0.39, CI 95% = 0.23, 0.66) and four (OR = 0.22, CI 95% = 0.07; 0.69) sedentary behavior simultaneously and those over 12 years of schooling were less likely of having two (OR = 0.22, CI 95% = 0.10; 0.49) and three (OR = 0.15, CI 95% = 0.05, 0.46) sedentary behavior simultaneously. More than half of servers have two sedentary behavior during the week. Having sedentary behavior in more than one domain simultaneously was associated with sex and educational level.

Maternal Knowledge Factor, Maternal Age and Maternal Parity Associated with Genesis of Normal Delivery at Palembang Hospital of Bari Year 2017

2018 ◽  
Vol 1 (1) ◽  
pp. 43-50
Author(s):  
Juliana Widyastuti Wahyuningsih
Keyword(s):  
Maternal Age ◽  
World Health ◽  
Survey Method ◽  
P Value ◽  
Maternal Knowledge ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Significance Level ◽  
Birth Canal ◽  
Maternal Parity

Childbirthis a processLabor of opening and depleting the cervix and the fetus down into the birth canal. Birth is a process in which the fetus and amniotic are pushed out through the birth canal. (Sarwono, 2008). According to the World Health Organization (WHO) estimates more than 585,000 mothers annually die during pregnancy or childbirth. Indonesia Health Demographic Survey (SDKI) Survey in 2012, Maternal Mortality Rate in Indonesia is still high at 359 per 100,000 live births. The purpose of this study is the knowledge of maternal knowledge, maternal age, and maternal parity associated with normal birth events at Palembang Bari Hospital 2017. This study used analytical survey method with cross sectional approach. The population in this study were all maternal mothers at the Palembang Bari Hospital in 2017. Sampling in the study was conducted non-randomly with the technique of "Accidental Sampling". Data analysis was done univariat and bivariate with Chi-Square statistical test with significance level α = 0,05. The result of this research shows that there is correlation between mother's knowledge with normal delivery incidence with p value 0,001, there is correlation between mother age with normal delivery incidence with p value 0,009, there is relation between mother parity with normal delivery incidence with p value 0,001. From result of this research hopes healthcare workers can improve normal delivery care services and more often to carry out maternal safety counseling.

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