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Jayakrishnan R.,Regional Cancer Center | Mathew A.,Regional Cancer Center | Uutela A.,National Institute for Health and Welfare THL
Asian Pacific Journal of Cancer Prevention | Year: 2011

Objectives: An attempt was made to compare tobacco prevalence and socioeconomic factors of two groups (intervention and control) from a selected rural community in Thiruvananthapuram, Kerala, India. Methods: Data were collected from resident males in the age group of 18.0 to 60.0 years from 4 randomly allocated Community Development Blocks of rural Thiruvananthapuram district (2 intervention & control groups).Trained Accredited Social Health Activists workers were utilised to collect data from both the groups through a face to face interview. Results: Among 3304 subjects were interviewed, the overall prevalence of smokers was 28% (n=928) (mean age=44.4 years, SD=9.2 years). Socio-economic status (SES) score points indicated that majority of smokers belonged to the upper lower SES category (61%) (mean SES score =10, SD= 3) and among non-smokers, the participants mainly belonged to the lower middle SES score (45%) (mean SES score =12, SD= 3) (p-value=0.0001). Among the 928 smokers, 474 subjects were in the intervention area (mean age =44.56 years, SD =9.66 years) and 454 in the control area (mean age= 44.47 years, SD =10.30 years). No significant difference was found between the intervention and control groups according to age (p=0.89) and SES (p=0.11). Majority of smokers in the intervention and control areas were from the upper lower SES group (64.14% and 57.17%). Conclusion: Smoking continues to be a predominant public health problem among males in rural Kerala particularly among lower socio-economic population. Apart from strengthening legislation, multiple cost effective intervention approaches are required to reduce tobacco consumption in the community. Source

Lamminpaa R.,University of Eastern Finland | Vehvilainen-Julkunen K.,Kuopio University Hospital | Gissler M.,National Institute for Health and Welfare THL | Gissler M.,Nordic School of Public Health | Heinonen S.,Kuopio University Hospital
BMC Pregnancy and Childbirth | Year: 2012

Background: Preeclampsia is a frequent syndrome and its cause has been linked to multiple factors, making prevention of the syndrome a continuous challenge. One of the suggested risk factors for preeclampsia is advanced maternal age. In the Western countries, maternal age at first delivery has been steadily increasing, yet few studies have examined women of advanced maternal age with preeclampsia. The purpose of this registry-based study was to compare the obstetric outcomes in primiparous and preeclamptic women younger and older than 35 years.Methods: The registry-based study used data from three Finnish health registries: Finnish Medical Birth Register, Finnish Hospital Discharge Register and Register of Congenital Malformations. The sample contained women under 35 years of age (N = 15,437) compared with those 35 and over (N = 2,387) who were diagnosed with preeclampsia and had their first singleton birth in Finland between 1997 and 2008. In multivariate modeling, the main outcome measures were Preterm delivery (before 34 and 37 weeks), low Apgar score (5 min.), small-for-gestational-age, fetal death, asphyxia, Cesarean delivery, induction, blood transfusion and admission to a Neonatal Intensive Care Unit.Results: Women of advanced maternal age (AMA) exhibited more preeclampsia (9.4%) than younger women (6.4%). They had more prior terminations (<0.001), were more likely to have a body mass index (BMI) >25 (<0.001), had more in vitro fertilization (IVF) (<0.001) and other fertility treatments (<0.001) and a higher incidence of maternal diabetes (<0.001) and chronic hypertension (<0.001). Multivariate logistic regression indicated that women of AMA had higher rates of: preterm delivery before 37 weeks 19.2% (OR 1.39 CI 1.24 to 1.56) and before 34 weeks 8.7% (OR 1.68 CI 1.43 to 2.00) low Apgar scores at 5 min. 7.1% (OR 1.37 CI 1.00 to 1.88), Small-for-Gestational Age (SGA) 26.5% (OR 1.42 CI 1.28 to 1.57), Asphyxia 12.1% (OR 1.54 CI 1.34 to 1.77), Caesarean delivery 50% (OR 2.02 CI 1.84 to 2.20) and admission to a Neonatal Intensive Care Unit (NICU) 31.6% (OR 1.45 CI 1.32 to 1.60).Conclusions: Preeclampsia is more common in women with advanced maternal age. Advanced maternal age is an independent risk factor for adverse outcomes in first-time mothers with preeclampsia. © 2012 Lamminpää et al.; licensee BioMed Central Ltd. Source

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