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Biomedical subjects

J S Kendrick

Publications and source records attributed to J S Kendrick.

At least 37 records · Page 2Linked to original sources
PubMed1996

Previous cesarean delivery and the risk of ectopic pregnancy.

OBJECTIVE: To determine whether previous cesarean delivery is an independent risk factor for ectopic pregnancy. METHODS: We analyzed data collected between October 1988 and August 1990 from a case-control study of ectopic pregnancy among parous, black, non-Hispanic women, 18-44 years old, at a major metropolitan hospital in Georgia. Cases were 138 women with confirmed ectopic pregnancy; controls were 842 women either seeking abortion or delivering an infant. Unconditional logistic regression was used to estimate the relative risk while controlling for the effects of potential confounders selected a priori. RESULTS: Adjusted for age, parity, marital status, history of pelvic inflammatory disease, infertility, douching, and smoking, the odds ratio was 0.6 (95% confidence interval 0.4-1.1), indicating no significant association. CONCLUSION: We found no evidence of an increased risk of ectopic pregnancy related to previous cesarean delivery.

Adolescent↗
PubMed1996

Women and smoking: an update for the 1990s.

Cigarette smoking is associated with many health hazards, ranging from lung cancer to low infant birth weight. In the United States in 1994, 23.1% of all women and 14.6% of pregnant women smoked. Few physicians ask their patients about smoking, although minimal effort by physicians could help many smokers to quit. This article summarizes the current data on smoking prevalence, reviews quitting techniques, covers topics of particular interest to physicians caring for women, and suggests ways in which physicians may become more active in preventing smoking among teens.

Adolescent↗
PubMed1995

Integrating smoking cessation into routine public prenatal care: the Smoking Cessation in Pregnancy project.

OBJECTIVES: In 1986, the state health departments of Colorado, Maryland, and Missouri conducted a federally-funded demonstration project to increase smoking cessation among pregnant women receiving prenatal care and services from the Women, Infants, and Children (WIC) program in public clinics. METHODS: Low-intensity interventions were designed to be integrated into routine prenatal care. Clinics were randomly assigned to intervention or control status; pregnant smokers filled out questionnaires and gave urine specimens at enrollment, in the eighth month of pregnancy, and postpartum. Urine cotinine concentrations were determined at CDC by enzyme-linked immunosorbent assay and were used to verify self-reported smoking status. RESULTS: At the eighth month of pregnancy, self-reported quitting was higher for intervention clinics than control clinics in all three states. However, the cotinine-verified quit rates were not significantly different. CONCLUSIONS: Biochemical verification of self-reported quitting is essential to the evaluation of smoking cessation interventions. Achieving changes in smoking behavior in pregnant women with low-intensity interventions is difficult.

Adult↗
PubMed1994

A prospective study of childbearing and 10-year weight gain in US white women 25 to 45 years of age.

Although birth rates to US women aged 25 and older have increased markedly over the last two decades, accurate estimates of the long-term weight gain associated with childbearing are not available for older mothers in the general population. We examined the effect of childbearing on weight change in 2547 white women aged 25-45 years who were initially weighed in the First National Health and Nutrition Examination Survey (1971-75) and who were reweighed an average of 10 years later. Linear and logistic regression estimates were adjusted for duration of follow-up, age, body mass index, initial parity, education, smoking, drinking, employment status, marital status, illness, physical activity, and dieting to lose weight. Compared to parous women who did not give birth during the study period, the mean excess weight gain was 1.6 kg (95% Confidence Limits, +/- 2.3 kg) for nulliparous women, and was 1.7 kg (+/- 1.1 kg), 1.7 kg (+/- 2.0 kg), and 2.2 kg (+/- 4.3 kg), for women having one, two and three live births, respectively. Among women who were nulliparous at baseline, those that had their live births during the study period gained similar amounts of weight to that of women who began childbearing before the beginning of the study. The risk of gaining more than 13 kg was increased by 40%-60%, and the risk of becoming overweight was increased by 60%-110% in women having live births during the study. We conclude that the average weight gain associated with childbearing after the age of 25 is quite modest in US white women. However, for some women who give birth after the age of 25 the risks of major weight gain and becoming overweight are increased in association wtih childbearing.

Adult↗
PubMed1993

Pregnancy planning and pre-conception counseling. The PRAMS Working Group.

OBJECTIVE: To estimate the percentage of women with one or more of four potentially modifiable risks who could have availed themselves of pre-conception counseling. METHODS: We defined pre-conception counseling to be consultation that occurs shortly before a couple attempts conception. Thus, we assumed that to obtain pre-conception counseling, a woman must plan her pregnancy. We used data from a population-based survey of 12,452 new mothers in four states who delivered babies during 1988-1990. Mothers were contacted 3-6 months after delivery and asked about pre-conception behaviors and the planning status of their pregnancies. We estimated the percentage of women who planned their pregnancies and had an indication for pre-conception counseling related to smoking, drinking, being underweight, or delaying initiation of prenatal care. RESULTS: State-specific response rates ranged from 68-84%. Sixty percent of mothers reported that their pregnancies were planned. In general, mothers with unintended pregnancies were more likely to have an indication for pre-conception counseling than mothers with planned pregnancies. Thirty-eight percent of all mothers planned their pregnancies and had one or more indications for pre-conception counseling. An additional 30% had one or more indications for counseling but did not have a planned pregnancy. CONCLUSIONS: Despite the limited range of indications for counseling that we considered, a substantial percentage of women potentially could have used counseling. A similar percentage of women could have benefited from family planning services.

Adult↗
PubMed1992

Hospitalization for pregnancy complications, United States, 1986 and 1987.

OBJECTIVE: The purpose of our analysis was to provide a national overview of the magnitude of the public health burden associated with inpatient care for pregnancy complications. STUDY DESIGN: We analyzed data from the National Hospital Discharge Survey for 1986 and 1987. We calculated ratios of hospitalizations for pregnancy complications for every 100 hospitalizations involving a birth. Standard errors for these ratios were calculated with RATIOEST, and relative ratios with 95% confidence intervals were calculated for subgroups of interest. RESULTS: We found that for every 100 hospitalizations involving a birth, there were 22.2 nondelivery hospitalizations for pregnancy complications (14.6 antenatal complications, 7.6 pregnancy loss complications). These ratios were higher for black than for white women (relative ratio 1.4, 95% confidence interval 1.2 to 1.6). The effects of marital status, age, and insurance coverage differed between black and white women, and mean length of stay was longer for black than for white women. CONCLUSION: Hospitalization for pregnancy complications is far more common than is widely appreciated and is more frequent among black than white women.

Adolescent↗
PubMed1992

Trends in obstetric operative procedures, 1980 to 1987.

OBJECTIVES: Increasing rates of cesarean deliveries have received widespread attention in recent years, as concern in the United States about unnecessary surgical procedures has increased. However, little information has been published on the national trends of other operative obstetric procedures occurring during deliveries. METHODS: We analyzed data from the National Hospital Discharge Survey to examine trends in the use of forceps, vacuum extraction, and cesarean section from 1980 through 1987. RESULTS: The rate of cesarean sections increased by 48%, while the rate of forceps procedures declined by 43%. Although the risk of cesarean section was significantly increased for older women, the risk of forceps and vacuum extraction procedures did not vary by age. Women with private insurance were significantly more likely to receive a cesarean section (rate ratio [RR] = 1.2), forceps procedure (RR = 1.7), and vacuum extraction procedure (RR = 1.8) than were women without private insurance. CONCLUSIONS: As pressure mounts to decrease the national cesarean section rate from 24% to 15% by the year 2000, attention should also be given to surveillance of other operative delivery procedures.

Adolescent↗
PubMed1992

Smoking, pregnancy, and source of prenatal care: results from the Pregnancy Risk Assessment Monitoring System. The Pregnancy Risk Assessment Monitoring System Working Group.

OBJECTIVE: To assess the impact of current smoking intervention efforts and to target future efforts by describing the relationships between maternal smoking, smoking cessation, and source of prenatal care. METHODS: We used population-based data from 6319 mothers who delivered live-born infants during 1988 and 1989 in Maine, Michigan, Oklahoma, and West Virginia. The number of women sampled per state ranged from 1490-2659; state-specific response rates ranged from 66-84%. Analysis weights adjusted for selection probability and non-response. RESULTS: The prevalences of maternal smoking before, during, and after pregnancy among women receiving publicly funded prenatal care were 2.3-3.4 times the comparable prevalences among privately insured women receiving prenatal care from private providers. Although many smokers reduced or quit smoking during pregnancy, most resumed or increased their smoking to nearly pre-pregnancy levels by 3-6 months postpartum. CONCLUSIONS: Interventions should target the very high levels of smoking among the 27% of women receiving publicly funded prenatal care. However, from a population perspective, the greatest potential for reduction in smoking is among patients of private providers, who care for 61% of pre-pregnancy smokers.

Female↗
PubMed1991

Trends in alcohol consumption by pregnant women. 1985 through 1988.

To examine trends in alcohol consumption among pregnant women, we examined data collected from 21 states participating in the Behavioral Risk Factor Surveillance System for 4 consecutive years: 1985 through 1988. Overall, 429 (25%) of 1712 pregnant women and 19,903 (55%) of 36,057 nonpregnant women 18 to 45 years of age reported using alcohol in the previous month. Pregnant women who used any alcohol reported consuming a median of four drinks per month, whereas nonpregnant women who used any alcohol reported nine. The prevalence of alcohol consumption among pregnant women declined steadily, from 32% in 1985 to 20% in 1988, but the median number of drinks per month for pregnant women who drank did not change. No decline was observed among the less educated or those under the age of 25 years. In 1988, the prevalence of alcohol use among pregnant women remained highest among smokers (37%) and the unmarried (28%). Although the overall consumption of alcohol by pregnant women in the United States appears to be declining, special efforts are needed to reduce alcohol use among pregnant women who are smokers, unmarried, less educated, or younger, women who may already be at high risk of a poor pregnancy outcome.

Adolescent↗
PubMed1991

Smoking during pregnancy: prevalence, effects, and intervention strategies.

Smoking prevalence rates have been declining in the United States, but an estimated 25 percent of pregnant women continue to smoke. Smoking during pregnancy is considered one of the leading, preventable causes of low birthweight. Research attributes 21 to 39 percent of low birthweight to smoking during pregnancy, although the exact mechanism of the effect is not completely understood. Several well-designed studies have shown that pregnant smokers are more likely to stop smoking if they are provided with systematic interventions. This overview describes adverse consequences, prevalence, possible mechanisms of action, and prenatal smoking-cessation programs that have proved effective. A five-step approach is outlined for clinicians who want to counsel their prenatal clients.

Counseling↗
PubMed1990

Smoking before, during, and after pregnancy.

We report the first national data on smoking before, during, and after pregnancy. Estimates are based on the 1986 Linked Telephone Survey that reinterviewed 1,550 White women 20-44 years of age who were respondents to the 1985 National Health Interview Survey. An estimated 39 percent of White women who had smoked before pregnancy quit smoking while pregnant (27 percent when they found out they were pregnant and 12 percent later during pregnancy). Women with less than 12 years of education were five times as likely to smoke and one-fourth as likely to quit as those with 16 or more years of education. Women who smoked more than one pack of cigarettes per day before pregnancy were one-fifth as likely to quit as those smoking less. Of the women who quit, 70 percent resumed smoking within one year of delivery. Of those who relapsed, 67 percent resumed smoking within three months of delivery and 93 percent within six months. There is little evidence of educational differentials in relapse rates. The fact that relapse remains high suggests that while health of the fetus is a strong influence on women's smoking habits, women may be less aware of the effect of passive smoke on the infant.

Adult↗
PubMed1989

The box plot: a simple visual method to interpret data.

Exploratory data analysis involves the use of statistical techniques to identify patterns that may be hidden in a group of numbers. One of these techniques is the "box plot," which is used to visually summarize and compare groups of data. The box plot uses the median, the approximate quartiles, and the lowest and highest data points to convey the level, spread, and symmetry of a distribution of data values. It can also be easily refined to identify outlier data values and can be easily constructed by hand. We apply box plots to tabular data from two recently published articles to show how readers can use box plots to improve the interpretation of data in complex tables. The box plot, like other visual methods, is more than a substitute for a table: It is a tool that can improve our reasoning about quantitative information. We recommend that the box plot be used more frequently.

Alcohol Drinking↗
PubMed1989

Comparing the prevalence of smoking in pregnant and nonpregnant women, 1985 to 1986.

The 1990 health objectives for the nation state that pregnant women should be only half as likely to smoke as nonpregnant women. To assess progress toward meeting this objective, we used cross-sectional data from the 26 states in the Behavioral Risk Factor Surveillance System in 1985 and 1986. We compared the prevalence of self-reported smoking among pregnant (N = 836) and nonpregnant (N = 18,025) women aged 18 to 45 years. Overall, pregnant women were 70% as likely to be current smokers as nonpregnant women (prevalence ratio, 0.7; 95% confidence interval, 0.6 to 0.8), while blacks showed the largest pregnancy-associated reduction in the prevalence of smoking (prevalence ratio, 0.5; 95% confidence interval, 0.3 to 0.9). Most of the difference in smoking prevalence occurred not because pregnant women were less likely to have ever smoked, but because pregnant women were more likely to have quit smoking than nonpregnant women. However, unmarried pregnant white women were 40% more likely to smoke than their nonpregnant counterparts (prevalence ratio, 1.4; 95% confidence interval, 1.1 to 1.7). We conclude from this analysis that the 1990 health objective for smoking among pregnant women is unlikely to be achieved. Clinicians providing care to pregnant women need to pay increased attention to smoking cessation.

Adolescent↗
PubMed1989

The Surgeon General's warnings in outdoor cigarette advertising. Are they readable?

Outdoor advertising media represent a major vehicle by which cigarette companies promote their products. We investigated the readability of the Surgeon General's warning in cigarette advertisements (ads) in two outdoor media: billboards and taxicab ads. In an experiment in metropolitan Atlanta under typical driving conditions, observers were able to read the entire health warning on 18 (46%) of 39 street billboards but on only two (5%) of 39 highway billboards. In contrast, the content of the ads (ie, brand name, other wording, and notable imagery) could be recognized under the same conditions on more than 95% of the billboards. In a similar study of 100 taxicab cigarette ads in New York City, observers were unable to read the health warning in any of the ads but were able to identify the brand name in all ads and notable imagery in 95% of the ads. Significant differences between the readability of the warning and identification of the advertising content persisted even when partially read warnings were considered to have been read. We conclude that the Surgeon General's warning is not readable in its current form in the vast majority of billboard and taxicab ads. Factors contributing to unreadability include the small size of the letters, the excessive length of the warnings, the distance between the viewers and the ads, and movement between the viewers and the ads.

Advertising↗
PubMed1989

Predicting lower-extremity injuries among habitual runners.

This prospective study of 583 habitual runners used baseline information to examine the relationship of several suspected risk factors to the occurrence of running-related injuries of the lower extremities that were severe enough to affect running habits, cause a visit to a health professional, or require use of medication. During the 12-month follow-up period, 252 men (52%) and 48 women (49%) reported at least one such injury. The multiple logistic regression results identified that running 64.0 km (40 miles) or more per week was the most important predictor of injury for men during the follow-up period (odds ratio = 2.9). Risk also was associated with having had a previous injury in the past year (odds ratio = 2.7) and with having been a runner for less than 3 years (odds ratio = 2.2). These results suggest that the incidence of lower-extremity injuries is high for habitual runners, and that for those new to running or those who have been previously injured, reducing weekly distance is a reasonable preventive behavior.

Adolescent↗
PubMed1988

Smoking by blacks and whites: socioeconomic and demographic differences.

Using data from the 1985 National Health Interview Survey for persons aged 25-64 years, we controlled simultaneously for socioeconomic status (SES), demographic factors, and race in multivariate logistic regression analyses. We found that the odds of ever smoking are not higher for Blacks compared with Whites, when the other variables are controlled. By contrast, the odds of heavy smoking for Blacks are far less than for Whites, while Blacks are significantly less likely than Whites to quit smoking regardless of SES or demographic factors. Smoking cessation and prevention programs must be planned with these behavioral, SES, and demographic differences in mind.

Adult↗
PubMed1987

The relative impact of smoking and oral contraceptive use on women in the United States.

Women who smoke and use oral contraceptives (OCs) are at increased risk for cardiovascular and cerebrovascular disease. To study the prevalence of smoking and OC use and other behaviors affecting health, 28 states and the District of Columbia conducted telephone surveys during 1981 through 1983. More than 22,000 US adults were interviewed, of whom 5779 women aged 18 to 44 years were studied. Data were weighted to represent the US population. Overall, 7.4% of US women aged 18 to 44 years reported smoking and using OCs; 1.1% reported smoking 25 or more cigarettes per day while using OCs. Although women aged 18 to 24 years were most likely to smoke and use OCs, combined smoking and OC use contributed substantially to the number of excess cases of myocardial infarctions occurring among US women aged 35 to 44 years. However, regardless of OC use, smoking accounted for most of the excess cases. Therefore, health care providers need to intensify their efforts to reduce smoking among their patients.

Adult↗