scholarly journals Use of Medicines with Unknown Fetal Risk among Parturient Women from the 2004 Pelotas Birth Cohort (Brazil)

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Andréa Dâmaso Bertoldi ◽  
Tatiane da Silva Dal Pizzol ◽  
Aline Lins Camargo ◽  
Aluísio J. D. Barros ◽  
Alicia Matijasevich ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Skin Color ◽  
Regression Models ◽  
Birth Cohort Study ◽  
White Skin ◽  
Maternal Characteristics ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Fetal Risk ◽  
Potential Risks

Background. To estimate the exposure to medicines with unknown fetal risk during pregnancy and to analyze the maternal characteristics associated with it.Methods. A questionnaire was administered to 4,189 mothers of children belonging to the 2004 Pelotas (Brazil) birth cohort study about use of any medicine during gestation. We evaluated the associations between use of medicines with unknown fetal risk and the independent variables through logistic regression models. Unknown fetal risk was defined as medicines in which studies in animals have revealed adverse effects on the fetus, and no controlled studies in women, or studies in women and animals, are available.Results. Out of the 4,189 women, 52.5% used at least one medicine from unknown fetal risk. Use of these medicines was associated with white skin color, high schooling, high income, six or more antenatal care consultations, hospital admission during pregnancy, and morbidity during gestation.Conclusion. The use of unknown fetal risk medicines is high, suggesting that their use must be addressed with caution with the aim of restricting their use to cases in which the benefits are greater than the potential risks.

scholarly journals Risk factors for and protective factors against breastfeeding interruption before 2 years: a birth cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Graciete Oliveira Vieira ◽  
Tatiana de Oliveira Vieira ◽  
Camilla da Cruz Martins ◽  
Michelle de Santana Xavier Ramos ◽  
Elsa Regina Justo Giugliani
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Birth Cohort ◽  
Skin Color ◽  
Family Income ◽  
World Health ◽  
Breastfeeding Duration ◽  
Birth Cohort Study ◽  
White Skin ◽  
Health Organization

Abstract Background Little is known about the factors associated with the World Health Organization (WHO) recommendation of breastfeeding for at least 2 years. The objective of this study was to identify risk factors for and protective factors against breastfeeding interruption before 2 years of age. Methods In this live birth cohort, mother and infant dyads were followed for 2 years. Data collection was performed at the maternity ward and subsequently at the children’s homes, monthly during the first 6 months of life and then at 9, 12, 18, and 24 months. The outcome of interest was breastfeeding interruption before 2 years of age. Median duration of breastfeeding was estimated using Kaplan-Meier’s survival analysis, and the associations were tested using Cox’s hierarchical multivariate model. Significance was set at 5%. Results Data from a total of 1344 dyads were assessed. Median breastfeeding duration was 385 days. The following risk factors for breastfeeding interruption were identified: white skin color (adjusted hazard ratio [HRa]: 1.31; 95% confidence interval [95%CI]: 1.10–1.56), primiparity (HRa: 1.21; 95%CI: 1.05–1.40), working outside the home (HRa: 1.52; 95%CI: 1.30–1.77), child sex male (HRa: 1.18; 95%CI: 1.03–1.35) and use of a pacifier (HRa: 3.46; 95%CI: 2.98–4.01). Conversely, the following protective factors were identified: lower family income (HRa: 0.81; 95%CI: 0.71–0.94), mother-infant bed-sharing (HRa:0.61, 95%CI: 0.52–0.73), on-demand breastfeeding in the first month (HRa: 0.64; 95%CI: 0.47–0.89) and exclusive breastfeeding at 4 months (HRa: 0.58, 95%CI: 0.48–0.70). Conclusions The findings allowed to identify both risk factors for and protective factors against breastfeeding interruption before 2 years of age. Knowledge of these factors may help prevent this event and aid in the development of programs that help women maintain breastfeeding for at least 2 years, as recommended by the WHO.

scholarly journals Sonographic Cervical Shortening after Labor Induction is a Predictor of Vaginal Delivery

2016 ◽  
Vol 38 (12) ◽  
pp. 585-588 ◽  
Author(s):  
Ugo Indraccolo ◽  
Gennaro Scutiero ◽  
Pantaleo Greco
Keyword(s):  
Logistic Regression ◽  
Vaginal Delivery ◽  
Regression Models ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Cervical Length ◽  
Labor Induction ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Sonographic Evaluation

Objective Analyzing if the sonographic evaluation of the cervix (cervical shortening) is a prognostic marker for vaginal delivery. Methods Women who underwent labor induction by using dinoprostone were enrolled. Before the induction and three hours after it, the cervical length was measured by ultrasonography to obtain the cervical shortening. The cervical shortening was introduced in logistic regression models among independent variables and for calculating receiver operating characteristic (ROC) curves. Results Each centimeter in the cervical shortening increases the odds of vaginal delivery in 24.4% within 6 hours; in 16.1% within 24 hours; and in 10.5% within 48 hours. The best predictions for vaginal delivery are achieved for births within 6 and 24 hours, while the cervical shortening poorly predicts vaginal delivery within 48 hours. Conclusion The greater the cervical shortening 3 hours after labor induction, the higher the likelihood of vaginal delivery within 6, 24 and 48 hours.

scholarly journals Can Cut-Off-Values for Tumor Size or Patient Age in Breast Ultrasound Reduce Unnecessary Biopsies or is it all About Bi-rads?– A Retrospective Analysis of 763 Biopsied T1-Sized Lesions

2017 ◽  
Vol 03 (03) ◽  
pp. E94-E98 ◽  
Author(s):  
Laura Holzer-Fruehwald ◽  
Matthias Meissnitzer ◽  
Michael Weber ◽  
Stephan Holzer ◽  
Klaus Hergan ◽  
...  
Keyword(s):  
Regression Models ◽  
Breast Lesion ◽  
Binary Logistic Regression ◽  
Lesion Size ◽  
Breast Lesions ◽  
Predictive Values ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Oval Shape ◽  
Histological Result

Abstract Aims and Objectives To assess whether it is possible to establish a size cut-off-value for sonographically visible breast lesions in a screening situation, under which it is justifiable to obviate a biopsy and to evaluate the grayscale characteristics of the identified lesions. Materials and Methods Images of sonographically visible and biopsied breast lesions of 684 patients were retrospectively reviewed and assessed for the following parameters: size, shape, margin, lesion boundary, vascularity, patient’s age, side of breast, histological result, and initial BI-RADS category. Statistical analyses (t-test for independent variables, ROC analyses, binary logistic regression models, cross-tabulations, positive/negative predictive values) were performed using IBM SPSS (Version 21.0). Results Of all 763 biopsied lesions, 223 (29.2%) showed a malignant histologic result, while 540 (70.8%) were benign. Although we did find a statistically significant correlation of malignancy and lesion size (p=0.031), it was not possible to define a cut-off value, under which it would be justifiable to obviate a biopsy in terms of sensitivity and specificity (AUC: 0.558) at any age. Lesions showing the characteristics of a round or oval shape, a sharp delineation and no echogenic rim (n=112) were benign with an NPV of 99.1%. Conclusion It is not possible to define a cut-off value for size or age, under which a biopsy of a sonographically visible breast lesion can be obviated in the screening situation. The combination of the 3 grayscale characteristics, shape (round or oval), margin (circumscribed) and no echogenic-rim sign, showed an NPV of 99.1%. Therefore, it seems appropriate to classify such lesions as BI-RADS 2.

scholarly journals Delirium symptoms are associated with decline in cognitive function between ages 53 to 69: findings from a British birth cohort study

2017 ◽  
Author(s):  
A Tsui ◽  
D Kuh ◽  
M Richards ◽  
D Davis
Keyword(s):  
Birth Cohort ◽  
Verbal Memory ◽  
Regression Models ◽  
Cognitive Outcomes ◽  
Birth Cohort Study ◽  
Linear Regression Models ◽  
Cognitive Domains ◽  
Time Period ◽  
Search Speed ◽  
Addenbrooke’S Cognitive Examination

AbstractINTRODUCTIONFew population studies have investigated whether longitudinal decline after delirium in mid-to-late life might affect specific cognitive domains.METHODSParticipants from a birth cohort completing assessments of search speed, verbal memory and the Addenbrooke’s Cognitive Examination at age 69 were asked about delirium symptoms between ages 60-69. Linear regression models estimated associations between delirium symptoms and cognitive outcomes.RESULTSPeriod prevalence of delirium between 60 and 69 was 4% (95% CI 3.2%,4.9%). Self-reported symptoms of delirium over the seventh decade were associated with worse scores in the Addenbrooke’s Cognitive Examination (−1.7 points, 95% CI −3.2, −0.1, p=0.04). In association with delirium symptoms, verbal memory scores were initially lower, with subsequent decline in search speed by age 69. These effects were independent of other Alzheimer’s risk factors.DISCUSSIONDelirium symptoms may be common even at relatively younger ages, and their presence may herald cognitive decline, particularly in search speed, over this time period.

scholarly journals Association of Fatigue With Sarcopenia and its Elements: A Secondary Analysis of SABE-Bogotá

2017 ◽  
Vol 3 ◽  
pp. 233372141770373 ◽  
Author(s):  
Daniela Patino-Hernandez ◽  
David Gabriel David-Pardo ◽  
Miguel Germán Borda ◽  
Mario Ulises Pérez-Zepeda ◽  
Carlos Cano-Gutiérrez
Keyword(s):  
Regression Models ◽  
Handgrip Strength ◽  
Secondary Analysis ◽  
Adverse Outcomes ◽  
Multiple Logistic Regression ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Confounding Variables ◽  
Aging Adults

Objective: Sarcopenia, fatigue, and depression are associated with higher mortality rates and adverse outcomes in the aging population. Understanding the association among clinical variables, mainly symptoms, is important for screening and appropriately managing these conditions. The aim of this article is to evaluate the association among sarcopenia and its elements with depression and fatigue. Method: We used cross-sectional data from 2012 SABE ( Salud, Bienestar y Envejecimiento)-Bogotá study, which included 2,000 participants of ages ≥60 years. Sarcopenia and its elements were taken as the dependent variable, while fatigue and depression were the main independent variables. We tested the association among these through multiple logistic regression models, which were fitted for each dependent variable and adjusted for confounding variables. Results: Our findings showed that gait speed was associated with fatigue (adjusted odds ratio [OR] = 1.41, 95% confidence interval [CI] = [1.05, 1.90], p = .02) as well as abnormal handgrip strength (adjusted OR = 1.40, 95% CI = [1.02, 1.93], p = .04). No other associations were significant. Conclusion: While sarcopenia and fatigue are not associated, two of the sarcopenia-defining variables are associated with fatigue; this suggests that lack of sarcopenia does not exclude undesirable outcomes related to fatigue in aging adults. Also, the lack of association between sarcopenia-defining elements and depression demonstrates that depression and fatigue are different concepts.

scholarly journals Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants—Results from HSHK Birth Cohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 258 ◽  
Author(s):  
Narendar Manohar ◽  
Andrew Hayen ◽  
Sameer Bhole ◽  
Amit Arora
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Economic Status ◽  
Population Based ◽  
Birth Cohort Study ◽  
Early Introduction ◽  
Logistic Regression Models ◽  
Part Time ◽  
Early Ninety

Early introduction of complementary foods can have a detrimental impact on children’s long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was ‘age at which particular core and discretionary food items were first introduced’. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54–7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99–5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17–11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.

scholarly journals Prenatal pet keeping and caregiver-reported attention deficit hyperactivity disorder through preadolescence in a United States birth cohort

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Andrea E. Cassidy-Bushrow ◽  
Alexandra R. Sitarik ◽  
Tisa M. Johnson-Hooper ◽  
Jannel M. Phillips ◽  
Kyra Jones ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Birth Cohort ◽  
Attention Deficit ◽  
Regression Models ◽  
Environmental Toxicants ◽  
Wayne County ◽  
Loss To Follow Up ◽  
Logistic Regression Models ◽  
Hyperactivity Disorder

Abstract Background While the keeping of pets has been shown to protect against childhood allergic disease and obesity, less is known regarding potential associations of prenatal pet keeping and attention deficit hyperactivity disorder (ADHD). We sought to examine the associations between prenatal dog or cat keeping with caregiver-reported ADHD in preadolescents in the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS) birth cohort (N = 1258). Methods At an interview with the caregiver at child age 10–12 years, caregivers reported if the WHEALS child had ever been diagnosed with ADHD. Similarly, during an interview with the mother prenatally, pet keeping (defined as dog or cat kept inside ≥1 h/day) was ascertained. Logistic regression models were fit to examine the association of prenatal pet keeping (dog keeping and cat keeping, separately) with ADHD. Results A subset of 627 children were included in the analyses: 93 who had ADHD and 534 with neurotypical development. After accounting for confounders and loss to follow-up, maternal prenatal dog exposure was associated with 2.23 times (95% CI: 1.15, 4.31; p = 0.017) greater odds of ADHD among boys. Prenatal dog keeping was not statistically significantly associated with ADHD in girls (odds ratio = 0.27, 95% CI: 0.06, 1.12; p = 0.070). Prenatal cat keeping was not associated with ADHD. Conclusions In boys, but not girls, maternal prenatal dog keeping was positively associated with ADHD. Further study to confirm these findings and to identify potential mechanisms of this association (e.g., modification of the gut microbiome, exposure to environmental toxicants or pet-related medications) is needed.

scholarly journals A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample

2019 ◽  
Vol 29 ◽  
Author(s):  
A. Caye ◽  
J. Agnew-Blais ◽  
L. Arseneault ◽  
H. Gonçalves ◽  
C. Kieling ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Regression Models ◽  
Adult Adhd ◽  
Clinical Sample ◽  
Test Sample ◽  
Population Based ◽  
Learning Approaches ◽  
Risk Calculator ◽  
Logistic Regression Models ◽  
Hyperactivity Disorder

Abstract Aim Few personalised medicine investigations have been conducted for mental health. We aimed to generate and validate a risk tool that predicts adult attention-deficit/hyperactivity disorder (ADHD). Methods Using logistic regression models, we generated a risk tool in a representative population cohort (ALSPAC – UK, 5113 participants, followed from birth to age 17) using childhood clinical and sociodemographic data with internal validation. Predictors included sex, socioeconomic status, single-parent family, ADHD symptoms, comorbid disruptive disorders, childhood maltreatment, ADHD symptoms, depressive symptoms, mother's depression and intelligence quotient. The outcome was defined as a categorical diagnosis of ADHD in young adulthood without requiring age at onset criteria. We also tested Machine Learning approaches for developing the risk models: Random Forest, Stochastic Gradient Boosting and Artificial Neural Network. The risk tool was externally validated in the E-Risk cohort (UK, 2040 participants, birth to age 18), the 1993 Pelotas Birth Cohort (Brazil, 3911 participants, birth to age 18) and the MTA clinical sample (USA, 476 children with ADHD and 241 controls followed for 16 years from a minimum of 8 and a maximum of 26 years old). Results The overall prevalence of adult ADHD ranged from 8.1 to 12% in the population-based samples, and was 28.6% in the clinical sample. The internal performance of the model in the generating sample was good, with an area under the curve (AUC) for predicting adult ADHD of 0.82 (95% confidence interval (CI) 0.79–0.83). Calibration plots showed good agreement between predicted and observed event frequencies from 0 to 60% probability. In the UK birth cohort test sample, the AUC was 0.75 (95% CI 0.71–0.78). In the Brazilian birth cohort test sample, the AUC was significantly lower –0.57 (95% CI 0.54–0.60). In the clinical trial test sample, the AUC was 0.76 (95% CI 0.73–0.80). The risk model did not predict adult anxiety or major depressive disorder. Machine Learning approaches did not outperform logistic regression models. An open-source and free risk calculator was generated for clinical use and is available online at https://ufrgs.br/prodah/adhd-calculator/. Conclusions The risk tool based on childhood characteristics specifically predicts adult ADHD in European and North-American population-based and clinical samples with comparable discrimination to commonly used clinical tools in internal medicine and higher than most previous attempts for mental and neurological disorders. However, its use in middle-income settings requires caution.

scholarly journals Body composition assessment using DXA in six-year-old children: the 2004 Pelotas Birth Cohort, Rio Grande do Sul State, Brazil

2014 ◽  
Vol 30 (10) ◽  
pp. 2123-2133 ◽  
Author(s):  
Roberta V. Zanini ◽  
Iná S. Santos ◽  
Denise P. Gigante ◽  
Alicia Matijasevich ◽  
Fernando C. Barros ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Skin Color ◽  
Maternal Education ◽  
Rio Grande ◽  
Dual Energy ◽  
Socioeconomic Conditions ◽  
Rio Grande Do Sul ◽  
Body Composition Assessment ◽  
White Skin ◽  
X Ray

The aim of this study was to describe fat (FM) and lean body mass (LBM) in six-year-old children from the 2004 Pelotas Birth Cohort, stratified by gender. Dual-Energy X-ray Absorptiometry was used to measure FM and LBM, FM and LBM indexes, and percentage (%) of FM and LBM. Mean measures of adiposity were higher among girls (6.3kg, 4.2kg/m2 and 23.4% vs. 5kg, 3.3kg/m2 and 18%) while LBM measures were higher among boys (19.3kg, 13kg/m2 and 78.5% vs. 17.7kg, 12.2kg/m2 and 73.2%). In both boys and girls mean measures of adiposity increased with socioeconomic status and maternal education. Mean measures of adiposity were higher among white-skinned children while %LBM was higher among black-skinned children. Preterm compared to full-term children showed lower mean measures of adiposity and LBM. Female sex, white skin color and higher socioeconomic conditions are associated with higher adiposity in childhood.

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