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Biomedical subjects

N J Secher

Publications and source records attributed to N J Secher.

At least 37 records · Page 2Linked to original sources
PubMed1999

Urinary incontinence: prevalence and risk factors at 16 weeks of gestation.

OBJECTIVE: To evaluate the prevalence of urinary incontinence at 16 weeks of gestation and to identify possible maternal and obstetric risk factors. DESIGN: Cross-sectional study and cohort study. SETTING: Department of Obstetrics and Gynaecology, Aarhus University Hospital, Denmark. POPULATION: Cross-sectional study: 7795 women attending antenatal care. Cohort study: a sub-group of 1781 pregnant women with one previous delivery at our department. RESULTS: Prevalence and maternal risk factors: the prevalence of urinary incontinence within the preceding year was 8.9% among women at 16 weeks of gestation (nulliparae, 3.9%, para 1, 13.8%, para 2+, 16.2%). Stress or mixed incontinence occurred at least weekly in 3% of all the women. After adjusting for age, parity, body mass index, smoking, previous abortions, and previous lower abdominal or urological surgery in a logistic regression model, primiparous women who had delivered vaginally had higher risk of stress or mixed urinary incontinence than nulliparous women (OR 5.7; 95% CI 3.9-8.3). Subsequent vaginal deliveries did not increase the risk significantly. Young age, body mass index > 30, and smoking were possible risk factors for developing urinary incontinence. Obstetric factors: weight of the newborn > 4000 g (OR 1.9; 95% CI 1.0-3.6) increased the risk of urinary incontinence; mediolateral episiotomy in combination with birthweight > 4000 g also increased the risk (OR 3.5; 95% CI 1.2-10.2); a number of other intrapartum factors did not increase the risk of urinary incontinence. CONCLUSIONS: The first vaginal delivery was a major risk factor for developing urinary incontinence; subsequent vaginal deliveries did not increase the risk significantly. Birthweight > 4000 g increased the risk; episiotomy in combination with birthweight > 4000 g also increased the risk.

Adolescent↗
PubMed1998

[Smoking during pregnancy and preterm delivery].

The purpose of the study was to evaluate the association between smoking during pregnancy and preterm birth. The overall rate of preterm delivery was 4.3%. Smokers had a 40% higher risk of preterm birth compared to non-smokers. A dose response relationship was found between smoking and risk of preterm birth. Adjustment for women's height, pre-pregnant weight, age of the mother, marital status, education, occupational status, and alcohol intake did not change the results. Among women with an intake of less than 400 mg of caffeine per day no difference in the risk of preterm birth between smokers and non-smokers was found. However, among women with an intake of more than 400 mg of caffeine per day, the risk of preterm birth was increased almost threefold among smokers compared to non-smokers. Furthermore, among women with a high intake of caffeine a dose response relationship was found between smoking and risk of preterm delivery.

Adolescent↗
PubMed1998

Father's effect on infant birth weight.

OBJECTIVE: We sought to determine whether paternal size at birth and during young adulthood influences the birth weight of the offspring. STUDY DESIGN: This historic cohort study followed up girls born in Copenhagen during 1959 to 1961. Their pregnancies in 1974 to 1989 were traced through the Danish Population Register, and the Personal Identification Numbers of the fathers of the children were obtained. Paternal birth weight was obtained from midwifery records and adult stature from military draft records. RESULTS: Compared with fathers who weighed at least 4 kg at birth, fathers who weighed 3 to 3.99 kg at birth had infants who were 109 gm lighter, and fathers who weighed <3 kg had infants who were 176 gm lighter after adjustment for maternal birth weight and adult stature, smoking, and medical and socioeconomic factors. After adjustment, fathers in the lowest quartile of adult body mass index had infants that were 105 gm lighter than those of fathers in the highest quartile. Both paternal birth weight and adult body mass index exhibited significant trends in association with infant birth weight. CONCLUSION: Independently of maternal size, the father's physical stature, particularly his own size at birth, influences the birth weight of his children.

Adult↗
PubMed1998

A prospective intervention study of stopping smoking in pregnancy in a routine antenatal care setting.

OBJECTIVES: To evaluate the effect of specific education of midwives on stopping smoking in pregnant women and to determine the effect of this programme on pregnancy outcome. DESIGN: A prospective intervention study. SETTING: Department of Gynaecology and Obstetrics, Aarhus University Hospital, Denmark. POPULATION AND METHODS: A group of midwives (9 out of 54) was taught the effects of smoking during pregnancy and instructed in various methods of educating women to stop smoking. All pregnant women who attended antenatal care from October 1994 to September 1995 were either in the intervention group (n = 527) or the control group (n = 2629). Pregnant women attending the specifically educated midwives were considered to be the intervention group. They were given individual advice about stopping smoking at the first antenatal visit at about 16 weeks of gestation and a leaflet on smoking and pregnancy. RESULTS: At the first antenatal visit at about 16 weeks of gestation, 22% of the pregnant women smoked. Between the first visit and the routine visit at 30 weeks of gestation 51 (2%) stopped smoking and 56 (2%) started smoking. No differences were found between the intervention group and the control group in the rate of stopping smoking, validated by cotinine measurements. Mean birthweight, mean gestational age and the proportion of preterm birth in the two groups were similar. CONCLUSION: Education of midwives and integration of advice about smoking cessation at a low cost in routine antenatal care failed to affect smoking habits among pregnant women.

Adolescent↗
PubMed1998

Smoking during pregnancy and babbling abilities of the 8-month-old infant.

Animal experiments suggest that the fetal brain is sensitive to nicotine. Although much attention has been given to the relation between cigarette smoking during pregnancy and neurodevelopment in children, this remains controversial. Our study describes the relationship between maternal cigarette smoking during pregnancy and babbling abilities of the 8-month-old infant. In a longitudinal cohort, information was collected at the 16th week of gestation, at delivery and when the infant was about 8 months old. At this age babbling abilities of the infant were evaluated by a health visitor during a home visit. Singleton infants without any disability born at Aarhus University Hospital, Denmark, 1991-92 and still living in the Community of Aarhus at the age of 8 months were eligible (n = 2302). Complete follow-up was obtained for 1871 children (81.3%). A dose-response-like relationship between number of cigarettes smoked per day during pregnancy and babbling abilities was found after controlling for potential confounders. Smoking 10 or more cigarettes per day during pregnancy almost doubled the risk (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.1-3.6) of the infant being a non-babbler at the examination at 8 months. Among children who were breast fed for less than 4 months this risk was even higher (OR = 2.7, CI 1.3-5.8).

Bias↗
PubMed1998

Closure versus non-closure of peritoneum at cesarean section--evaluation of pain. A randomized study.

OBJECTIVE: To evaluate the effects of leaving the parietal peritoneum open at lower segment cesarean section (LSCS) measured by postoperative pain. DESIGN: A randomized, prospective and double-blind study. SETTING: Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark. POPULATION: Forty women referred for an elective cesarean section were assigned to one of two groups: peritoneum open (n=21) or peritoneum closed (n=19). METHODS: Pain was evaluated twice a day from the first to the fifth postoperative day by Visual Analog Scales. MAIN OUTCOME MEASURES: Postoperative pain. Other outcomes include usage of analgesics, bowel function, postoperative complications, and hospital stay. RESULTS: We found no overall difference in postoperative pain. A tendency to less pain was found in the non-closure group from the third postoperative day to the fifth postoperative day. No differences were found either in the incidence of postoperative complications, or the time to return of bowel function. Concerning opiate analgesics the non-closure group had a significantly higher use in the second postoperative 24-hour period, but in the remains of the registration period it was significantly lower. For oral analgesics no difference was found in the first 24-hour period, but in the remains of the period the non-closure group had a significantly lower use. CONCLUSIONS: The VAS-scales showed no difference in postoperative pain comparing closure to non-closure of the parietal peritoneum. However, the use of analgesics is lower in the non-closure group. We suggest leaving the parietal peritoneum open when performing LSCS.

Adult↗
PubMed1998

Smoking habits among Danish pregnant women from 1989 to 1996 in relation to sociodemographic and lifestyle factors.

BACKGROUND: The aim of the study was to describe changes in smoking habits among Danish pregnant women during an eight-year period in relation to changes in sociodemographic and lifestyle factors. METHODS: From 1989 to 1996 all pregnant women attending routine antenatal care at the Department of Gynecology and Obstetrics at Aarhus University Hospital who completed an inclusion questionnaire were invited to participate in the present study (n=27,194). They were asked to complete two additional questionnaires during pregnancy. Apart from smoking habits. these questionnaires provided information on medical and obstetric history together with information on sociodemographic and other lifestyle variables. RESULTS: The proportion of pregnant smokers decreased from 34% (95% CI: 32%/36%) in 1989 to 21% (95% CI: 19%-22%) in 1996 (p<0.001). The mean number of cigarettes per day remained almost constant during the study period. Stratified and multivariate analyses showed that the results were not confounded by changes in sociodemographic and lifestyle factors. CONCLUSIONS: From 1989 to 1996 a significant reduction in the proportion of pregnant smokers was found. There were no specific campaigns against smoking in pregnancy during this period and the reduction was not associated with changes in sociodemographic and lifestyle factors.

Caffeine↗
PubMed1997

Preterm and small-for-gestational-age birth across generations.

OBJECTIVE: Our purpose was to determine whether women who were themselves small for gestational age at birth are at risk of giving birth to a small-for-gestational-age child and whether women who were themselves preterm at birth are at risk for preterm delivery. STUDY DESIGN: Women born in Copenhagen as subjects in the Danish Perinatal Study (1959 to 1961) were traced through the Danish Population Register. Information was obtained on their pregnancies during 1974 through 1989. RESULTS: A total of 25% of the children of small-for-gestational-age women were small for gestational age compared with 11% of the children of non-small-for-gestational-age women. Eleven percent of the children of preterm women were preterm compared with 7% of the children of women born at term. The adjusted odds ratios were 2.0 (95% confidence interval 1.4 to 3.0) for women who were small for gestational age to have small-for-gestational-age children and 1.5 (95% confidence interval 0.9 to 2.5) for women who were born preterm to have preterm children. Small-for-gestational-age women were not at significantly increased risk of preterm delivery (odds ratio 1.2), and preterm women were not at significantly increased risk of having small-for-gestational-age children (odds ratio 1.3). CONCLUSIONS: Reduced intrauterine growth of the mother is a risk factor for reduced intrauterine growth of her children. However, preterm birth of the mother is not strongly associated with preterm birth of her children.

Cohort Effect↗
PubMed1997

Time to pregnancy and preterm delivery.

OBJECTIVE: To test whether subfertile women may be at higher risk of preterm delivery. METHODS: We used data from two population-based cohort studies on risk factors and pregnancy outcome for approximately 20,000 deliveries in three major Danish obstetric departments. The Aalborg-Odense study comprised all pregnant women attending routine antenatal care at two obstetric departments from 1984 to 1987. In all, 11,850 women (86%) filled in a questionnaire at about 36 weeks' gestation. The Aarhus study addressed women at the routine visit near 16 weeks' gestation from 1989 to 1991; a study questionnaire was returned by 6857 (80%). Both studies excluded women with chronic illnesses, multiple fetuses, and inability to speak Danish. Only women with planned pregnancies were included in the analysis. In all, 8855 and 3985 women from Aalborg-Odense and Aarhus, respectively, were eligible for the analyses. In both cohorts, women were categorized according to their waiting time to pregnancy (0-6 months, 7-12 months, and greater than 1 year) and according to examination or treatment for infertility (yes, no). Preterm delivery was defined as birth before 37 completed weeks. RESULTS: Compared with women who tried for 6 months or less before they conceived, women who tried for 7-12 months had 1.3 times (95% confidence interval [CI] 0.8, 2.1) the adjusted risk of preterm delivery in both cohorts, and women with a time to pregnancy of greater than 12 months had adjusted relative risks for preterm delivery of 1.6 (95% CI 1.1, 2.2) for Aalborg-Odense and 1.7 (95% CI 1.1, 2.6) for Aarhus. The results remained similar after excluding women with infertility treatment. CONCLUSIONS: Pregnant women with subfertility and clinically defined infertility are more prone to preterm delivery, even in the absence of infertility treatment.

Adult↗
PubMed1996

[Smoking among pregnant women and the significance of sociodemographic factors on smoking cessation].

In order to describe smoking habits among pregnant women and predictors of smoking cessation all pregnant women attending routine antenatal care from 1989 to 1991 at the Department of Obstetrics, Aarhus University Hospital, were asked to fill in questionnaires. Information about smoking habits from 8806 women revealed that 44% smoked prior to pregnancy. One fifth of the smokers stopped smoking early in pregnancy, leaving 33% women smoking during pregnancy. The strongest predictor of smoking cessation was the number of cigarettes smoked prior to pregnancy, where those that smoked the least were most likely to give up smoking. Caffeine intake, parity, years of education, and partner's smoking habits were also associated with smoking cessation whereas social status, alcohol intake, marital status, and age of the women had no influence on smoking cessation. Thus, a strategy for a smoking cessation campaign among pregnant women could be directed towards women who smoke heavily prior to pregnancy and women with a high daily intake of caffeine.

Adult↗
PubMed1996

Do stressful life events affect duration of gestation and risk of preterm delivery?

The present study was designed to test the relation between stressful life events experienced during pregnancy and the risk of preterm delivery and shortened duration of pregnancy. We collected data prospectively in a general population sample, including repeated questionnaire measures of exposure to stressful life events during pregnancy. Between August 1989 and September 1991, 8,719 Danish-speaking women with singleton pregnancies attended antenatal care. Of these women, 5,873 (67%) completed all questionnaires. When indicating an event, the woman was asked to rate the amount of stress induced by this event. Measurement of gestational duration was primarily based on early ultrasound scan. When we evaluated life events independently of the individual's appraisal, we found no association with duration of gestation or risk of preterm delivery. In contrast, life events assessed by the subject as highly stressful were associated with shorter mean duration of gestation and increased risk of preterm delivery. This association was observed primarily with events experienced between the 16th and 30th week of gestation. Women who had one or more highly stressful life events had a risk of preterm delivery 1.76 times greater than those without stressful events (95% confidence interval = 1.15-2.71). We found no evidence for a buffering effect of social support.

Adult↗
PubMed1996

Effects of fish oil supplementation in late pregnancy on blood pressure: a randomised controlled trial.

OBJECTIVE: To study the effect of fish oil supplementation on blood pressure during the third trimester of pregnancy. DESIGN: In the 30th week of pregnancy 533 healthy women were randomly assigned in a ratio 2:1:1 to receive fish oil (2.7 g/day n-3 fatty acids (Pikasol)), or a control regimen of either olive oil or no oil supplementation. MAIN OUTCOME MEASURES: Blood pressure measured with an automatic device (Dinamap 1846 SX, Criticon) at baseline and in weeks 33, 37, 39 and subsequently weekly until delivery. RESULTS: Mean blood pressure increased during the third trimester, and this was not influenced by group assignment. No significant effects on either systolic or diastolic blood pressure were seen in the fish oil group compared to the control groups. The proportions of women with a systolic blood pressure above 140 mmHg or a diastolic blood pressure above 90 mmHg were not significantly different in the fish oil group compared with the control groups, although the proportion of women with diastolic above 90 mmHg tended to be lower in the fish oil group compared with the olive oil group. The corresponding relative risk was RR = 0.48 (95% CI 0.22-1.06; P = 0.07). CONCLUSION: 2.7 g/day of marine n-3 fatty acids provided in the third trimester of normal pregnancy showed no effect on blood pressure.

Adult↗
PubMed1996

Smoking during pregnancy and preterm birth.

OBJECTIVE: To evaluate the association between smoking during pregnancy and preterm birth. DESIGN: A follow up study. SETTING: Department of Gynaecology and Obstetrics, Aarhus University Hospital, Denmark. PARTICIPANTS: Four thousand one hundred and eleven nulliparous women with singleton pregnancies who returned questionnaires about smoking habits at 16 weeks of gestation. RESULTS: The overall rate of preterm delivery was 4.3%. Smokers had a 40% higher risk of preterm birth compared with nonsmokers. A dose response relationship was found between smoking and risk of preterm birth. Adjustment for women's height, prepregnancy weight, age of the mother, marital status, education, occupational status, and alcohol intake did not change the results. Among women with an intake of less than 400 mg of caffeine per day no difference in the risk of preterm birth between smokers and nonsmokers was found. However, among women with an intake of more than 400 mg of caffeine per day, the risk of preterm birth was increased almost threefold among smokers compared with nonsmokers. Furthermore, among women with a high intake of caffeine a dose-response relationship was found; women smoking one to five cigarettes per day had no increased risk of preterm birth compared with nonsmokers with the same intake of caffeine, women smoking six to ten cigarettes per day had almost three times higher risk of preterm birth, and women smoking more than 10 cigarettes per day had almost five times higher risk of preterm birth compared with nonsmokers with the same intake of caffeine. CONCLUSIONS: Smoking increases the risk of preterm birth. The association between smoking and preterm birth was only present among women with a high intake of caffeine. However, whether smoking alone influences the risk of preterm birth among heavy consumers of caffeine needs further investigation.

Adolescent↗