Paediatric and perinatal epidemiology最新文献

{"title":"Sex-Specific Associations of Small, Vulnerable Newborns With Mental Capital in Early School-Aged Children.","authors":"Shuhei Terada, Aya Isumi, Takeo Fujiwara","doi":"10.1111/ppe.70213","DOIUrl":"https://doi.org/10.1111/ppe.70213","url":null,"abstract":"<p><strong>Background: </strong>Although mental capital is increasingly recognised as a foundation for children's later well-being, its perinatal determinants remain unclear because traditional classifications such as preterm birth and small for gestational age (SGA) capture only partial and overlapping aspects of vulnerability.</p><p><strong>Objectives: </strong>Using the integrated small vulnerable newborn (SVN) framework with mutually exclusive categories, we aimed to assess associations between SVN categories and mental capital at ages 6-7 years by sex.</p><p><strong>Methods: </strong>We analysed data from six waves of the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, a population-based repeated cross-sectional survey of first-grade students in Adachi City, Tokyo, conducted between 2015 and 2024 (n = 20,928). Caregivers provided gestational week and birthweight from the Maternal and Child Health Handbook, and children were classified into SVN categories (term non-SGA, term SGA, preterm non-SGA, preterm SGA). Mental capital, including behavioural problems, prosocial behaviour, and resilience, was assessed using the parent-reported Strengths and Difficulties Questionnaire and Children's Resilience and Coping Scale. Multivariable regression models were fitted, stratified by biological sex.</p><p><strong>Results: </strong>Among the 20,928 children, 3402 (16.3%) were term SGA, 1093 (5.2%) were preterm non-SGA, and 227 (1.1%) were preterm SGA. Compared with term non-SGA, term SGA was associated with higher total difficulties scores among girls (standardised β 0.11, 95% confidence interval [CI] 0.05, 0.17) but not among boys (β 0.03, 95% CI -0.03, 0.09). Term SGA girls also showed lower resilience (β -0.07, 95% CI -0.12, -0.01). In contrast, preterm non-SGA boys had higher total difficulties scores (β 0.13, 95% CI 0.04, 0.21). There was no evidence that any SVN category was associated with prosocial behaviour in either sex.</p><p><strong>Conclusions: </strong>Term SGA tended to be associated with behavioural problems and lower resilience among girls, whereas preterm non-SGA tended to be associated with behavioural problems among boys.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconception Systemic Inflammation Response Index and Time-to-Pregnancy.","authors":"Yuxian Zhang, Dongling Gu, Yanyuan Xie, Dayong Zha, Jianwei Zhao, Na Zhu, Yanyan Fu, Bing Li","doi":"10.1111/ppe.70208","DOIUrl":"https://doi.org/10.1111/ppe.70208","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation may affect female reproductive function, but there is relatively little epidemiological evidence regarding the association between pre-pregnancy inflammatory status and fertility. We explore the association between the pre-pregnancy Systemic Inflammation Response Index (SIRI) and the time to pregnancy (TTP) in couples trying to conceive.</p><p><strong>Method: </strong>This study included 1739 couples from the National Free Preconception Check-up Project (NFPCP) in Guangzhou. SIRI was calculated as neutrophil count × monocyte count/lymphocyte count from routine complete blood count (CBC) at baseline. Quartile and continuous variable analysis of SIRI was performed, and restricted cubic spline functions were used to evaluate the dose-response relationship. The associations were adjusted for demographic, behavioural, and lifestyle factors.</p><p><strong>Results: </strong>In the NFPCP preconception couple cohort, 1182 pregnancy events were observed. In categorical analyses, women in the highest quartile of SIRI (Q4: 0.99, 5.58) had lower fecundability than those in Q2 (FR, 0.79; 95% CI 0.63, 0.98), indicating a longer TTP. The inverse association became more apparent at SIRI levels above approximately 0.89 in spline-based analyses. Sensitivity analyses yielded comparable effect estimates after restricting the analysis to live birth outcomes and excluding women with chronic inflammatory conditions, fertility-related disorders, or antibiotic use, supporting the robustness of the observed association.</p><p><strong>Conclusions: </strong>Higher preconception SIRI was associated with longer TTP, and the association remained generally consistent across adjusted and sensitivity analyses. SIRI may have potential value in preconception risk stratification, but further studies are required to confirm its clinical relevance.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic Complications in Pregnancy and Biological Ageing in the Offspring: A Systematic Review and Meta-Analysis.","authors":"Eskedar Getie Mekonnen, Tina Bianco-Miotto, Kai Liu, Jessica A Grieger","doi":"10.1111/ppe.70206","DOIUrl":"https://doi.org/10.1111/ppe.70206","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic complications in pregnancy may alter the intrauterine environment, influence offspring biological ageing and potentially increase the risk of chronic diseases later in life.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aimed to examine associations between diabetes in pregnancy, hypertensive disorders of pregnancy, maternal BMI and metabolic syndrome, and offspring biological ageing markers, including telomere length and DNA methylation.</p><p><strong>Data sources: </strong>Studies were retrieved from PubMed, EMBASE, Scopus and Web of Science.</p><p><strong>Study selection and data extraction: </strong>Study characteristics, exposures and outcomes were independently extracted and summarised.</p><p><strong>Synthesis: </strong>Standardised mean differences in telomere length were calculated using Hedges' g, and random effects meta-analysis was applied to pool effect estimates.</p><p><strong>Results: </strong>Of the 123 studies, 90 assessed DNA methylation, 28 reported telomere length and 5 reported both outcomes. No differences in telomere length were observed in offspring exposed to gestational diabetes (7 studies) or hypertensive disorders (14 studies). Each unit increase in maternal BMI was associated with a 0.27% decrease in offspring telomere length (3 studies). Exposure to cardiometabolic complications was associated with aberrant DNA methylation patterns in genes related to cardiometabolic pathways. Higher mean methylation level was reported in cord blood (2 studies) and placenta (7 studies) following exposure to diabetes and hypertensive disorders.</p><p><strong>Conclusions: </strong>Higher maternal BMI was associated with slightly shorter offspring telomeres, while no differences were observed following exposure to gestational diabetes or hypertensive disorders. Altered DNA methylation in cardiometabolic genes suggests epigenetic effects of in utero exposure, although heterogeneity in biospecimens and measurement methods limits definitive conclusions.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Pre-Labour Caesarean Delivery for a Low-Risk Indication on Hospital Length of Stay and Costs in Singleton, Nulliparous Women.","authors":"Taylor Traaseth, Kirsten M Niles, Claire Cordingley, Hannah Peters, Ellen Giesbrecht, Amy Hobbs, Laura Schummers, Erin C Strumpf, Jessica Liauw, Jennifer A Hutcheon","doi":"10.1111/ppe.70188","DOIUrl":"https://doi.org/10.1111/ppe.70188","url":null,"abstract":"<p><strong>Background: </strong>Understanding the costs to the healthcare system of caesarean delivery with a low-risk indication ('maternal request') is important for informing policies on its use. Numerous studies have examined hospital length of stay (LOS)-a key driver of hospital costs-by actual mode of delivery (vaginal vs. caesarean). This comparison, however, is misaligned with the information available at the time of antenatal decision-making, as a planned vaginal delivery could result in either an actual vaginal delivery or an emergency intrapartum caesarean.</p><p><strong>Objectives: </strong>To compare maternal LOS in hospital and hospital costs for pre-labour caesarean delivery for a low-risk indication with planned vaginal delivery.</p><p><strong>Methods: </strong>We conducted a population-based cohort study of all singleton births ≥ 37 weeks from nulliparous pregnancies in British Columbia, Canada, 2013-2023, using the British Columbia Perinatal Data Registry. We identified pre-labour caesarean deliveries for breech presentation (proxies for caesarean deliveries with no medical indication) as well as planned vaginal deliveries. We examined maternal total LOS in hospital, in days, and hospital costs. Differences were estimated using generalized linear models with a gamma distribution and a log link.</p><p><strong>Results: </strong>The planned caesarean group comprised 5545 women, and the planned vaginal group comprised 146,270 women (29% emergency caesarean). The total length of hospital stay for the planned caesarean group was 2.9 days and 2.7 days for planned vaginal delivery (absolute difference 0.22 days; relative difference 8.3%, 95% considence interval [CI] -1.75, 19.4). Hospital delivery admission costs were CDN$981 higher (95% CI 886, 1076) for low-risk, pre-labour caesarean delivery than planned vaginal delivery.</p><p><strong>Conclusion: </strong>Maternal hospital length of stay for pre-labour caesareans for a low-risk indication was similar to planned vaginal delivery, while hospital costs were 21% higher. These findings provide contemporary evidence to help inform policy development on the use of 'maternal request' caesareans, alongside other clinical, patient, and health system considerations.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent Pregnancy and Perinatal Outcomes: A Hospital-Based Cross-Sectional Study.","authors":"Ana Clara Pereira Simplício, Anna Luiza Henriques Fonseca, Juliana Dantas de Araújo Santos Camargo, Amaxsell Thiago Barros de Souza, Gabriela Santana Oliveira de Freitas, Rafael Antônio Santana Oliveira de Freitas, Ricardo Ney Cobucci, Sávio Ferreira Camargo, Ana Karla Monteiro Santana Oliveira de Freitas","doi":"10.1111/ppe.70210","DOIUrl":"https://doi.org/10.1111/ppe.70210","url":null,"abstract":"<p><strong>Background: </strong>Adolescent pregnancy is linked to adverse perinatal outcomes, yet distinctions between early (10-14 years) and late (15-19 years) adolescence and the impact of prenatal care adequacy remain unclear. We compared perinatal outcomes across maternal-age groups and explored the contribution of prenatal-care inadequacy to the association between maternal age and preterm birth.</p><p><strong>Methods: </strong>We conducted a hospital-based cross-sectional study using SINASC data from a tertiary referral centre in Brazil. Live births to mothers aged 10-24 years from 2015 to 2020 were classified as early adolescence (10-14 years), late adolescence (15-19 years), or 20-24 years (reference). Preterm birth (< 37 weeks), preterm-birth severity, a birth-weight-percentile proxy, and prenatal-care adequacy were assessed. Adjusted risk ratios (RRs) were estimated using modified Poisson regression with robust variance and multiple imputation (20 datasets). An exploratory g-computation analysis evaluated the contribution of inadequate prenatal care (< 7 visits) to the maternal-age-preterm-birth association.</p><p><strong>Results: </strong>Early and late adolescents had higher risks of preterm birth (RR 1.33 and 1.19) and inadequate prenatal care (RR 1.13 for both) compared to the reference group. Early adolescents also had increased risk of low birth-weight percentile (RR 1.47). Inadequate prenatal care accounted for approximately 10% of the association between adolescent age and preterm birth.</p><p><strong>Conclusions: </strong>Adolescent pregnancy, especially early adolescence, is associated with increased preterm birth and prenatal care inadequacy. While prenatal care partially explains this risk, substantial direct associations persist, highlighting the need for comprehensive interventions beyond prenatal visit frequency.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Racial and Ethnic Disparities in Hospital-Reported Perinatal Mental Disorders in California.","authors":"Mahader Tamene, Sai Ramya Maddali, Marina Magalhães, Juan R Cabrera, Jennifer Ahern, Patrick T Bradshaw, Suzan L Carmichael, Mahasin S Mujahid","doi":"10.1111/ppe.70169","DOIUrl":"https://doi.org/10.1111/ppe.70169","url":null,"abstract":"<p><strong>Background: </strong>Perinatal mental disorders (PMD), including perinatal mood and anxiety disorders (PMAD) and serious mental illness (SMI), pose a critical public health concern with consequences for birthing persons and their children. Evidence on racial and ethnic disparities is mixed, and little is known about how these disparities have changed over time.</p><p><strong>Objective: </strong>To evaluate long-term trends and racial and ethnic disparities in the prevalence of hospital-reported PMD.</p><p><strong>Methods: </strong>We analysed all live hospital births in California from 1997 to 2019 (N = 10,703,966). PMAD and SMI were identified using ICD-9-CM and ICD-10-CM codes from hospital discharge records. We estimated age-standardised prevalence and average annual percentage change (AAPC) by race/ethnicity and used modified Poisson regression to estimate unadjusted and adjusted risk ratios (RRs). Temporal changes in disparities were examined using smoothed multi-year periods.</p><p><strong>Results: </strong>Overall, PMD prevalence was 2.0% (PMAD: 1.6%; SMI: 0.6%) and increased across all racial and ethnic groups, with Hispanic and Asian or Pacific Islander birthing persons experiencing the largest AAPC. Compared to their non-Hispanic white peers, American Indian or Alaska Native birthing people had a higher risk of any PMD (RR 1.16, 95% confidence interval [CI] 1.11, 1.21), and Black birthing people had a higher unadjusted SMI risk (RR 1.10, 95% CI 1.07, 1.13). Over time, disparities showed persistently lower risk among Asian or Pacific Islander and Hispanic individuals, and comparable or higher risk among American Indian or Alaska Native individuals; SMI risk among Black birthing people approached parity with White birthing people in several periods.</p><p><strong>Conclusions: </strong>Hospital-reported PMD increased substantially over two decades, with racial and ethnic differences likely shaped by structural barriers to care, stigma, and diagnostic bias that contribute to underdiagnosis among minoritised populations. Future research should examine social and structural drivers to inform equity-focused interventions.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Complex Interplay of Duration of Residence and Region of Birth on Perinatal Outcomes Among Migrant Women in Australia: A Cohort Study.","authors":"Natalie Holowko, Sol P Juárez, Kirsten R Palmer, Marian Knight, Fatima El Assaad, Miranda Davies-Tuck","doi":"10.1111/ppe.70205","DOIUrl":"https://doi.org/10.1111/ppe.70205","url":null,"abstract":"<p><strong>Background: </strong>Although migrants are recognised as heterogeneous, research often emphasises origin over receiving-context experiences.</p><p><strong>Objectives: </strong>We investigated maternal risk factors and perinatal outcomes by duration of residence in Australia, stratified by region of birth.</p><p><strong>Methods: </strong>This population-based cohort study using Victorian Perinatal Data Collection data included singleton births between 2017-2019 (N = 199,935). Exposures were maternal region of birth (United Nations-grouped countries) and duration of residence (< 2, 2-5, 6-10, > 10 years, [~15% missing]). Outcomes were grouped into preconception health (smoking, body mass index (BMI), pre-existing conditions, social disadvantage), structural factors (antenatal care, early ultrasound) and pregnancy/perinatal outcomes (gestational diabetes, hypertensive disorders, gestation at birth, stillbirth). Relative risks were estimated using robust Poisson regression, adjusted for maternal age and birth year, stratified by region of birth.</p><p><strong>Results: </strong>Among the 36.7% of women born outside of Australia, most were from South Asia or South-East/East Asia, with a mean residence of 10 years. Compared with Australia-born women, migrant women generally had a lower risk of smoking, pre-existing hypertension, BMI ≥ 25, preeclampsia and preterm birth-although advantages were less pronounced in women residing longer and varied by region. Some groups had a higher risk of gestational diabetes (Oceania, South Asia, South-East/East Asia, West Asia) and stillbirth (Oceania, South Asia, Africa), with risks persisting regardless of residence duration. Late initiation of antenatal care was consistently observed among women born in New Zealand, Oceania, Africa, West Asia and Other regions. Sensitivity analyses (i) treating missing duration as a category; (ii) restricting to women migrating ≥ 18 years; and (iii) imputing missing data for duration, BMI and smoking, yielded similar results.</p><p><strong>Conclusions: </strong>Perinatal outcomes varied by region of birth and duration of residence, indicating the importance of both origin and receiving-context factors. Improving outcomes requires addressing structural barriers and upstream determinants disproportionately affecting specific migrant groups.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health and Pregnancy Outcomes: Making Sense of the Links.","authors":"Alison Gemmill","doi":"10.1111/ppe.70204","DOIUrl":"https://doi.org/10.1111/ppe.70204","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Diagnosis Counts Need Care-Pathway Measures in Pregnancy.","authors":"Jo Yen Man, Lien-Chung Wei","doi":"10.1111/ppe.70203","DOIUrl":"https://doi.org/10.1111/ppe.70203","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to: Mental Health Diagnosis Counts Need Care-Pathway Measures in Pregnancy.","authors":"Laura L Manzo, Chrystelle Kiang, Clinton Hall","doi":"10.1111/ppe.70202","DOIUrl":"https://doi.org/10.1111/ppe.70202","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}