Early pregnancy body mass index and spontaneous preterm birth in Northwest Russia: a registry-based study

BACKGROUND: International studies on the association between maternal body mass index (BMI) and spontaneous preterm birth (PTB) yield controversial results warranting large studies from other settings. The aim of this article was to study association between maternal early pregnancy BMI and the risk of spontaneous PTB in Murmansk County (MC), Northwest Russia. METHODS: This is a registry-based cohort study. All women with singleton pregnancies registered at antenatal clinics during the first 12 weeks of gestation and who delivered in MC between January, 1(st) 2006 and December, 31(st) 2011 comprised the study base (n = 29,709). All women were categorized by BMI into four groups: underweight (<18.5 kg/m(2)), normal (18.5–24.9 kg/m(2)), overweight (25.0–29.9 kg/m(2)), and obese (≥30.0 kg/m(2)). Multivariable logistic regression was used to study associations between maternal BMI and PTB (<37 weeks) and very preterm birth (VPTB) (<32 weeks) adjusted for socio-economic factors, biological and lifestyle characteristics. RESULTS: The prevalence of underweight, overweight and obesity were 7.1% (95% CI: 6.8-7.4), 18.3% (95% CI: 17.8-18.7) and 7.1% (95% CI: 6.8-7.4), respectively. Altogether, 5.5% (95% CI: 5.3-5.8) of the births were PTB and 0.8% (95% CI: 0.7-0.9) were VPTB. After adjustment, both underweight (OR = 1.25, 95% CI: 1.03-1.50), overweight (OR = 1.10, 95% CI: 0.97-1.26) and obese (OR = 1.31, 95% CI: 1.08-1.57) women were more likely to deliver preterm. VPTB was associated with overweight (OR = 1.47, 95% CI: 1.056-2.03) and obesity (OR = 1.63, 95% CI: 1.02-2.60). CONCLUSION: The findings demonstrate a J-shaped association between first trimester maternal BMI and spontaneous PTB and VPTB with increased risk among underweight, overweight and obese women

COVID-19: seroprevalence and adherence to preventive measures in Arkhangelsk, Northwest Russia

Background - The published estimates of SARS-CoV-2 seroprevalence in Russia are few. The study aimed to assess the SARS-CoV-2 seroprevalence in Arkhangelsk (Northwest Russia), in a year after the start of the pandemic, to evaluate the population adherence to non-pharmaceutical interventions (NPIs), and to investigate characteristics associated with COVID-19 seropositive status. Methods - We conducted a SARS-CoV-2 seroprevalence study between 24 February and 30 June 2021 involving 1332 adults aged 40–74 years. Logistic regression models were fit to identify factors associated with seropositive status and with adherence to NPIs. Results - Less than half (48.9%) of study participants adhered all recommended NPIs. Male sex (odds ratio [OR] 1.7, 95% confidence intervals [CI] 1.3; 2.3), regular employment (OR 1.8, 95% CI 1.3; 2.5) and low confidence in the efficiency of the NPIs (OR 1.9, 95% CI 1.5; 2.5) were associated with low adherence to internationally recommended NPIs. The SARS-CoV-2 seroprevalence rate was 65.1% (95% CI: 62.5; 67.6) and increased to 73.0% (95% CI: 67.1; 85.7) after adjustment for test performance. Regular employment (OR 2.0, 95% CI 1.5; 2.8) and current smoking (OR 0.4, 95% CI 0.2; 0.5) were associated with being seropositive due to the infection. Conclusions - Two third of the study population were seropositive in a year after the onset of the pandemic in Arkhangelsk. Individuals with infection-acquired immunity were more likely to have regular work and less likely to be smokers. The adherence to NPIs was not found associated with getting the virus during the first year of the pandemic

Shift work is associated with 10-year incidence of atrial fibrillation in younger but not older individuals from the general population: results from the Tromsø Study

Objectives - Shift work is associated with myocardial infarction and stroke. We studied if shift work is also associated with incident atrial fibrillation (AF) and if this association differs, depending on sex and age. Methods - We studied 22 339 participants (age 37.0±9.8 years, 49% women) with paid work from the third (1986–1987), fourth (1994–1995), fifth (2001) and sixth (2007–2008) surveys of the population-based Tromsø Study, Norway. Participants were followed up for ECG-confirmed AF through 2016. Shift work was assessed by questionnaire at each survey. We used unadjusted and multivariable-adjusted Cox regression models to study the association of shift work with 10-year incident AF and incident AF during extensive follow-up up to 31 years. Interactions with sex and age were tested in the multivariable model. Results - Shift work was reported by 21% of participants at the first attended survey. There was an interaction between shift work and age for 10-year incident AF (p=0.069). When adjusted for AF risk factors, shift work was significantly associated with 10-year incident AF in participants Conclusions - Shift work was associated with 10-year incident AF in individuals <40 years but not ≥40 years of age. Shift work was not associated with incident AF during extensive follow-up up to 31 years, and there were no sex differences.<p

Shift work is associated with 10-year incidence of atrial fibrillation in younger but not older individuals from the general population:results from the Tromso Study

Objectives Shift work is associated with myocardial infarction and stroke. We studied if shift work is also associated with incident atrial fibrillation (AF) and if this association differs, depending on sex and age. Methods We studied 22 339 participants (age 37.0 +/- 9.8 years, 49%women) with paid work from the third (1986-1987), fourth (1994-1995), fifth (2001) and sixth (2007-2008) surveys of the population-based Tromso Study, Norway. Participants were followed up for ECG-confirmed AF through 2016. Shift work was assessed by questionnaire at each survey. We used unadjusted and multivariable-adjusted Cox regression models to study the association of shift work with 10-year incident AF and incident AF during extensive follow-up up to 31 years. Interactions with sex and age were tested in the multivariable model. Results Shift work was reported by 21% of participants at the first attended survey. There was an interaction between shift work and age for 10-year incident AF (p=0.069). When adjusted for AF risk factors, shift work was significantly associated with 10-year incident AF in participants = 40 years of age (HR 0.90, 95% CI 0.53 to 1.51). Shift work was not associated with incident AF during extensive follow-up (HR 1.03, 95% CI 0.89 to 1.20). There was no interaction between shift work and sex. Conclusions Shift work was associated with 10-year incident AF in individuals = 40 years of age. Shift work was not associated with incident AF during extensive follow-up up to 31 years, and there were no sex differences

Seroprevalence of SARS-Cov-2 Antibodies in Adults, Arkhangelsk, Russia.

Population-based data on coronavirus disease in Russia and on the immunogenicity of the Sputnik V vaccine are sparse. In a survey of 1,080 residents of Arkhangelsk 40-75 years of age, 65% were seropositive for IgG. Fifteen percent of participants had been vaccinated; of those, 97% were seropositive

Decline in resting heart rate, its association with other variables, and its role in cardiovascular disease The Tromsø Study

Background: Resting heart rate (RHR) is an easily measured cardiovascular parameter that is considered an independent predictor of cardiovascular disease (CVD) and mortality in the general population. However, results on the association between RHR and these outcomes are inconsistent, and studies on longitudinal trends in RHR and the role of long-term changes in RHR in CVD and mortality are scarce. Objective: To investigate secular trends in RHR in the general population of Tromsø, Northern Norway over the last decades, and to explore the role of RHR and long-term changes in RHR in CVD and mortality. Methods: Participants from four surveys of the Tromsø Study conducted between 1986 and 2008 were included in these analyses (n=34 751). RHR in these participants was measured with an automated Dinamap device and resultant data were linked to validated information on incident myocardial infarction, atrial fibrillation, ischemic stroke, cardiovascular death and total death. Statistical methods included mixed models analysis, fractional polynomials, and trajectory analysis. Main results: Over 22 years of observation, the mean age-adjusted RHR declined from 73.4 to 64.7 beats per minute in men, and from 78.3 to 66.4 beats per minute in women; 17.4% of the decline in men and 16.1% of the decline in women was attributable to favourable changes in other cardiovascular risk factors. In men, elevated RHR independently predicted the risk of myocardial infarction, atrial fibrillation, and cardiovascular death. In women, the associations with myocardial infarction and total death were similar to those in men, and we found a J-shaped association with ischemic stroke. Having a constantly elevated RHR or a RHR that increased from moderate to high over 15 years increased the risk of myocardial infarction, cardiovascular death, and total death in men, whereas estimates in women were insignificant. Conclusions: Over the last decades RHR has declined substantially, and this decline has occurred to a large extent independently of other cardiovascular risk factors. RHR independently predicts the risk of CVD and mortality though there are sex differences. Long-term changes in RHR provide additional information for risk assessment. Thus, RHR is as an independent cardiovascular risk factor, and as such it should be monitored and used in risk assessments by both people themselves and by health professionals. RHR is a modifiable cardiovascular risk factor; however it is unclear whether people could benefit from RHR-lowering interventions

Resting heart rate trajectories and myocardial infarction, atrial fibrillation, ischaemic stroke and death in the general population: The Tromso Study

Background: Resting heart rate (RHR) is an established risk factor for cardiovascular disease (CVD), but long-term individual RHR trajectories and their effect on CVD morbidity and mortality have not yet been described. Methods: This large population-based longitudinal study included 14,208 men and women aged 20 years or older, not pregnant, and not using blood pressure medications, who attended at least two of the three Tromsø Study surveys conducted between 1986 and 2001. RHR was measured using an automated Dinamap device. Participants were followed up from 2001 to 2012 with respect to myocardial infarction (MI), atrial fibrillation, ischemic stroke, CVD death, and total death. The Proc Traj statistical procedure was used to identify RHR trajectories. Results: Five common long-term RHR trajectories were identified: low, moderate, decreasing, increasing, and elevated. In men, an elevated RHR trajectory was independently associated with an increased risk of MI when low RHR trajectory was used as a reference (hazard ratio 1.83, 1.11-3.02). Risk of total death in men was lowest in the low RHR trajectory group and highest in the increasing and elevated RHR trajectory groups. In women, the association between RHR trajectories and MI was similar to that in men, but it was not significant. Conclusions: Among the five long-term RHR trajectories we identified, increasing and elevated trajectories were associated with an increased risk of MI and total death in men. Our results suggest that changes in long-term individual RHR in the general population may provide additional prognostic information

Resting heart rate predicts incident myocardial infarction, atrial fibrillation, ischaemic stroke and death in the general population: The Tromsø Study

Background: Elevated resting heart rate (RHR) increases risk of death overall, but a comprehensive picture of the associations between RHR, cardiovascular morbidity and mortality events has not yet been presented. We aimed to investigate the effect of RHR on the risk of 5 cardiovascular events: incident myocardial infarction (MI), incident atrial fibrillation (AF), incident ischaemic stroke, total death and cardiovascular death in a general population from Norway. Methods: We followed 24 489 men and women from the Tromsø Study 1994–1995, a population-based cohort study, for 18 years, and analysed the association between RHR and the investigated cardiovascular events. Sex-specific Cox regression with time-dependent covariates was applied with the best-fitting fractional polynomials of RHR. Results: Among men, an independent positive relationship was observed for MI and AF (adjusted HR for AF per 20 bpm increase=1.14; 95% CI 1.02 to 1.27). In women, the corresponding HR for MI was 1.23 (1.09 to 1.40). A J-shaped association was observed for ischaemic stroke in women when compared with a RHR of 70 bpm (HR for 50 bpm=1.31; 0.90 to 1.90; HR for 100 bpm=1.32; 1.04 to 1.69). Total and cardiovascular death showed a strong positive association with RHR in men. In women, the pattern for total death was similar. Conclusions: RHR is an independent risk factor for several cardiovascular events. A novel finding is the positive association between RHR and AF in men and the sex difference in association with ischaemic stroke

Impact of introducing capacity-based mental health legislation on the use of community treatment orders in Norway: case registry study

Background: In 2017, a capacity-based criterion was added to the Norwegian Mental Health Act, stating that those with capacity to consent to treatment cannot be subjected to involuntary care unless there is risk to themselves or others. This was expected to reduce incidence and prevalence rates, and the duration of episodes of involuntary care, in particular regarding community treatment orders (CTOs). Aims: The aim was to investigate whether the capacity-based criterion had the expected impact on the use of CTOs. Method: This retrospective case register study included two catchment areas serving 16% of the Norwegian population (aged ≥18). In total, 760 patients subject to 921 CTOs between 1 January 2015 and 31 December 2019 were included to compare the use of CTOs 2 years before and 2 years after the legal reform. Results: CTO incidence rates and duration did not change after the reform, whereas prevalence rates were significantly reduced. This was explained by a sharp increase in termination of CTOs in the year of the reform, after which it reduced and settled on a slightly higher leven than before the reform. We found an unexpected significant increase in the use of involuntary treatment orders for patients on CTOs after the reform. Conclusions: The expected impact on CTO use of introducing a capacity-based criterion in the Norwegian Mental Health Act was not confirmed by our study. Given the existing challenges related to defining and assessing decision-making capacity, studies examining the validity of capacity assessments and their impact on the use of coercion in clinical practice are urgently needed

Sociodemographic characteristics, sexual behaviour and knowledge about cervical cancer prevention as risk factors for high-risk human papillomavirus infection in Arkhangelsk, North-West Russia

While sociodemographic predictors of cervical cancer (CC) are well understood, predictors of high-risk (HR) human papillomavirus (HPV) infection have not been fully elucidated. This study explored the HR-HPV infection positivity in relation to sociodemographic, sexual behavior characteristics and knowledge about HPV and CC prevention among women who visited the Arkhangelsk clinical maternity hospital named after Samoylova, Russia. This cross-sectional study was conducted in the city of Arkhangelsk, Northwest Russia. Women who consulted a gynecologist for any reason between 1 January 2015 and 30 April 2015 were residents of Arkhangelsk, 25–65 years of age were included. The Mann–Whitney and Pearson’s χ2 tests were used. To determine the HR-HPV status, we used the Amplisens HPV-DNA test. We used a questionnaire to collect the information on sociodemographic factors. Logistic regression was applied. The prevalence of HR-HPV infection was 16.7% (n = 50). HR-HPV infection was more prevalent in younger women, cohabiting, nulliparae, smokers, having had over three sexual partners and early age of sexual debut. The odds of having a positive HR-HPV status increased by 25% with an annual decrease in the age of sexual debut. Moreover women with one child or more were less likely to have positive HR-HPV status.publishedVersion© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/ ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited