We analyzed all children born in Sweden between 1983 and 2009 to investigate the effect of SDP on multiple indicators
of adverse outcomes in three areas: pregnancy outcomes (birth weight, preterm birth and being born small for gestational age), long - term cognitive abilities (low academic achievement and general cognitive ability) and externalizing behaviors (criminal conviction, violent criminal conviction and drug misuse).
Examples of risk factors that have been found to be associated with depression included partner conflict, single - parenthood, low education and stressful life events [44, 45, 46], which have all, in turn, been related to greater risk
of adverse outcomes in children [47, 48, 49].
After adjusting for variables which could impact the outcomes, such as age, sex, intensity of depression, and other conditions in addition to use of other medicines, the researchers determined that SSRIs and medications in the group of other medications for depression were linked to a greater risk of a number
of adverse outcomes in contrast to TCAs.
Did they provide you with the relative rates
of adverse outcomes in home vs. hospital?
Predictors
of adverse outcome in adolescents and adults with isolated left ventricular noncompaction
Not exact matches
Important factors that could cause actual results to differ materially from those reflected
in such forward - looking statements and that should be considered
in evaluating our outlook include, but are not limited to, the following: 1) our ability to continue to grow our business and execute our growth strategy, including the timing, execution, and profitability
of new and maturing programs; 2) our ability to perform our obligations under our new and maturing commercial, business aircraft, and military development programs, and the related recurring production; 3) our ability to accurately estimate and manage performance, cost, and revenue under our contracts, including our ability to achieve certain cost reductions with respect to the B787 program; 4) margin pressures and the potential for additional forward losses on new and maturing programs; 5) our ability to accommodate, and the cost
of accommodating, announced increases
in the build rates
of certain aircraft; 6) the effect on aircraft demand and build rates
of changing customer preferences for business aircraft, including the effect
of global economic conditions on the business aircraft market and expanding conflicts or political unrest
in the Middle East or Asia; 7) customer cancellations or deferrals as a result
of global economic uncertainty or otherwise; 8) the effect
of economic conditions
in the industries and markets
in which we operate
in the U.S. and globally and any changes therein, including fluctuations
in foreign currency exchange rates; 9) the success and timely execution
of key milestones such as the receipt
of necessary regulatory approvals, including our ability to obtain
in a timely fashion any required regulatory or other third party approvals for the consummation
of our announced acquisition
of Asco, and customer adherence to their announced schedules; 10) our ability to successfully negotiate, or re-negotiate, future pricing under our supply agreements with Boeing and our other customers; 11) our ability to enter into profitable supply arrangements with additional customers; 12) the ability
of all parties to satisfy their performance requirements under existing supply contracts with our two major customers, Boeing and Airbus, and other customers, and the risk
of nonpayment by such customers; 13) any
adverse impact on Boeing's and Airbus» production
of aircraft resulting from cancellations, deferrals, or reduced orders by their customers or from labor disputes, domestic or international hostilities, or acts
of terrorism; 14) any
adverse impact on the demand for air travel or our operations from the outbreak
of diseases or epidemic or pandemic outbreaks; 15) our ability to avoid or recover from cyber-based or other security attacks, information technology failures, or other disruptions; 16) returns on pension plan assets and the impact
of future discount rate changes on pension obligations; 17) our ability to borrow additional funds or refinance debt, including our ability to obtain the debt to finance the purchase price for our announced acquisition
of Asco on favorable terms or at all; 18) competition from commercial aerospace original equipment manufacturers and other aerostructures suppliers; 19) the effect
of governmental laws, such as U.S. export control laws and U.S. and foreign anti-bribery laws such as the Foreign Corrupt Practices Act and the United Kingdom Bribery Act, and environmental laws and agency regulations, both
in the U.S. and abroad; 20) the effect
of changes
in tax law, such as the effect
of The Tax Cuts and Jobs Act (the «TCJA») that was enacted on December 22, 2017, and changes to the interpretations
of or guidance related thereto, and the Company's ability to accurately calculate and estimate the effect
of such changes; 21) any reduction
in our credit ratings; 22) our dependence on our suppliers, as well as the cost and availability
of raw materials and purchased components; 23) our ability to recruit and retain a critical mass
of highly - skilled employees and our relationships with the unions representing many
of our employees; 24) spending by the U.S. and other governments on defense; 25) the possibility that our cash flows and our credit facility may not be adequate for our additional capital needs or for payment
of interest on, and principal
of, our indebtedness; 26) our exposure under our revolving credit facility to higher interest payments should interest rates increase substantially; 27) the effectiveness
of any interest rate hedging programs; 28) the effectiveness
of our internal control over financial reporting; 29) the
outcome or impact
of ongoing or future litigation, claims, and regulatory actions; 30) exposure to potential product liability and warranty claims; 31) our ability to effectively assess, manage and integrate acquisitions that we pursue, including our ability to successfully integrate the Asco business and generate synergies and other cost savings; 32) our ability to consummate our announced acquisition
of Asco
in a timely matter while avoiding any unexpected costs, charges, expenses,
adverse changes to business relationships and other business disruptions for ourselves and Asco as a result
of the acquisition; 33) our ability to continue selling certain receivables through our supplier financing program; 34) the risks
of doing business internationally, including fluctuations
in foreign current exchange rates, impositions
of tariffs or embargoes, compliance with foreign laws, and domestic and foreign government policies; and 35) our ability to complete the proposed accelerated stock repurchase plan, among other things.
These risks and uncertainties include, among others: the unfavorable
outcome of litigation, including so - called «Paragraph IV» litigation and other patent litigation, related to any
of our products or products using our proprietary technologies, which may lead to competition from generic drug manufacturers; data from clinical trials may be interpreted by the FDA
in different ways than we interpret it; the FDA may not agree with our regulatory approval strategies or components
of our filings for our products, including our clinical trial designs, conduct and methodologies and, for ALKS 5461, evidence
of efficacy and adequacy
of bridging to buprenorphine; clinical development activities may not be completed on time or at all; the results
of our clinical development activities may not be positive, or predictive
of real - world results or
of results
in subsequent clinical trials; regulatory submissions may not occur or be submitted
in a timely manner; the company and its licensees may not be able to continue to successfully commercialize their products; there may be a reduction
in payment rate or reimbursement for the company's products or an increase
in the company's financial obligations to governmental payers; the FDA or regulatory authorities outside the U.S. may make
adverse decisions regarding the company's products; the company's products may prove difficult to manufacture, be precluded from commercialization by the proprietary rights
of third parties, or have unintended side effects,
adverse reactions or incidents
of misuse; and those risks and uncertainties described under the heading «Risk Factors»
in the company's most recent Annual Report on Form 10 - K and
in subsequent filings made by the company with the U.S. Securities and Exchange Commission («SEC»), which are available on the SEC's website at www.sec.gov.
«The complexity
of this deal and the measurement
of the
outcomes makes this event challenging and we fear disruption,
in the interim, could have an
adverse impact on business,» he writes.
Let us say that you reckon there is a 20 % chance
of an
adverse outcome; that is like saying you will be proven wrong one
in every five times.
One must ask then how it is that if Protestant leaders
in higher education generally made the right — or at least virtually inevitable — decisions, what has gone wrong that the
outcome should be so
adverse to the apparent interests
of Protestant Christianity?
«The Australian beverages industry is responsive to the health and dietary requirements
of Australians but isolating any food or beverage as the sole contributor
in any
adverse health
outcome overlooks many other factors that need to be considered such as health, diet and lifestyle,» the Australian Beverages Council CEO Geoff Parker said.
Mr Joyce has previously described ESCAS as making Australia «a clear world leader
in the welfare
of exported live animals» due to statistics that showed from a performance report that 8,035,633 livestock were exported with just 12,958 animals — or 0.16 pc — experiencing a potentially
adverse animal welfare
outcome.
Explain that if they plan birth at home there is a small increase
in the risk
of an
adverse outcome for the baby.
Moreover,
in out -
of - hospital settings, there is likely less antepartum testing and no continuous electronic intrapartum fetal monitoring, both
of which may have affected
adverse outcomes.
In reality, only a very small proportion of home birth transports actually do result in such an adverse outcome, and thus essentially have a negligible effect on hospital outcome
In reality, only a very small proportion
of home birth transports actually do result
in such an adverse outcome, and thus essentially have a negligible effect on hospital outcome
in such an
adverse outcome, and thus essentially have a negligible effect on hospital
outcomes.
Quote from the midwife site:» There was no evidence that planned home birth among low risk women leads to an increased risk
of severe
adverse maternal
outcomes in a maternity care system with well trained midwives and a good referral and transportation system.»
I counter: To insist the general risk pool (etc) pay for your first birth without medical resources present,
in spite
of the fact that same risk pool will still be responsible for caring for any
adverse outcomes due to lack
of medical resources is hypocritical beyond belief.
Her research portfolio includes findings that suggest disparities
in adverse pregnancy
outcomes begin as early as conception, multivitamin use around the time
of conception prevents some miscarriages, over-the-counter use
of non-steroidal anti-inflammatory agents is not a probable cause
of miscarriage (and may be protective
in some women), and the vast majority
of uterine fibroids are not associated with
adverse pregnancy
outcomes including miscarriage and preterm birth, though fibroids are related to a moderately higher likelihood
of cesarean.
Dr. Fisher believes that dispassionate, rigorous study
of birth across all settings is more important than ever given disparities
in women's access to trained and licensed care providers, current and future physician workforce issues, rising costs
of health care, and unacceptably high rates
of adverse outcomes for mothers and infants
in the U.S. compared to other industrialized countries.
Ongoing projects include studies
of gene - environment interactions and
adverse pregnancy
outcomes, as well as informed medical decision making demonstration projects
in Medicaid maternity populations and within HealthWise, the nation's largest source
of health information materials distributed through healthcare networks.
Women who planned a home birth were at reduced risk
of all obstetric interventions assessed and were at similar or reduced risk
of adverse maternal
outcomes compared with women who planned to give birth
in hospital accompanied by a midwife or physician.
The incidence
of adverse perinatal
outcomes was low
in all settings.
For healthy nulliparous women with a low risk pregnancy, the risk
of an
adverse perinatal
outcome seems to be higher for planned births at home, and the intrapartum transfer rate is high
in all settings other than an obstetric unit
* If * morbidity is lower
in the homebirth group because more
of those ill women died, and were thus removed from the sample, the apparent rate
of «severe
adverse maternal»
outcomes has been artificially deflated
in the homebirth group — by an unknown amount — and therefore is evidence
of pretty much nothing.
For healthy women with low risk pregnancies, the incidence
of adverse perinatal
outcomes is low
in all birth settings
There is a lack
of good quality evidence comparing the risk
of rare but serious
adverse perinatal
outcomes in these settings
There was no evidence that planned home birth among low risk women leads to an increased risk
of severe
adverse maternal
outcomes in a maternity care system with well trained midwives and a good referral and transportation system.
The strengths
of the study include the ability to compare
outcomes by the woman's planned place
of birth at the start
of care
in labour, the high participation
of midwifery units and trusts
in England, the large sample size and statistical power to detect clinically important differences
in adverse perinatal
outcomes, the minimisation
of selection bias through achievement
of a high response rate and absence
of self selection bias due to non-consent, the ability to compare groups that were similar
in terms
of identified clinical risk (according to current clinical guidelines) and to further increase the comparability
of the groups by conducting an additional analysis restricted to women with no complicating conditions identified at the start
of care
in labour, and the ability to control for several important potential confounders.
Discontinuation
of epidural analgesia late
in labour for reducing the
adverse delivery
outcomes associated with epidural analgesia.
Tanaka K, Yamada H, Minami M, Kataoka S, Numazaki K, Minakami H, Tsutsumi H. «Screening for vaginal shedding
of cytomegalovirus
in healthy pregnant women using real - time PCR: correlation
of CMV
in the vagina and
adverse outcome of pregnancy.»
Regional variations
in practice significantly affect rates
of interventions, near misses, and
adverse outcomes.
A 2014 study that examines nearly 17,000 courses
of midwife - led care confirms that among low - risk women, home births result
in low rates
of interventions without an increase
in adverse outcomes for babies and mothers alike.
Secondly, some conditions mentioned
in this brochure may increase the risk
of adverse pregnancy
outcomes including premature labor and delivery, birth injury, and stillbirth.
The tradeoff between the additional physical safety conferred by a hospital setting
in the case
of an
adverse outcome, and the emotional comfort
of being
in a familiar environment, is sufficient for her.
The study reviewed the births
of nearly 17,000 women and found that, among low - risk women, planned home births result
in low rates
of birth interventions without an increase
in adverse outcomes for mothers and newborns.
We categorized out -
of - hospital and
in - hospital births
in Oregon according to the intended place
of delivery and
in comparing
outcomes found that the risks for some
adverse neonatal
outcomes were increased among planned out -
of - hospital births.
In many previous U.S. studies, it was not possible to disaggregate planned in - hospital births from planned out - of - hospital births that took place in the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 % of planned out - of - hospital births in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantially
In many previous U.S. studies, it was not possible to disaggregate planned
in - hospital births from planned out - of - hospital births that took place in the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 % of planned out - of - hospital births in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantially
in - hospital births from planned out -
of - hospital births that took place
in the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 % of planned out - of - hospital births in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantially
in the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 %
of planned out -
of - hospital births
in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantially
in our population, and misclassification
of these births as
in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantially
in - hospital births caused rates
of adverse outcomes among planned out -
of - hospital births to be underestimated (
in some cases, substantially
in some cases, substantially).
Rates
of obstetrical intervention are high
in U.S. hospitals, and we found large absolute differences in the risks of these interventions between planned out - of - hospital births and in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in U.S. hospitals, and we found large absolute differences
in the risks of these interventions between planned out - of - hospital births and in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in the risks
of these interventions between planned out -
of - hospital births and
in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in - hospital births.38
In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
In contrast, serious
adverse fetal and neonatal
outcomes are infrequent
in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in all the birth settings we assessed, and the absolute differences
in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyse
in risk that we observed between planned birth locations were correspondingly small; for example, planned out -
of - hospital births were associated with an excess
of less than 1 fetal death per 1000 deliveries
in multivariate and propensity - score - adjusted analyse
in multivariate and propensity - score - adjusted analyses.
For example, the Dutch home - birth system (
in which home birth is common and
adverse outcomes are rare) includes formal collaborative agreements between out -
of - hospital and
in - hospital providers, clear and mutually agreed - upon stratification
of risk, and protocols for the transfer
of care.35, 36 The process
of devising evidence - based guidelines for U.S. home births is under way.37
Labor induction has been increasing since the early 1990s, 1 and the rate is running at about 20 % for pregnancies at term.2, 3 Induction
of labor compared with spontaneous labor is associated with
adverse maternal
outcomes, including at least a doubling
in the caesarean delivery rate, 4,5 25 — 50 % increase
in instrumental vaginal delivery rate, 3,5 higher postpartum hemorrhage rate, 5 and prolonged labor.5 Neonates born after induced labor are more likely to have low Apgar score and low umbilical cord blood pH. 5
In analyses adjusted for maternal race and ethnic group, age, parity, and medical conditions associated with greater risk, the associations between planned location
of delivery and most
adverse outcomes and obstetrical procedures remained significant (Table 4).
«Planned home births result
in low rates
of interventions without an increase
in adverse outcomes for mothers and babies,» Simkins boasts.
Planned birth at home
in low risk women without complicating conditions at the start
of care
in labour was associated with significant cost savings and a significant decrease
in adverse perinatal
outcomes avoided.
There was, however, an increased incidence
of adverse perinatal
outcome associated with planned birth at home
in nulliparous low risk women, resulting
in the probability
of it being the most cost effective option at a cost effectiveness threshold
of # 20000 declining to 0.63.
This economic evaluation was based on a rigorously conducted cohort study
of sufficient size to detect clinically important differences
in adverse perinatal
outcomes.
We used multiple regression to estimate the differences
in total cost between the settings for birth and to adjust for potential confounders, including maternal age, parity, ethnicity, understanding
of English, marital status, BMI, index
of multiple deprivation score, parity, and gestational age at birth, which could each be associated with planned place
of birth and with
adverse outcomes.12 For the generalised linear model on costs, we selected a γ distribution and identity link function
in preference to alternative distributional forms and link functions on the basis
of its low Akaike's information criterion (AIC) statistic.
In further analyses restricted to women without complicating conditions at the start of care in labour, the adjusted odds of adverse perinatal outcomes were higher for births planned at home compared with those planned in obstetric units (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52
In further analyses restricted to women without complicating conditions at the start
of care
in labour, the adjusted odds of adverse perinatal outcomes were higher for births planned at home compared with those planned in obstetric units (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52
in labour, the adjusted odds
of adverse perinatal
outcomes were higher for births planned at home compared with those planned
in obstetric units (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52
in obstetric units (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52).
The paucity
of evidence for the longer term consequences
of adverse events and other health
outcomes after birth for both mother and baby remains and further research to generate combined QALY estimates for the linked mother - baby dyad should be a priority for research
in this specialty.
There was, however, an increased incidence
of adverse perinatal
outcomes associated with planned birth at home
in nulliparous low risk women, resulting
in the probability
of it being the most cost effective option at a threshold
of # 20000 declining to 0.63.
The definition
of low risk used
in the cohort study was based on criteria contained
in the NICE Intrapartum Care Guidelines.11 The primary clinical
outcome was a composite measure
of adverse perinatal
outcomes encompassing perinatal mortality and specified neonatal morbidities (box).