Paediatric and perinatal epidemiology最新文献

{"title":"Addressing the Persistent Social Challenges of Very Preterm Birth.","authors":"Marina Mendonça","doi":"10.1111/ppe.13152","DOIUrl":"https://doi.org/10.1111/ppe.13152","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807108","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":"Gestational Age-Specific Stillbirth Rates: Are We Using the Right Denominator?","authors":"Jessica Sexton, Aleena M Wojcieszek, Georgina M Chambers, Michael Coory, Christine Andrews, Aya Al-Gharibeh, David Ellwood, Vicki Flenady","doi":"10.1111/ppe.13148","DOIUrl":"https://doi.org/10.1111/ppe.13148","url":null,"abstract":"<p><strong>Background: </strong>Globally, a stillbirth occurs every 17 seconds totalling almost 2 million every year. The global standard for reporting stillbirths is the stillbirth rate. While a critical and accessible summary statistic, it masks gestational age-specific trends.</p><p><strong>Objectives: </strong>This study aimed to summarise and critique stillbirth trends and document gestational age-specific rates and risk calculations according to three published methodologies: gestational age-specific stillbirth rate (GS-SBR), foetus-at-risk (FAR) stillbirth rate, and continuity corrected foetus-at-risk (ccFAR) stillbirth rate.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of all births from the National Perinatal Data Collection in Australia (1998-2018). Stillbirth was defined as the birth of a baby with no sign of life from 20 weeks of gestation or weighing 400 grams at birth. Three statistical measures were applied reflecting alternate denominators: the GS-SBR measure used the number of births in a given week, the FAR used the number of foetuses in utero at the start of a week, and the ccFAR used the number of foetuses at the midpoint of the week.</p><p><strong>Results: </strong>In Australia from 1998 to 2018, there were 39,576 stillbirths among 5.9 million births, an overall stillbirth rate of 6.7 per 1000 births. For each week of gestation (20-41+), the average GS-SBR varied from 1.0 to 790.0 stillbirths per 1000 births; FAR varied from 0.1 to 1.2 stillbirths per 1000 FAR; and ccFAR varied from 0.1 to 2.4 stillbirths per 1000 ongoing pregnancies. The three stillbirth rate calculations showed distinct trends during pregnancy, and only FAR and ccFAR reflected increased stillbirth risk as gestation advances.</p><p><strong>Conclusions: </strong>When calculating gestational-age-specific stillbirth rates, the FAR or ccFAR approaches provide the most accurate representation of the probability of stillbirth throughout pregnancy and better enable clinicians to act on risk.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780435","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":"Neighbourhood Deprivation and Gestational Diabetes Mellitus in Arizona From the AzPEARS Study.","authors":"Kimberly L Parra, Leslie V Farland, Robin B Harris, Matthew Toro, Melissa Furlong","doi":"10.1111/ppe.13146","DOIUrl":"https://doi.org/10.1111/ppe.13146","url":null,"abstract":"<p><strong>Background: </strong>The maternal population residing in rural areas, tribal lands or near the United States-Mexico border are at high risk for adverse pregnancy complications, notably gestational diabetes mellitus (GDM). Few studies have considered the socioeconomic status (SES) attributes of neighbourhoods on maternal health during gestation. Given that the national and global rate of GDM is rising, this analysis moves beyond individual-level factors and investigates the role of neighbourhood deprivation on GDM risk.</p><p><strong>Objective: </strong>To investigate the relationship between neighbourhood deprivation and risk of GDM using Arizona state birth records.</p><p><strong>Methods: </strong>This population-based study of singleton live births (N = 481,113) utilised birth certificates from 2014 to 2020 from the AzPEARS study. Using American Community Survey (5-year data) linked to 2010 US Census tracts, a composite neighbourhood deprivation index (NDI) score (continuous and quartiles) was derived from 8 socioeconomic indicators. Risk ratios (RR) and 95% confidence intervals (95% CI) were used to examine the association between NDI and GDM risk, adjusting for maternal age, maternal education, race/ethnicity, parity, rurality, and birth year.</p><p><strong>Results: </strong>The state-wide incidence of GDM was 7.8% (n = 37,636) with variation by neighbourhoods (4% to 12%). GDM risk was highest for Native Americans (17.6%), Asian/Pacific Islanders (13.7%) and Hispanic/Latinas (8.3%). Compared to mothers living in areas with the lowest quartile of NDI, mothers living in neighbourhoods with the highest deprivation had an adjusted risk ratio of 1.21 for developing GDM (95% CI 1.18, 1.26).</p><p><strong>Conclusions: </strong>We observed that neighbourhood deprivation was positively associated with a higher risk of GDM for each increase in quartile. These results suggest that NDI, a proxy for neighbourhood socioeconomic status, may contribute to GDM risk. Identifying high-risk neighbourhoods for place-based interventions targeting the most vulnerable birthing populations may be an effective strategy in the prevention of GDM.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780489","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":"Cancer incidence and stage at diagnosis in children and adolescents in the Community of Madrid, 2015-2018.","authors":"Raquel López-González, David Parra-Blázquez, Daniel Moñino, Candela Pino-Rosón, Marina Pollán, Nuria Aragonés","doi":"10.1111/ppe.13144","DOIUrl":"https://doi.org/10.1111/ppe.13144","url":null,"abstract":"<p><strong>Background: </strong>Cancer is the leading cause of death in children aged 1-14 and the second in 15-19-year-old adolescents in Spain. The Paediatric Population-Based Cancer Registry of the Community of Madrid was created to monitor its incidence and survival.</p><p><strong>Objectives: </strong>This study presents the incidence of childhood and adolescent cancer (0-19 years) in Madrid at a population level by sex, age group, type of tumour and stage at diagnosis.</p><p><strong>Methods: </strong>This study was a retrospective analysis of the total number of cases registered in the Paediatric Population-Based Cancer Registry of the Community of Madrid. The registry employs passive and active case finding: by cross-referencing hospital discharge data, primary healthcare data, mortality data and administrative information; and by validation of all potential incident cases through a review of electronic medical charts. All new diagnoses of malignant neoplasms, non-malignant neoplasms of the Central Nervous System, and uncertain and in situ neoplasms of the bladder, identified in 2015-2018 in individuals under age 20 residing in Madrid, were included. Patient information was collected along with tumour characteristics, including stage at diagnosis according to the Toronto Childhood Cancer Stage Guidelines. Age-specific and age-standardised incidence rates were computed with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 1002 tumours were registered in 5,269,524 person-years, yielding an age-standardised rate of 192.7 (95% CI 184.3, 201.4) cases per million person-years. Male/female rate ratio was 1.1. The most common cancers across all ages comprised CNS tumours, leukaemias and lymphomas (primarily Hodgkin): 45.5 (95% CI 39.9, 51.7), 41.1 (95% CI 35.7, 47.1) and 35.8 (95% CI 30.9, 41.3) cases per million person-years, respectively. The proportion of metastatic tumours at diagnosis was similar for ages 0-14 (18.6%) and 15-19 (18.7%).</p><p><strong>Conclusions: </strong>This study provides a comprehensive understanding of childhood and adolescent cancer incidence in Madrid. The registry provides high-quality data and consolidates epidemiological surveillance of cancer in the region.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780431","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":"Opioid analgesic and antidepressant use during pregnancy and the risk of spontaneous preterm birth: A nested case-control study.","authors":"Maria C Padilla-Azain, Sarah S Osmundson, Olivia Bosworth, Andrew Wiese, Amelie Pham, Ashley A Leech, Andrew J Spieker, Carlos G Grijalva, Margaret A Adgent","doi":"10.1111/ppe.13142","DOIUrl":"10.1111/ppe.13142","url":null,"abstract":"<p><strong>Background: </strong>Given the high prevalence of both mental health and acute pain conditions during pregnancy, use of antidepressants and analgesic opioids in this period is widespread. Whether single and combined use of these medications is associated with spontaneous preterm birth (sPTB) remains unclear.</p><p><strong>Objectives: </strong>To investigate the association between maternal prescription opioid and antidepressant medication exposures for co-occurring mental health and acute pain management, either alone or in combination, and sPTB.</p><p><strong>Methods: </strong>We used Tennessee Medicaid data (2007-2019) linked to birth certificates to conduct a nested case-control study among 15- to 44-year-old pregnant patients with singleton live births. Cases were identified as spontaneous live births between 24 and <37 gestational weeks using a validated birth certificate-based algorithm. We selected up to 10 controls per case, matched on estimated pregnancy start date and other factors. We identified analgesic opioid and antidepressant pharmacy fills to define medication exposures in the 60 days before index date (case delivery date) and categorised them as unexposed, opioid-only, antidepressant-only and combined exposure. We estimated odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression, adjusting for confounders. We assessed the additive interaction between opioids and antidepressants by estimating relative excess risk due to interaction.</p><p><strong>Results: </strong>We identified 25,406 eligible cases of sPTB and 225,771 matched controls. Opioid-only and combined exposures were associated with higher odds of sPTB relative to unexposed (adjusted OR 1.29, 95% CI 1.23, 1.35 and 1.22, 95% CI 1.06, 1.40, respectively), while antidepressant-only exposure was not (1.04, 95% CI 0.96, 1.12). No additive interaction was identified for combined exposure.</p><p><strong>Conclusions: </strong>Exposure to prescription opioids during pregnancy, but not antidepressants, was associated with increased relative odds of sPTB. Co-exposure to opioids and antidepressants did not elevate the odds of sPTB above what we observed for opioid-only exposure.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648425","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":"Post-term births as a risk factor for small for gestational age births and infant mortality in Brazil, Mexico, and Palestinian refugees: An analysis of electronic birth records.","authors":"Zeina Jamaluddine, Lorena Suarez Idueta, Enny S Paixao, Julia M Pescarini, Hala Ghattas, Miho Sato, Akihiro Seita, Luis A Martinez-Juarez, Mauricio L Barreto, Eric O Ohuma, Louise T Day, Oona M R Campbell, Hannah Blencowe","doi":"10.1111/ppe.13137","DOIUrl":"https://doi.org/10.1111/ppe.13137","url":null,"abstract":"<p><strong>Background: </strong>Post-term pregnancy, defined as reaching or exceeding 42 + 0 weeks of gestation, is known to be associated with unfavourable birth outcomes. High-income countries have responded to this risk by widely adopting labour induction protocols in late-term, but many low- and middle-income countries have not. However, understanding underlying mechanisms linking post-term births to adverse newborn and infant outcomes remains limited.</p><p><strong>Objective: </strong>To investigate the (a) prevalence of post-term, (b) the risk factors associated with post-term (c) the association between post-term births and the risk of small-for-gestational-age (SGA) neonates and of infant mortality in middle-income settings.</p><p><strong>Methods: </strong>We used existing electronic datasets from the general population of Brazil, Mexico, and Palestinian refugees. Regression models were used to explore the associations between post-term birth and SGA and infant mortality.</p><p><strong>Results: </strong>We analysed 21,335,033 live births in Brazil (2011-2018), 23,416,126 in Mexico (2008-2019), and 966,102 in Palestinian refugees (2010-2020) (N = 45,717,261). Post-term deliveries accounted for 3.1% of births in Brazil, 1.2% in Mexico, and 2.1% in Palestinian refugees. Post-term births had approximately three times the risk of resulting in SGA neonates compared to term births. Additionally, post-term neonates exhibited a 15% to 40% increased risk of infant mortality compared to term infants. Notably, post-term SGA neonates faced a significantly increased risk of infant mortality compared to term appropriate for gestational age neonates.</p><p><strong>Conclusions: </strong>These findings emphasise the critical significance of implementing induction strategies to prevent post-term pregnancies and mitigate the associated risks of SGA neonates and subsequent infant mortality. Moreover, the study highlights the importance of accurately determining gestational age and using INTERGROWTH-21st charts to improve the identification of SGA cases, enabling targeted interventions. This is especially relevant because post-term SGA neonates may not exhibit low birthweight (a commonly used risk marker) and, therefore, may miss out on required specialised attention.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648430","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":"Making sense of US maternal mortality data.","authors":"Elliott K Main","doi":"10.1111/ppe.13139","DOIUrl":"https://doi.org/10.1111/ppe.13139","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625337","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":"Data have consequences-Centring equity in the maternal mortality surveillance debate.","authors":"Teresa Janevic, Eugene Declercq, Elizabeth A Howell","doi":"10.1111/ppe.13138","DOIUrl":"https://doi.org/10.1111/ppe.13138","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625335","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":"Substance Use and Cardiovascular Health in Pre-Conception Care: Surprising Findings!","authors":"Amy R Mahar, Jorge E Chavarro","doi":"10.1111/ppe.13145","DOIUrl":"https://doi.org/10.1111/ppe.13145","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":"38 8","pages":"677-678"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740202","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 burden of paediatric adverse medical events.","authors":"Asma M Ahmed, Lindsay A Thompson","doi":"10.1111/ppe.13127","DOIUrl":"10.1111/ppe.13127","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"700-702"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292857","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}