Levels and risk factors for perinatal mortality in Ahmedabad, India

To estimate levels and determinants of perinatal mortality, we conducted a hospital-based surveillance and case-control study, linked with a population survey, in Ahmedabad, India. The perinatal mortality rate was 79.0 per 1000, and was highest for preterm low-birth-weight babies. The case-control study of 451 stillbirths, 160 early neonatal deaths and 1465 controls showed that poor maternal nutritional status, absence of antenatal care, and complications during labour were independently associated with substantially increased risks of perinatal death. Multivariate analyses indicate that socioeconomic factors largely operate through these proximate factors and do not have an independent effect. Estimates of attributable risk derived from the prevalence of exposures in the population survey suggest that improvements in maternal nutrition and antenatal and intrapartum care could result in marked reductions of perinatal mortality.     

Assessment of some risk factors for hepatocellular carcinoma: a case control study

A case-control study of risk for hepatocellular carcinoma (HCC) was carried out in our Department from December 1980 to December 1983. One hundred and twenty consecutive inpatients with HCC were compared with 360 controls pair-matched by sex and age (within years). For each case three different controls were selected from inpatients at the same hospital: one patient with liver cirrhosis; one patient with solid tumor and one patient with chronic illness other than neoplasm or liver disease. We report here the results on alcohol consumption, smoking habit and hepatitis B virus infection. The risk factors investigated are distributed similarly in HCC and cirrhosis. The prevalence of alcohol abuse in HCC is similar to that in cirrhosis and is significantly higher than in other neoplastic or otherwise chronically ill patients (odds ratio 2 X 3 and 3 X 2 respectively). Thus alcohol abuse is probably a risk factor for HCC as a cause of cirrhosis. Smoking habits were similar among the various disease groups and independent of alcohol consumption. The prevalence of heavy smoking was comparable in cases and controls. HbsAg negative-HCC with an ultrasonographic pattern of 'diffuse' alteration was more frequent in heavy smokers.     

银川市孕产妇胚胎停育影响因素病例对照研究

摘要:目的　探讨银川市孕产妇胚胎停育影响因素,为降低胚胎停育的发生提供理论依据。方法　采用病例对照研究对121例胚胎停育患者和253例正常妊娠分娩者进行问卷调查,对相关数据进行χ2检验与非条件Logistic回归分析。结果　年龄、自然流产次数、孕后食欲变化、进食谷类、水果频次、进食牛奶及运动情况经单因素检验具有统计学差异,非条件Logistic逐步回归分析,按先后顺序进入模型的因素依次为:自然流产次数（OR＝1.488）、进食牛奶情况（OR＝0.722）、年龄（OR＝1.399）、孕后食欲增加（OR＝0.513）、运动情况（OR＝0.728）。结论　适度体育锻炼,注意孕前及孕期均衡营养,合理搭配饮食,可降低胚胎停育发生风险,在提倡晚婚晚育的同时,把握最佳生育年龄及受孕时机。     

恶性淋巴瘤影响因素病例对照研究

目的探讨恶性淋巴瘤（ML）发生的危险因素。方法采用以医院病例为基础的1：2配比病例对照研究方法，对从江苏省南通市4家医院收集的72例经组织病理学确诊的恶性淋巴瘤（ML）患者及144例其他肿瘤和非肿瘤对照进行问卷调查。采用多分类结局Logistic回归分析模型拟合的方法，单因素和多因素分析ML的相关因素。结果住所周围环境污染（OR=2．747，90％CI：1．216～6．204）、经常接触有机溶剂（OR=4．310，90％CI=1．079～17．219）、经常接触化肥农药（OR=2．648，90％CI=1．188～5．903）、本人其他肿瘤史（OR=7．586，90％CI=1．202～47．890）、家族肿瘤史（OR=5．268，90％CI=2．054～13．515）等5个因素可能增加ML的危险性；而经常吃淡水鱼虾（OR=0．456，90％CI=0．246～0．842）可降低ML的危险性。结论恶性淋巴瘤影响因素较为复杂，环境污染、化学毒物接触及家族史是主要危险因素。     

Labour complications remain the most important risk factors for perinatal mortality in rural Kenya

OBJECTIVES: To identify and quantify risk factors for perinatal mortality in a Kenyan district hospital and to assess the proportion of perinatal deaths attributable to labour complications, maternal undernutrition, malaria, anaemia and human immunodeficiency virus (HIV). METHODS: A cross-sectional study of 910 births was conducted between January 1996 and July 1997 and risk factors for perinatal mortality were analysed. FINDINGS: The perinatal mortality rate was 118 per 1000 births. Complications of labour such as haemorrhage, premature rupture of membranes/premature labour, and obstructed labour/ malpresentation increased the risk of death between 8- and 62-fold, and 53% of all perinatal deaths were attributable to labour complications. Placental malaria and maternal HIV, on the other hand, were not associated with perinatal mortality. CONCLUSIONS: Greater attention needs to be given to the quality of obstetric care provided in the rural district-hospital setting.     

Regional socioeconomic factors and length of hospital stay: a case study in Appalachia

Journal of Public Health - The role of socioeconomic status (SES) of patients in health care outcomes has been investigated in many health care systems. The health care literature suggests that...     

The socioeconomic position of employed women, risk factors and mortality.

Many studies have demonstrated the graded association between socioeconomic position and health. Few of these studies have examined the cumulative effect of socioeconomic position throughout the lifecourse, and even fewer have included women. Those that have explored gender differences affirm the importance of studying the factors that predict women and men's health separately. This study addresses the associations between cross-sectional and longitudinal socioeconomic position, risk factors for cardiovascular disease and mortality from various causes. Analyses are based on data from a cohort of working Scottish women recruited between 1970 and 1973. Five socioeconomic measures were explored in relation to diastolic blood pressure, plasma cholesterol concentration, body mass index, forced expiratory volume in 1 s (FEV1). amount of recreational exercise taken, cigarette smoking and alcohol consumption. In general, for each of the five measures of socioeconomic position, there were significant differences in at least one of the age-adjusted physiological risk factors for cardiovascular disease (diastolic blood pressure, plasma cholesterol concentration, body mass index, FEV1). There were also significant differences in the percentage of current cigarette smokers according to different measures of socioeconomic position, although this was not the case for the other behavioural risk factors for cardiovascular disease (amount of recreational exercise taken, and alcohol consumption). Measures of socioeconomic position were also examined in relation to cause of death for the women who died before 1 January 1999. After adjusting for age and risk factors, a composite measure of lifetime socioeconomic experience was a more potent predictor of all cause mortality and mortality from cardiovascular disease than other measures of socioeconomic position. It therefore seems that conventional measurcs of socioeconomic position, estimated at one point in time, do not adequately capture the effects of socioeconomic circumstances on the risk of mortality among employed women. Thus, a broader range of explanatory factors for mortality differentials than currently exists must be considered, and must include consideration of factors operating throughout the lifecourse.     

Dietary factors and breast cancer risk: a case control study among a population in Southern France

This case-control study examined different food groups in relation to breast cancer. Between 2002 and 2004, 437 cases and 922 controls matched according to age and area of residence were interviewed. Diet was measured by a validated food frequency questionnaire. Adjusted odds ratios (Ors) were computed across levels of various dietary intakes identified by two methods: the "classical" and the "spline" methods. Neither of the 2 methods found an association between total fruit and vegetable consumption and breast cancer. Results of the 2 methods showed a nonsignificant decreased association with cooked vegetables intake as well as legumes and fish consumption. Whereas the spline method showed no association, the classical method showed significant associations related to the lowest consumption of raw vegetables or dairy products and breast cancer risk: Adjusted OR for raw vegetable consumption between (67.4 and 101.3 g/day) vs. (< 67.4 g/day) was 0.63 [95% confidence interval (CI) = 0.43-0.93]. Adjusted OR for dairy consumption between (134.3 and 271.2 g/day) vs. (< 134.3 g/day) was 1.57 (95% CI = 1.06-2.32). However, the overall results were not consistent. Compared to the classical method, the use of the spline method showed a significant association for cereal, meat, and olive oil. Cereal and olive oil were inversely associated with breast cancer risk. Breast cancer risk increased by 56% for each additional 100 g/day of meat consumption. Studies using novel methodological techniques are needed to confirm the dietary threshold responsible for changes in breast cancer risk. New approaches that consist in analyzing dietary patterns rather than dietary food are necessary.     

Risk factors for autism: perinatal factors, parental psychiatric history, and socioeconomic status

Research suggests that heredity and early fetal development play a causal role in autism. This case-control study explored the association between perinatal factors, parental psychiatric history, socioeconomic status, and risk of autism. The study was nested within a cohort of all children born in Denmark after 1972 and at risk of being diagnosed with autism until December 1999. Prospectively recorded data were obtained from nationwide registries in Denmark. Cases totaled 698 children with a diagnosis of autism; each case was individually matched by gender, birth year, and age to 25 controls. Analyses by conditional logistic regression produced risk ratios and 95% confidence intervals. Adjusted analyses showed that the risk of autism was associated with breech presentation (risk ratio (RR) = 1.63, 95% confidence interval (CI): 1.18, 2.26), low Apgar score at 5 minutes (RR = 1.89, 95% CI: 1.10, 3.27), gestational age at birth <35 weeks (RR = 2.45, 95% CI: 1.55, 3.86), and parental psychiatric history (schizophrenia-like psychosis: RR = 3.44, 95% CI: 1.48, 7.95; affective disorder: RR = 2.91, 95% CI: 1.65, 5.14). Analyses showed no statistically significant association between risk of autism and weight for gestational age, parity, number of antenatal visits, parental age, or socioeconomic status. Results suggest that prenatal environmental factors and parental psychopathology are associated with the risk of autism. These factors seem to act independently.     

Social and health care factors and perinatal mortality in Spain--ecological study

The results of the multiple regression and correlation analysis between perinatal mortality and social and health care variables in Spanish provinces between 1975 and 1979 are presented. Although the perinatal mortality rates of Spanish provinces correlate significantly with a series of socioeconomic variables (family income available per capita, percentage of active population in primary sector, educational level of women at childbearing age) and health care variables (active obstetricians per 1000 live births and active pediatricians per 1000 live births), the multiple correlation and regression analysis has shown that the most important variable is the family income available per capita: 44% of the variability of perinatal mortality in Spanish provinces can be accounted for by this factor. By regression analysis, it is also possible to predict a decrease of 0.065 points in perinatal mortality for every additional 1000 pesetas in the family income available per capita.     

扬州市肺癌危险因素病例对照研究

目的探讨扬州市肺癌病人发病的危险因素,为肺癌病因研究提供线索。方法采用匹配病例对照研究方法,所有病例取自扬州市中医院2010年1月-2013年12月住院治疗的肺癌患者,均为病理诊断确诊病例,共425例,对照组为同期来院体检或探视病人的家属,共425例。采用自行设计的问卷进行调查,运用SPSS 13.0软件进行统计分析。结果非条件logistic回归多因素分析表明,扬州市人群肺癌的危险因素为吸烟(OR=1.831,95%CI:1.575~2.128)、负面情绪因素(OR=2.424,95%CI:1.865~3.151)、既往患有肺部疾病(OR=4.585,95%CI:3.146~6.681)、高血压(OR=1.404,95%CI:1.027~1.920);经常食用新鲜蔬菜瓜果(OR=0.426,95%CI:0.344~0.527)则是肺癌的保护因素。结论吸烟、不良情绪因素及某些慢性疾病是肺癌的危险因素,常吃新鲜瓜果蔬菜是保护因素。应大力提倡健康的生活方式,加强控烟力度,多吃新鲜蔬果,防治慢性病。     

174例孕妇艾滋病病毒感染危险因素的病例对照研究

云南省2004年艾滋病男、女感染比例为3．8：1，2006年报告孕妇HIV感染率超过1％的县（市、区）达4个。孕妇是处于特殊时期的妇女，对其HIV感染危险因素的研究，除在一定程度上反映妇女感染情况外，对于预防孕妇HIV感染，减少艾滋病母婴传播也具有十分重要的意义。为此，国家“十五”科技攻关课题“云南省HIV／AIDS综合防治研究项目”子课题“农村艾滋病母婴传播阻断策略研究”在云南省开展了孕妇HIV感染危险因素病例对照研究工作。[第一段]     

Maternal mortality in Ile-Ife, Nigeria: a study of risk factors.

The objective of this study was to determine which background factors predispose women to maternal mortality at the Obafemi Awolowo University Hospital in Nigeria. The study examined 35 cases of maternal death occurring in the hospital during the period 1 October 1989 to 30 April 1991. The control group comprised 35 women who were admitted to the hospital with similar complications during the same period, but who survived. Both cases and controls were investigated for their sociodemographic characteristics, their use of prenatal care, and the incidence of delay in clinical management. The results showed that the maternal deaths involved women who were younger and of poorer socioeconomic status than the women in the control group. Both groups showed an equal lack of prenatal care. However, a higher incidence of delayed treatment was found in the management of the cases of maternal deaths. Maternal mortality in the study population can be reduced through improved transportation and institutional management, and, on a long-term basis, through the adoption of measures to improve the socioeconomic status of women.     

妊娠期高血压疾病危险因素的病例对照研究

目的 研究妊娠期高血压疾病发病的危险因素,为该病的防治及产前指导提供依据.方法 在产科专家及统计学专家的指导下,自行设计调查表,并选择2007年1月～2010年6月期间,在某三甲医院住院的妊娠期高血压疾病患者650例及同期住院的正常孕产妇583例进行病例对照研究.结果 孕产妇年龄、体重指数、居住地及妊娠季节影响该病的发生.年龄越大、体重指数越高,发病率越高;居住地为村镇的孕产妇较居住于城市的孕产妇来说,发病率更高;夏季为该病的保护性因素.结论 指导孕产妇选择合适的妊娠年龄,加强农村及乡镇的医疗卫生资源投入,有利于减少该病的发生.     

孤独症、精神发育迟滞的围生期危险因素及家族史的病例对照研究

【目的】 研究孤独症和精神发育迟滞的围生期危险因素及相关家族史之间的差异。 【方法】 分析在复旦大学附属儿科医院诊治的100例孤独症儿童、60例精神发育迟滞儿童以及80例发育正常儿童的围生期及家族史资料,应用方差分析、秩和检验以及χ²检验分析三组儿童围生期危险因素及家族史之间的差异。 【结果】 孤独症及精神发育迟滞儿童有家族史的比例显著高于正常儿童(35.0% vs 6.3%,P＜0.001;31.7% vs 6.3%,P=0.005),而孤独症组和精神发育迟滞组的家族史差异无统计学意义(P=0.362)。三组儿童有孕期疾病史的比例存在差异(28.00% vs 45.00% vs 26.25%,χ²=6.635,P=0.036),但两两比较后发现各组之间差异均不显著。孤独症组母亲的孕龄显著高于正常儿童组(P＜0.001),与精神发育迟滞组差异不显著,而精神发育迟滞组与正常儿童组之间的差异也不显著。三组儿童围生期缺氧或窒息史的比例不存在显著差异(8.00% vs 10.00% vs 2.50%,χ²=3.589,P=0.166)。在胎产次、孕周、生产方式、产重上,三组儿童之间差异也无统计学意义。 【结论】 1)孤独症与精神发育迟滞患儿家族史的阳性率不相上下,但均显著高于正常儿童;2)晚孕可能是孤独症的一个危险因素。