European Journal of Epidemiology最新文献_第3页

The relationship between PFAS exposure and dyslipidemia: an updated review, meta-analysis, and evaluation of bias. PFAS暴露与血脂异常之间的关系：一项最新综述、荟萃分析和偏倚评估。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-08-13 DOI: 10.1007/s10654-025-01271-4

Michael R Hussey,Tiffany G Kornberg,James M Sherrick,Abigail M Olson,John A Kind,Angela L Perez

{"title":"The relationship between PFAS exposure and dyslipidemia: an updated review, meta-analysis, and evaluation of bias.","authors":"Michael R Hussey,Tiffany G Kornberg,James M Sherrick,Abigail M Olson,John A Kind,Angela L Perez","doi":"10.1007/s10654-025-01271-4","DOIUrl":"https://doi.org/10.1007/s10654-025-01271-4","url":null,"abstract":"There is concern that widespread exposure to per- and polyfluoroalkyl substances (PFAS) may induce changes in serum lipids, however, current evidence is insufficient to establish causality in humans. This systematic review evaluated 69 articles examining exposure to perfluorooctanoic acid (PFOA) or perfluorooctane sulfonic acid (PFOS) and alterations in adult serum lipid outcomes. The majority of associations for PFOA or PFOS with serum lipids were either not significant, significantly negative, or were mixed versus significantly positive findings, suggesting non-consensus of any associations. A subset of 37 studies were examined via meta-analysis and reviewed for biases. Using pooled estimates, PFOA and PFOS exposure were significantly positively associated with total cholesterol (TC) and low-density lipoprotein (LDL). PFOA was significantly positively associated with triglycerides (TG), whereas PFOS had a non-significant positive association with high-density lipoprotein (HDL). TC and LDL estimates demonstrated high heterogeneity, peaking within cross-sectional and non-occupational studies that comprised the majority of the meta-analysis. Conversely, pooled estimates from longitudinal investigations trended towards null and were not significant. Potential reasons for heterogeneity were identified in a bias analysis and primarily included inconsistent confounding controls and possible subject recruitment bias from regions with known PFAS contamination. These factors indicate inconsistencies in PFAS-lipid literature that require further prospective investigations.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"16 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations between multiple perinatal exposures and risk of childhood hospitalisation with infection: a registry-based study in two countries. 多次围产期暴露与儿童感染住院风险之间的关系：两个国家的基于登记的研究

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-08-13 DOI: 10.1007/s10654-025-01266-1

Isobel M F Todd,Lars Henning Pedersen,Maria C Magnus,Natasha Nassar,Jessica E Miller,David P Burgner

{"title":"Associations between multiple perinatal exposures and risk of childhood hospitalisation with infection: a registry-based study in two countries.","authors":"Isobel M F Todd,Lars Henning Pedersen,Maria C Magnus,Natasha Nassar,Jessica E Miller,David P Burgner","doi":"10.1007/s10654-025-01266-1","DOIUrl":"https://doi.org/10.1007/s10654-025-01266-1","url":null,"abstract":"Several perinatal exposures impact severe infection risk in offspring. However, most studies consider exposures in isolation rather than the impact of multiple co-occurring perinatal exposures. Here, we investigated the risk of hospitalised childhood infections associated with combinations of multiple perinatal exposures. We studied liveborn, singleton births in Denmark between 1997 and 2019 (n = 1,113,708) and Norway between 2008 and 2018 (n = 470,270) through national registry linkage. Seven perinatal exposures were evaluated including maternal antibiotic use during pregnancy, maternal smoking, maternal diabetes, hypertensive disorders of pregnancy, caesarean section birth, offspring being small for gestational age (SGA), and preterm birth. The outcome was hospitalised infections before 5 years age. Using Cox regression, we estimated hazard ratios (HR) of hospitalised infections for: (1) each exposure individually; (2) the cumulative number of exposures; (3) each unique combination of the seven exposures; (4) pairwise interactions between exposures. Results were combined through meta-analysis. Each exposure was individually associated with greater hospitalised infection risk with pooled HR estimates ranging from 1.08 (95% CI 1.08-1.09) for SGA to 1.45 (95% CI 1.43-1.46) for preterm birth. Cumulative risk was observed for increasing number of exposures from a pooled HR of 1.17 (95% CI 1.17-1.18) for one exposure to 1.88 (95% CI 1.78-1.99) for five or more exposures. Analyses of unique combinations of the exposures showed a particularly increased risk among preterm children with one or more additional exposures. Our findings can inform targeted strategies for the prevention and management of childhood infections. We highlight a simple, intuitive method for measuring risk associated with co-occurring exposures.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"15 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and epidemiological characteristics of the 2024-2025 measles outbreak in Sarajevo Canton. 萨拉热窝州2024-2025年麻疹暴发的临床和流行病学特征

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-08-13 DOI: 10.1007/s10654-025-01287-w

Anes Jogunčić,Rusmir Baljić,Aysun Tekin,Asaf Salčinović,Irma Dizdarević,Alma Sejtarija Memišević,Belma Gazibera,Amila Muratspahić,Amos Lal,Lutvo Sporišević

引用次数: 0

Circulating inflammation-related proteome improves cardiovascular risk prediction. Results from two large European cohort studies. 循环炎症相关蛋白质组改善心血管风险预测。来自两个大型欧洲队列研究的结果。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-08-13 DOI: 10.1007/s10654-025-01285-y

Ruijie Xie,Sha Sha,Hermann Brenner,Ben Schöttker

{"title":"Circulating inflammation-related proteome improves cardiovascular risk prediction. Results from two large European cohort studies.","authors":"Ruijie Xie,Sha Sha,Hermann Brenner,Ben Schöttker","doi":"10.1007/s10654-025-01285-y","DOIUrl":"https://doi.org/10.1007/s10654-025-01285-y","url":null,"abstract":"BACKGROUNDInflammation plays a crucial role in cardiovascular disease (CVD), but the value of inflammation-related proteins in predicting major adverse cardiovascular events (MACE) is unclear. This study evaluated whether incorporating inflammation-related proteins into the SCORE2 model improves 10-year MACE risk prediction.METHODSThis study included 47,382 participants from the UK Biobank and 4,135 participants from the German ESTHER study without prior CVD or diabetes. We tested C-reactive protein (CRP) and 73 inflammation-related proteins measured with Olink® panels. Biomarker selection was performed using least absolute shrinkage and selection operator (LASSO) regression with bootstrapping separately for males and females. Selected proteins were added to the SCORE2 model variables. Model performance was evaluated using Harrell's C-index, net reclassification index (NRI), and integrated discrimination index (IDI).RESULTSSeven inflammation-related proteins but not CRP were selected, including two for both sexes, three specifically for males, and two specifically for females. Incorporating these proteins significantly improved the C-index (95% confidence interval (95%CI)) of the refitted SCORE2 model from 0.716 (0.698, 0.734) to 0.750 (0.732, 0.768) in internal validation in the UK Biobank and from 0.677 (0.644, 0.710) to 0.713 (0.681, 0.745) in external validation in the ESTHER study. The NRI with 95%CI was 12.4% (5.2%, 16.3%) in internal validation and 4.2% (0.5%, 23.6%) in external validation. The IDI also improved significantly.CONCLUSIONIncorporating inflammation-related proteins into the SCORE2 model significantly improves the prediction of 10-year MACE risk among individuals without prior CVD or diabetes. Measuring these proteins may enhance risk stratification in clinical practice.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"114 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is educational attainment protective against developing dementia? A twin study of genetic and environmental contributions. 受教育程度能预防痴呆吗？基因和环境作用的双胞胎研究。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-08-12 DOI: 10.1007/s10654-025-01286-x

Ellen E Walters,Susan E Luczak,Christopher R Beam,Malin Ericsson,William S Kremen,Robert F Krueger,Kristian E Markon,Matt McGue,Marianne Nygaard,Matthew S Panizzon,Brenda L Plassman,Chandra A Reynolds,Perminder S Sachdev,Anbu Thalamuthu,Keith E Whitfield,Nancy L Pedersen,Margaret Gatz,

{"title":"Is educational attainment protective against developing dementia? A twin study of genetic and environmental contributions.","authors":"Ellen E Walters,Susan E Luczak,Christopher R Beam,Malin Ericsson,William S Kremen,Robert F Krueger,Kristian E Markon,Matt McGue,Marianne Nygaard,Matthew S Panizzon,Brenda L Plassman,Chandra A Reynolds,Perminder S Sachdev,Anbu Thalamuthu,Keith E Whitfield,Nancy L Pedersen,Margaret Gatz, ","doi":"10.1007/s10654-025-01286-x","DOIUrl":"https://doi.org/10.1007/s10654-025-01286-x","url":null,"abstract":"Low educational attainment is recognized as a modifiable risk factor for dementia. Despite the commonly accepted notion that greater educational attainment confers lower dementia risk, few family-based studies have investigated the causal bases for the association. Using data from seven twin samples from Sweden, Denmark, Australia, and the US participating in the IGEMS (Interplay of Genes and Environment in Multiple Studies) consortium (N = 60,027, 10.92% with dementia), we tested whether twins who achieve higher education than their co-twins have lower risk of dementia. The primary analysis applied a multilevel between-within regression framework, supported by descriptive statistics of within-pair differences. Results confirmed an overall association between educational attainment and dementia risk, such that individuals with higher educational attainment had less likelihood of developing dementia (phenotypic regression coefficient = -0.68, p <.0001). Within twin pairs, however, twins who achieved greater education than their co-twins did not uniformly show lower dementia risk (within-family regression coefficient = -0.07, p =.0983, while between-family regression coefficient = -0.98, p <.0001). Taken together, the pattern of results shows that the effect of educational attainment on dementia risk is largely attributable to genetic influences in common to educational attainment and dementia, although there are also contributions from environmental influences shared between members of the same family. Results were similar in men and women. These findings add to the literature by using a co-twin control design to address possible reasons that low educational attainment is associated with greater dementia risk.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"41 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complex methods for complex data: key considerations for interpretable and actionable results in exposome research. 复杂数据的复杂方法：暴露研究中可解释和可操作结果的关键考虑因素。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-08-06 DOI: 10.1007/s10654-025-01281-2

Marta Ponzano,Ran S Rotem,Andrea Bellavia

{"title":"Complex methods for complex data: key considerations for interpretable and actionable results in exposome research.","authors":"Marta Ponzano,Ran S Rotem,Andrea Bellavia","doi":"10.1007/s10654-025-01281-2","DOIUrl":"https://doi.org/10.1007/s10654-025-01281-2","url":null,"abstract":"Complex multidimensional data are becoming more widely available and are drastically affecting the way epidemiological studies are designed and conducted. Novel frameworks such as the exposome-which encompasses the comprehensive and cumulative set of exposures affecting individuals throughout their lifetime and the complex mechanisms through which they act - provide a unique opportunity to transform how public health recommendations are identified at the population and individual level. This data revolution is accompanied by a growing interest in analytical approaches that can handle the complexity of these novel research questions. These include semi-parametric and non-parametric statistical and machine learning methodologies that provide compelling frameworks for analyzing large-scale databases while mitigating overfitting. Nevertheless, interpreting results from these complex methods is often challenging. While discussions on interpretability have largely focused on statistical inference, causal considerations and the practical applicability of the findings to inform the design of tangible interventions have received less attention-despite being essential components of epidemiological research. With this commentary we provide a general overview of these three levels of interpretability-statistical, causal, and actionable-and discuss available tools that can aid epidemiologists to improve results interpretability as they start utilizing more complex analytical approaches.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"57 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Methods of estimating prevalence of multiple sclerosis in six European healthcare data sources: a contribution from the ConcePTION project. 估计六个欧洲医疗保健数据源中多发性硬化症患病率的方法：来自ConcePTION项目的贡献。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-07-31 DOI: 10.1007/s10654-025-01243-8

Marie Beslay,Anna-Belle Beau,Davide Messina,Justine Benevent,Elisa Ballardini,Laia Barrachina-Bonet,Clara Cavero-Carbonell,Alex Coldea,Laura García-Villodre,Anja Geldhof,Rosa Gini,Kerstin Hellwig,Sue Jordan,Maarit K Leinonen,Sandra Lopez-Leon,Marco Manfrini,Visa Martikainen,Vera R Mitter,Amanda J Neville,Hedvig Nordeng,Aurora Puccini,Sandra Vukusic,Christine Damase-Michel,Yvonne Geissbühler,Joan K Morris

{"title":"Methods of estimating prevalence of multiple sclerosis in six European healthcare data sources: a contribution from the ConcePTION project.","authors":"Marie Beslay,Anna-Belle Beau,Davide Messina,Justine Benevent,Elisa Ballardini,Laia Barrachina-Bonet,Clara Cavero-Carbonell,Alex Coldea,Laura García-Villodre,Anja Geldhof,Rosa Gini,Kerstin Hellwig,Sue Jordan,Maarit K Leinonen,Sandra Lopez-Leon,Marco Manfrini,Visa Martikainen,Vera R Mitter,Amanda J Neville,Hedvig Nordeng,Aurora Puccini,Sandra Vukusic,Christine Damase-Michel,Yvonne Geissbühler,Joan K Morris","doi":"10.1007/s10654-025-01243-8","DOIUrl":"https://doi.org/10.1007/s10654-025-01243-8","url":null,"abstract":"Multiple sclerosis (MS) is a chronic autoimmune condition primarily affecting women and often diagnosed during childbearing years. This study assessed the impact of the lookback period and calculation method on MS prevalence in three healthcare data sources including women of childbearing age (from Italy, Norway and Wales) and three data sources including pregnant women (from France, Finland and Spain). Women aged 15 to 49 years from 2005 to 2019 were included, data from pregnant women were collected around the pregnancy period. MS cases were identified based on at least one MS diagnosis or one dispensation for an MS-specific medication. All data sources provided inpatient diagnoses and medication data; outpatient diagnoses were available in Norway and Finland, and primary care diagnoses in Norway, Finland and Wales. We assessed MS case detection rate by lookback period, and compared three methods for estimating yearly MS prevalence: period prevalence (PP), average point prevalence (APP) and person-time prevalence (PTP). The estimated lookback periods to identify 95% of MS cases ranged from 6 to 9 years. APP and PTP provided lower prevalence estimates than PP, especially when the lookback to identify MS was short. In women of childbearing age, MS prevalence increased over time with all calculation methods and the highest MS prevalence was observed in Norway (PP of 402 per 100,000 in 2019). Finland showed the highest MS prevalence in pregnant women (PP of 218 per 100,000 in 2018). This study highlights the importance of sufficient lookback and available data to accurately estimate MS prevalence.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"1 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Heavy prenatal alcohol exposure and healthcare use during childhood and adolescence: a Danish nationwide cohort study 1997-2022. 大量产前酒精暴露和儿童和青少年期间的医疗保健使用：1997-2022年丹麦全国队列研究

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-07-24 DOI: 10.1007/s10654-025-01280-3

Julie Marie Winckler,Kathrine Kold Sørensen,Katrine Strandberg-Larsen,Christian Torp-Pedersen,Ulrik Schiøler Kesmodel,Mikkel Porsborg Andersen,Marcella Broccia

{"title":"Heavy prenatal alcohol exposure and healthcare use during childhood and adolescence: a Danish nationwide cohort study 1997-2022.","authors":"Julie Marie Winckler,Kathrine Kold Sørensen,Katrine Strandberg-Larsen,Christian Torp-Pedersen,Ulrik Schiøler Kesmodel,Mikkel Porsborg Andersen,Marcella Broccia","doi":"10.1007/s10654-025-01280-3","DOIUrl":"https://doi.org/10.1007/s10654-025-01280-3","url":null,"abstract":"Children with heavy prenatal alcohol exposure may experience increased healthcare needs and access barriers. We aimed to quantify their healthcare utilisation patterns compared to all other Danish children in this nationwide cohort study of children born 1997-2020, followed until Dec 31, 2022. Data was derived from eight national registers. Heavy prenatal alcohol exposure was defined by hospital contacts with 100% alcohol-attributable diagnoses given to mother or child, redeemed prescriptions for drugs to treat alcohol dependence, or enrollment into treatment clinics, one year before or during pregnancy. We estimated age- and sex-specific rates and incidence rate ratios (IRRs) for use of somatic and psychiatric hospitals, and use of general practice (GP), and risk ratio (RR) for participation in the GP-based preventive child health programme. Of 1,457,962 children followed for 17,778,705 person-years, 5898 (0.4%) were heavily prenatal alcohol exposed. Exposed children had higher use of GP and hospitals compared to reference children, particularly notable for psychiatric hospital contacts with IRR for respectively ages 0-5, 6-11 and 12-18 years of 3.55 (2.98-4.24), 2.68 (2.41-2.98), and 2.19 (1.95-2.46); and for planned outpatient contacts 2.01 (1.92-2.10), 1.29 (1.21-1.37), and 1.20 (1.12-1.28). Despite higher healthcare use, participation in the preventive child health programme had a RR of 0.69 (95% CI 0.67-0.72) for exposed compared to reference children. The higher use of hospitals and GP, but lower participation in the child health programme underscores the long-term consequences and societal burden of heavy prenatal alcohol exposure, and leaves a need for awareness and adequate support to ensure health equity.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"23 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Particulate matter exposure during pregnancy and birth outcomes: exposure windows of susceptibility and socioeconomic inequalities. 怀孕期间的颗粒物暴露和分娩结果：易感性的暴露窗口和社会经济不平等。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-07-24 DOI: 10.1007/s10654-025-01274-1

Mònica Guxens,Núria Botella,Massimo Stafoggia,Marcelle Canto,Sami Petricola,Antònia Valentín,Aitana Lertxundi,Ana Fernández-Somoano,Carmen Freire,Anna García-Altés,Elia Diez,Marc Marí-Dell'Olmo,Carmen Iñiguez,María José López,Rebeca Ramis,Anne-Claire Binter

{"title":"Particulate matter exposure during pregnancy and birth outcomes: exposure windows of susceptibility and socioeconomic inequalities.","authors":"Mònica Guxens,Núria Botella,Massimo Stafoggia,Marcelle Canto,Sami Petricola,Antònia Valentín,Aitana Lertxundi,Ana Fernández-Somoano,Carmen Freire,Anna García-Altés,Elia Diez,Marc Marí-Dell'Olmo,Carmen Iñiguez,María José López,Rebeca Ramis,Anne-Claire Binter","doi":"10.1007/s10654-025-01274-1","DOIUrl":"https://doi.org/10.1007/s10654-025-01274-1","url":null,"abstract":"We aimed (i) to assess the relationship of pregnancy-average particulate matter (PM) exposure with birthweight, birthweight at term, low birthweight at term, small for gestational age, and preterm birth, (ii) to identify critical windows of susceptibility to PM exposure across pregnancy on birthweight and small for gestational age, and (iii) to assess the presence of socioeconomic inequalities on these associations. We established a population-based, nationwide cohort using the Spanish birth registry between 2004 and 2016 (N = 3,678,445). We estimated daily PM10 and PM2.5 concentrations for the entire pregnancy at the maternal residential address at child's delivery using spatiotemporal land use random-forest models. Linear, logistic, and distributed lag linear models were used for the different analysis. All models were stratified by maternal educational level and area-level deprivation index. Mean PM10 and PM2.5 concentrations during pregnancy were 25.1 and 12.7 µg/m3, respectively. Higher pregnancy-average PM10 concentrations were associated with lower birthweight and increased odds of preterm birth (-7.1 g [95%CI -8.5; -5.7] and OR 1.04 [95%CI 1.02; 1.05], respectively, per 10 µg/m3 increase in PM10). Similar results were found for PM2.5, in particular for levels above 10 µg/m3. These associations were stronger in infants born to mothers with lower education, particularly when combined with residence in more deprived areas. We observed some windows of susceptibility to PM10 for birthweight, mainly in the third trimester of pregnancy, with a similar pattern across socioeconomic levels. We did not observe windows of susceptibility to PM2.5. Structural policies to reduce exposure to current PM levels in pregnant women and socioeconomic inequalities are needed.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"20 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Completeness and generalizability of the Swedish MS register. 瑞典MS寄存器的完整性和通用性。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-07-24 DOI: 10.1007/s10654-025-01276-z

Peter Alping,Thomas Frisell,Anna He,Jan Hillert,Katharina Fink,Kyla A McKay

{"title":"Completeness and generalizability of the Swedish MS register.","authors":"Peter Alping,Thomas Frisell,Anna He,Jan Hillert,Katharina Fink,Kyla A McKay","doi":"10.1007/s10654-025-01276-z","DOIUrl":"https://doi.org/10.1007/s10654-025-01276-z","url":null,"abstract":"The Swedish Multiple Sclerosis (MS) Register is a nationwide clinical tool and research database. Its generalizability to the broader MS population has not been previously assessed. We aimed to quantify the register's completeness and potential disparities between those who were included and those who were not. Using linked national registers, we identified persons with MS through December 2020 as those with ≥ 3 MS diagnoses in the National Patient Register. We assessed the MS register's completeness and compared characteristics between included and non-included persons, using overlap weighting to account for age differences. Among 21,320 prevalent (2020) and 7,355 incident (2011-2020) MS cases, the completeness of the MS register was 85% and 87%, respectively, but varied by county (67-94% in 2020). Prevalent cases not included in the register were older (mean 62.4 vs. 52.3 years) and more likely to have no salaried income (55.3% vs. 30.5%); had fewer years of education (20.8% vs. 12.0% with ≤ 9 years); more often been hospitalized (41.5% vs. 32.2%); and collected more unique prescribed drugs (median 7 vs. 5 drugs per year). Incident cases were also older at first MS diagnosis (mean 50.3 vs. 39.2 years). All differences were attenuated by adjusting for age, although disparities remained. The Swedish MS Register demonstrates high completeness, but may not fully represent older persons with MS, those diagnosed later in life, and those of lower socioeconomic status. These limitations should be considered when interpreting findings based on the register's data.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"277 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0