scholarly journals The effect of maternal health conditions on maternal morbidity in women with a prior cesarean: the role of elective repeat cesarean delivery

2019 ◽  
Vol 5 (2) ◽  
pp. 17
Author(s):  
Moshe Fridman ◽  
Lisa M Korst ◽  
Elizabeth Lawton ◽  
Naomi Greene ◽  
Samia Saeb ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Disease ◽  
Older Women ◽  
Cesarean Delivery ◽  
Maternal Morbidity ◽  
Gestational Hypertension ◽  
Health Conditions ◽  
Odds Ratios ◽  
Increased Risk ◽  
Mental Health Diagnoses

Background: We evaluated women with a prior cesarean delivery (CD) who were eligible for elective repeat CD or trial of labor to test whether the risk of severe maternal morbidity (SMM) was: 1) directly associated with important pre-existing and gestational conditions or 2) indirectly associated (significantly increased or decreased) with the decision to undergo elective repeat CD.Methods: Women with a prior CD who had inborn, liveborn, term, singleton, vertex deliveries were identified in California 2010-2011 hospital discharge datasets. Using discharge codes, this population was stratified into two groups: attempted labor and elective repeat CD. A mediation model (stratified by younger vs. older women [>35 years]) was built for each of the following maternal conditions (exposure): chronic/gestational diabetes mellitus (DM), chronic/gestational hypertension, heart disease, obesity, and mental health diagnoses. Elective repeat CD was the mediator and SMM was the outcome.Results: Of 141,535 eligible deliveries, 72.7% had an elective repeat CD; 2.3% had SMM, which occurred in 2.2% of younger vs. 2.6% of older women. For younger and older women respectively, the modeled total effect odds ratios (95% CI) for heart disease were: 10.7 (8.5, 13.5) and 8.8 (6.4, 12.2); for hypertension: 1.7 (1.4, 1.9) and 2.0 (1.6, 2.4); and for mental health diagnoses: 1.9 (1.6, 2.3) and 1.7 (1.3, 2.3). Neither DM nor obesity demonstrated a direct effect. Odds ratios for indirect effects were negligible for all models.Conclusion: Among women with a prior CD, in the presence of important health conditions, the increased risk of SMM mediated by an elective repeat CD was negligible.

scholarly journals Causes of Death and Comorbidities in Patients with COVID-19

2020 ◽  
Author(s):  
Sefer Elezkurtaj ◽  
Selina Greuel ◽  
Jana Ihlow ◽  
Edward Michaelis ◽  
Philip Bischoff ◽  
...  
Keyword(s):  
Septic Shock ◽  
Heart Disease ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Pulmonary Infection ◽  
Diffuse Alveolar Damage ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Fatal Disease ◽  
Increased Risk

ABSTRACTInfection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has caused several hundreds of thousands of deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information on causes of death and the contribution of comorbidities to death yet is missing. Here, we report autopsy findings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID-19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to diffuse alveolar damage presented as the most immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients. Our findings reveal that causes of death were directly related to COVID-19 in the majority of decedents, while they appear not to be an immediate result of preexisting health conditions and comorbidities. We therefore suggest that the majority of patients had died of COVID-19 with only contributory implications of preexisting health conditions to the mechanism of death.

scholarly journals Experience of mental health diagnosis and perceived misdiagnosis in autistic, possibly autistic and non-autistic adults

Autism ◽  
2018 ◽  
Vol 23 (6) ◽  
pp. 1508-1518 ◽  
Author(s):  
Sheena K Au-Yeung ◽  
Louise Bradley ◽  
Ashley E Robertson ◽  
Rebecca Shaw ◽  
Simon Baron-Cohen ◽  
...  
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Case Reports ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Autistic People ◽  
Mental Health Difficulties ◽  
Mental Health Diagnoses ◽  
Health Diagnosis

Previous research shows that autistic people have high levels of co-occurring mental health conditions. Yet, a number of case reports have revealed that mental health conditions are often misdiagnosed in autistic individuals. A total of 420 adults who identified as autistic, possibly autistic or non-autistic completed an online survey consisting of questions regarding mental health diagnoses they received, whether they agreed with those diagnoses and if not why. Autistic and possibly autistic participants were more likely to report receiving mental health diagnoses compared to non-autistic participants, but were less likely to agree with those diagnoses. Thematic analysis revealed the participants’ main reasons for disagreement were that (1) they felt their autism characteristics were being confused with mental health conditions by healthcare professionals and (2) they perceived their own mental health difficulties to be resultant of ASC. Participants attributed these to the clinical barriers they experienced, including healthcare professionals’ lack of autism awareness and lack of communication, which in turn prevented them from receiving appropriate support. This study highlights the need for autism awareness training for healthcare professionals and the need to develop tools and interventions to accurately diagnose and effectively treat mental health conditions in autistic individuals.

Migraine, cardiovascular disease, and stroke during pregnancy: Systematic review of the literature

Cephalalgia ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Ashley Wabnitz ◽  
Cheryl Bushnell
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Vascular Disease ◽  
Gestational Hypertension ◽  
Cochrane Review ◽  
Review Of The Literature ◽  
Increased Risk ◽  
In Pregnancy

Objective The objective of this article is to review the literature relating migraine, cardiovascular disease, and stroke during pregnancy in order to better define the relationship between migraines and vascular disease. Methods We conducted a systematic review of the literature using Medline and Cochrane Review with the following search terms: migraine AND pregnancy and vascular disease OR myocardial infarction OR heart disease OR stroke OR cerebrovascular disease OR hypertension in pregnancy. We also reviewed the bibliographies of papers identified in this search to obtain additional relevant studies. Results Of the 219 papers obtained with the primary search, we found 17 that were topically relevant. Altogether, there is an increased risk both of gestational hypertension (OR range from 1.23 to 1.68) and preeclampsia (OR range 1.08 to 3.5) in migraineurs compared to nonmigraineurs. In addition, there is an association between an increased risk of ischemic stroke in pregnancy (OR range 7.9 to 30.7), particularly with active migraine. There is also an association between migraine and increased risk of acute myocardial infarction and heart disease (OR 4.9; 95% CI 1.7, 14.2), and thromboembolic events during pregnancy (deep venous thrombosis OR 2.4; 95% CI 1.3, 4.2 and pulmonary embolus OR 3.1; 95% CI 1.7, 5.6). Conclusion In this review, we summarized the association between migraine and risk of vascular disease during pregnancy, based on the available literature. Given the limited amount of data, more research on these associations is needed to determine which women with migraine may be at risk while pregnant.

Understanding barriers to the realization of human rights among older women with mental health conditions

2021 ◽  
Author(s):  
Myra Hamilton ◽  
Carmelle Peisah ◽  
Kiran Rabheru ◽  
Liat Ayalon ◽  
Hilde Verbeek ◽  
...  
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Older Women ◽  
Health Conditions ◽  
Mental Health Conditions

scholarly journals Maternal mental health and risk of child protection involvement: mental health diagnoses associated with increased risk

2015 ◽  
Vol 69 (12) ◽  
pp. 1175-1183 ◽  
Author(s):  
Melissa O'Donnell ◽  
Miriam J Maclean ◽  
Scott Sims ◽  
Vera A Morgan ◽  
Helen Leonard ◽  
...  
Keyword(s):  
Mental Health ◽  
Child Protection ◽  
Maternal Mental Health ◽  
Increased Risk ◽  
Mental Health Diagnoses

scholarly journals Social and Behavioral Difficulties in 10-Year-Old Children With Congenital Heart Disease: Prevalence and Risk Factors

2020 ◽  
Vol 8 ◽  
Author(s):  
Isabelle Werninger ◽  
Melanie Ehrler ◽  
Flavia M. Wehrle ◽  
Markus A. Landolt ◽  
Susanne Polentarutti ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Social Interaction ◽  
Congenital Heart ◽  
Maternal Mental Health ◽  
Behavioral Outcomes ◽  
Behavioral Difficulties ◽  
Increased Risk

Children with congenital heart disease (CHD) may be at increased risk for neurodevelopmental impairments. Long-term behavioral profiles and respective risk factors are less frequently described. The aim of this study was to evaluate multidimensional behavioral outcomes and associated medical, psychological, and social risk factors in children with complex CHD. At 10-years of age, 125 children with CHD were assessed for general behavioral difficulties, attention deficit hyperactivity disorder (ADHD)-related behavior, and social interaction problems and were compared to normative data. Medical and cardiac factors, IQ, maternal mental health at 4 years of age and parental socioeconomic status were tested as predictors for all behavioral outcomes. Children with CHD showed no significant differences in general behavioral difficulties. However, increased ADHD-related symptoms (p < 0.05) and difficulties in social interaction (p < 0.05) were observed. In 23% of the children, a combination of ADHD-related symptoms and social interaction problems was reported by parents. In multivariate analyses, IQ (p < 0.01) and maternal mental health (p < 0.03) at 4 years of age were found to be predictive for all behavioral outcomes at 10 years while medical and cardiac risk factors were not. Our findings reveal significant difficulties in ADHD-related symptoms and social interaction problems with a significant comorbidity. Behavioral difficulties were not detected with a screening tool but with disorder-specific questionnaires. Furthermore, we demonstrate the importance of maternal mental health during early childhood on later behavioral outcomes of children with CHD. This underlines the importance of identifying and supporting parents with mental health issues at an early stage in order to support the family and improve the child's neurodevelopment.

scholarly journals BURDEN OF MENTAL HEALTH DIAGNOSES IN HOSPITALIZATIONS IN ADULTS WITH CONGENITAL HEART DISEASE IN THE STATE OF TEXAS: A 10-YEAR REVIEW

2021 ◽  
Vol 77 (18) ◽  
pp. 483
Author(s):  
Amelia Mercado ◽  
Andrew Well ◽  
Alexandra Lamari-Fisher ◽  
Michelle Mizrahi ◽  
Gregory Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
The State ◽  
Mental Health Diagnoses

scholarly journals Eight-Year Retrospective Study of Young Adults in a Diabetes Transition Clinic

2021 ◽  
Author(s):  
Aarooran Sritharan ◽  
Uchechukwu Levi Osuagwu ◽  
Manjula Ratnaweera ◽  
David Simmons
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Health Condition ◽  
Diabetes Type ◽  
Health Conditions ◽  
Mental Health Condition ◽  
Mental Health Conditions ◽  
Transition Clinic ◽  
Increased Risk ◽  
Before And After

The transition of people from paediatric to adult diabetes services is associated with worsening glycaemia and increased diabetes-related hospitalisation. This study compared the clinical characteristics of those with and without mental health conditions among attenders at a diabetes young adult clinic diabetes before and after changes in service delivery. Retrospective review of 200 people with diabetes attending a Sydney public hospital over eight years corresponding to the period before (2012-2016) and after (2017-2018) restructuring of a clinic for young adults aged 16-25 years. Characteristics of those with and without mental health conditions (depression, anxiety, diabetes related distress, eating disorders), were compared. Among clinic attenders (type 1 diabetes n=184, 83.2%), 40.5% (n=89) had a mental health condition particularly, depression (n=57, 64%), which was higher among Indigenous than non-Indigenous people (5.6% vs 0.8% p=0.031) but similar between diabetes type. Over eight years, those with, compared with those without a mental health condition had higher HbA1c at the last visit (9.4%[79 mmol/mol] vs 8.7% [71 mmol/mol], p=0.027), the proportion with diabetic ketoacidosis (DKA 60.7% vs 42.7%,p=0.009), smoking (38.4 vs 13.6%,p=0.009), retinopathy (9.0 vs 2.3%,p=0.025), multiple DKAs (28.4 vs 16.0%,p=0.031) were significantly higher. Having a mental health condition was associated with 2.02 (95% Confidence intervals 1.1-3.7) fold increased risk of HbA1c ≥ 9.0%[75mmol/mol]. Changes to the clinic were not associated with improvements in mental health condition (39.0% vs 32.4%, p=0.096). In conclusion, we found that mental health conditions, particularly depression, are common in this population and are associated with diabetes complications. Diabetes type and clinic changes did not affect the reported mental health conditions. Additional strategies are required to reduce complication risks among those with mental health conditions. .

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