Biomedical subjects

Bengt Haglund

Publications and source records attributed to Bengt Haglund.

At least 19 recordsLinked to original sources

PubMed2006

Characteristics of women giving birth at home in Sweden: a national register study.

OBJECTIVE: The objective of the study was to estimate the proportion of planned home births in Sweden and to identify maternal characteristics of women giving birth at home. STUDY DESIGN: This case-control study included register data of births from 1992 to 2001 in 352 women giving birth at home and 1760 women giving birth in a hospital. RESULTS: Four hundred thirty-nine out-of-hospital births were found during the study period, and the proportion of planned home births was less than 0.5/1000. Women with home birth were more likely to have 4 children or more (odds ratio 3.7 [1.4 to 9.9]), be born in a European country outside Sweden (odds ratio 3.5 [1.8 to 6.8]), have a family income below the median (odds ratio 2.9 [2.0 to 4.1]), not work outside the home (odds ratio 2.4 [1.7 to 3.5]), have a high level of education (odds ratio 2.1 [1.5 to 3.0]), and be older than 35 years (odds ratio 1.7 [1.1 to 2.5]). CONCLUSION: Women with planned home births appear to be a group having a different lifestyle, compared with Swedish women in general.

Adult↗

PubMed2006

Chronic hypertension as a risk factor for offspring to be born small for gestational age.

BACKGROUND: Chronic hypertension during pregnancy is associated with an increased risk for birth of small for gestational age offspring. The aim of this study was to determine whether the risk remains after consideration of maternal characteristics and superimposed pre-eclampsia. METHOD: A population-based cohort study based on the Swedish Medical Birth Register 1992-98 and comprising 560 188 women aged 15-44 years with singleton pregnancies including 2,754 women with chronic hypertension. The register contains data of maternal characteristics besides maternal and fetal complications. Multiple logistic regression analysis was used. Small for gestational age was defined as birth weight less than -2SD adjusted for gestational age and sex. RESULTS: Chronic hypertensive women have an independent risk for small for gestational age (OR 3.1; 95% CI 2.7-3.7) when controlling for confounding of maternal characteristics such as age, parity, BMI, smoking, and ethnic origin. After introducing superimposed pre-eclampsia in the model the risk remains but decreases (OR 2.4; 95% CI 2.1-2.9). CONCLUSION: Chronic hypertension is an independent risk factor for birth of small for gestational age offspring. Pre-eclampsia is a strong mediating factor.

Adolescent↗

PubMed2006

Trends in alcohol-related mortality in Sweden 1969-2002: an age-period-cohort analysis.

AIM: To study the effects of age, period and cohorts on alcohol-related mortality trends in Sweden. DESIGN: The study comprises an age-period-cohort analysis. SETTING AND PARTICIPANTS: The analysis was based on all deaths in the Swedish population between 1969 and 2002. MEASUREMENTS: Data on alcohol-related deaths in Sweden from 1969 to 2002 excluding accidental injury and homicide were used. The analysis covered 43 021 deaths. FINDINGS: Time period and birth cohort both influenced alcohol-related mortality. Male cohorts born in the 1930-40s exhibited the highest alcohol-related mortality, while for females those born in the 1940-50s had the highest alcohol-related mortality. For both men and women, those born in the 1960-70s had the lowest age-adjusted alcohol-related mortality. High-risk cohorts were young or in early adulthood during the periods that alcohol became more available in Sweden. The low-risk cohorts of the 1960-70s were brought up during a period when society was concerned with increasing alcohol problems and more emphasis was placed on issuing alcohol awareness information in schools. CONCLUSIONS: Cohort effects were found suggesting that the link between alcohol consumption and non-accident alcohol-related mortality at the population level is dependent on other factors that may change over time. One such factor may be that restrictive alcohol policies have a greater effect on drinking in those who are younger at the time they are put into effect.

Adolescent↗

PubMed2005

From healthy survivors to sick survivors--implications for the twenty-first century.

BACKGROUND: Hypotheses concerning compression of morbidity have gained support, particularly due to improved lifestyles from 1950 to date, but now the increase is largely due to improvements in healthcare. METHODS: Survey data from Sweden were used to test whether the older population aged 65-84 years during 1995-2002 had more longstanding illnesses than the older population of 1980-87 or 1988-94. RESULTS: There was an increased prevalence of many longstanding illnesses among the elderly in Sweden between 1988-94 and 1995-2002. The increase was especially pronounced among those with at least three longstanding illnesses. For diabetes, heart disease, and hypertension, the prevalence among elderly men increased by over 20%. However, those reporting these kinds of longstanding illnesses perceive improved health and are less restricted in their daily activities. CONCLUSIONS: Results from Sweden indicate that many countries approaching Sweden's life expectancy will have an increased need for care for the oldest population in the future. The compression-of-morbidity hypothesis is being challenged, probably due to improvements in healthcare.

Aged↗

PubMed2005

Does prenatal sonography affect intellectual performance?

BACKGROUND: Little is known about potential risks of ultrasound during pregnancy. The developing brain is susceptible to environmental influences, and prenatal ultrasound has been reported to affect cognitive abilities in animals. METHODS: To assess a possible association between prenatal ultrasound and intellectual performance, we studied men born in Sweden from 1973 to 1978 who enrolled for military service from 1991 to 1996. Intellectual scores (mean +/- standard deviation = 5 +/- 2) were measured by a test battery at enrollment, and subnormal performance was defined as a score of 3 or less. We estimated differences in mean intellectual score between ultrasound-exposed and ultrasound-unexposed using linear regression, and we calculated relative risks of subnormal performance using logistic regression analysis. RESULTS: There were 7999 eligible men born in a hospital (Malmo) that included ultrasound scanning in standard antenatal care (exposed) and 197,829 men born in hospitals without ultrasound scanning programs (unexposed). We found lower intellectual performance scores (mean difference = -0.16; 95% confidence interval = -0.21 to -0.11) and an increased risk of subnormal performance (odds ratio = 1.28; CI = 1.18 to 1.38) among ultrasound-exposed compared with unexposed. However, men born in Malmo before scanning was introduced also had lower scores, and the decrease in test scores after the introduction of ultrasound was small. Moreover, we found no differences in intellectual performance within pairs of brothers as a result of ultrasound exposure. CONCLUSIONS: This study failed to demonstrate a clear association between ultrasound scanning and intellectual performance.

Adolescent↗

PubMed2005

Maternal complications in women with chronic hypertension: a population-based cohort study.

BACKGROUND: The aim of the study was to determine if pregnant women with chronic hypertensive disease have an independent risk for preeclampsia, gestational diabetes or placental abruption. To examine if superimposed preeclampsia in this group of women is related to an increased risk of placental abruption. METHODS: This study is a population-based cohort study using the Swedish Medical Birth Register 1992-98. A population of 681 515 women aged between 15-44 years with singleton pregnancies, excluding women with systemic lupus erythematosus (SLE), diabetes mellitus and chronic renal disease were studied. Among these, 3374 women were diagnosed with chronic hypertensive disease. Multiple logistic regression analysis was performed and the outcome measures of crude and adjusted odds ratios (OR) were presented with 95% confidence intervals (CI). RESULTS: Chronic hypertensive disease is associated with multiparity, age, high body mass index and Nordic ethnicity. After controlling for confounders, chronic hypertensive disease is an independent risk factor for preeclampsia (OR 3.8; 95% CI 3.4-4.3), gestational diabetes (OR 1.8; 95% CI 1.4-2.4) and placental abruption (OR 2.3; 95% CI 1.6-3.4). CONCLUSION: Chronic hypertensive disease is independently associated with an increased incidence of preeclampsia, gestational diabetes and placental abruption.

Abruptio Placentae↗

PubMed2005

Infant morbidity following amniocentesis and chorionic villus sampling for prenatal karyotyping.

OBJECTIVE: To investigate whether amniocentesis and chorionic villus sampling increase the risk of postural deformities, limb reduction defects, respiratory problems in the newborn, fetal and infant mortality, prematurity, low birthweight and fetal distress, and to investigate the impact of gestational length at the time of the procedure. DESIGN: A population-based cohort study. SETTING: Sweden, 1991-1996. POPULATION: All women, 35 to 49 years old, with single births (n= 71,586). The women were classified as exposed to amniocentesis (n= 21,748) or chorionic villus sampling (n= 1984) or not exposed (n= 47,854). METHODS: Infant outcomes were collected from the Swedish Medical Birth Register, the Swedish Hospital Discharge Register, the Swedish Malformation Register and the Swedish Cause of Death Register. Odds ratios were calculated with logistic regression analyses. MAIN OUTCOME MEASURES: Crude and adjusted odds ratios of postural deformities, limb reduction defects, respiratory problems in the newborn, fetal and infant mortality, prematurity, low birthweight and fetal distress. Women exposed to amniocentesis or chorionic villus sampling were compared with non-exposed women. RESULTS: An increased risk of musculoskeletal deformities (OR = 1.32, 95% CI 1.11-1.57) including club foot and hip dislocation was found in the amniocentesis group, especially for amniocentesis prior to 14 weeks of gestation. Respiratory disturbances such as neonatal pneumonia, meconium aspiration, atelectasis and tachypnea were found more often in the amniocentesis group (OR = 1.12, 95% CI 1.02-1.24), with the greatest risk at 14 and 15 weeks of gestation. For the chorionic villus sampling group, no significant associations were found. No increase regarding limb reduction defects, fetal and infant mortality, prematurity, low birthweight and fetal distress was found in either the amniocentesis or the chorionic villus sampling group. CONCLUSIONS: Among women aged 35-49 years, amniocentesis before 14 weeks of gestation increases the risk of postural deformities. Amniocentesis at 14 and 15 weeks increases the risk of respiratory disturbances. For chorionic villus sampling, a larger study group is needed before such risks can be ruled out.

Adult↗

PubMed2005

The risk of maternal ischaemic heart disease after gestational hypertensive disease.

OBJECTIVE: The aim of this study was to investigate whether the risk of developing ischaemic heart disease (IHD) later in life increases with severity and recurrence of gestational hypertensive disease. DESIGN: Cross-sectional population-based study. SETTING: Sweden. POPULATION: Women (403,550) giving birth to their first child in Sweden, 1973-1982. Of this cohort, 207,054 women who also gave birth to a second child during the same period were analysed separately. METHODS: All women were followed up for 15 years, starting 4-14 years after the index pregnancy. Women who suffered from hypertensive disease during pregnancy were compared with women with normal pregnancies with regard to hospitalisation for, or death from, IHD during the follow up period. MAIN OUTCOME MEASURES: Fatal or non-fatal IHD. RESULTS: The adjusted incidence rate ratio (IRR) for later development of IHD was 1.6 (95% CI 1.3-2.0) when the first pregnancy was complicated by gestational hypertension without proteinuria, 1.9 (95% CI 1.6-2.2) for mild pre-eclampsia and 2.8 (95% CI 2.2-3.7) for severe pre-eclampsia. Women with gestational hypertension in their first pregnancy but not in their second had an adjusted IRR of 1.9 (95% CI 1.5-2.4) for development of IHD. Women with hypertensive disease in both pregnancies had an IRR of 2.8 (95% CI 2.0-3.9) compared with women with two normal pregnancies. CONCLUSION: Severe hypertensive disease in pregnancy has a stronger association with later development of IHD than has mild hypertensive disease. Recurrent hypertensive disease is more strongly associated with IHD than is non-recurrent disease.

Adolescent↗

PubMed2004

Gestational diabetes and preeclampsia.

OBJECTIVE: To determine whether gestational diabetes mellitus (GDM) increases the risk for preeclampsia independent of other risk factors. STUDY DESIGN: The association between GDM and preeclampsia was analyzed in a population of women who had given birth to singletons registered in Swedish Medical Birth Register from 1992 through 1996 (n=430,852). RESULTS: GDM occurred in 0.8% and preeclampsia in 2.9% of all pregnancies. The rate of preeclampsia was higher in the GDM than in the non-GDM group (6.1% versus 2.8%). High age, nullipara, chronic hypertension, kidney disease, and high body mass index (BMI) were all independently associated with increased risk for preeclampsia. Smoking was associated with decreased risk. Adjusted odds ratio for GDM as a risk factor for preeclampsia was 1.61 (95% confidence interval (CI) 1.39-1.86) when prepregnancy BMI, which was a true confounder, was included in the last step of the multiple logistic regression analysis. CONCLUSIONS: There is an independent and significant association between GDM and preeclampsia. Obesity is a major confounding factor but could not explain the total excess risk.

Adolescent↗

PubMed2004

Inequality in access to coronary revascularization in Sweden.

OBJECTIVES: To investigate social and gender equality in access to coronary revascularization for those treated for coronary heart disease in Sweden between 1991 and 2000. DESIGN: All Swedish residents between 25 and 74 years old with a hospital stay for coronary heart disease were eligible for the study, in total about 153,000 persons. The Swedish Hospital Discharge Register from 1988 through 2000 was used to define the study population. Poisson regression analyses were used to estimate the effect of socio-economic status on the likelihood for coronary artery bypass grafting (CABG) within 2 years. In the analysis of gender differences, the likelihood for percutaneous coronary intervention (PCI) was also included. RESULTS: Males were 1.5 times more likely to undergo revascularization procedures than females even after adjusting for confounding factors and the fact that women are less eligible for interventions. The analyses also showed significant socio-economic inequalities in access to CABG among men, but not among women. CONCLUSIONS: There are gender and socio-economic inequalities in access to cardiac procedures in Sweden.

Adult↗

PubMed2004

Premature death among teenage mothers.

OBJECTIVE: Some data suggest an association between teenage childbearing and premature death. Whether this possible increase in risk is associated with social circumstances before or after childbirth is not known. We studied premature death in relation to age at first birth, social background and social situation after first birth. DESIGN: Population-based cohort study. SETTING: Women born in Sweden registered in the 1985 Swedish Population Census. POPULATION: Swedish women born 1950-1964 who had their first infant before the age of 30 years (N= 460,434). METHODS: Information on the women's social background and social situation after first birth was obtained from Population Censuses. The women were followed up with regard to cause of death from December 1, 1990 to December 31, 1995. Mortality rate ratios and 95% confidence intervals (CI) were calculated. MAIN OUTCOME MEASURES: Mortality rates by cause of death. RESULTS: Independent of socio-economic background, teenage mothers faced an increased risk of premature death later in life compared with older mothers (rate ratio 1.6, 95% CI 1.4-1.9). The increased risk was most evident for deaths from cervical cancer, lung cancer, ischaemic heart disease, suicide, inflicted violence and alcohol-related diseases. Some, but not all, of these increases in risk were associated with the poorer social position of teenagers mothers. CONCLUSIONS: Teenage mothers, independent of socio-economic background, face an increased risk of premature death. Strategies to reduce teenage childbearing are likely to contribute to improved maternal and infant health.

Adolescent↗

PubMed2003

Mortality, severe morbidity, and injury in children living with single parents in Sweden: a population-based study.

BACKGROUND: Growing up with one parent has become increasingly common, and seems to entail disadvantages in terms of socioeconomic circumstances and health. We aimed to investigate differences in mortality, severe morbidity, and injury between children living in households with one adult and those living in households with two adults. METHODS: In this population-based study, we assessed overall and cause-specific mortality between 1991 and 1998 and risk of admission between 1991 and 1999 for 65085 children with single parents and 921257 children with two parents. We estimated relative risks by Poisson regression, adjusted for factors that might be presumed to select people into single parenthood, and for other factors, mainly resulting from single parenthood, that might have affected the relation between type of parenting and risk. FINDINGS: Children with single parents showed increased risks of psychiatric disease, suicide or suicide attempt, injury, and addiction. After adjustment for confounding factors, such as socioeconomic status and parents' addiction or mental disease, children in single-parent households had increased risks compared with those in two-parent households for psychiatric disease in childhood (relative risk for girls 2.1 [95% CI 1.9-2.3] and boys 2.5 [2.3-2.8]), suicide attempt (girls 2.0 [1.9-2.2], boys 2.3 [2.1-2.6]), alcohol-related disease (girls 2.4 [2.2-2.7], boys 2.2 [2.0-2.4]), and narcotics-related disease (girls 3.2 [2.7-3.7], boys 4.0 [3.5-4.5]). Boys in single-parent families were more likely to develop psychiatric disease and narcotics-related disease than were girls, and they also had a raised risk of all-cause mortality. CONCLUSIONS: Growing up in a single-parent family has disadvantages to the health of the child. Lack of household resources plays a major part in increased risks. However, even when a wide range of demographic and socioeconomic circumstances are included in multivariate models, children of single parents still have increased risks of mortality, severe morbidity, and injury.

Adolescent↗

PubMed2003

Maternal complications following amniocentesis and chorionic villus sampling for prenatal karyotyping.

OBJECTIVE: To investigate whether amniocentesis and chorionic villus sampling increase the risk of bleeding, placental abruption, complications related to amniotic cavity and membranes, abnormal labour, operative deliveries and to investigate the impact of gestational length at the time of the procedure. DESIGN: A population-based cohort study. SETTING: Sweden, 1991-1996. POPULATION: All women, 35 to 49 years old, with single births (N = 71,586). The women were classified as exposed to amniocentesis (N = 21,748) or chorionic villus sampling (N = 1984) or not exposed (N = 47,854). METHODS: Maternal outcomes were collected from the Swedish Medical Birth Register and the Swedish Hospital Discharge Register. With Logistic regression analyses odds ratios were calculated. MAIN OUTCOME MEASURES: Crude and adjusted odds ratios of bleeding, complications related to amniotic cavity and membranes, abnormal labour and operative deliveries. Women exposed to amniocentesis or chorionic villus sampling were compared with women non-exposed. RESULTS: Neither amniocentesis nor chorionic villus sampling was associated with severe pregnancy complications such as placental abruption or placenta praevia. Women in the amniocentesis group had a lower chance of normal delivery (OR = 0.93, 95% CI 0.90-0.97), an increased risk of complications related to amniotic cavity and membranes (OR = 1.15, 95% CI 1.06-1.24) and hypotonic uterine dysfunction (OR = 1.12, 95% CI 1.06-1.18). The risks were higher for amniocentesis before 15 weeks of gestation. Women in the amniocentesis group were more often delivered by forceps or vacuum extractions (OR = 1.11, 95% CI 1.03-1.19) and elective caesarean sections (OR = 1.09, 95% CI 1.02-1.16). For the chorionic villus sampling group, no significant associations were found. CONCLUSIONS: Among women aged 35-49 years, amniocentesis is not associated with important adverse outcomes such as abruption or placenta praevia. Minor associations were found for other maternal complications when amniocentesis was performed before 15 weeks of gestation. Improved methods to identify women with increased risk of chromosomally abnormal pregnancies might minimise the number of women exposed to invasive procedures.

Abruptio Placentae↗

PubMed2003

Deliveries, mothers and newborn infants in Sweden, 1973-2000. Trends in obstetrics as reported to the Swedish Medical Birth Register.

INTRODUCTION: The aim of this report is to present descriptive data from the Swedish Medical Birth Register (MBR) reflecting trends in obstetric and neonatal practices over three decades. MATERIAL: Since 1973 the MBR at the Swedish National Board of Health and Welfare receives information on all pregnancies in Sweden--around 95,000 annually--that have lead to delivery regarding the pregnancy, delivery and the newborn infant. In this study selected data from the MBR are presented as they have developed between 1973 and 2000. RESULTS: There was a shift in age distribution of childbearing women towards older women. Cigarette smoking in early pregnancy decreased from 30% to 12%. In-hospital time after both vaginal and cesarean (CS) delivery decreased and more than 50% of all women with a vaginal singleton delivery left hospital within 48 hours in 2000. The proportion of CS increased from 5 to 15% at singleton deliveries. The CS rate for breech deliveries increased and was nearly 80% in 2000. The mean birth weight increased, particularly the proportion of heavy infants. The proportion of early neonatal deaths decreased continuously, both for term infants and infants born after short gestational length, whereas no such downward trends was found for stillbirth during the last 10-15 years. CONCLUSION: Although several of the changes regarding pregnancy and delivery that occurred between 1973 and 2000 could be expected to influence pregnancy outcome negatively, the trends described here generally suggest improvement in maternal and child health.

Adolescent↗

PubMed2002

Registration artifacts in international comparisons of infant mortality.

Large differences in infant mortality are reported among and within industrialised countries. We hypothesised that these differences are at least partly the result of intercountry differences in registration of infants near the borderline of viability (<750 g birthweight) and/or their classification as stillbirths vs. live births. We used the database of the International Collaborative Effort (ICE) on Perinatal and Infant Mortality to compare infant mortality rates and registration practices in Norway (n = 112484), Sweden (n = 215 908), Israeli Jews (n = 148123), Israeli non-Jews (n = 52 606), US Whites (n = 6 074 222) and US Blacks (n = 1328332). To avoid confounding by strong secular trends in these outcomes, we restricted our analysis to 1987-88, the most recent years for which data are available in the ICE database for all six groups. Compared with Norway (with an infant mortality rate of 8.5 per 1000), the crude relative risks [95% confidence intervals] were 0.75 [0.69,0.81] in Sweden, 0.97 [0.90,1.06] in Israeli Jews, 1.98 [1.81,2.17] in Israeli non-Jews, 0.95 [0.89,1.01] in US Whites and 2.05 [1.95,2.19] in US Blacks. For borderline-viable infants, fetal deaths varied twofold as a proportion of perinatal deaths, with Norway reporting the highest (83.9% for births <500 g and 61.8% for births 500-749 g) and US Blacks the lowest (40.3% and 37.6% respectively) proportions. Reported proportions of live births <500 g varied 50-fold from 0.6 and 0.7 per 10000 in Sweden and Israeli Jews and non-Jews to 9.1 and 33.8 per 10000 in US Whites and Blacks respectively. Reported proportions 500-749 g varied sevenfold from 7.5 per 10000 in Sweden to 16.2 and 55.4 in US Whites and Blacks respectively. After eliminating births <750 g, the relative risks (again with Norway as the reference) of infant mortality changed drastically for US Whites and Blacks: 0.82 [0.76,0.87] and 1.42 [1.33,1.53] respectively. The huge disparities in the ratio of fetal to infant deaths <750 g and in the proportion of live births <750 g among these developed countries probably result from differences in birth and death registration practices. International comparisons and rankings of infant mortality should be interpreted with caution.

Adult↗

PubMed2002

A population-based study on the incidence and possible pre- and perinatal etiologic risk factors of biliary atresia.

OBJECTIVE: To study the incidence, etiologic risk factors, and outcome of biliary atresia. STUDY DESIGN: Register study using Swedish national health databases. The study population consisted of 1,204,791 children, corresponding to 99% of the entire cohort of Swedish children born between 1987 and 1997, with an end point of follow-up at 2 years of age. Cases with biliary atresia with and without major heart malformations were identified with indicators from various national health databases. RESULTS: Eighty-five cases with biliary atresia were identified, the incidence being 1 in 14,000. A major heart malformation was found in 13 (15%) cases. In a multivariate analysis, 4 independent risk factors were identified: high maternal age (odds ratio [OR] = 3.0), parity of at least 4 (OR = 2.2), prematurity (OR = 2.9), and low birth weight for gestational age (OR = 4.7). No significant differences were found in the distribution of birth months. The outcome did not differ between the two groups with and without major heart malformations, nor with respect to any of the risk factors. CONCLUSIONS: The Swedish incidence of biliary atresia is similar to that found in other European countries. The identified risk factors may suggest the existence of a maternal vulnerability and the importance of viral infections transmitted from mother to fetus/neonate.

Adolescent↗

PubMed2002

Reintervention after laparoscopic and open cholecystectomy in Sweden 1987-1995: analysis of data from a hospital discharge register.

OBJECTIVE: To find out the incidence of cholecystectomy and of reintervention after cholecystectomy in Sweden 1987 to 1995, and to compare mortality and reintervention after simple laparoscopic and conventional open cholecystectomy (without exploration of the common bile duct or simultaneous operation). DESIGN: Analysis of data from Swedish national registers. SETTING: Two hospitals and government department, Sweden. MAIN OUTCOME MEASURES: Mortality and reintervention during readmission within one year after cholecystectomy classified as: reoperation on bile duct, endoscopic or percutaneous reintervention, or reoperation for wound complication, bleeding, or unspecified cause. RESULTS: Incidence of cholecystectomy rose between 1987-89 and 1993-95 from 0.97 to 1.04 for men and from 1.70 to 2.05 operations/1000 inhabitants for women. Reoperation on the bile ducts declined from 1987 to 1991 but returned to previous levels thereafter. Endoscopic reinterventions increased tenfold from 1987 to 1995, whereas those for general complications and mortality did not change significantly. Among simple cholecystectomies laparoscopic surgery was associated with an increased risk of endoscopic reintervention, odds ratio 1.8 (95% CI 1.2 to 2.6), and with a lower risk for postoperative mortality, odds ratio 0.5 (95% CI 0.3 to 0.8). CONCLUSIONS: Incidence, mortality, and readmission with reintervention are important endpoints in gallbladder surgery. Significant changes in these variables were identified after the introduction of laparoscopic cholecystectomy.

Adolescent↗

PubMed2002

Mortality, severe morbidity and injury among long-term lone mothers in Sweden.

BACKGROUND: Being a lone mother often implies disadvantage in terms of both socioeconomic circumstances and health. Our aim was to examine differences in mortality, severe morbidity and injury between lone mothers and mothers living with partners, on the assumption that the disadvantaged socioeconomic circumstances contribute to poor health. METHODS: The odds for receipt of hospital care or death between 1991 and 1994 were estimated for 26 619 lone mothers and 379 855 partnered mothers from data collected for the Swedish Population and Housing Census of 1990. We computed odds ratios by means of logistic regression, adjusting for confounders, mediators, and factors with an indeterminate position in various models. To control for health-selection effects, we only considered initially healthy women, as measured by non-hospitalization 4 years prior to follow-up. To reduce the impact of distress following divorce on health, we only included mothers who had been either lone or partnered for a period of > or =5 years. RESULTS: Lone mothers showed increased risks of total mortality, lung cancer, suicide/ suicide attempt, inflicted violence, traffic injury and other accident, psychiatric disease, and addiction. The main explanation for increased risks seems for most outcomes to lie in deficient household resources, as indicated here by receipt of social-welfare benefit and housing situation. For all the initially elevated outcomes, except for total mortality, significant risk increases remained unaccounted for even in the full model. Relationships varied according to subgroup. Lone motherhood was not related to accident, suicide and addiction among medium- and high-grade non-manual workers. Although lone mothers in general showed no increased risk of ischaemic heart disease, those receiving social benefit were exposed to a significantly increased risk. CONCLUSIONS: Our findings suggest that lone motherhood entails health disadvantages. Lack of household resources seems to play a major role in accounting for increased risks, but the risks are partly independent of socioeconomic circumstances, selection factors, and distress following divorce.

Adult↗