scholarly journals Gestational diabetes and intraoperative tubal sterilization are risk factors for high incidence of pain after cesarean delivery: a prospective observational study

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Patchareya Nivatpumin ◽  
Pawinee Pangthipampai ◽  
Sukanya Dej-Arkom ◽  
Somkiat Aroonpruksakul ◽  
Tripop Lertbunnaphong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gestational Diabetes ◽  
Observational Study ◽  
Cesarean Delivery ◽  
Prospective Observational Study ◽  
Tubal Sterilization ◽  
High Incidence

scholarly journals Gestational Diabetes and Intraoperative Tubal Sterilization are Risk Factors for Pain After Cesarean Delivery: A Prospective Observational Study.

2020 ◽  
Author(s):  
Patchareya Nivatpumin ◽  
Pawinee Pangthipampai ◽  
Sukanya Dej-Arkom ◽  
Somkiat Aroonpruksakul ◽  
Tripop Lertbunnaphong ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Observational Study ◽  
Pain Score ◽  
Cesarean Delivery ◽  
Severe Pain ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Tubal Sterilization ◽  
Number Of Patients ◽  
Median Pain

Abstract Background: Postcesarean delivery pain leads to several adverse maternal outcomes. The primary objective of this study was to determine the incidence of moderate-to-severe pain after the use of spinal morphine for cesarean delivery. The secondary aim was to identify the factors influencing the moderate-to-severe pain.Methods: This prospective observational study was conducted at a single university hospital. The inclusion criteria were a patient age of ≥ 18 years, and undergoing elective cesarean delivery under spinal anesthesia with intrathecal morphine (200 mcg). Moderate-to-severe pain was defined as a numerical-rating-scale score of more than 3 within 24 hours postoperatively. Patients’ demographic characteristics, preoperative obstetric data, and intraoperative and postoperative data were collected and analyzed.Results: In all, 660 patients were enrolled. As 16 were subsequently removed because they met the study withdrawal criteria, data relating to 644 patients were analyzed. The incidence of moderate-to-severe pain during the first postoperative day was 451/644 patients (70.03%; 95% confidence interval [CI], 66.38%–73.44%). The median pain score (interquartile range [IQR]) was 5 (3–6), with 176/644 (27.33%) of patients requiring a rescue analgesic. A multivariate analysis revealed that two factors were associated with moderate-to-severe pain on the first postoperative day: gestational diabetes (adjusted OR [AOR], 1.849; 95% CI, 1.068–3.203; p-value = 0.028), and intraoperative tubal sterilization (AOR, 1.533; 95% CI, 1.060–2.218; p = 0.023). A significantly higher number of patients experienced moderate-to-severe pain on postoperative Day 1 (451/644 [70.03%]) than Day 2 (348/644 [54.19%]; p < 0.001). The median pain score (IQR) on postoperative Day 2 was 4 (3–5), which was less than that for Day 1 (p < 0.001).Conclusions: A high incidence of moderate-to-severe postoperative pain was found after a single dose of spinal morphine for cesarean delivery. Gestational diabetes and intraoperative tubal sterilization were the independent factors correlated with the pain.Trial registration: Clinicaltrial.gov registration number NCT03205813

scholarly journals The impacts of maternal iron deficiency and being overweight during pregnancy on neurodevelopment of the offspring

2017 ◽  
Vol 118 (7) ◽  
pp. 533-540 ◽  
Author(s):  
Staffan K. Berglund ◽  
Francisco J. Torres-Espínola ◽  
Luz García-Valdés ◽  
Mª Teresa Segura ◽  
Cristina Martínez-Zaldívar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iron Deficiency ◽  
Gestational Diabetes ◽  
Observational Study ◽  
Pregnant Women ◽  
Prospective Observational Study ◽  
Infant Neurodevelopment ◽  
Spanish Women ◽  
Independent Effects ◽  
Maternal Iron

AbstractBoth maternal Fe deficiency (ID) and being overweight or obese (Ow/Ob, BMI≥25 kg/m2) may negatively affect offspring brain development. However, the two risk factors correlate and their independent effects on infant neurodevelopment are unclear. PREOBE is a prospective observational study that included 331 pregnant Spanish women, of whom 166 had pre-gestational Ow/Ob. Fe status was analysed at 34 weeks and at delivery, and babies were assessed using Bayley III scales of neurodevelopment at 18 months. In confounder-adjusted analyses, maternal ID at 34 weeks was associated with lower composite motor scores at 18 months (mean 113·3 (sd 9·9) v. 117·1 (sd 9·2), P=0·039). Further, the offspring of mothers with ID at delivery had lower cognitive scores (114·0 (sd 9·7) v. 121·5 (sd 10·9), P=0·039) and lower receptive, expressive and composite (99·5 (sd 8·6) v. 107·6 (sd 8·3), P=0·004) language scores. The negative associations between maternal ID at delivery and Bayley scores remained even when adjusting for maternal Ow/Ob and gestational diabetes. Similarly, maternal Ow/Ob correlated with lower gross motor scores in the offspring (12·3 (sd 2·0) v. 13·0 (sd 2·1), P=0·037), a correlation that remained when adjusting for maternal ID. In conclusion, maternal ID and pre-gestational Ow/Ob are both negatively associated with Bayley scores at 18 months, but independently and on different subscales. These results should be taken into account when considering Fe supplementation for pregnant women.

scholarly journals POS0441 DEVELOPMENT OF RHEUMATOID ARTHRITIS AMONG ANTI-CITRULLINATED PROTEIN ANTIBODIES POSITIVE ASYMPTOMATIC INDIVIDUALS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 449.1-449
Author(s):  
S. Mizuki ◽  
K. Horie ◽  
K. Imabayashi ◽  
K. Mishima ◽  
K. Oryoji
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Observational Study ◽  
Rheumatoid Factor ◽  
Prospective Observational Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
P Value ◽  
Healthy Population ◽  
Asymptomatic Individuals ◽  
Citrullinated Protein

Background:In the idividuals with genetic and enviromental risk factors, immune events at mucosal surfaces occur and may precede systemic autoimmunity. Anti-citrullinated protein antibodies (ACPA) are present in the serum for an average of 3-5 years prior to the onset of rheumatoid arthritis (RA) during an asymptomatic period. In ACPA-positivite individuals, the additional presence of RA-related risk factors appears to add significant power for the development of RA. To date, there have been few reports in which clinical courses of ACPA-positive asymptomatic individuals were investigated prospectively.Objectives:To observe the clinical time course of ACPA-positive healthy population for the development of RA.Methods:Healthy volunteers without joint pain or stiffness, who attended the comprehensive health screening of our hospital, were enrolled in this prospective observational study. The serum ACPA levels were quantified by Ig-G anti-cyclic citrullinated peptide enzyme-linked immunosorbent assay with levels > 4.4 U/mL considered positive. ACPA-positive subjects were followed by rheumatologists of our department clinically or a questionnaire sent by mail for screening to detect arthritis.Results:5,971 healthy individuals without joint symptons were included. Ninty-two (1.5%) were positive for ACPA. Of these, 19 (20.7%) developed RA and two were suspected as RA by mail questionnaire. Their average age were 58-years, and women were 68%. The average duration between the date of serum sampling and diagnosis was 10.7 months. ACPA-positive individuals who developed to RA had higher serum ACPA and Ig-M rheumatoid factor levels than ACPA-positive individuals who did not (P value by Mann-Whitney U test: 0.002, 0.005, respectively).Conclusion:Among ACPA-positive asymptomatic individuals, 20% developed RA. The higher titer of ACPA and Ig-M rheumatoid factor levels are risk factors for devoloping RA.Disclosure of Interests:None declared

Prospective Incidence Study of Bloodstream Infection in Infants and Children With Central Venous Catheters After Cardiac Surgery in Italy

2009 ◽  
Vol 30 (7) ◽  
pp. 698-701 ◽  
Author(s):  
Stefania Bezzio ◽  
C. Scolfaro ◽  
R. Broglia ◽  
R. Calabrese ◽  
F. Mignone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Observational Study ◽  
Bloodstream Infection ◽  
Medical Staff ◽  
Prospective Observational Study ◽  
Central Venous Catheters ◽  
Central Venous ◽  
In Infants And Children ◽  
Catheter Related Bloodstream Infection

This prospective observational study was designed to assess the incidence of, risk factors for, and outcome of catheter-related bloodstream infection in children undergoing cardiac surgery. A staff specifically trained to handle the central venous catheters with proper aseptic techniques and an appropriate patient to medical staff ratio remain the most effective measures to prevent this infection.

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