The question as to whether abdominal obesity has an adverse effect on hip fracture remains unanswered. The purpose of this study was to investigate the associations of waist circumference, hip circumference, waist-hip ratio, and body mass index with incident hip fracture.
The data in this prospective study is based on Cohort of Norway, a population-based cohort established during 1994-2003. Altogether 19,918 women and 23,061 men aged 60-79 years were followed for a median of 8.1 years. Height, weight, waist and hip circumference were measured at baseline using standard procedures. Information on covariates was collected by questionnaires. Hip fractures (n = 1,498 in women, n = 889 in men) were identified from electronic discharge registers from all general hospitals in Norway between 1994 and 2008.
The risk of hip fracture decreased with increasing body mass index, plateauing in obese men. However, higher waist circumference and higher waist-hip ratio were associated with an increased risk of hip fracture after adjustment for body mass index and other potential confounders. Women in the highest tertile of waist circumference had an 86% (95% CI: 51-129%) higher risk of hip fracture compared to the lowest, with a corresponding increased risk in men of 100% (95% CI 53-161%). Lower body mass index combined with abdominal obesity increased the risk of hip fracture considerably, particularly in men.
Abdominal obesity was associated with an increased risk of hip fracture when body mass index was taken into account. In view of the increasing prevalence of obesity and the number of older people suffering osteoporotic fractures in Western societies, our findings have important clinical and public health implications.
The development of high-resolution real-time ultrasound has created the opportunity to identify fetal congenital anomalies. Making this technique part of a screening activity must be based on the belief that early identification and early care will have a favourable impact on the natural history of the disease. This is not the case when pregnancies are screened in the second trimester to detect malformations. On the contrary; in Norway, this might lead to the yearly elimination of 300 desired fetuses. Some of these would otherwise have had a longer intrauterine life, some might have benefited from postnatal medical treatment and some might otherwise have been born as healthy children instead of being eliminated due to misclassification.
The aim of this study was to examine the relationship between the maternal level of antiphospholipid antibodies (aPA) measured by anticardiolipin antibodies (aCL) and fetal growth retardation (SGA).
A nested case control design was carried out in a prospective cohort study of 1552 para I and para II women. The study group consisted of all 138 women who gave birth to a SGA-child (defined as birthweight
We examined the association between a history of childhood abuse and caesarean section in the population-based Norwegian Mother and Child Cohort Study (MoBa). Our sample consisted of 26 923 primiparous women with singleton pregnancies at term. Of all women, 18.8% (5060) had experienced any childhood abuse, 14.3% (3856) reported emotional abuse, 5.2% (1413) reported physical abuse and 6.4% (1730) reported sexual abuse. The proportion of caesarean sections before labour was not affected by any childhood abuse. Any childhood abuse was associated with a slightly increased risk of caesarean sections during labour (adjusted odds ratio 1.16; 95% CI 1.03-1.30).
The present study investigated the risk of incident hip fractures according to serum concentrations of vitamin K1 and 25-hydroxyvitamin D in elderly Norwegians during long-term follow-up. The results showed that the combination of low concentrations of both vitamin D and K1 provides a significant risk factor for hip fractures.
This case-cohort study aims to investigate the associations between serum vitamin K1 and hip fracture and the possible effect of 25-hydroxyvitamin D (25(OH)D) on this association.
The source cohort was 21,774 men and women aged 65 to 79 years who attended Norwegian community-based health studies during 1994-2001. Hip fractures were identified through hospital registers during median follow-up of 8.2 years. Vitamins were determined in serum obtained at baseline in all hip fracture cases (n?=?1090) and in a randomly selected subcohort (n?=?1318). Cox proportional hazards regression with quartiles of serum vitamin K1 as explanatory variable was performed. Analyses were further performed with the following four groups as explanatory variable: I: vitamin K1?=?0.76 and 25(OH)D?=?50 nmol/l, II: vitamin K1?=?0.76 and 25(OH)D?
The previously reported decline in age-adjusted hip fracture rates in Norway during 1999-2008 continued after 2008. The annual number of hip fractures decreased in women and increased in men.
Norway has among the highest hip fracture incidence rates ever reported despite previously observed declining rates from 1999 through 2008. The aim of the present study was to investigate whether this downward trend continued through 2013, and to compare gender-specific trends in 5 year age-groups during three time periods: 1999-2003, 2004-2008, and 2009-2013.
All hip fractures (cervical, trochanteric, and sub-trochanteric) admitted to Norwegian hospitals were retrieved. Annual age-standardized incidence rates of hip fracture per 10,000 person-years by gender were calculated for the period 1999-2013. Time trends were tested by age-adjusted Poisson regression.
From 1999 through 2013 there were 140,136 hip fractures in persons aged 50 years and above. Age-adjusted hip fracture incidence rates declined by 20.4 % (95 % CI: 18.6-20.1) in women and 10.8 % (95 % CI: 7.8-13.8) in men, corresponding to an average annual age-adjusted decline of 1.5 % in women and 0.8 % in men. Except for the oldest men, hip fracture rates declined in all age-groups 70 years and older. The average annual number of fractures decreased in women (-0.3 %) and increased in men (+1.1 %).
During the past 15 years, hip fracture rates have declined in Norway. The forecasted growing number of older individuals might, however, cause an increase in the absolute number of fractures, with a substantial societal economic and public health burden.
Cites: J Bone Miner Res. 2012 Nov;27(11):2325-32 PMID 22692958
The relationship between living in a physical abusive relationship and adverse outcome of pregnancy was examined using a structured interview including an obstetrical history. Sixty-six women living in a physically abusive relationship, and 114 women randomly selected and not presently living in such a relationship were interviewed. The women reported 312 completed pregnancies. Five of these were twin pregnancies and one was a stillbirth without information on birth weight. Of the 306 pregnancies included in the analysis, violence had occurred in 40. The mean birth weight of births reported by women exposed to violence during pregnancy was 229 g less than the equivalent figure in non-exposed pregnancies. Adjustment for education, primiparity, and history of addiction reduced the difference in mean birth weight to 175 g.
This study was undertaken to validate a Norwegian translation of the Edinburgh Postnatal Depression Scale (EPDS). The EPDS was validated against the DSM-IV criteria for major depression, derived from the PRIME-MD, in an interview study of 56 women selected from a community-based questionnaire study of 310 women 6 weeks postpartum. A score of > or =10 on the EPDS scale identified all women with major depression, giving a sensitivity of 100% (95% confidence interval; 72%-100%) and a specificity of 87% (95% confidence interval; 77%-95%). The EPDS scores were strongly correlated with the Montgomery-Asberg Depression Rating Scale in the subsample of women interviewed (n=56) and with the Hopkins Symptom Check List (SCL-25) scores in the questionnaire study (n=310). Our results with regard to the sensitivity and specificity estimates are comparable with prior validation studies; however, the confidence intervals around the estimates are wide. Nevertheless, this study confirms that the EPDS is a valid clinical screening instrument for detecting postpartum depression.
BACKGROUND: Abuse against women causes much suffering for individuals and is a major concern for society. We aimed to estimate the prevalence of three types of abuse in patients visiting gynaecology clinics in five Nordic countries, and to assess the frequency with which gynaecologists identify abuse victims. METHODS: We did a cross-sectional, multicentre study of women attending five departments of gynaecology in Denmark, Finland, Iceland, Norway, and Sweden. We recruited 4729 patients; 3641 (77%) responded and were included in the study. Participants completed a postal questionnaire (norvold abuse questionnaire) confidentially. Primary outcome measures were prevalences of emotional, physical, and sexual abuse, and whether abused patients had told their gynaecologist about these experiences. We assessed differences between countries with Pearson's chi(2) test. FINDINGS: The ranges across the five countries of lifetime prevalence were 38-66% for physical abuse, 19-37% for emotional abuse, and 17-33% for sexual abuse. Not all abused women reported current ill-effects from the abusive experience. Most women (92-98%) had not talked to their gynaecologist about their experiences of abuse at their latest clinic visit. INTERPRETATION: Despite prevalences of emotional, physical, and sexual abuse being high in patients visiting gynaecology clinics in the Nordic countries, most victims of abuse are not identified by their gynaecologists. This lack of discussion might increase the risk of abused patients not being treated according to their needs. Gynaecologists should always consider asking their patients about abuse.