Dataset Information

Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study.

ABSTRACT: OBJECTIVES:To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. DESIGN:Retrospective cohort study. SETTING AND PARTICIPANTS:All live births in Denmark between 2004 and 2010 (n=450?856). Births were classified by intended caesarean delivery (n=45?053) or intended vaginal delivery (n=405?803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcome measure was postpartum urinary tract infection (n=16?295) within 30 days post partum, defined as either a diagnosis of urinary tract infection in the National Patient Registry or redemption of urinary tract infection-specific antibiotics recorded in the Register of Medicinal Product Statistics. RESULTS:We found that 4.6% of women with intended caesarean delivery and 3.5% of women with intended vaginal delivery were treated for postpartum urinary tract infection.Women with intended caesarean delivery had a significantly increased risk of postpartum urinary tract infection compared with women with intended vaginal delivery (OR 1.33, 95% CI 1.27 to 1.40), after adjustment for age at delivery, smoking, body mass index, educational level, gestational diabetes mellitus, infection during pregnancy, birth weight, preterm delivery, preterm prelabour rupture of membranes, pre-eclampsia, parity and previous caesarean delivery (adjusted OR 1.24, 95% CI 1.17 to 1.46).Using actual mode of delivery as exposure, all types of operative delivery had an equally increased risk of postpartum urinary tract infection compared with spontaneous vaginal delivery. CONCLUSIONS:Compared with intended vaginal delivery, intended caesarean delivery was significantly associated with a higher risk of postpartum urinary tract infection. Future studies should focus on reducing routine catheterisation prior to operative vaginal delivery as well as improving procedures related to catheterisation.

SUBMITTER: Gundersen TD

PROVIDER: S-EPMC5857667 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study.

Gundersen Tina Djernis TD Gundersen Tina Djernis TD Krebs Lone L Loekkegaard Ellen Christine Leth ECL Rasmussen Steen Christian SC Glavind Julie J Clausen Tine Dalsgaard TD

BMJ open 20180314 3

<h4>Objectives</h4>To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery.<h4>Design</h4>Retrospective cohort study.<h4>Setting and participants</h4>All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or ...[more]

PMID: 29540408

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Project description:Background Cardiovascular involvement in systemic sclerosis (SSc) comprises a wide range of manifestations with prevalence and incidence that remain uncertain. Methods and Results In the Danish administrative registries between 1995 and 2015, all patients aged ?18 years with a first diagnosis of SSc were matched by age and sex with controls (1:5) from the general population. Prevalence of cardiovascular diseases at the time of the SSc diagnosis and incidence during follow-up were assessed by in- and outpatient discharge diagnoses. Conditional logistic and Cox proportional hazards regression models were used respectively to calculate odds ratios for prevalent cardiovascular diseases and hazard ratios (HRs) for incident diseases associated with SSc. Patients with SSc (n=2778; 76% women; mean±SD age: 55±15 years) had more established cardiovascular risk factors than their respective controls at baseline, including greater prevalence of hypertension (31.2% versus 21.0%, P<0.0001) and treated dyslipidemia (9.8% versus 8.5%, P=0.02). SSc was associated with an increased relative risk of developing most cardiovascular diseases, including myocardial infarction (HR: 2.08; 95% CI, 1.65-2.64), peripheral vascular disease (HR: 5.73; 95% CI, 4.63-7.09), pulmonary hypertension (HR: 21.18; 95% CI, 14.73-30.45), mitral regurgitation (HR: 4.60; 95% CI, 3.12-6.79), aortic regurgitation (HR: 3.78; 95% CI, 2.55-5.58), aortic stenosis (HR: 2.99; 95% CI, 2.25-3.97), pericarditis (HR: 8.78; 95% CI, 4.84-15.93), heart failure (HR: 2.86; 95% CI, 2.43-3.37), atrial fibrillation (HR: 1.75; 95% CI, 1.51-2.04), and venous thromboembolism (HR: 2.10; 95% CI, 1.65-2.67). Additional adjustment for medications and comorbidities yielded results similar to the main analyses. Conclusions In this nationwide study, SSc was associated with greater risks of distinct cardiovascular diseases for patients than for matched controls, suggesting a significant disease-related adverse impact across the vascular bed and specific cardiac structures.

Dataset Information

Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study.

Publications

Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study.

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