Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Lewis CA [original query] |
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Effects of maternal smokeless tobacco use on selected pregnancy outcomes in Alaska Native women: a case-control study
England LJ , Kim SY , Shapiro-Mendoza CK , Wilson HG , Kendrick JS , Satten GA , Lewis CA , Tucker MJ , Callaghan WM . Acta Obstet Gynecol Scand 2013 92 (6) 648-55 OBJECTIVE: To examine the potential effects of prenatal smokeless tobacco use on selected birth outcomes. DESIGN: A population-based, case-control study using a retrospective medical record review. POPULATION: Singleton deliveries 1997-2005 to Alaska Native women residing in western Alaska. METHODS: Hospital discharge codes were used to identify potential case deliveries and a random control sample. Data on tobacco use and confirmation of pregnancy outcomes were abstracted from medical records for 1123 deliveries. Logistic regression was used to examine associations between tobacco use and pregnancy outcomes. Adjusted odds ratios (OR), 95% confidence intervals (95% CI), and p-values were calculated. MAIN OUTCOMES MEASURES: Preterm delivery, pregnancy-associated hypertension, and placental abruption. RESULTS: In unadjusted analysis, smokeless tobacco use was not significantly associated with preterm delivery (OR 1.44, 95% CI 0.97-2.15). After adjustment for parity, pre-pregnancy body mass index, and maternal age, the point estimate was attenuated and remained non-significant. No significant associations were observed between smokeless tobacco use and pregnancy-associated hypertension (adjusted OR 0.92, 95% CI 0.56-1.51) or placental abruption (adjusted OR 1.11, 95% CI 0.53-2.33). CONCLUSIONS: Prenatal smokeless tobacco use does not appear to reduce risk of pregnancy-associated hypertension or to substantially increase risk of abruption. An association between smokeless tobacco and preterm delivery could not be ruled out. Components in tobacco other than nicotine likely play a major role in decreased pre-eclampsia risk in smokers. Nicotine adversely affects fetal neurodevelopment and our results should not be construed to mean that smokeless tobacco use is safe during pregnancy. |
An analysis of hepatitis C virus-related public inquiries from health professionals: 2009-2010
Jorgensen CM , Lewis CA , Liu J . Clin Infect Dis 2012 55 Suppl 1 S54-7 A content analysis was performed on e-mail inquiries about viral hepatitis that were submitted by health professionals to the Centers for Disease Control and Prevention's (CDC's) public inquiry system, CDC-INFO. All hepatitis C virus (HCV)-related inquiries from health professionals were identified, representing 10% of all inquiries received during the 2-year period of 2009-2010. Three-fourths of the inquiries included professional degree and organizational affiliation information, with 35% representing physicians, 33% representing nurses, and 6% representing midlevel clinicians, the majority of whom provided direct clinical care or worked in a healthcare organization. Two independent coders analyzed content, with kappa coefficients for interrater agreement ranging from 0.82 to 0.93. Overall, the inquiries demonstrated important knowledge gaps regarding HCV, with the most frequently asked questions focusing on transmission, serology, and policy/legal issues surrounding patient care and infected healthcare workers. |
Maternal smokeless tobacco use in Alaska Native women and singleton infant birth size
England LJ , Kim SY , Shapiro-Mendoza CK , Wilson HG , Kendrick JS , Satten GA , Lewis CA , Whittern P , Tucker MJ , Callaghan WM . Acta Obstet Gynecol Scand 2011 91 (1) 93-103 OBJECTIVE: To examine the effects of maternal prenatal smokeless tobacco use on infant birth size. DESIGN: A retrospective medical record review of 502 randomly selected deliveries. POPULATION: Singleton deliveries to Alaska Native women residing in a defined geographical region in western Alaska, 1997-2005. MATERIAL AND METHODS: A regional medical center's electronic records were used to identify singleton deliveries. Data on maternal tobacco exposure and pregnancy outcomes were abstracted from medical records. Logistic models were used to estimate adjusted mean birthweight, length, and head circumference for deliveries to women who used no tobacco (n=121), used smokeless tobacco (n=237), or smoked cigarettes (n=59). Differences in mean birthweight, length, and head circumference, 95% confidence intervals, and p-values were calculated using non-users as the reference group. MAIN OUTCOME MEASURES: Infant birthweight, crown-heel length, and head circumference. RESULTS: After adjustment for gestational age and other potential confounders, the mean birthweight of infants of smokeless tobacco users was reduced by 78g compared with that of infants of non-users (p=0.18), and by 331g in infants of smokers (p<0.01). No association was found between maternal smokeless tobacco use and infant length or infant head circumference. CONCLUSIONS: We found a modest but non-significant reduction in the birthweight of infants of smokeless tobacco users compared with infants of tobacco non-users. Because smokeless tobacco contains many toxic compounds that could affect other pregnancy outcomes, results of this study should not be construed to mean that smokeless tobacco use is safe during pregnancy. |
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