Paediatric and perinatal epidemiology最新文献

{"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":"10.1111/ppe.13138","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"311-313"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066965/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Age Differences in Interpregnancy Interval and Preterm Birth Associations Accounting for Multiple Epidemiologic Biases.","authors":"Julie M Petersen, Mahsa M Yazdy, Anne Marie Darling, Martha M Werler","doi":"10.1111/ppe.70022","DOIUrl":"https://doi.org/10.1111/ppe.70022","url":null,"abstract":"<p><strong>Background: </strong>People who recently gave birth are strongly advised to wait 6 months before attempting pregnancy. Interpregnancy intervals (IPI) of ≥ 18 months are considered optimal. Current guidance is not tailored based on maternal characteristics (e.g., age).</p><p><strong>Objectives: </strong>We evaluated whether maternal age modifies IPI-preterm birth (PTB) associations.</p><p><strong>Methods: </strong>From a US retrospective cohort of multiparae (1997-2011), we categorised IPI: < 6, 6-11, 12-17, 18-23 (reference), 24-59 or ≥ 60 months. PTB occurred before 37 0/7 weeks' gestation. We estimated risk ratios (RR) between IPI and PTB using modified Poisson regression, adjusted for potential confounders and stratified by age at prior delivery: < 25 (n = 2484), 25-29 (n = 1626) or ≥ 30 (n = 1209) years. We conducted quantitative bias analysis to adjust for volunteer bias and dependent misclassification between IPI and gestational length (since both are calculated using the estimated start of pregnancy). We computed E-values when RR lower bounds of the 95% simulation intervals were > 1.00.</p><p><strong>Results: </strong>Estimates were imprecise due to small numbers. However, in terms of general patterns, PTB risk was highest with < 6 months IPI in all age groups (covariate-adjusted RR point estimates ≥ 1.30). The strongest associations were observed among 25-29 years. For ≥ 30 years, PTB risk was lowest with 6-17 months IPI. After multiple bias adjustments, estimates tended to move downward, but similar patterns remained. For 25-29 years, the lower bound of the 95% simulation interval for < 6 versus 18-23 months IPI was > 1.00, with an E-value of 3.82, suggesting unmeasured confounding would need to be very strong to explain the association.</p><p><strong>Conclusions: </strong>Estimates were imprecise. However, our study adds to growing evidence that IPI associations may be weaker among older individuals. Older individuals with shorter IPI may have lower PTB risk than those with currently recommended IPI, but more research is needed.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998707","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":"Selection Biases in Perinatal Research: A Comparison of Inverse Probability Weighting, Instrumental Variable and Sibling-Comparison Design.","authors":"Basma N Dib, Ellen C Caniglia, Sean Brummel, Roger Shapiro, Sonja A Swanson","doi":"10.1111/ppe.70021","DOIUrl":"https://doi.org/10.1111/ppe.70021","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal perinatal studies that study the effects of preconception or prenatal treatments on pregnancy outcomes can have inherent forms of selection bias. For example, these studies often restrict analyses to those who had a livebirth, those with a specified gestation duration or those with complete follow-up. These selection factors are often associated with the treatment and have shared causes with the outcome, which may induce bias in estimating causal effects. Though such selection bias can affect all causal inference approaches, what is unknown is how this bias compares in direction and magnitude across different approaches.</p><p><strong>Objectives: </strong>We conducted a simulation study to assess and compare the direction and magnitude of bias due to censoring across three common analytic approaches: inverse probability weighting (IPW), instrumental variable (IV) and sibling-comparison design.</p><p><strong>Methods: </strong>We simulated data for various scenarios under two censoring mechanisms (loss to follow-up; and competing events) with a null true causal treatment effect. The simulated scenarios varied in the probability of the censoring mechanism or its strength of association with treatment or outcome. For each scenario, we generated 500 datasets (sample size = 10,000) and calculated the mean bias in risk difference estimates obtained from the three analytic approaches.</p><p><strong>Results: </strong>Across all approaches, the proportion of censoring had no specific effect on mean bias. However, increasing the association of censoring with treatment or outcome increased the mean bias. The mean bias in all approaches was generally away from the null in the same direction and often to a similar extent (e.g., 0.5 percentage points away from the null in simulated scenarios with moderate association between treatment and censoring). However, in simulated scenarios with strong association between treatment and censoring, IV analyses were meaningfully more biased than IPW and sibling-comparison design analyses, with mean bias reaching two percentage points.</p><p><strong>Conclusions: </strong>Across the simulated scenarios, the mean bias in all three approaches was generally away from the null in the same direction and often to a similar extent. Thus, triangulating effect estimates from different analytic approaches in perinatal studies is challenging and may lead to invalid interpretations in the presence of selection processes.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006788","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":"Monitoring Perinatal Health in Europe: Strengths and Challenges of the Euro-Peristat Project.","authors":"Thillagavathie Pillay","doi":"10.1111/ppe.70024","DOIUrl":"https://doi.org/10.1111/ppe.70024","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049449","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":"Reducing Inequalities in Timing of Antenatal Care Initiation: A Hypothetical Intervention in the Generation R Study.","authors":"Clair A Enthoven, Jeremy A Labrecque, Hanan El Marroun, Nicole Lucassen, Dionne V Gootjes, Eefje van Vliet, Hilmar H Bijma, Pauline W Jansen","doi":"10.1111/ppe.70020","DOIUrl":"https://doi.org/10.1111/ppe.70020","url":null,"abstract":"<p><strong>Background: </strong>Much research has focused on identifying predictors of late antenatal care initiation. Many of these predictors (e.g., young age, migration background, socioeconomic position) are impossible to modify, illustrating the need to explore other interventions.</p><p><strong>Objectives: </strong>This study aims to investigate inequalities in antenatal care initiation and assess whether early pregnancy recognition may reduce these inequalities.</p><p><strong>Methods: </strong>Data from Generation R were used (N = 4196), a population-based birth cohort study in Rotterdam, The Netherlands. The association of gestational age at pregnancy recognition with the timing of antenatal care initiation and associations of individual and socioeconomic factors with the timing of antenatal care initiation were assessed using linear regression analyses. G-methods were used to estimate the reduction of the inequalities in antenatal care initiation if everyone would have recognised the pregnancy within 6 weeks.</p><p><strong>Results: </strong>Participants who recognised their pregnancy within 6 weeks (81.7%) had their first antenatal care visit 1.3 weeks (95% confidence interval [CI] -1.6, -0.9) earlier than those who recognised their pregnancy after 6 weeks. All individual and socioeconomic factors were associated with the timing of antenatal care initiation. Modelling a scenario where pregnancy recognition occurred within 6 weeks reduced inequalities in antenatal care initiation timing across several groups: age < 20 versus 30-35 (-0.4 weeks, 95% CI -0.7, -0.2), first-generation migrants versus no migration (-0.1 weeks, 95% CI -0.2, 0.0), unplanned/ambivalent versus planned pregnancies (-0.4 weeks, 95% CI -0.6, -0.2), lower versus higher educational attainment (-0.1 weeks, 95% CI -0.2, 0.0), unemployed versus employed (-0.1 weeks, 95% CI -0.2, 0.0), low versus high household income (-0.1 weeks, 95% CI -0.3, 0.0), renters versus homeowners (-0.1 weeks, 95% CI -0.2, 0.0), and high versus low neighbourhood deprivation (-0.1 weeks, 95% CI -0.2, -0.1).</p><p><strong>Conclusions: </strong>Early recognition of pregnancy may help reduce the impact of socio-economic inequalities in the timely initiation of antenatal care.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795888","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":"Left Truncation in the Periviable Period and the Black Survival Advantage.","authors":"Tim A Bruckner, Allison Stolte, Brenda Bustos, Alison Gemmill, Joan A Casey, Hedwig Lee, Ralph A Catalano","doi":"10.1111/ppe.70019","DOIUrl":"https://doi.org/10.1111/ppe.70019","url":null,"abstract":"<p><strong>Background: </strong>Infants born in the periviable period show an extremely high risk of infant death. At all gestational ages in the periviable period, non-Hispanic (NH) Black infants counterintuitively show relatively lower infant mortality risk than do NH white infants. The literature theorises that cohort variation over time in pregnancy loss (a form of left truncation in utero) could explain a portion of this survival advantage.</p><p><strong>Objectives: </strong>We test this left truncation hypothesis in the US (Jan 1996 to Jun 2018) by focusing on NH Black singleton periviable males. We use twin sex ratios as a gauge of cohort left truncation against frail males.</p><p><strong>Methods: </strong>We retrieved US birth and infant death records for all NH Black and NH white singleton infants born in the periviable range for 282 monthly conception cohorts. We used high and low outliers in the monthly sex ratio of extremely preterm twins (M:F), where a higher sex ratio indicates less selection against frail males. We applied augmented time-series methods which control for both autocorrelation and confounding.</p><p><strong>Results: </strong>NH Black male periviable singleton infants show a stronger survival advantage (relative to NH whites) for cohorts with high outliers in left truncation (4.0 fewer deaths per 100 live births, 95% confidence interval 1.0, 7.2).</p><p><strong>Conclusions: </strong>Elevated left truncation in utero may contribute to the survival advantage of NH Black male singletons in the periviable period. Observed racial/ethnic differences in infant mortality across conception cohorts vary, at least in part, from left truncation.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764473","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":"Evaluating Perinatal Health in Europe: A Comparison of Routine Population Birth Data Sources.","authors":"Marianne Philibert, Mika Gissler, Oscar Zurriaga, Serena Donati, Zeljka Drausnik, Günther Heller, Alison Macfarlane, Ashna Mohangoo, Luule Sakkeus, Vlad Tica, Petr Velebil, Jeannette Klimont, Lisa Broeders, Tonia A Rihs, Jennifer Zeitlin","doi":"10.1111/ppe.13178","DOIUrl":"https://doi.org/10.1111/ppe.13178","url":null,"abstract":"<p><strong>Background: </strong>International comparisons of population birth data provide essential benchmarks for evaluating perinatal health policies.</p><p><strong>Objectives: </strong>This study aimed to describe routine national data sources in Europe by their ability to provide core perinatal health indicators.</p><p><strong>Methods: </strong>The Euro-Peristat Network collected routine national data on a recommended set of core indicators from 2015 to 2021 using a federated protocol based on a common data model with 16 data items. Data providers completed an online questionnaire to describe the sources used in each country. We classified countries by the number of data items they provided (all 16, 15-14, < 14).</p><p><strong>Results: </strong>A total of 29 out of the 31 countries that provided data responded to the survey. Routine data sources included birth certificates (15 countries), electronic medical records (EMR) from delivery hospitalisations (16 countries), direct entry by health providers (9 countries), EMR from other care providers (7 countries) and Hospital Discharge Summaries (7 countries). Completeness of population coverage was at least 98%, with 17 countries reporting 100%. These databases most often included mothers giving birth in the national territory, regardless of nationality or place of residence (24 countries), whereas others register births to residents only. In 20 countries, routine sources were linked, including linkage between birth and death certificates (16 countries). Countries providing all 16 items (N = 8) were more likely to use EMRs from delivery hospitalisations (100%) compared to 50% and 11% in countries with 15-14 items (N = 12) and < 14 items (N = 9), respectively. Linkage was also more common in these countries (100%) versus 75% and 56%, respectively. Other data source characteristics did not differ by the ability to provide data on core perinatal indicators.</p><p><strong>Conclusions: </strong>There are wide differences between countries in the data sources used to construct perinatal health indicators in Europe. Countries using EMR linking to other sources had the best data availability.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605957","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 Risk Factors for Adult Pre-Pregnancy Obesity and High Gestational Weight Gain: A Longitudinal Study.","authors":"Susan M Mason, Kriszta Farkas, Lisa M Bodnar, Richard F MacLehose, Dianne Neumark-Sztainer","doi":"10.1111/ppe.70007","DOIUrl":"https://doi.org/10.1111/ppe.70007","url":null,"abstract":"<p><strong>Background: </strong>Risk factors during adolescence appear to shape adult health, but little is known about how they are associated with pregnancy health.</p><p><strong>Objectives: </strong>We aimed to assess whether a variety of adolescent risk factors with links to adult overweight or obesity are associated with pre-pregnancy obesity (Body Mass Index [BMI] ≥ 30 kg/m²) and high gestational weight gain (GWG; > 0.5 SD for pre-pregnancy BMI category and gestational age) in a cohort of women participating since adolescence in a longitudinal cohort.</p><p><strong>Methods: </strong>At age 11-18 years participants reported on adolescent risk factors (overweight or obesity, healthy and unhealthy home food availability, food insufficiency, family meals, depressive symptoms, body dissatisfaction, weight teasing, binge eating, unhealthy weight control behaviours and dieting). Twenty years later, participants reporting a live birth (n = 656) recalled their pre-pregnancy weight and total GWG. Modified Poisson regression models were used to estimate associations of each factor with pre-pregnancy obesity and high GWG, adjusting for sociodemographics. We used Multivariate Imputation by Chained Equations to account for outcome misclassification using internal validation data.</p><p><strong>Results: </strong>Eighteen percent of the sample had pre-pregnancy obesity and 26% had high GWG. Adolescent overweight or obesity (RR = 4.98, 95% CI 3.27, 7.57), body dissatisfaction (RR = 1.99; 95% CI: 1.31, 3.03) and unhealthy weight control behaviours (RR = 1.70; 95% CI: 1.06, 2.74), among other factors, were associated with pre-pregnancy obesity risk. For high GWG, there were imprecise associations with adolescent overweight or obesity (RR = 1.57; 95% CI: 1.06, 2.31), binge eating (RR = 1.36; 95% CI: 0.77, 2.39) and unhealthy weight control behaviours (RR = 1.38; 95% CI: 0.84, 2.25), among others.</p><p><strong>Conclusions: </strong>Findings suggest that some risk markers for pre-pregnancy obesity (and possibly high GWG) may be apparent as early as adolescence. Supporting adolescent health and well-being might have a role in improving weight-related health in the perinatal period.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605951","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":"Re: Addressing the Role of Socioeconomic Status in Perinatal Famine Exposure.","authors":"Albana Isai","doi":"10.1111/ppe.13177","DOIUrl":"10.1111/ppe.13177","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"301-302"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059335","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":"A Life-Course Approach to Gestational Exposure to Famine and Risk of Mortality.","authors":"Rana F Chehab, Sonia M Grandi, Susanna D Mitro","doi":"10.1111/ppe.13149","DOIUrl":"10.1111/ppe.13149","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"242-243"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952645","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}