Paediatric and perinatal epidemiology最新文献

{"title":"Pregnancy and ADHD Medications: Is It Time for Clinical Guidelines?","authors":"Julie Werenberg Dreier, Kathrine Bang Madsen","doi":"10.1111/ppe.70048","DOIUrl":"https://doi.org/10.1111/ppe.70048","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567646","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":"Longitudinal Methods Versus Multiple Imputation to Infer Missing Maternal Data in Registry-Based Pregnancy Studies.","authors":"Takamasa Sakai, Hedvig Nordeng, Marleen M H J van Gelder","doi":"10.1111/ppe.70011","DOIUrl":"https://doi.org/10.1111/ppe.70011","url":null,"abstract":"<p><strong>Background: </strong>In birth registries, incomplete recording of information leads to missing values. Multiple imputation (MI) by chained equations is a widely used method for analysing datasets with missing data. It is unknown whether using registry records from multiple pregnancies contributed by the same woman could potentially give more accurate values when resolving missing data.</p><p><strong>Objectives: </strong>To investigate the relative performance of five methods to infer missing data on maternal characteristics using data from a medical birth registry, comparing longitudinal methods and MI with data from previous and future pregnancies.</p><p><strong>Methods: </strong>We used data from the Medical Birth Registry of Norway (MBRN), selecting records among mothers with more than one pregnancy between 2004 and 2018. Longitudinal methods used reference pregnancies in three time directions: past, future and closest pregnancy record. MI was conducted with only index pregnancy records (single-pregnancy MI) and with both index and closest reference pregnancy records (multiple-pregnancy MI). Validity was assessed by comparing the actual values with inferred/imputed values. For continuous variables, we calculated the proportion of inferred values within predefined increments. For binary variables, we calculated five parameters: agreement rate, sensitivity, specificity, positive predictive value and negative predictive value.</p><p><strong>Results: </strong>We included 578,670 pregnancies among 256,658 women. For continuous variables, the longitudinal methods showed the highest proportion within predefined increments, followed by multiple-pregnancy MI, and single-pregnancy MI showed the lowest value. For binary variables, longitudinal methods generally showed higher values among the five validity parameters than MI. Single-pregnancy MI had substantially lower agreement, while multiple-pregnancy MI performed similarly to longitudinal methods.</p><p><strong>Conclusions: </strong>The longitudinal method outperformed MI in inferring missing data on maternal characteristics in a medical birth registry.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507272","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":"Linkage of Electronic Health Record Data Across Two Healthcare Systems for Perinatal Health Research: A Privacy-Preserving Approach.","authors":"Kirsten Ehresmann, Claire Smith, Gabriela Vazquez-Benitez, Elisabeth M Seburg, Terese A DeFor, Asha Farah, Abbey Sidebottom, Kristin Palmsten","doi":"10.1111/ppe.70039","DOIUrl":"https://doi.org/10.1111/ppe.70039","url":null,"abstract":"<p><strong>Background: </strong>In the United States, birthing parent-infant dyads may receive care from multiple healthcare systems. Linkage of an individual's electronic health records (EHR) across healthcare systems, in addition to birthing parent-infant linkage, may be necessary to obtain appropriate clinical data for perinatal health research.</p><p><strong>Objectives: </strong>To develop a privacy-preserving process to link the health records of patients shared by two health systems for a perinatal health study, and to assess data enhancements associated with the linkage.</p><p><strong>Methods: </strong>We included pregnant patients who received care from at least one of two healthcare systems based in Minnesota, USA and their infants born between December 2020 and September 2022 who had at least one well visit. We identified infants from one health system with birthing parents who potentially received care in the second health system based on the infant's delivery hospital. We implemented a one-way matching process using an algorithm to generate unique hash values for each record at each health system. Specifically, we used four hash ID rules based on six identifiers available in the EHR at both sites plus a consistent salt.</p><p><strong>Results: </strong>One health system identified 3524 infants with birthing parents who potentially received care in the second system. The second system identified 39,321 infants delivered at the hospitals of interest during the study period. The algorithm matched 3406 (96.7%) infant records. After applying the study eligibility criteria, the birthing-parent records gained through hash matching increased the study population by 7.2% from 8100 to 8686. Overall, 13.6% of the study population had data from the second health system. Some demographic and pregnancy characteristics differed from those with data from the first system only.</p><p><strong>Conclusions: </strong>The hash matching approach can increase study size, patient diversity, and data completeness in a privacy-preserving manner for perinatal health studies among patients that use multiple healthcare systems.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512267","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":"Fenton Third-Generation Growth Charts of Preterm Infants Without Abnormal Fetal Growth: A Systematic Review and Meta-Analysis.","authors":"Tanis R Fenton, Seham Elmrayed, Belal N Alshaikh","doi":"10.1111/ppe.70035","DOIUrl":"https://doi.org/10.1111/ppe.70035","url":null,"abstract":"<p><strong>Background: </strong>Experts recommend assessing preterm infant growth against fetal growth patterns. However, obtaining accurate estimates of healthy fetal growth from preterm infants is challenging as many had intrauterine faltering growth.</p><p><strong>Objectives: </strong>To improve preterm infant growth assessments by developing Fenton third-generation sex-specific preterm growth charts based on anthropometric distributions of preterm infants without abnormal fetal growth. We also aimed to evaluate the consistency of the new charts' growth velocities.</p><p><strong>Data sources: </strong>From the last search for the 2013 Fenton growth charts to November 2024, MEDLINE and EMBASE databases, grey literature, as well as US Vital statistics and iNeo Consortium.</p><p><strong>Study selection and data extraction: </strong>We followed systematic review methodology to identify population-based sex-specific anthropometric estimates of preterm cohorts without abnormal fetal growth beginning ≤ 24 weeks of gestation. Specified a priori, outcomes included newborn sex-specific estimates of birthweight, length, and head circumference.</p><p><strong>Synthesis: </strong>We followed PRISMA guidelines. Literature screening and quality assessment were performed in duplicate. We harmonised weight, length, and head circumference weighted-average meta-analyses with the World Health Organization growth standard and rescaled the charts' x-axis from completed gestational weeks to exact gestational age (weeks and days).</p><p><strong>Results: </strong>Seven studies from 15 countries (Australia, Brazil, Canada, China, Finland, Israel, Italy, Japan, Netherlands, New Zealand, Sweden, Switzerland, Spain, United Kingdom and United States) were included, representing 4.8 million births 22-42 weeks of gestation. 174,184 were < 30 weeks gestational age. The Fenton third-generation preterm growth charts' weights showed improved growth velocity across percentiles with consistent declines for weight, length and head circumference velocity as post-menstrual age increased. The birthweight meta-analysis curves had similar shapes to fetal ultrasound estimates.</p><p><strong>Conclusions: </strong>The Fenton third-generation preterm infant growth chart curves demonstrate improved and more uniform slopes across percentiles and closer alignment with fetal ultrasound estimates, offering a growth standard for preterm infants.</p><p><strong>Prospero registration: </strong>CRD42024589756.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326492","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":"Early-Onset Neonatal Infection and Attention Deficit Hyperactivity and Autism Spectrum Disorder: A Nationwide Cohort Study.","authors":"Mads Andersen, Niels Bjerregård Matthiesen, May Murra, Stine Yde Nielsen, Tine Brink Henriksen","doi":"10.1111/ppe.70036","DOIUrl":"https://doi.org/10.1111/ppe.70036","url":null,"abstract":"<p><strong>Background: </strong>Early-onset neonatal infections are among the most common neonatal diseases. However, the long-term outcomes of the infections are not well understood.</p><p><strong>Objective: </strong>To study the association between early-onset neonatal infection and attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).</p><p><strong>Methods: </strong>A nationwide register-based cohort study was conducted, including near-term and term children born between 1997 and 2013 with follow-up until 2021. An early-onset infection was defined as an invasive bacterial infection occurring within the first week of life, including both physician-assigned diagnoses and positive bacterial cultures. ADHD and ASD were defined by diagnoses or prescriptions of relevant medication. Associations between sepsis and the neurodevelopmental disorders were investigated using multivariable Cox regression to estimate adjusted hazard ratios (HR), whereas associations with meningitis were examined using person-time incidence rate ratios (IRR). Sibling-matched analyses were also conducted for associations with sepsis.</p><p><strong>Results: </strong>A total of 981,869 children were included, with 8154 defined as having sepsis and 152 defined as having meningitis. Among these, only 257 children had culture-positive sepsis, whereas 32 had culture-positive meningitis. The incidence rate of ADHD and ASD for children with sepsis was 4.5 per 1000 and 3.3 per 1000 person-years, respectively. Sepsis was associated with an increased adjusted likelihood of both ADHD (HR 1.28, 95% CI 1.17, 1.39) and ASD (HR 1.43, 95% CI 1.30, 1.58). However, sibling-matched analyses especially attenuated the association with ADHD (HR 1.12, 95% CI 0.93, 1.34). Point estimates suggested that children with meningitis also had an increased likelihood of both ADHD (IRR 1.77, 95% CI 0.88, 3.17) and ASD (IRR 2.05, 95% CI 0.89, 4.04).</p><p><strong>Conclusions: </strong>Early-onset sepsis was associated with an increased likelihood of ASD, whereas the majority of the association with ADHD could be explained by unmeasured shared familial confounding.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317574","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":"Time-Varying Associations Between Physical Activity and Injury Risk Among Children.","authors":"Chinchin Wang, Michal Abrahamowicz, Marie-Eve Beauchamp, Jay S Kaufman, Russell J Steele, Eva Jespersen, Niels Wedderkopp, Ian Shrier","doi":"10.1111/ppe.70040","DOIUrl":"https://doi.org/10.1111/ppe.70040","url":null,"abstract":"<p><strong>Background: </strong>Physical activity has time-varying associations with injury risk among children. While previous activity may predispose to injury through tissue damage, fatigue and insufficient recovery, it may protect against injury by strengthening tissues and improving fitness and skills. It is unclear what the relevant time window and relative importance of past activity are with regard to current injury risk in children.</p><p><strong>Objectives: </strong>The objectives of this study were to assess how previous activity patterns are associated with injury risk among children.</p><p><strong>Methods: </strong>Our data source was the Childhood Health, Activity, and Motor Performance School Study Denmark (CHAMPS-DK), a prospective cohort study of Danish school children conducted between 2008 and 2014. We applied flexible weighted cumulative exposure methods within a Cox proportional hazards model to estimate the time-varying association between the number of weekly activity sessions and time-to-first injury in each school year. We estimated several models with varying time windows and compared goodness-of-fit.</p><p><strong>Results: </strong>Out of 1667 study participants, 986 (59.1%) were injured at least once, with a total of 1752 first injuries across school years. The best-fitting model included 20 weeks of past physical activity. Higher levels of activity performed 10-20 weeks ago were associated with decreased injury risk, while higher levels of activity performed 2-9 weeks ago were associated with higher injury risks. Compared to those who remained minimally active for the entire past 20-week period, children who were highly active in the past 10 weeks after being minimally active 11-20 weeks ago had an injury hazard ratio of 1.63 (95% confidence interval 1.18, 2.23).</p><p><strong>Conclusions: </strong>Flexible weighted cumulative exposure methods suggest a complex temporal relationship between past physical activity history and injury in children.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302648","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 Value of Population-Level Data and Looking Toward the Future.","authors":"Eric Rubenstein, Stephanie L Santoro","doi":"10.1111/ppe.70038","DOIUrl":"https://doi.org/10.1111/ppe.70038","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249036","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":"Is Adolescence a Window of Opportunity for Prepregnancy Obesity Prevention?","authors":"Romy Gaillard","doi":"10.1111/ppe.70037","DOIUrl":"https://doi.org/10.1111/ppe.70037","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249034","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":"Temporal Changes in the Contribution of Chronic Disease to Maternal Mortality in the United States.","authors":"Yasser Sabr, Sarka Lisonkova, Chantal Mayer, K S Joseph","doi":"10.1111/ppe.70034","DOIUrl":"https://doi.org/10.1111/ppe.70034","url":null,"abstract":"<p><strong>Background: </strong>Increases in maternal age, obesity and other factors have led to an increase in hypertension, diabetes, and other chronic diseases among pregnant women. However, the impact of chronic diseases on maternal mortality has not been adequately studied.</p><p><strong>Objectives: </strong>To quantify the contribution of maternal mortality associated with chronic disease to maternal mortality in the United States in 1999-2002 and 2018-2022.</p><p><strong>Methods: </strong>The study was based on maternal deaths in the United States in 1999-2002 and 2018-2022, with data obtained from the mortality and live birth files of the National Center for Health Statistics. Maternal deaths and maternal deaths associated with chronic disease were identified based on the presence of pregnancy-related causes and chronic diseases among the multiple causes of death. Maternal mortality ratios (MMR) and ratios of MMRs and their 95% confidence intervals (CI) were estimated to assess period change. Temporal changes in MMRs were adjusted for maternal age using direct standardisation.</p><p><strong>Results: </strong>Although overall MMRs were stable, direct obstetrical deaths decreased by 14% (95% CI 9, 23) from 1999-2002 to 2018-2022. Maternal deaths associated with chronic disease increased by 28% (95% CI 17, 40) from 5.41 in 1999-2002 to 6.92 per 100,000 live births in 2018-2022. The temporal increases in chronic disease-related maternal deaths were attenuated but not abolished following adjustment for maternal age (age-adjusted increase 16%, 95% CI 10, 23). MMRs associated with chronic disease increased in all age groups, especially among women aged < 20 and 30-39 years (57% and 17% increase, respectively). Non-Hispanic Black women had the highest MMRs associated with chronic disease (15.8 per 100,000 live births in 2018-2022), while age-adjusted MMRs increased among non-Hispanic White women (45% increase, 95% CI 33, 59).</p><p><strong>Conclusions: </strong>A substantial fraction of maternal deaths in the United States is associated with chronic disease, although patterns vary by race/ethnicity.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249035","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":"Placental Abruption and Perinatal Mortality: Abnormal Placentation and Spontaneous Abortion as Contributors to Left Truncation Bias.","authors":"Alan C Kinlaw, Hillary L Graham, Cande V Ananth","doi":"10.1111/ppe.70010","DOIUrl":"https://doi.org/10.1111/ppe.70010","url":null,"abstract":"<p><strong>Background: </strong>Generally, studies in perinatal epidemiology restrict cohort entry to 20 weeks of gestation, but exposures and outcomes may occur earlier. This restriction may introduce left truncation bias.</p><p><strong>Objectives: </strong>To examine the impact of left truncation bias when estimating the causal effect of abruption on perinatal mortality in the context of abnormal placentation, with spontaneous abortion (SAB) as a censoring event.</p><p><strong>Methods: </strong>Through 80 Monte Carlo simulation scenarios based on realistic clinical assumptions, we estimated risk differences (RD), risk ratios (RR) and bias parameters for the abruption-perinatal mortality association.</p><p><strong>Results: </strong>Censoring by SAB ranged from 5.6% to 7.6% across simulation setups. The risk of mortality was underestimated in observable (left-truncated) data at ≥ 20 weeks compared to an unobservable cohort starting follow-up at placental implantation (conception cohort). Underestimation of risks was stronger among abruption pregnancies. RDs for the abruption-mortality association were biased by +1% to +3% among conceptions with normal implantation and by +5% to +43% among abnormal placentation. Due to the disproportionate underestimation of mortality among nonabruption pregnancies, RRs were overestimated by 1.1 to 1.2-fold for normal implantations and by 1.1 to 8.4-fold for abnormal implantations.</p><p><strong>Conclusions: </strong>The findings of this simulation study highlight the critical importance of placentation in successful pregnancy. Abnormal placentation has profound consequences for unsuccessful pregnancies, remarkably increasing the risks of early losses, placental abruption and other obstetrical complications. This study underscores that left truncation can bias the abruption-perinatal mortality association, differentially by whether the placentation was normal or abnormal. However, defining the causal question regarding the abruption-perinatal mortality association requires consideration of the target population, which may include all conceptions. In studies of these effects, outcome follow-up capability may introduce left truncation bias. We do not prescribe one analytic approach to account for left truncation, but rather, the approach should be guided by the causal question.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226099","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}