Objective: The purpose of this study was to compare maternal and neonatal morbidity among Somali immigrants, US- born blacks and whites in Washington state. Study design: Washington state birth certificate data was li...Objective: The purpose of this study was to compare maternal and neonatal morbidity among Somali immigrants, US- born blacks and whites in Washington state. Study design: Washington state birth certificate data was linked to hospital discharge records comparing singleton deliveries among Somali immigrants with US- born blacks and whites between 1993 and 2001, in a 1∶ 3 ratio. Outcomes were compared using unconditional multiple logistic regression models calculating odds ratios (ORs), and 95% confidence intervals (95% CIs). Results: Five hundred seventy-nine pregnancies from Somali women were compared with 2384 and 2435 pregnancies from black and white women, respectively. Nulliparous Somali women were more likely to have a cesarean delivery than black or white control women, OR 1.6 (95% CI, 1.1- 2.3) and 2.0 (95% CI, 1.4- 2.8), respectively. Among all women who had cesarean deliveries, Somali women more commonly had cesarean deliveries associated with fetal distress and failed induction of labor. They were 9 times more likely than both control groups to deliver after 42 weeks gestation, and 4 times more likely than black women and 8 times more likely than white women to have oligohydramnios. Somali women were more likely to have gestational diabetes and significant perineal lacerations, and less likely to smoke. Newborns of Somali women were at increased risk for prolonged hospitalization, lower 5- minute Apgar scores, assisted ventilation, and meconium aspiration. Conclusion: Pregnancy outcomes should be evaluated within ethnically and culturally unique groups; Somali immigrants are a high-risk subpopulation.展开更多
We studied the impact of progestin dose on this risk. The pattern and number of days per month that progestin is given in postmenopausal combined hormone therapy appears to affect endometrial cancer risk. We assessed ...We studied the impact of progestin dose on this risk. The pattern and number of days per month that progestin is given in postmenopausal combined hormone therapy appears to affect endometrial cancer risk. We assessed the impact of progestin dose on this risk. A population based, case control study included 647 cases with endometrial cancer and 1209 controls. Among users of estrogen with medroxyprogesterone acetate (MPA) 10 to 24 days/month, women who took >100 mg/month had an endometrial cancer risk that was equal to that of hormone nonusers (95% CI 0.6- 1.7). The corresponding relative risk was 0.8 (95% CI 0.5- 1.5) in those who used a lower monthly MPA dose for 10 to 24 days/month. Among users of a continuous combined hormone regimen, the risk of endometrial cancer was low relative to hormone nonusers, regardless of MPA dose. Among the combined hormone regimens most commonly used by postmenopausal women today, MPA monthly dose bears little or no relation to endometrial cancer risk.展开更多
文摘Objective: The purpose of this study was to compare maternal and neonatal morbidity among Somali immigrants, US- born blacks and whites in Washington state. Study design: Washington state birth certificate data was linked to hospital discharge records comparing singleton deliveries among Somali immigrants with US- born blacks and whites between 1993 and 2001, in a 1∶ 3 ratio. Outcomes were compared using unconditional multiple logistic regression models calculating odds ratios (ORs), and 95% confidence intervals (95% CIs). Results: Five hundred seventy-nine pregnancies from Somali women were compared with 2384 and 2435 pregnancies from black and white women, respectively. Nulliparous Somali women were more likely to have a cesarean delivery than black or white control women, OR 1.6 (95% CI, 1.1- 2.3) and 2.0 (95% CI, 1.4- 2.8), respectively. Among all women who had cesarean deliveries, Somali women more commonly had cesarean deliveries associated with fetal distress and failed induction of labor. They were 9 times more likely than both control groups to deliver after 42 weeks gestation, and 4 times more likely than black women and 8 times more likely than white women to have oligohydramnios. Somali women were more likely to have gestational diabetes and significant perineal lacerations, and less likely to smoke. Newborns of Somali women were at increased risk for prolonged hospitalization, lower 5- minute Apgar scores, assisted ventilation, and meconium aspiration. Conclusion: Pregnancy outcomes should be evaluated within ethnically and culturally unique groups; Somali immigrants are a high-risk subpopulation.
文摘We studied the impact of progestin dose on this risk. The pattern and number of days per month that progestin is given in postmenopausal combined hormone therapy appears to affect endometrial cancer risk. We assessed the impact of progestin dose on this risk. A population based, case control study included 647 cases with endometrial cancer and 1209 controls. Among users of estrogen with medroxyprogesterone acetate (MPA) 10 to 24 days/month, women who took >100 mg/month had an endometrial cancer risk that was equal to that of hormone nonusers (95% CI 0.6- 1.7). The corresponding relative risk was 0.8 (95% CI 0.5- 1.5) in those who used a lower monthly MPA dose for 10 to 24 days/month. Among users of a continuous combined hormone regimen, the risk of endometrial cancer was low relative to hormone nonusers, regardless of MPA dose. Among the combined hormone regimens most commonly used by postmenopausal women today, MPA monthly dose bears little or no relation to endometrial cancer risk.
