Paediatric and perinatal epidemiology最新文献

{"title":"Patterns of multiple chronic conditions in pregnancy: Population-based study using latent class analysis.","authors":"Hilary K Brown, Kinwah Fung, Eyal Cohen, Cindy-Lee Dennis, Sonia M Grandi, Laura C Rosella, Catherine Varner, Simone N Vigod, Walter P Wodchis, Joel G Ray","doi":"10.1111/ppe.13016","DOIUrl":"10.1111/ppe.13016","url":null,"abstract":"<p><strong>Background: </strong>Adults with multiple chronic conditions (MCC) are a heterogeneous population with elevated risk of future adverse health outcomes. Yet, despite the increasing prevalence of MCC globally, data about MCC in pregnancy are scarce.</p><p><strong>Objectives: </strong>To estimate the population prevalence of MCC in pregnancy and determine whether certain types of chronic conditions cluster together among pregnant women with MCC.</p><p><strong>Methods: </strong>We conducted a population-based cohort study in Ontario, Canada, of all 15-55-year-old women with a recognised pregnancy, from 2007 to 2020. MCC was assessed from a list of 22 conditions, identified using validated algorithms. We estimated the prevalence of MCC. Next, we used latent class analysis to identify classes of co-occurring chronic conditions in women with MCC, with model selection based on parsimony, clinical interpretability and statistical fit.</p><p><strong>Results: </strong>Among 2,014,508 pregnancies, 324,735 had MCC (161.2 per 1000, 95% confidence interval [CI] 160.6, 161.8). Latent class analysis resulted in a five-class solution. In four classes, mood and anxiety disorders were prominent and clustered with one additional condition, as follows: Class 1 (22.4% of women with MCC), osteoarthritis; Class 2 (23.7%), obesity; Class 3 (15.8%), substance use disorders; and Class 4 (22.1%), asthma. In Class 5 (16.1%), four physical conditions clustered together: obesity, asthma, chronic hypertension and diabetes mellitus.</p><p><strong>Conclusions: </strong>MCC is common in pregnancy, with sub-types dominated by co-occurring mental and physical health conditions. These data show the importance of preconception and perinatal interventions, particularly integrated care strategies, to optimise treatment and stabilisation of chronic conditions in women with MCC.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49680761","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":"Conditional logistic versus conditional Poisson regression in sibship studies of interpregnancy interval.","authors":"Mark A Klebanoff, Erinn M Hade","doi":"10.1111/ppe.13044","DOIUrl":"10.1111/ppe.13044","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707492","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":"Association of maternal cancer with congenital anomalies in offspring.","authors":"Nathalie Auger, Amanda Maniraho, Aimina Ayoub, Laura Arbour","doi":"10.1111/ppe.13031","DOIUrl":"10.1111/ppe.13031","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies are common, but the possibility that maternal cancer increases the chance of having a child with a birth defect is not fully understood.</p><p><strong>Objectives: </strong>To examine the association between maternal cancer before or during pregnancy and the risk of birth defects in offspring.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of live births in Quebec, Canada, between 1989 and 2022 using hospital data. The main exposure measure was maternal cancer before or during pregnancy. The outcome included birth defects detected in offspring during gestation or at birth. We estimated risk ratios (RR) and 95% confidence intervals (CI) for the association of maternal cancer with birth defects using log-binomial regression models adjusted for potential confounders.</p><p><strong>Results: </strong>In this study of 2,568,120 newborns, birth defects were present in 6.0% and 6.7% of infants whose mothers had cancer before or during pregnancy, respectively, compared with 5.7% of infants whose mothers never had cancer. Cancer during pregnancy was associated with heart (RR 1.58, 95% CI 1.03, 2.44), nervous system (RR 4.05, 95% CI 2.20, 7.46) and urinary defects (RR 1.72, 95% CI 1.01, 2.95). Among specific types of malignancies during pregnancy, breast cancer was the most prominent risk factor for birth defects (RR 1.55, 95% CI 1.02, 2.37). Cancer before pregnancy was not associated with any type of birth defect or with defects overall (RR 1.01, 95% CI 0.92, 1.11). Moreover, no specific type of cancer before pregnancy was associated with an increased risk of birth defects.</p><p><strong>Conclusions: </strong>Maternal cancer during pregnancy is associated with the risk of congenital anomalies in offspring, however, cancer before pregnancy is not associated with this outcome.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808124","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":"Spatial-temporal distribution of preterm birth in China, 1990-2020: A systematic review and modelling analysis.","authors":"Wei-Hua Hu, Xin-Yuan Gao, Xiu-Xiu Li, Qing-Mei Lin, Li-Ping He, Ying-Si Lai, Yuan-Tao Hao","doi":"10.1111/ppe.13028","DOIUrl":"10.1111/ppe.13028","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the long-term trends of preterm birth rates in China and their geographic variation by province.</p><p><strong>Objectives: </strong>To estimate the annual spatial-temporal distribution of preterm birth rates in China by province from 1990 to 2020.</p><p><strong>Data sources: </strong>We searched PubMed, EMBASE, Web of Science, CNKI, WANFANG and VIP from January 1990 to September 2023.</p><p><strong>Study selection and data extraction: </strong>Studies that provided data on preterm births in China after 1990 were included. Data were extracted following the Guidelines for Accurate and Transparent Health Estimates Reporting.</p><p><strong>Synthesis: </strong>We assessed the quality of each survey using a 9-point checklist. We estimated the annual preterm birth risk by province using Bayesian multilevel logistic regression models considering potential socioeconomic, environmental, and sanitary predictors.</p><p><strong>Results: </strong>Based on 634 survey data from 343 included studies, we found a gradual increase in the preterm birth risk in most provinces in China since 1990, with an average annual increase of 0.7% nationally. However, the preterm birth rates in Inner Mongolia, Hubei, and Fujian Province showed a decline, while those in Sichuan were quite stable since 1990. In 2020, the estimates of preterm birth rates ranged from 2.9% (95% Bayesian credible interval [BCI] 2.1, 3.8) in Inner Mongolia to 8.5% (95% BCI 6.6, 10.9) in Jiangxi, with the national estimate of 5.9% (95% BCI 4.3, 8.1). Specifically, some provinces were identified as high-risk provinces for either consistently high preterm birth rates (e.g. Jiangxi) or relatively large increases (e.g. Shanxi) since 1990.</p><p><strong>Conclusions: </strong>This study provides annual information on the preterm birth risk in China since 1990 and identifies high-risk provinces to assist in targeted control and intervention for this health issue.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087949","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":"The association between preconception cannabis use and gestational diabetes mellitus: The Preconception Period Analysis of Risks and Exposures Influencing health and Development (PrePARED) consortium.","authors":"Ke Pan, Anne Marie Jukic, Gita D Mishra, Sunni L Mumford, Lauren A Wise, Enrique F Schisterman, Sylvia H Ley, Brittany M Charlton, Jorge E Chavarro, Jaime E Hart, Stephen Sidney, Xu Xiong, Celestina Barbosa-Leiker, Karen C Schliep, Jeffrey G Shaffer, Lydia A Bazzano, Emily W Harville","doi":"10.1111/ppe.13008","DOIUrl":"10.1111/ppe.13008","url":null,"abstract":"<p><strong>Background: </strong>The metabolic changes that ultimately lead to gestational diabetes mellitus (GDM) likely begin before pregnancy. Cannabis use might increase the risk of GDM by increasing appetite or promoting fat deposition and adipogenesis.</p><p><strong>Objectives: </strong>We aimed to assess the association between preconception cannabis use and GDM incidence.</p><p><strong>Methods: </strong>We analysed individual-level data from eight prospective cohort studies. We identified the first, or index, pregnancy (lasting ≥20 weeks of gestation with GDM status) after cannabis use. In analyses of pooled individual-level data, we used logistic regression to estimate study-type-specific odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential confounders using random effect meta-analysis to combine study-type-specific ORs and 95% CIs. Stratified analyses assessed potential effect modification by preconception tobacco use and pre-pregnancy body mass index (BMI).</p><p><strong>Results: </strong>Of 17,880 participants with an index pregnancy, 1198 (6.7%) were diagnosed with GDM. Before the index pregnancy, 12.5% of participants used cannabis in the past year. Overall, there was no association between preconception cannabis use in the past year and GDM (OR 0.97, 95% CI 0.79, 1.18). Among participants who never used tobacco, however, those who used cannabis more than weekly had a higher risk of developing GDM than those who did not use cannabis in the past year (OR 2.65, 95% CI 1.15, 6.09). This association was not present among former or current tobacco users. Results were similar across all preconception BMI groups.</p><p><strong>Conclusions: </strong>In this pooled analysis of preconception cohort studies, preconception cannabis use was associated with a higher risk of developing GDM among individuals who never used tobacco but not among individuals who formerly or currently used tobacco. Future studies with more detailed measurements are needed to investigate the influence of preconception cannabis use on pregnancy complications.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41162046","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 clinical performance and population health impact of birthweight-for-gestational age indices at term gestation.","authors":"Sid John, K S Joseph, John Fahey, Shiliang Liu, Michael S Kramer","doi":"10.1111/ppe.12994","DOIUrl":"10.1111/ppe.12994","url":null,"abstract":"<p><strong>Background: </strong>The assessment of birthweight for gestational age and the identification of small- and large-for-gestational age (SGA and LGA) infants remain contentious, despite the recent creation of the Intergrowth 21st Project and World Health Organisation (WHO) birthweight-for-gestational age standards.</p><p><strong>Objective: </strong>We carried out a study to identify birthweight-for-gestational age cut-offs, and corresponding population-based, Intergrowth 21st and WHO centiles associated with higher risks of adverse neonatal outcomes, and to evaluate their ability to predict serious neonatal morbidity and neonatal mortality (SNMM) at term gestation.</p><p><strong>Methods: </strong>The study population was based on non-anomalous, singleton live births between 37 and 41 weeks' gestation in the United States from 2003 to 2017. SNMM included 5-min Apgar score <4, neonatal seizures, need for assisted ventilation, and neonatal death. Birthweight-specific SNMM was modelled by gestational week using penalised B-splines. The birthweights at which SNMM odds were minimised (and higher by 10%, 50% and 100%) were estimated, and the corresponding population, Intergrowth 21st, and WHO centiles were identified. The clinical performance and population impact of these cut-offs for predicting SNMM were evaluated.</p><p><strong>Results: </strong>The study included 40,179,663 live births and 991,486 SNMM cases. Among female singletons at 39 weeks' gestation, SNMM odds was lowest at 3203 g birthweight, and 10% higher at 2835 g and 3685 g (population centiles 11th and 82nd, Intergrowth centiles 17th and 88th and WHO centiles 15th and 85th). Birthweight cut-offs were poor predictors of SNMM, for example, the cut-offs associated with 10% and 50% higher odds of SNMM among female singletons at 39 weeks' gestation resulted in a sensitivity, specificity, and population attributable fraction of 12.5%, 89.4%, and 2.1%, and 2.9%, 98.4% and 1.3%, respectively.</p><p><strong>Conclusions: </strong>Reference- and standard-based birthweight-for-gestational age indices and centiles perform poorly for predicting adverse neonatal outcomes in individual infants, and their associated population impact is also small.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9717832","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":"Complexities of studying fertility across the reproductive life course.","authors":"Martha M Werler","doi":"10.1111/ppe.13035","DOIUrl":"10.1111/ppe.13035","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808173","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":"Prevalence and correlates of very rapid repeat pregnancy: Pregnancy Risk Assessment Monitoring System, United States, 2009-2020.","authors":"Amanda Luff, Michelle Menegay, Maria F Gallo","doi":"10.1111/ppe.13014","DOIUrl":"10.1111/ppe.13014","url":null,"abstract":"<p><strong>Background: </strong>Most rapid repeat pregnancies, defined as those occurring within 18 months of a previous birth, are unintended. These pregnancies are associated with later initiation of prenatal care and are more common among people with lower socio-economic status and among racially and ethnically minoritised populations.</p><p><strong>Objectives: </strong>To assess prevalence and correlate pregnancies occurring in the immediate period after a live birth in the United States, using the Pregnancy Risk Assessment Monitoring System (PRAMS).</p><p><strong>Methods: </strong>We assessed data from the 2009-2020 PRAMS, a population-based survey of perinatal maternal characteristics of mothers of liveborn infants in US locations. We assessed pregnancies reported during the immediate postpartum period (approximately 2-6 months post-delivery), and term this 'very rapid repeat pregnancy' (VRRP). We assessed the adjusted prevalence of VRRP from 2009 to 2020. From 2016 to 2020, we calculated adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) for maternal characteristics.</p><p><strong>Results: </strong>The adjusted prevalence of VRRP ranged from 0.38% (95% CI: 0.29, 0.48) in 2009 to 0.76% (95% CI: 0.61, 0.91) in 2020. Demographic characteristics associated with VRRP included younger age, lower educational attainment, and being unmarried. Black mothers had a higher prevalence of VRRP compared to white mothers. Mothers who attended a healthcare visit in the 12 months preconception had a lower prevalence of VRRP as did mothers who attended a postpartum check-up, compared to their counterparts without these visits. Among those receiving prenatal care, mothers whose prenatal healthcare provider asked about postpartum contraception birth had a lower prevalence of VRRP, compared to those not asked about postpartum contraception.</p><p><strong>Conclusions: </strong>VRRP appeared to increase over time in 2009-2020. Mothers who are younger, Black, have lower educational attainment, or who did not attend healthcare visits before or after pregnancy had a higher prevalence of VRRP and may comprise a population who would benefit from additional family planning resources.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10841439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49691811","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":"Using mothers as the denominator.","authors":"Katherine A Ahrens","doi":"10.1111/ppe.13027","DOIUrl":"10.1111/ppe.13027","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482713","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":"Insights from the epidemiology of cerebral palsy: Navigating the advantages and limitations of registry versus administrative health data.","authors":"Sandra Julsen Hollung, Joanne Given","doi":"10.1111/ppe.13036","DOIUrl":"10.1111/ppe.13036","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040342","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}