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Anal incontinence after caesarean and vaginal delivery in Sweden: a national population-based study.

https://arctichealth.org/en/permalink/ahliterature299811
Source
Lancet. 2019 Mar 23; 393(10177):1233-1239
Publication Type
Comparative Study
Journal Article
Observational Study
Date
Mar-23-2019
Author
Charlotta Larsson
Charlotta Linder Hedberg
Ewa Lundgren
Lars Söderström
Katarina TunÓn
Pär Nordin
Author Affiliation
Department of Surgical and Perioperative Sciences, University of Umeå and Hospital of Östersund, Östersund, Sweden.
Source
Lancet. 2019 Mar 23; 393(10177):1233-1239
Date
Mar-23-2019
Language
English
Publication Type
Comparative Study
Journal Article
Observational Study
Keywords
Adult
Birth weight
Cesarean Section - adverse effects - methods
Delivery, Obstetric - adverse effects - methods
Fecal Incontinence - diagnosis - epidemiology - etiology
Female
Humans
Male
Maternal Age
Pelvic Floor Disorders - diagnosis - epidemiology - etiology
Pregnancy
Risk factors
Sweden - epidemiology
Abstract
Elective caesarean delivery is increasing rapidly in many countries, and one of the reasons might be that caesarean delivery is widely believed to protect against pelvic floor disorders, including anal incontinence. Previous studies on this issue have been small and with conflicting results. The aim of present study was to compare the risk of developing anal incontinence in women who had a caesarean delivery, in those who had a vaginal delivery, and in two age-matched control groups (nulliparous women and men).
In this observational population-based study, we included all women in the Swedish Medical Birth Register who gave birth by caesarean delivery or vaginal delivery during 1973-2015 in Sweden and were diagnosed with anal incontinence according to ICD 8-10 in the Swedish National Patient Register during 2001-15. Exclusion criteria were multiple birth delivery, mixed vaginal and caesarean delivery, and four or more deliveries. We compared the diagnosis of anal incontinence between women previously delivered solely by caesarean delivery and those who solely had delivered vaginally. We also compared it with two age-matched control groups of nulliparous women and men from the Swedish Total Population Register. Finally, we analysed risk factors for anal incontinence in the caesarean delivery and vaginal delivery groups.
3?755?110 individuals were included in the study. Between 1973 and 2015, 185?219 women had a caesarean delivery only and 1?400?935 delivered vaginally only. 416 (0·22 %) of the 185?219 women in the caesarean delivery group were diagnosed with anal incontinence compared with 5171 (0·37%) of 1?400?935 women in the vaginal delivery group. The odds ratio (OR) for being diagnosed with anal incontinence after vaginal delivery compared with caesarean delivery was 1·65 (95% CI 1·49-1·82; p
Notes
CommentIn: Lancet. 2019 Mar 23;393(10177):1183-1184 PMID 30799058
PubMed ID
30799061 View in PubMed
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[Antibiotic prophylaxis in cesarean section]

https://arctichealth.org/en/permalink/ahliterature64360
Source
Ugeskr Laeger. 1997 Feb 24;159(9):1265-7
Publication Type
Article
Date
Feb-24-1997
Author
T K Pedersen
J. Blaakaer
Author Affiliation
Gynaekologisk-obstetrisk afdeling, Sønderborg Sygehus.
Source
Ugeskr Laeger. 1997 Feb 24;159(9):1265-7
Date
Feb-24-1997
Language
Danish
Publication Type
Article
Keywords
Antibiotic Prophylaxis
Cesarean Section - adverse effects
Denmark
English Abstract
Female
Humans
Obstetrics and Gynecology Department, Hospital
Physician's Practice Patterns
Pregnancy
Questionnaires
Abstract
We investigated the guidelines for patient selection and drug regimens for use of antibiotic prophylaxis in relation to Caesarean section in the maternity clinics in Denmark. A questionnaire was sent to all the Danish maternity clinics that perform Caesarean section, concerning indications for use of antibiotic prophylaxis and antibiotic regimens to patients undergoing acute and elective Caesarean section. All departments (n = 48) returned the questionnaire. Twenty departments (46%) provided written guidelines for antibiotic prophylaxis. Four departments (8%) used antibiotic prophylaxis in elective Caesarean sections, 25 departments (52%) used antibiotics in all emergency sections. In the presence of rupture of the membranes or prolongation of labour (> 12 hrs) 58 and 63% of the departments used antibiotic prophylaxis, respectively. The most frequent first choice drug was cefuroxim, employed by 27 departments (56%). Concerning timing, 21 departments (44%) gave antibiotics after cord clamping and 13 departments (27%) before incision. We propose a nation-wide prospective investigation on the rate of infections associated with Caesarean section to set up rational guidelines for antibiotic prophylaxis.
PubMed ID
9072872 View in PubMed
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Antibiotics prophylaxis in connection with caesarean section--guidelines at Norwegian maternity departments.

https://arctichealth.org/en/permalink/ahliterature129131
Source
Tidsskr Nor Laegeforen. 2011 Nov 29;131(23):2355-8
Publication Type
Article
Date
Nov-29-2011
Author
Hanne-Merete Eriksen
Anja Ramberg Sæther
Inger Økland
Ellen Langen
Ylva Sandness
Anne Bødtker
Finn Egil Skjeldestad
Author Affiliation
Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Norway. hmer@fhi.no
Source
Tidsskr Nor Laegeforen. 2011 Nov 29;131(23):2355-8
Date
Nov-29-2011
Language
English
Norwegian
Publication Type
Article
Keywords
Anti-Bacterial Agents - administration & dosage
Antibiotic Prophylaxis
Cesarean Section - adverse effects
Female
Humans
Norway
Obstetrics and Gynecology Department, Hospital
Physician's Practice Patterns
Practice Guidelines as Topic
Pregnancy
Surgical Wound Infection - prevention & control
Abstract
The frequency of caesarean sections is increasing. Infection in operation wounds and/or underlying spaces and organs is a common complication. In Veileder I fødselshjelp [Clinical Guidelines in Obstetrics], 2008, antibiotic prophylaxis is recommended in the form of single dose ampicillin or first generation cephalosporins in connection with acute caesarean sections and under special conditions such as prolonged operations. We wanted to find out whether Norwegian maternity departments follow these recommendations.
All head senior consultants at maternity departments that carried out more than one caesarean section in 2008 were invited to take part in a survey of the department's written guidelines for use of antibiotic prophylaxis in connection with caesarean section. The extent to which the guidelines were followed was evaluated using data from the Norwegian Surveillance System for Hospital-Associated Infections (NOIS).
38 of the 42 maternity wards in the investigation had written guidelines for antibiotic prophylaxis. Four of these maternity wards gave prophylaxis in all Caesarean sections, one only on indication, and 33 in acute Caesarean section. The guidelines varied as regards choice of type of antibiotic and time of administration. In the maternity wards with written guidelines recommending use of antibiotic prophylaxis in all Caesarean sections, were practice in accordance with the guidelines. When the guidelines recommended prophylactic use only in acute operations, there was agreement between practice and guidelines in 71 % to 97 % of the patients in the ward.
Most Norwegian maternity wards have written guidelines on antibiotic prophylaxis in Caesarean section. The contents of the guidelines varied but are mainly in agreement with current Norwegian recommendations.
PubMed ID
22139118 View in PubMed
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The association between obstetrical interventions and late preterm birth.

https://arctichealth.org/en/permalink/ahliterature104857
Source
Am J Obstet Gynecol. 2014 Jun;210(6):538.e1-9
Publication Type
Article
Date
Jun-2014
Author
Kate L Bassil
Abdool S Yasseen
Mark Walker
Michael D Sgro
Prakesh S Shah
Graeme N Smith
Douglas M Campbell
Muhammad Mamdani
Ann E Sprague
Shoo K Lee
Jonathon L Maguire
Author Affiliation
Maternal-Infant Care Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
Source
Am J Obstet Gynecol. 2014 Jun;210(6):538.e1-9
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Adult
Cesarean Section - adverse effects - statistics & numerical data - utilization
Cross-Sectional Studies
Delivery, obstetric - statistics & numerical data
Female
Gestational Age
Humans
Infant, Newborn
Labor, Induced - statistics & numerical data - utilization
Male
Ontario - epidemiology
Population Surveillance
Pregnancy
Premature Birth - epidemiology
Regression Analysis
Risk factors
Abstract
There is concern that obstetric interventions (prelabor cesarean section and induced delivery) are drivers of late preterm (LP) birth. Our objective was to evaluate the independent association between obstetric interventions and LP birth and explore associated independent maternal and fetal risk factors for LP birth.
In this population-based cross-sectional study, the BORN Information System was used to identify all infants born between 34 and 40 completed weeks of gestation between 2005 and 2012 in Ontario, Canada. The association between obstetric interventions (preterm cesarean section and induced delivery) and LP birth (34 to 36 completed weeks' gestation vs 37 to 40 completed weeks' gestation) was assessed using generalized estimating equation regression.
Of 917,013 births between 34 and 40 weeks, 49,157 were LP (5.4%). In the adjusted analysis, "any obstetric intervention" (risk ratio [RR], 0.65; 95% confidence interval [CI], 0.57-0.74), induction (RR, 0.71; 95% CI, 0.61-0.82) and prelabor cesarean section (RR, 0.66; 95% CI, 0.59-0.74) were all associated with a lower likelihood of LP vs term birth. Several independent potentially modifiable risk factors for LP birth were identified including previous cesarean section (RR, 1.28; 95% CI, 1.16-1.40), smoking during pregnancy (RR, 1.28; 95% CI, 1.21-1.36) and high material (RR, 1.1; 95% CI, 1.03-1.18) and social (RR, 1.09; 95% CI, 1.02-1.16) deprivation indices.
After accounting for differences in maternal and fetal risk, LP births had a 35% lower likelihood of obstetric interventions than term births. Obstetric care providers may be preferentially avoiding induction and prelabor cesarean section between 34 and 37 weeks' gestation.
PubMed ID
24582931 View in PubMed
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Avoiding the first cesarean section--results of structured organizational and cultural changes.

https://arctichealth.org/en/permalink/ahliterature275550
Source
Acta Obstet Gynecol Scand. 2016 May;95(5):580-6
Publication Type
Article
Date
May-2016
Author
Marie Blomberg
Source
Acta Obstet Gynecol Scand. 2016 May;95(5):580-6
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adult
Apgar score
Cesarean Section - adverse effects
Culturally Competent Care - methods - organization & administration
Female
Fetal Monitoring - methods
Gestational Age
Humans
Infant, Newborn
Midwifery - methods - standards
Natural Childbirth - methods - psychology
Organizational Innovation
Parity
Patient Care Team - standards
Pregnancy
Pregnancy Outcome - epidemiology
Quality Improvement
Sweden - epidemiology
Term Birth
Abstract
In 2006 the overall rates of instrumental deliveries (10%) and cesarean sections (CS) (20%) were high in our unit. We decided to improve quality of care by offering more women a safe and attractive normal vaginal delivery. The target group was primarily nulliparous women at term with spontaneous onset of labor and cephalic presentation.
Implementation of a "nine-item list" of structured organizational and cultural change in Linköping 2006-15. The nine items include monitoring of obstetric results, recruitment of a midwife coordinator, risk classification of women, introduction of three different midwife competence levels, improved teamwork, obstetrical morning round, fetal monitoring skills, obstetrical skills training, and public promotion of the strategy.
The CS rate in nulliparous women at term with spontaneous onset of labor decreased from 10% in 2006 to 3% in 2015. During the same period the overall CS rate dropped from 20% to 11%. The prevalence of children born at the unit with umbilical cord pH
PubMed ID
26870916 View in PubMed
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Birth by Caesarean Section and the Risk of Adult Psychosis: A Population-Based Cohort Study.

https://arctichealth.org/en/permalink/ahliterature279444
Source
Schizophr Bull. 2016 May;42(3):633-41
Publication Type
Article
Date
May-2016
Author
Sinéad M O'Neill
Eileen A Curran
Christina Dalman
Louise C Kenny
Patricia M Kearney
Gerard Clarke
John F Cryan
Timothy G Dinan
Ali S Khashan
Source
Schizophr Bull. 2016 May;42(3):633-41
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cesarean Section - adverse effects - statistics & numerical data
Cohort Studies
Delivery, Obstetric - adverse effects - statistics & numerical data
Elective Surgical Procedures - adverse effects - statistics & numerical data
Female
Humans
Male
Psychotic Disorders - epidemiology - etiology
Registries
Sweden - epidemiology
Young Adult
Abstract
Despite the biological plausibility of an association between obstetric mode of delivery and psychosis in later life, studies to date have been inconclusive. We assessed the association between mode of delivery and later onset of psychosis in the offspring. A population-based cohort including data from the Swedish National Registers was used. All singleton live births between 1982 and 1995 were identified (n= 1,345,210) and followed-up to diagnosis at age 16 or later. Mode of delivery was categorized as: unassisted vaginal delivery (VD), assisted VD, elective Caesarean section (CS) (before onset of labor), and emergency CS (after onset of labor). Outcomes included any psychosis; nonaffective psychoses (including schizophrenia only) and affective psychoses (including bipolar disorder only and depression with psychosis only). Cox regression analysis was used reporting partially and fully adjusted hazard ratios (HR) with 95% confidence intervals (CI). Sibling-matched Cox regression was performed to adjust for familial confounding factors. In the fully adjusted analyses, elective CS was significantly associated with any psychosis (HR 1.13, 95% CI 1.03, 1.24). Similar findings were found for nonaffective psychoses (HR 1.13, 95% CI 0.99, 1.29) and affective psychoses (HR 1.17, 95% CI 1.05, 1.31) (?(2)for heterogeneityP= .69). In the sibling-matched Cox regression, this association disappeared (HR 1.03, 95% CI 0.78, 1.37). No association was found between assisted VD or emergency CS and psychosis. This study found that elective CS is associated with an increase in offspring psychosis. However, the association did not persist in the sibling-matched analysis, implying the association is likely due to familial confounding by unmeasured factors such as genetics or environment.
Notes
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PubMed ID
26615187 View in PubMed
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Blood loss after cesarean delivery: a registry-based study in Norway, 1999-2008.

https://arctichealth.org/en/permalink/ahliterature130818
Source
Am J Obstet Gynecol. 2012 Jan;206(1):76.e1-7
Publication Type
Article
Date
Jan-2012
Author
Finn Egil Skjeldestad
Pål Oian
Author Affiliation
Department of Clinical Medicine, University of Tromsø, Norway.
Source
Am J Obstet Gynecol. 2012 Jan;206(1):76.e1-7
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Blood Loss, Surgical - statistics & numerical data
Case-Control Studies
Cesarean Section - adverse effects
Child
Emergency Treatment - statistics & numerical data
Female
Humans
Middle Aged
Norway - epidemiology
Postpartum Hemorrhage - epidemiology
Pregnancy
Prevalence
Registries - statistics & numerical data
Risk factors
Severity of Illness Index
Young Adult
Abstract
The objective of the study was to assess risk factors for moderate and severe blood loss after cesarean delivery (CD).
All planned (n = 32,716) and emergency (n = 47,942) cesareans, as reported over a 10-year period to the Medical Birth Registry of Norway, were analyzed separately in a case-control design. Women with moderate (500 to =1500 mL) or severe (>1500 mL) blood loss were analyzed with women with blood loss less than 500 mL as controls in SPSS (version 17.0) with ?(2) test and logistic regression.
The prevalence of severe blood loss was consistently higher in emergency (3.2%) than planned CD (1.9%). Planned and emergency CDs share common risk factors for both moderate and severe blood loss, whereas emergency CD carries in addition delivery-related risk factors.
When revising management schemes for CD, anesthetic procedures should be reconsidered as surgical competence in cases with placenta previa, placental abruption, and low hemoglobin.
PubMed ID
21963102 View in PubMed
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Broad-Spectrum Antibiotic Treatment and Subsequent Childhood Type 1 Diabetes: A Nationwide Danish Cohort Study.

https://arctichealth.org/en/permalink/ahliterature284960
Source
PLoS One. 2016;11(8):e0161654
Publication Type
Article
Date
2016
Author
Tine D Clausen
Thomas Bergholt
Olivier Bouaziz
Magnus Arpi
Frank Eriksson
Steen Rasmussen
Niels Keiding
Ellen C Løkkegaard
Source
PLoS One. 2016;11(8):e0161654
Date
2016
Language
English
Publication Type
Article
Keywords
Adolescent
Anti-Bacterial Agents - adverse effects - therapeutic use
Cesarean Section - adverse effects
Child
Child, Preschool
Cohort Studies
Delivery, Obstetric - adverse effects
Denmark
Diabetes Mellitus, Type 1 - epidemiology
Female
Humans
Male
Pregnancy
Proportional Hazards Models
Registries
Abstract
Studies link antibiotic treatment and delivery by cesarean section with increased risk of chronic diseases through changes of the gut-microbiota. We aimed to evaluate the association of broad-spectrum antibiotic treatment during the first two years of life with subsequent onset of childhood type 1 diabetes and the potential effect-modification by mode of delivery.
A Danish nationwide cohort study including all singletons born during 1997-2010. End of follow-up by December 2012. Four national registers provided information on antibiotic redemptions, outcome and confounders. Redemptions of antibiotic prescriptions during the first two years of life was classified into narrow-spectrum or broad-spectrum antibiotics. Children were followed from age two to fourteen, both inclusive. The risk of type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 858,201 singletons contributed 5,906,069 person-years, during which 1,503 children developed type 1 diabetes.
Redemption of broad-spectrum antibiotics during the first two years of life was associated with an increased rate of type 1 diabetes during the following 13 years of life (HR 1.13; 95% CI 1.02 to 1.25), however, the rate was modified by mode of delivery. Broad-spectrum antibiotics were associated with an increased rate of type 1 diabetes in children delivered by either intrapartum cesarean section (HR 1.70; 95% CI 1.15 to 2.51) or prelabor cesarean section (HR 1.63; 95% CI 1.11 to 2.39), but not in vaginally delivered children. Number needed to harm was 433 and 562, respectively. The association with broad-spectrum antibiotics was not modified by parity, genetic predisposition or maternal redemption of antibiotics during pregnancy or lactation.
Redemption of broad-spectrum antibiotics during infancy is associated with an increased risk of childhood type 1 diabetes in children delivered by cesarean section.
Notes
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PubMed ID
27560963 View in PubMed
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Caesarean delivery and risk of developing asthma in the offspring.

https://arctichealth.org/en/permalink/ahliterature78931
Source
Acta Paediatr. 2007 Apr;96(4):595-6
Publication Type
Article
Date
Apr-2007
Author
Werner Anette
Ramlau-Hansen Cecilia Høst
Jeppesen Simone K
Thulstrup Ane Marie
Olsen Jørn
Author Affiliation
Institute of Public Health, Aarhus University, and Department of Occupational Medicine, Aarhus University Hospital, Denmark. Anette@garudahr.com
Source
Acta Paediatr. 2007 Apr;96(4):595-6
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Asthma - epidemiology
Cesarean Section - adverse effects
Cohort Studies
Denmark - epidemiology
Female
Humans
Infant, Newborn
Male
Odds Ratio
Questionnaires
Risk assessment
Abstract
AIM: To evaluate the association between caesarean section and risk of developing asthma. METHOD: We evaluated this association in a Danish cohort, comprising of 11,147 mothers and their babies of which 7119 mother-child pairs were included in the analyses. The mothers' reported asthma data on their children were linked to hospitalization records on mode of delivery. RESULTS: The adjusted odds ratio for developing asthma was 1.11 (95% CI, 0.88-1.39) for caesarean sections versus vaginal births. CONCLUSION: We found no evidence that children being delivered by caesarean section have an increased risk of asthma.
PubMed ID
17274805 View in PubMed
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Caesarean section. A clinical study with special reference to the increasing section rate.

https://arctichealth.org/en/permalink/ahliterature60743
Source
Acta Obstet Gynecol Scand. 1978;57(3):245-8
Publication Type
Article
Date
1978
Author
E. Patek
B. Larsson
Source
Acta Obstet Gynecol Scand. 1978;57(3):245-8
Date
1978
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cesarean Section - adverse effects
Female
Fetal Diseases - epidemiology
Humans
Middle Aged
Parity
Postoperative Complications
Pregnancy
Pregnancy Complications - epidemiology
Risk
Sweden
Abstract
At Huddinge University Hospital 539 Caesarean Sections (C.S.) were made among 8415 deliveries from October 1972 to June 1976, corresponding to an over all C.S. rate of 6.4%. Over these years the rate has increased from 3.5% in 1972 to 9.7% in 1976. The main increase was due to a higher incidence of abdominal deliveries in cases of imminent fetal asphyxia. The maternal complication rate and the neonatal morbidity rate were both 6.5 times higher and the neonatal mortality rate was 4.1 times higher in emergency than in elective surgery. There was neither any mortality nor any morbidity in infants delivered by elective C.S. from healthy mothers at term.
PubMed ID
665168 View in PubMed
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125 records – page 1 of 13.