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Biomedical subjects

A P Lange

Publications and source records attributed to A P Lange.

At least 19 recordsLinked to original sources
PubMed1999

[Pregnancy and drug abuse].

The antenatal care of pregnant women with drug abuse is very complex and costly both in money and in time. The women often live under different circumstances than non-abusing women, and their personal and social resources are often very small. Collaboration between the hospital and the social system is essential in order to obtain a positive outcome of the pregnancy. Retrospective records of pregnancy, outcome and follow-up on 18 morphine-abusing women referred for delivery at Glostrup hospital in Copenhagen county over the three year period 1992-1994 are reported here. The study show the children are born in relatively good condition, although almost all needed postnatal detoxification, since their mothers was not able to stop their drug abuse during pregnancy. The pregnancy was with few complications because of tight antenatal care for these women. The study also shows a need for defining a common goal for the care of these women and their children and binding political commitments in order to obtain this goal.

Adult↗
PubMed1998

Folate and neural tube defects. Recommendations from a Danish working group.

A working group was established to evaluate the need for an increased folate intake in Danish women to decrease the risk of neural tube defects (NTDs). NTD are birth defects which include anencephaly, encephalocele and spina bifida. In Denmark the incidence is about 1.4 per 1,000 pregnancies. Folate is a B-vitamin found in most food groups. In case-control studies and randomised studies, a protective effect of folic acid supplements on NTDs has been found. The studies show that a periconceptional folic acid supplement of 360 micrograms to 4 mg daily decreases the recurrence rate of NTDs. Likewise, in the few studies which calculate folate intake from the diet, a lower risk of NTD with higher intake of folate from the diet has been found. The folate intake can be increased by the diet, by folic acid supplements or by fortification of food with folic acid. It is concluded that the incidence of NTDs in Denmark will decrease if the folate intake in fertile women increases. All women planning pregnancy should receive dietary counselling. Women who do not eat according to the Nordic Nutrition Recommendations, and women with an increased risk due to diseases are recommended a supplement of 400 micrograms folic acid daily from a multivitamin/folic acid tablet. Women who have had a child with NTD and women who themselves have NTDs are recommended a supplement of 5 mg folic acid daily. Dietary changes and supplements should be initiated when pregnancy is planned.

Adolescent↗
PubMed1997

[Hysterectomy in a Danish population. Weight-related factors, psychological factors and life style variables].

The aim was to assess risk factors for hysterectomy performed for benign conditions. In a prevalence study, 2301 Danish women were selected at random in 1982. Information about weight and slimming history, life-styles, psychological factors, gynaecological history, and social background were obtained. In an incidence study, the cohort was followed from 1982 to 1990 to assess the incidence of hysterectomy. In the prevalence study, weight cycling (recurrent weight loss and weight gain of more than 5 kg) was associated with hysterectomy for benign disease (adjusted odds ratio 1.77, 95% confidence interval 1.05-2.99) independently of overweight, smoking, oral contraceptives, psychological and social factors. In the incidence study, weight cycling was the only significant weight-related risk factor for hysterectomy performed for benign disease (adjusted relative risk 2.49, 95% confidence interval 1.10-5.60), explaining the relation between hysterectomy and psychological factors. Weight cycling might be an important risk factor for premenopausal hysterectomy performed for benign conditions.

Adult↗
PubMed1997

Gynaecological correlates of hysterectomy in Danish women.

BACKGROUND: The aim has been to assess the gynaecological characteristics of importance for hysterectomy performed for benign diseases. METHODS: In a prevalence study, 2301 Danish women aged 30, 40, 50, or 60 years, were selected at random in 1982, and self-report questionnaires were collected from 77%. Information about gynaecological and obstetric history, social background, weight and dieting history, and various lifestyles were recorded. Weight and height were measured. In an incidence study, the cohort was followed during 1982-1990 via central registers to assess the incidence of hysterectomy. Logistic and Cox regression were used to analyse data. RESULTS: In the prevalence study, 85% of the hysterectomies were performed for benign conditions. Early menarche (< or = 11 years old) and short-term use of oral contraceptives (OC) (1-4 years) were independent correlates of these hysterectomies by multivariate analyses, whereas multiparity (> or = 4 childbirths) was confounded by education and weight-related factors. Long-term use of OC was associated with lower prevalence of hysterectomy. In the incidence study, short-term use of OC and ever use of progestogen-only minipills were independent risk factors for hysterectomy performed recently for benign diseases in women under 50 in the multivariate analyses. Abortions did not reach significance, and neither multiparity, long-term use of OC, nor early menarche were important. CONCLUSION: The most important gynaecological characteristics related to premenopausal hysterectomy performed for benign diseases are hormonal contraceptives. These findings imply that the decision-making process concerning hysterectomy might depend on women's choice of contraception and compliance with OC as medical treatment.

Adult↗
PubMed1996

Hysterectomy in Danish women: weight-related factors, psychologic factors, and life-style variables.

OBJECTIVE: To assess weight-related risk factors, psychologic factors, and life-styles of importance for hysterectomy performed for benign conditions. METHODS: In a prevalence study, 2301 Danish women aged 30, 40, 50, or 60 years were selected at random in 1982, and self-report questionnaires were collected from 77%. Information about weight and dieting history, life-style, psychologic factors, gynecologic history, and social background were recorded. Weight, height, and plasma lipids were measured. In an incidence study, the cohort was followed during 1982-1990 via central registers to assess the incidence of hysterectomy. Logistic and Cox regression were used to analyze the data. RESULTS: In the prevalence study, weight cycling (recurrent weight loss and weight gain of more than 5 kg) was associated with hysterectomy for benign disease (odds ratio 1.77, 95% confidence interval [CI]1.05-2.99) by multivariate analysis independent of overweight, smoking, psychologic factors, social factors, and gynecologic characteristics. In the incidence study, all the weight-related factors except slimming diets were significant risk factors for hysterectomy performed recently for benign disease in women under age 50. In the multivariate analysis, weight cycling was the only significant weight-related factor (relative risk 2.49, 95% CI 1.10-5.60), explaining the relation between hysterectomy and psychologic factors. Coffee, tea, alcohol, smoking, and plasma lipids were not related to hysterectomy in either study. CONCLUSION: Weight cycling might be an important risk factor for premenopausal hysterectomy performed for benign conditions. Whether weight cycling causes menstrual irregularities and leiomyomas, these results give us a better understanding of the pathways to hysterectomy.

Adult↗
PubMed1995

[Home births].

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Denmark↗
PubMed1993

[Do pregnant women need supplementation of folic acid?].

Neutral tube defects (NTDs) occur at an incidence of about 0.01 per cent, and in Denmark 40-50 new cases are recorded annually. Although the metabolism of folic acid increases during pregnancy, the dietary supply is marginal. Finding in recent studies suggest that folic acid supplementation as prophylactic treatment of gravidae reduces the incidence of NTDs. Folic acid prophylaxis is already being recommended as a general policy, with treatment starting before conception.

Female↗
PubMed1992

[Cesarean section].

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Cesarean Section↗
PubMed1991

[The validity of the perinatal classification by the Health Department].

On the basis of 273 perinatal and neonatal deaths in three Danish counties in 1985 and 1986, the validity of the abbreviated classification of perinatal deaths by the National Board of Health which comprises six categories was assessed. The classification is relatively robust regarding incorrect classification of International Classification of Diseases (ICD) as 87% of the deaths were classified in the relevant categories. This may be because the classification is relatively rough but also because the classification, as regards ICD diagnoses, is based on information from the register of births.

Cause of Death↗
PubMed1991

[The quality of registration of causes of death in perinatal and neonatal deaths].

The quality of registration of the causes of death in 273 perinatal and neonatal deaths was assessed. The present authors classified the causes of death according to WHO classification of disease. The authors classification was compared with the Danish Health Department's original classification of deaths and a classification undertaken by one of the staff of the Danish Health Department, the coding of which was based exclusively on information from the original death certificates (death certificate classification). Agreement between the respective forms of classification was assessed by the observed agreement for positive diagnosis and the kappa coefficients calculated by the three-figure level in the ICD diagnosis for categories and between categories of causes of perinatal and neonatal death, respectively. The investigation revealed that the deaths were classified with great accuracy by coding by the staff member when the death certificates were correctly completed. Comparison between the "authors classification" and the "Danish Health Department's original classification" and the "death certificate classification", respectively revealed that the observed agreement for positive diagnoses were 52% and 50% and that the kappa coefficients were between 0.80-0.07 and 0.81-0.04, respectively, on comparison with the three-figure levels in the ICD diagnoses and 0.93-0.32 and 0.85 and 0.32 on comparing the categories in between. It is concluded that considerable improvement in registration of perinatal and neonatal deaths may be obtained if the Danish Health Departments states precisely what information is required on the death certificate in connection with perinatal and neonatal deaths. Correspondingly, local efforts should be made to complete death certificates more correctly.

Cause of Death↗
PubMed1991

[Classification of perinatal and neonatal deaths. Fetal, obstetrical and neonatal causes].

A new method of classification of causes of death which may be employed in connection with perinatal and neonatal deaths is presented. The classification of causes of death proposed by the authors identifies the factor which probably initiated the train of events leading to death. This classification includes nine main categories and illustrates foetal conditions, happenings in pregnancy, the course of delivery and also the neonatal period. Employment of classification is proposed in regional registration of perinatal and neonatal deaths and as an aid in the current assessment of the quality of antenatal, obstetric and neonatal care as these are employed in medical audits of the perinatal and neonatal deaths in many Danish counties.

Cause of Death↗